NHLBI Workshop to Investigate Short-Term Research Training Programs in Heart, Lung, Blood, and Sleep Disorders for Clinicians and PhDs

Background

Historically, NHLBI has supported a number of short-term research training programs ranging in duration from several days up to six months. An objective of many of these programs is to increase the diversity of the biomedical workforce. To this end, NHLBI funds research education project grants and other mechanisms that address the cultural, professional, and scientific challenges faced by individuals from socio-economic and racial-ethnic groups that are under-represented in the health-related sciences and those with disabilities. Other programs support skills development as exemplified by the six-week NHLBI Summer Institute for Research Education in Biostatistics, and by NHLBI’s contribution to The US Ten Day Seminar on the Epidemiology and Prevention of Cardiovascular Disease.

The accelerating pace of scientific knowledge and new methodologies presents great opportunities, but has brought new challenges to researchers in maintaining their skills and productivity and in progressing in their careers. These challenges are amplified by the continually changing administrative and fiscal constraints faced by academic and research institutions, and by sociocultural factors particularly for individuals from under-represented groups and women. This workshop initiated a discussion about how short-term training programs might be used to meet such challenges in a way that employs best practices, avoids pitfalls, and can be evaluated in a meaningful way.

Workshop Discussion

After a brief review of the workshop objectives and the short-term training programs supported by NHLBI, there were informational presentations by working group experts that addressed: 1) Current Challenges a) in maintaining a sufficient number of physician-scientists, b) for women researchers and those from diverse backgrounds to advance in their careers, and c) in training health professionals in the conduct of late translational and implementation science research; and 2) Web-based Approaches of E-Learning and Personalized Learning.

A discussion-focused format followed with 13 short presentations by working group members in the following general categories:

• Promoting Culturally-Sensitive Research
• Responsible and Ethical Conduct of Research
• Enhancing the Pipeline to Maintain and Diversify the Biomedical Workforce
• Developing Junior Investigators
• Developing Scientific Leaders
• Emerging Opportunities in Basic Science
• Emerging Opportunities in Clinical and Behavioral Science
• Partnerships with Outside Organizations

Each presenter had expertise in one of these categories and was asked to describe briefly a short-term training course in that area, either from experience or from a vision that he or she had, to fulfill relevant and critical objectives. To stimulate subsequent discussion, the presenter was tasked with identifying effective strategies, strategies to avoid, innovative or emerging resources, and valuable partnerships. This format then stimulated 10 to 20 minute discussions by the whole group and laid the groundwork for several hours at the end of the workshop to develop recommendations. There was a consensus that the wide variety of expertise within the group enriched the conversation and that more frequent opportunities for individuals interested in research training to share ideas would be valuable in the future.

Working Group Recommendations

In developing its recommendations, the working group was encouraged to think “out of the box”. The result was an impressive list of ideas that will require additional effort to identify priorities for potential future action. Overriding principles were that all short-term training programs should be highly focused, of great interest to the prospective trainees, and designed both to accelerate the dissemination of new knowledge and to enhance the participants’ enthusiasm for the research enterprise. Specific recommendations were made in five areas:

