Measuring rehabilitation research capacity: report from the AAPM&R Research Advisory Committee

Building academic capacity in physical and rehabilitation medicine. A background paper by a working group of the european academy of rehabilitation medicine

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Methodological Issues in Rehabilitation Research: A Scoping Review

OBJECTIVE

To identify, synthesize, and categorize the methodological issues faced by the rehabilitation field.

DATA SOURCES

A scoping review was conducted using studies identified in MEDLINE, the Cochrane Library, EMBASE, Web of Science, Scopus, Physiotherapy Evidence Database, and Google Scholar up to August 2018.

STUDY SELECTION

We included all type of publications describing methodological issues in rehabilitation research where rehabilitation is described as a multimodal process. The methodological issues have been categorized and classified.

DATA EXTRACTION

The synthesis included qualitative and quantitative analysis. To focus the attention on rehabilitation, we post hoc divided in "specific issues" (highly related to, even if not exclusive of, rehabilitation research) and "generic issues" (common in biomedical research).

DATA SYNTHESIS

Seventy-one publications were included: 68% were narrative reviews, 15% systematic reviews, 7% editorials, 4% meta-epidemiologic studies, and 5% others. Specific methodological issues include the following: problematic application of randomized controlled trials (32%), absent definition of core outcome sets (28%), poor interventions description (22%), weak methodological (conducting) and reporting quality (21%), scarce clinical practice applicability (14%), lack of blinding assessor (10%), inadequate randomization methods or inadequate allocation concealment (8%), and inadequate participants description and recruitment (8%). "Generic" issues included the following: data and statistical description (31%), authors' methodological training (7%), peer review process (6%, n=4), funding declaration (6%), ethical statement (3%), protocol registration (3%), and conflict of interest declaration (1%).

CONCLUSIONS

Methodological and reporting issues might influence the quality of the evidence produced in rehabilitation research. The next steps to move forward in the field of rehabilitation could be to evaluate the influence of all these issues on the validity of trial results through meta-epidemiologic studies and to develop specific checklists to provide guidance to authors to improve the reporting and conduct of trials in this field.

Scholarly Research Projects Benefit Medical Students' Research Productivity and Residency Choice: Outcomes From the University of Pittsburgh School of Medicine

PURPOSE

Many medical schools require scholarly research projects. However, outcomes data from these initiatives are scarce. The authors studied the impact of the Scholarly Research Project (SRP), a four-year longitudinal requirement for all students at the University of Pittsburgh School of Medicine (UPSOM), on research productivity and residency match.

METHOD

The authors conducted a longitudinal study of non-dual-degree UPSOM graduates in 2006 (n = 121, non-SRP participants) versus 2008 (n = 118), 2010 (n = 106), and 2012 (n = 132), all SRP participants. The authors used PubMed for publication data, National Resident Matching Program for residency match results, and Blue Ridge Institute for Medical Research for National Institutes of Health funding rank for residency-affiliated academic institutions.

RESULTS

Research productivity of students increased for those completing the SRP, measured as a greater proportion of students with publications (27.3% in 2006 vs. 45.8% in 2008, 55.7% in 2010, and 54.5% in 2012; P < .001) and first-authorship (9.9% in 2006 vs. 26.3% in 2008, 33.0% in 2010, and 35.6% in 2012; P < .001). Across years, there was a significantly greater proportion of students with peer-reviewed publications matched in higher-ranked residency programs (57.0% with publications in the top 10%, 52.7% in the top 10%-25%, 32.4% in the top 25%-50%, 41.2% in the bottom 50%, and 45.2% in unranked programs; P = .018).

CONCLUSIONS

Longitudinal research experiences for medical students may be one effective tool in fostering student publications and interest in extending training in a research-focused medical center.

Validation of the research capacity and culture (RCC) tool: measuring RCC at individual, team and organisation levels

Research capacity building (RCB) in Australia has recently focussed on strategies that take a whole of system approach to developing research culture at individual, team and organisation levels. Although a theoretical framework exists, no tool has been published that quantitatively measures the effectiveness of RCB interventions aimed at these three levels. A sample of 134 allied health workers was used to validate the research capacity and culture (RCC) tool. Item level analysis was undertaken using Cronbach's α and exploratory factor analysis, and test-retest reliability was examined using intra-class correlations (ICC). The tool had one factor emerge for each domain, with excellent internal consistency for organisation, team and individual domains (α=0.95, 0.96 and 0.96 respectively; and factor loadings ranges of 0.58-0.89, 0.65-0.89 and 0.59-0.93 respectively). The overall mean score (total) for each domain was: 5.4 (inter-quartile range 3.9-7.7), 4.4 (IQR 2.6-6.1) and 3.9 (IQR 2.9-6) for the organisation, team and individual domains respectively. Test-retest reliability was strong for each domain: organisation ICC=0.77, team ICC=0.83 and individual ICC=0.82. The RCC tool has three domains measuring research capacity and culture at organisation, team and individual levels. It demonstrates excellent internal consistency and strong test-retest reliability.

How Gender Impacts Career Development and Leadership in Rehabilitation Medicine: A Report From the AAPM&R Research Committee

OBJECTIVE

To examine the role that gender plays in meeting the medical academic mission by assessing career development, leadership, and research productivity among rehabilitation researchers.

DESIGN

Prospective, cross-sectional cohort study.

SETTING

National survey.

PARTICIPANTS

Three hundred sixty rehabilitation professionals linked to the American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and/or the American Congress of Rehabilitation Medicine.

INTERVENTION

Online or paper survey.

MAIN OUTCOME MEASURES

Research skills, resources and productivity, salary, leadership, and academic advancement.

RESULTS

Results suggested that women rated themselves as being less skilled and having fewer resources for research compared with their male counterparts. Additionally, significantly fewer women applied for grant funding and had a lower publication rate compared with men. A proportionally larger number of women remained at lower academic ranks than men, and fewer women achieved senior academic ranks or positions of leadership. Even after adjusting for potential confounding factors, female sex remained a significant variable associated with lower salaries and lower manuscript production. Unlike men, female respondents tended to believe that being a woman was a negative factor with respect to academic advancement, leadership opportunities, salary, and resources.

CONCLUSIONS

Female rehabilitation researchers were less developed professionally than their male counterparts and saw themselves as disadvantaged. These findings have potential implications for attracting women into rehabilitation research and the rehabilitation research community's efforts to sustain its academic mission, to improve research capacity, and to meet the needs of the 52 million people in the United States with disabilities.

Through the looking glass: a personal view of the field of rehabilitation medicine. The 56th John Stanley Coulter Memorial Lecture

This lectureship reviews the past, present, and future of the field of physical medicine and rehabilitation (PM&R) from the clinical, educational, and research points of view. I make recommendations for the field on how members of the various PM&R associations can make a difference in mapping the future.