Integrating clinical medicine into biomedical graduate education to promote translational research: strategies from two new PhD programs

The TCI Clinical Encounter Program for PhD Students in Cancer Biology: a Feasibility Pilot

Clinical rotations are often not included in graduate-level cancer biology curricula; however, basic insight into clinical oncology is often crucial for developing translational research that addresses unmet needs with the potential to benefit cancer patients. We describe a needs assessment, design, implementation, and descriptive evaluation of an oncology-specific pilot clinical encounter program developed for PhD students in the Cancer Biology Training Area (CAB) in the Graduate School of Biomedical Sciences (GSBS) and Tisch Cancer Institute (TCI) at the Icahn School of Medicine at Mount Sinai (ISMMS). Prior to the development of this pilot program, CAB students, in years 2-5 + , were surveyed to determine their interest in a structured clinical experience. Seventeen out of thirty-one students responded (55%) to the survey. Of those seventeen respondents, fifteen (88.2%) expressed that exposure to cancer patients in the clinical setting would be useful for their pre-doctoral biomedical science and cancer biology training and indicated an interest in participating in the clinical encounter program. Based on these responses, a three-session clinical encounter pilot program was designed. Two separate cohorts of 5 students participated in this pilot program. During a formal debrief, following the clinical experience, students commented on the resilience of patients and the importance of research on clinical decision making, and reported that they found the experience motivational. Five out of 10 students responded (50%) to a post-program assessment survey; all five respondents answered that they would recommend the clinical encounter program to their peers. While limited in size and scope, this pilot TCI Clinical Encounter Program proved feasible and has the potential to enrich and inform the experience of PhD students pursing advanced degrees in a cancer biology.

The Molecular Medicine PhD program alumni perceptions of career preparedness

Over the past two decades, graduate programs have sought to meet the rising need for cross-disciplinary biomedical and translational research training; however, among program evaluation efforts, little is known about student satisfaction with these programs. We report survey results aimed at assessing the overall satisfaction of Molecular Medicine (MolMed) PhD program graduates with their training program and subsequent employment, their research productivity since graduation, and the program elements important for entering their diverse career choices. The survey consisted of quantitative and qualitative instruments and was deployed in June 2020 via email to 45 alumni who had graduated at least two years prior. Investigators assessed mean and median Likert scale data and they conducted a qualitative content analysis on all open-ended narrative survey data using inductive analysis to identify themes. Of the 45 contacted, 26 PhD graduates of the MolMed program responded to the survey. Overall, graduates felt the MolMed curriculum prepared them well for their current career (mean 3.4 out a 4-point Likert scale); and, knowing what they know now, they would likely pursue a PhD degree again (mean 3.7 out of 4). Four overarching themes emerged from the content analysis of the narrative survey data: curriculum and other training experiences; professional skills; importance of a strong advisor/mentor; and, networking and career development. Overall, alumni were satisfied with their MolMed Program experience. They found the curriculum to be strong and relevant, and they believed that it prepared them well for their careers. There may be opportunities to embed additional skills into the curriculum, and the program should continue to offer a strong mentoring and clinical experience, as well as train students for diverse career trajectories.

Building bridges between basic science and clinical medicine: a liberal arts perspective

A critical issue for improving global health care is to better integrate basic science and clinical practice, as such integration will lead to innovative solutions. In this article, I will present models for how to prepare students to participate effectively on multidisciplinary teams that foster cooperation between scientists, medical centers, biotechnology businesses, and governmental bodies. I will provide examples of training programs in the United States (USA) designed to increase the number of and diversity of scientists and clinicians engaged in bridging basic science and clinical medicine, also called translational research. The training programs target different stages in career development, from pre-medical students through early career faculty, and have varied organisational structures. Many of the programs have existed long enough for institutions to be able to evaluate their effectiveness, and despite the different program contexts, there are key characteristics common to all of the programs that correlate with successful outcomes. Many of these characteristics can be adapted to other career stages and settings. I will summarize these and describe an example of an interdisciplinary, integrated science course for undergraduates that introduces students at the earliest stage of their careers to addressing complex problems through teamwork. Finally, I will provide suggestions for how other institutions can implement training programs that will build bridges between basic science and clinical medicine.

Building Diverse Careers in Clinical and Translational Research: Evaluation of a Certificate Program in Translational Research

Introduction

The Certificate Program in Translational Research (CPTR) at the Georgia Clinical and Translational Science Alliance provides Ph.D. students, postdoctoral fellows and faculty with didactic, mentored, and experiential training in clinical and translational research.

Methods

Quantitative evaluation includes tracking trainee competency, publications, grants and careers in clinical and translational research. Qualitative evaluation includes interviews with trainees about program experiences.

Results

The CPTR provided knowledge and skills in clinical and translational research through coursework, clinical rotations, and collaboration with interdisciplinary scientists. Trainees reported increased confidence in 22 program competencies. Trainees have published more than 290 peer-reviewed articles and received over $4 million in grants from the NIH, over $15 million from the U.S. Department of Defense, and more than $300,000 from foundations. Trainees who completed the program remained in clinical and translational research.