Cross-Cutting Recommendations for All Short-Term Training Programs

• Integrate feedback from the community (e.g., Requests for Information) and advice from experts (e.g., workshops) into the design and priorities of each program
• Learn from the success and failure of past and ongoing programs. Don’t “reinvent the wheel”
• Focus on desired and potential outcomes in deciding whether a training program should be pursued and how it should be designed and evaluated
• Support and encourage flexibility in defining content since things can change quickly, particularly for emerging disciplines
• Capture the essentials that are needed for the trainees to further their research careers
• Enable effective program design, administration and mentoring
  • Provide resources and incentives to skilled trainers at universities and research institutions to conceive, design, and administer short-term training programs and to execute mentoring strategies
  • Support a nation-wide study on the hidden costs and challenges of mentoring and how best to achieve effective mentoring of the research workforce
• Incorporate experiential learning, network building, and professional development of NHLBI investigators as key components of short-term training programs
• Make “team building” both a component and an outcome of short-term training
• Incorporate opportunities for the trainees to teach one another their newly acquired skills to bolster retention, and to enable the trainees to instruct new audiences after completing the short-term program
• Enable short-term training leaders to communicate and meet periodically so they may share best practices and lessons learned
• Develop an online network of short-term training program directors
• Plan early and meet all requirements for effective online and in-person learner support (e.g., technology, licensing, personal obligations, etc.)
• Ensure that all trainees have complete access to the resources that are required, especially in rural areas, at smaller institutions, in Tribal lands, or in low-income environments where there may be limitations (e.g., lack of high-speed internet, libraries’ limited access to journals)
• Encourage planning for programs to become independently sustainable after a certain period of NIH support through partnerships, dissemination into standard training, or other approaches.
• Encourage hybrid programs that mix online/technology and in-person components (e.g., in preparation for face-to-face training, initiate online communication between the mentors, between mentor(s) and trainee(s), and among the trainees and if appropriate have the trainees do some preliminary online exercises or simulations)
• Collaborate with online learning experts in designing and executing short-term training programs
  • Incorporate the methods of “Personalized Learning” and “Concept Mapping” of what’s needed for the trainees to achieve the desired outcomes into program design
• Partner with technology providers on a more global scale in a purposeful and thoughtful manner being mindful to use open source standards and tools as appropriate.
• Accelerate adoption of emerging education and learning approaches and technologies

Enhancing the Pipeline

• Institute programs to increase the number of researchers from diverse backgrounds and under-served communities (e.g., American Indians, Alaska Natives, lower socio-economic status) at early career stages (e.g., high school) to foster understanding and interest in science and research
• Expose high school and college students to science and research
• Develop programs to introduce students from lower socio-economic backgrounds to the healthcare professions and to exciting opportunities in research
• Partner with tribal colleges for research training programs focused on American Indians/Alaska Natives
• Develop short-term training for research projects where the needed skills do not require a PhD to open new career opportunities to health care professionals and to create teams and, more broadly, national or global networks
• Explore short-term training programs to complement the Burroughs Welcome Fund Physician-Scientist Institutional Award Program, which trains MDs to do research

Sustaining Careers

• Recognize that professional development is a career-long endeavor and different skills are required for early, mid, and late career investigators
• Create a network (e.g. alumni network) that lasts beyond the training program
• Assemble a centralized course catalog of small, shareable online courses and related materials to supplement and refresh the content of short-term training programs and for use as a future reference by the trainees
• Ensure that the duration and content of short-term training for mid-career researchers are compatible with the demands that they face while maintaining work/life balance:
  • Require adequate protected time periods for learning while accommodating competing demands for trainees’ attention (e.g., restrict text messaging and checking email except in designated time slots)
  • Ensure that the specific areas of instruction are well designed and efficiently presented
  • Avoid instruction that is peripheral to the focused objectives or is already within the expertise of the trainees
  • Include provisions such as child care
• Design the training to impart skills that are needed to overcome obstacles to career advancement rather than adding new impediments or requirements, i.e., don’t exacerbate the “postdocalypse” or the quandary of an extended and isolated associate professorship
• Eliminate transition barriers for women and those from diverse backgrounds into senior scientist leadership positions
• Achieve sustainable mentoring and training of the next generation by creating scientific workforce diversity in senior leadership and role model positions

Building New Skills

• Explore short-term training in NHLBI areas in partnership with programs that support the dissemination of innovative methods and technology such as the National Institute for Innovation in Manufacturing Biopharmaceuticals (NIIMBL) program and the DOD-funded Advanced Regenerative Manufacturing Institute (ARMI)
• Leverage the resources and infrastructure supported by Clinical Translational Science Awards
• Use existing data sets (dbGaP, TOPMed, etc.) and instruction from experienced users for training in applied statistics
• Make short-term training in effective and successful grant writing readily available in a variety of venues (e.g., professional societies, etc.)

