The Culture of Translational Science Research: Participants' Stories

The rocky road to translational science: An analysis of Clinical and Translational Science Awards

Studies point out that the productivity decline in biomedicine is in significant part due to difficulties in translating basic science into clinical application. To promote translational research, the US NIH launched the Clinical and Translational Science Awards (CTSA) program in 2006. Prior evaluations of the CTSA program often assumed that the key to translation is inter-organizational collaboration or multidisciplinarity; hence, changes in either of these were measured as evidence of translational science. However, using novel measures of translational science, this study examines the relationship between CTSAs and translational science per se. We define ‘translational science’ as basic science that has translational features, and we employ two distinct, complementary measures of translational science based on publication data. Using 115 Carnegie R1 universities and their translational science publications, we find that receiving a CTSA does not obviously cause receiving institutions to conduct more translational science. Furthermore, our Principal Investigator-level analysis shows that those who received direct support from the CTSA program had already generated more translational science than others and that their research behavior did not change significantly after receiving a CTSA. Future evaluation research can adopt our novel measures of translational science and evaluation research design in the assessment of translational research activities. Finally, we conclude with a discussion of the implications of our findings for science governance.

Finding the story

Story is the oldest known way of sharing knowledge and information and engages us in our collective humanity. In research settings, story brings meaning to complex ideas, making them feel palpable and connects us with our audience. Historically, the disciplines that take a research interest in the importance of narrative have been largely in fields like the philosophy of science/medicine, medical humanities, and sociology though story is “always already” a part of scientific research. Humanities have gained traction in medical and science education, and researchers are seeking such curricula to communicate more effectively with the public and their students. We believe that story is an effective tool to enable CTS investigators to be effective educators and communicators of translational science. Story-based interdisciplinary pedagogy emphasizes an approach encouraging clinical researchers to keep the human story as the driving force of research design, dissemination, and application of research to diverse audiences. In this article, we provide backgrounds on successful programs that have used story in science communication and education as well as a tool researchers can use to incorporate the structure of story into their own work.

A mixed-methods study to test a tailored coaching program for health researchers to manage stress and achieve work-life balance

Dissemination and implementation (D&I) researchers serve critical scientific, practical, and personal roles in translating science to public health benefit. However, they face multifaceted barriers that may erode their capacity to plan, lead, and evaluate implementation. Individualized coaching focused on human flourishing is an unexplored approach to fully actualize D&I researchers' capacity to bridge the research-practice gap. The purpose of this exploratory pilot study was to investigate a tailored coaching program to support human flourishing among D&I researchers. A pragmatic, mixed-methods approach guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework was used to evaluate an individualized, nine session coaching program called FUEL (Focus, Unplug, Exercise, Love). Reach and Implementation were assessed through descriptive statistics and rapid qualitative analysis of surveys and coaching logs. Effectiveness and Maintenance were assessed through descriptive statistics and iterative content analysis of participant surveys, as well as iterative content analysis of proxy (e.g., colleague) semi-structured interviews. Reach results indicated that demand for coaching exceeded study enrollment capacity (n = 16 participants). Implementation results showed that the coach spent 12.96 ± 2.82 hr per participant over 3 months. Effectiveness and Maintenance results indicated that FUEL was well-received and provided participants with myriad psychological and professional benefits. Preliminary evidence suggests that the FUEL coaching program is a promising and feasible approach to enhance flourishing among D&I researchers. Future research is needed to evaluate Adoption and scalability. This pilot study may inform future D&I capacity-building initiatives that address researchers' holistic situatedness within the implementation process.

Dialectics and dilemmas arising from Covid-19 immunity testing: presenting a workforce management paradox

Purpose

Covid-19 has caused many businesses to rethink their short- and potentially long-term workforce operations. The use of lateral flow serology can provide a clinically convenient approach for the assessment of prior infection with Covid-19. However, its widespread adoption in organisations seeking to use it to test for workforce immunity is controversial and confusing. This paper aims to explore the paradoxical dilemmas and dialectics immunity workforce testing creates.

Design/methodology/approach

This study involved capturing the ethnographical participation of a chief executive officer (CEO) dealing with the experience of managing the outcomes of Covid-19 workforce immunity testing. The aim was to take a snapshot in time of the CEO's empirical world, capturing their lived experiences to explore how management actions resulting from Covid-19 immunity testing can played out.

Findings

Providing staff with immunity tests at first glance appears sensible, decent and a caring action to take. Nevertheless, once such knowledge is personalised by employees, they can, through dialectic dialogue, feel disadvantaged and harbour feelings of unfairness. Subsequently, this paper suggests that immunity testing may only serve to raise awareness and deepen the original management dilemma of whether testing is a worthwhile activity.