Conclusions

Programs like the CPTR are needed to train investigators to advance biomedical discoveries into population health.

Incorporation of autopsy case-based learning into PhD graduate education: a novel approach to bridging the "bench-to-bedside" gap

Given the current rapid expansion of biological knowledge and the challenges of translating that knowledge into clinical practice, finding effective methods of teaching graduate students clinical medicine concepts has become even more critical. The utility of autopsy in medical student and resident education has been well established. Multiple studies have reported it to be a helpful means of teaching anatomy, pathophysiology, clinical problem-solving skills, and medical diagnostic techniques. Although various models of training PhD candidates in clinical medicine have been reported, an autopsy-based curriculum has not been previously described. For over 4 years, our pathology department has offered a novel semester-long autopsy-based course to educate future Cellular and Molecular Pathology scientists about clinical medicine. Our results indicate that this "hands-on" approach is a popular as well as effective means of teaching the pathogenesis of disease at the level of the cell, organ, and patient. The course reputation has recently led to requests to open registration to graduate students from other university programs as well as undergraduate students. Additionally, it has played an important role in our Cellular and Molecular Pathology program's recent receipt of a 5-year renewal National Institutes of Health-funded T32 award. Overall, this course model has been successful at our own institution and could provide a useful template for other institutions seeking to provide graduate investigators with in-depth exposure to clinical medicine.

Graduate Training at the Interface of Computational and Experimental Biology: An Outcome Report from a Partnership of Volunteers between a University and a National Laboratory

Leading voices in the biological sciences have called for a transformation in graduate education leading to the PhD degree. One area commonly singled out for growth and innovation is cross-training in computational science. In 1998, the University of Tennessee (UT) founded an intercollegiate graduate program called the UT-ORNL Graduate School of Genome Science and Technology in partnership with the nearby Oak Ridge National Laboratory. Here, we report outcome data that attest to the program's effectiveness in graduating computationally enabled biologists for diverse careers. Among 77 PhD graduates since 2003, the majority came with traditional degrees in the biological sciences, yet two-thirds moved into computational or hybrid (computational-experimental) positions. We describe the curriculum of the program and how it has changed. We also summarize how the program seeks to establish cohesion between computational and experimental biologists. This type of program can respond flexibly and dynamically to unmet training needs. In conclusion, this study from a flagship, state-supported university may serve as a reference point for creating a stable, degree-granting, interdepartmental graduate program in computational biology and allied areas.

Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices

Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics.

Mentoring by design: integrating medical professional competencies into bioengineering and medical physics graduate training

Many students in bioengineering and medical physics doctoral programs plan careers in translational research. However, while such students generally have strong quantitative abilities, they often lack experience with the culture, communication norms, and practice of bedside medicine. This may limit students' ability to function as members of multidisciplinary translational research teams. To improve students' preparation for careers in cancer translational research, we developed and implemented a mentoring program that is integrated with students' doctoral studies and aims to promote competencies in communication, biomedical ethics, teamwork, altruism, multiculturalism, and accountability. Throughout the program, patient-centered approaches and professional competencies are presented as foundational to optimal clinical care and integral to translational research. Mentoring is conducted by senior biomedical faculty and administrators and includes didactic teaching, online learning, laboratory mini-courses, clinical practicums, and multidisciplinary patient planning conferences (year 1); student development and facilitation of problem-based patient cases (year 2); and individualized mentoring based on research problems and progress toward degree completion (years 3-5). Each phase includes formative and summative evaluations. Nineteen students entered the program from 2009 through 2011. On periodic anonymous surveys, the most recent in September 2013, students indicated that the program substantially improved their knowledge of cancer biology, cancer medicine, and academic medicine; that the mentors were knowledgeable, good teachers, and dedicated to students; and that the program motivated them to become well-rounded scientists and scholars. We believe this program can be modified and disseminated to other graduate research and professional health care programs.

Examining the Transfer of Academic Knowledge to Business Practitioners

This study explores whether practitioners who hold a Ph.D. in business act as intermediaries in the transfer of academic knowledge from academia to practice. Twenty Ph.D. graduates were interviewed, and the data were subjected to deductive content analysis. It was concluded that the previous claims that academic research does not influence decision-making of industry practitioners are not fully warranted. Graduates of doctoral business programs act as knowledge-transfer intermediaries that aggregate, summarize, communicate, and implement findings reported in academic publications. Academic journals have the potential to disseminate scholarly knowledge beyond the academic world. Demand for evidence-based knowledge in the practitioner's environment determines his or her probability of applying academic knowledge. Not all academic knowledge is perceived as useful by practitioners, and limited access to academic literature is a major impediment to the application of scholarly findings in practice. The practitioners' connection with academia after graduation is also linked to their probability of using academic literature.