Evaluating Outcomes

• Require ongoing periodic assessment, such as by an advisory board, for every short-term training program so that improvements can be implemented across different programs in a timely fashion
• Assess the competency and proficiency of learners within each program and conduct meaningful, short- and long-term impact assessment
• Incorporate learner-reported evaluation to help identify the most effective and valuable components in a program and others that should be modified or eliminated
• Document the subsequent use and improvement of skills
• Consider novel metrics for both the short- and long-term evaluation of programs (e.g., social network analysis)
• Develop a centralized resource to evaluate short-term training programs in a standardized manner, and to facilitate best practices for individual programs to conduct internal assessments
• Write meaningful and appropriate peer review criteria (e.g., for the goals and needs of the training programs) into funding opportunity announcements (FOAs)
• Develop effective methods to track, assess, and document the short and long term progress of trainees (e.g., partner with NLM to identify publications enabled by the training)
• Make the xTrain and xTRACT systems used by NIH in eRA Commons more user friendly for short-term training programs supported by T35 and R25 grants
• Assess long-term metrics for each program in relation to the grand objective of improving the conduct of science across the Nation

Publication Plans

The working group plans to prepare a manuscript for publication in a peer-reviewed journal.

NHLBI Workshop Organizing Committee:

• Cheryl Boyce, PhD, Center for Translation Research and Implementation Science
• Drew Carlson, PhD, Division of Cardiovascular Sciences
• Henry Chang, MD, Division of Blood Diseases and Resources
• Sandra Colombini-Hatch, MD, Division of Lung Diseases
• Lawrence Fine, MD, Division of Cardiovascular Sciences
• Peyvand Ghofrani, MDE, CCRA, National Center on Sleep Disorders Research
• David Goff, MD, PhD, Division of Cardiovascular Sciences
• Melissa Green Parker, PhD, Center for Translation Research and Implementation Science
• Roya Kalantari, PhD, Division of Lung Diseases
• Charlotte Pratt, PhD Division of Cardiovascular Sciences
• Jane Scott, ScD, MSN, Division of Cardiovascular Sciences
• Catherine Stoney, PhD Division of Cardiovascular Sciences
• Xenia Tigno, PhD, MS, Division of Lung Diseases
• Wayne Wang, PhD, Division of Cardiovascular Sciences
• Ye Yan, PhD, Division of Cardiovascular Sciences

NHLBI Contacts:

• Catherine Stoney, PhD, Division of Cardiovascular Sciences
• Xenia Tigno, PhD, Division of Lung Diseases
• Henry Chang, MD, Division of Blood Diseases and Resources
• Melissa Green Parker, PhD, Center for Translation Research and Implementation Science

Co-Chairs:

• Kirsten Bibbins-Domingo, PhD, MD, MAS, University of California San Francisco
• Karina W. Davidson, PhD, Columbia University Irving Medical Center

Members:

• Scott A. Berceli, MD, PhD, University of Florida
• Rhonda Blackburn, PhD, Barnes and Noble Education LoudCloud, B&B Consulting, and University of Maryland University College
• Lawrence Brass, MD, PhD, University of Pennsylvania
• Elena Brondolo, MBA, MPH, Columbia University
• John Forrest, Jr, MD, Yale University
• Paula Gregory, PhD, Louisiana State University School of Medicine, New Orleans
• Elizabeth Heitman, PhD, University of Texas Southwestern Medical Center
• Allison Hubel, PhD, University of Minnesota
• Peter Kaufman, PhD, University of South Florida College of Nursing
• Alison King, MD, MPH, PhD, Washington University in Saint Louis
• Kay Lund, PhD, Division of Biomedical Research Workforce, National Institutes of Health
• Betty S. Pace, MD, Augusta University, Medical College of Georgia
• John Quackenbush, PhD, Harvard University
• Robby Reynolds, MPA, American Society of Hematology
• Irelene, P. Ricks, PhD, Keystone Symposia on Molecular & Cellular Biology
• Alan Rozet, BA, Columbia University
• Anne Sales, PhD, RN, MSN, University of Michigan Medical School
• Larissa Shimoda, PhD, Johns Hopkins School of Medicine
• Kristen Speakman, MA, MPH, Johns Hopkins Bloomberg School of Public Health
• Nancy Spector, MD, Executive Leadership in Academic Medicine (ELAM), Drexel University College of Medicine
• Bonnie Spring, PhD, Northwestern University