Originality/value

This paper aims to be amongst the first works to empirically explore the workforce management challenges that arise within small businesses within the service sector following the completion of Covid-19 immunity testing of their staff. It seeks to achieve this via utilising the robust theoretical framework of the paradox theory to examine Covid-19's impact upon small business workforce management thinking and practice.

The innovation scorecard for continuous improvement applied to translational science

Introduction

This paper reports on the baseline stage of a qualitative evaluation of the application of the Innovative Scorecard (ISC) to the Clinical and Translational Science Award (CTSA) at the University of Texas Medical Branch (UTMB) at Galveston. The ISC is adopted from the established Balanced Scorecard system for strategic planning and performance management. In formulating the evaluation, we focused on the organizational identity literature.

Methods

The initial evaluation consisted of a series of semi-structured interviews with 22 participants of the ISC Boot Camp conducted in July 2015.

Results

The logic of grounded theory pointed to the clustering of perceptions of the ISC around respondents’ occupational locations at UTMB. Administrators anticipate the expansion of planning activities to include a wider range of participants under the current CTSA award period (2015–2020) than under our first CTSA approval period (2009–2014). A common viewpoint among the senior scientists was that the scientific value of their work will continue to speak for itself without requiring the language of business. Junior scientists looked forward to the ISC’s emphasis on increasingly horizontal leadership that will give them more access to and more control over their work and resources. Postdocs and senior staff welcomed increased involvement in the total research process at UTMB.

Conclusion

The report concludes with strategies for future follow-up.

Optimising Translational Research Opportunities: A Systematic Review and Narrative Synthesis of Basic and Clinician Scientists' Perspectives of Factors Which Enable or Hinder Translational Research

Introduction

Translational research is central to international health policy, research and funding initiatives. Despite increasing use of the term, the translation of basic science discoveries into clinical practice is not straightforward. This systematic search and narrative synthesis aimed to examine factors enabling or hindering translational research from the perspective of basic and clinician scientists, a key stakeholder group in translational research, and to draw policy-relevant implications for organisations seeking to optimise translational research opportunities.

Methods and Results

We searched SCOPUS and Web of Science from inception until April 2015 for papers reporting scientists’ views of the factors they perceive as enabling or hindering the conduct of translational research. We screened 8,295 papers from electronic database searches and 20 papers from hand searches and citation tracking, identifying 26 studies of qualitative, quantitative or mixed method designs. We used a narrative synthesis approach and identified the following themes: 1) differing concepts of translational research 2) research processes as a barrier to translational research; 3) perceived cultural divide between research and clinical care; 4) interdisciplinary collaboration as enabling translation research, but dependent on the quality of prior and current social relationships; 5) translational research as entrepreneurial science. Across all five themes, factors enabling or hindering translational research were largely shaped by wider social, organisational, and structural factors.

Conclusion

To optimise translational research, policy could consider refining translational research models to better reflect scientists’ experiences, fostering greater collaboration and buy in from all types of scientists. Organisations could foster cultural change, ensuring that organisational practices and systems keep pace with the change in knowledge production brought about by the translational research agenda.

The Multidisciplinary Translational Team (MTT) Model for Training and Development of Translational Research Investigators

Multiinstitutional research collaborations now form the most rapid and productive project execution structures in the health sciences. Effective adoption of a multidisciplinary team research approach is widely accepted as one mechanism enabling rapid translation of new discoveries into interventions in human health. Although the impact of successful team-based approaches facilitating innovation has been well-documented, its utility for training a new generation of scientists has not been thoroughly investigated. We describe the characteristics of how multidisciplinary translational teams (MTTs) promote career development of translational research scholars through competency building, interprofessional integration, and team-based mentoring approaches. Exploratory longitudinal and outcome assessments from our experience show that MTT membership had a positive effect on the development of translational research competencies, as determined by a self-report survey of 32 scholars. We also observed that all trainees produced a large number of collaborative publications that appeared to be associated with their CTSA association and participation with MTTs. We conclude that the MTT model provides a unique training environment for translational and team-based learning activities, for investigators at early stages of career development.

Evolution of Multidisciplinary Translational Teams (MTTs): Insights for Accelerating Translational Innovations

There is growing consensus about the factors critical for development and productivity of multidisciplinary teams, but few studies have evaluated their longitudinal changes. We present a longitudinal study of 10 multidisciplinary translational teams (MTTs), based on team process and outcome measures, evaluated before and after 3 years of CTSA collaboration. Using a mixed methods approach, an expert panel of five judges (familiar with the progress of the teams) independently rated team performance based on four process and four outcome measures, and achieved a rating consensus. Although all teams made progress in translational domains, other process and outcome measures were highly variable. The trajectory profiles identified four categories of team performance. Objective bibliometric analysis of CTSA-supported MTTs with positive growth in process scores showed that these teams tended to have enhanced scientific outcomes and published in new scientific domains, indicating the conduct of innovative science. Case exemplars revealed that MTTs that experienced growth in both process and outcome evaluative criteria also experienced greater innovation, defined as publications in different areas of science. Of the eight evaluative criteria, leadership-related behaviors were the most resistant to the interventions introduced. Well-managed MTTs demonstrate objective productivity and facilitate innovation.

COLLABORATING WITH THE COMMUNITY: THE EXTRA-TERRITORIAL TRANSLATIONAL RESEARCH TEAM

The purpose of the present study is to suggest a revision of the team science concept to the more inclusive extra-territorial research team (ETRT). Translational thinking is largely marked by the perception of the team as a thing-like structure at the center of the scientific activity. Collaboration accordingly involves bringing external others (e.g., scientists, community members, and clinicians) into the team through limited or dependent participation. We suggest that a promising and innovative way to see the team is as an idea: a schema for assembling and managing relationships among otherwise disparate individuals with vested interests in the problem at hand. Thus, the ETRT can be seen as a process as well as an object. We provide a case study derived from a qualitative analysis of the impact of the logic of translational science on a team assessment of environmental health following an off-coast oil disaster. The ETRT in question displayed the following principles of constructive relationship management: a high sense of adventure given the quick pace and timeliness given the relevance of the oil spill to all team members; regular meetings in the community to avoid the appearance of academic hegemony; open access by lay as well as institutional scientists; integration of emergency management coordinators into the group; and the languages of public health, environmental pharmacology/toxicology and coastal culture seamlessly interwoven in discussion. The ETRT model is an appropriate strategy for mobilizing and integrating the knowledge and skills needed for comprehensive science and service responses, especially during crisis.

Symbolic Interaction and Applied Social Research: A FOCUS ON TRANSLATIONAL SCIENCE RESEARCH1

In symbolic interaction, a traditional yet unfortunate and unnecessary distinction has been made between basic and applied research. The argument has been made that basic research is intended to generate new knowledge, whereas applied research is intended to apply knowledge to the solution of practical (social and organizational) problems. I will argue that the distinction between basic and applied research in symbolic interaction is outdated and dysfunctional. The masters of symbolic interactionist thought have left us a proud legacy of shaping their scholarly thinking and inquiry in response to and in light of practical issues of the day (e.g., Znaniecki, and Blumer). Current interactionist work continues this tradition in topical areas such as social justice studies. Applied research, especially in term of evaluation and needs assessment studies, can be designed to serve both basic and applied goals. Symbolic interaction provides three great resources to do this. The first is its orientation to dynamic sensitizing concepts that direct research and ask questions instead of supplying a priori and often impractical answers. The second is its orientation to qualitative methods, and appreciation for the logic of grounded theory. The third is interactionism's overall holistic approach to interfacing with the everyday life world. The primary illustrative case here is the qualitative component of the evaluation of an NIH-funded, translational medical research program. The qualitative component has provided interactionist-inspired insights into translational research, such as examining cultural change in medical research in terms of changes in the form and content of formal and informal discourse among scientists; delineating the impact of significant symbols such as "my lab" on the social organization of science; and appreciating the essence of the self-concept "scientist" on the increasingly bureaucratic and administrative identities of medical researchers. This component has also contributed to the basic social scientific literature on complex organizations and the self.

Translational Science Project Team Managers: Qualitative Insights and Implications from Current and Previous Postdoctoral Experiences

The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle.

Assessing and evaluating multidisciplinary translational teams: a mixed methods approach

A case report illustrates how multidisciplinary translational teams can be assessed using outcome, process, and developmental types of evaluation using a mixed-methods approach. Types of evaluation appropriate for teams are considered in relation to relevant research questions and assessment methods. Logic models are applied to scientific projects and team development to inform choices between methods within a mixed-methods design. Use of an expert panel is reviewed, culminating in consensus ratings of 11 multidisciplinary teams and a final evaluation within a team-type taxonomy. Based on team maturation and scientific progress, teams were designated as (a) early in development, (b) traditional, (c) process focused, or (d) exemplary. Lessons learned from data reduction, use of mixed methods, and use of expert panels are explored.