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Thakar MS, Rubio DM, Murrell AJ, Morone NE, Mitchell Miland C, White GE. The impact of inclusive mentoring and identity work on self-efficacy in career advancement and career commitment among underrepresented early-career faculty and post-doctoral fellows. J Clin Transl Sci 2024; 8:e61. [PMID: 38655454 PMCID: PMC11036437 DOI: 10.1017/cts.2024.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
Objective Researchers from underrepresented groups leave research positions at a disproportionate rate. We aim to identify factors associated with self-efficacy in career advancement and career commitment among underrepresented post-doctoral fellows and early-career faculty. Methods Building Up is a cluster-randomized trial with 25 academic health institutions. In September-October 2020, 219 Building Up participants completed the pre-intervention assessment, which included questions on demographics, science identity, mentoring, self-efficacy in career advancement (i.e., advancement is open to me, confidence in career progression, confidence in overcoming professional barriers), and career commitment (i.e., intent to continue research training or studying in a field related to biomedical sciences). Using logistic and multinomial logistic regression, we identified characteristics independently associated with self-efficacy in career advancement and career commitment. Results The cohort is 80% female, 33% non-Hispanic/Latinx Black, and 34% Hispanic/Latinx. Having mentors that address diversity was significantly associated with the belief that advancement is open to them (OR = 1.7). Higher science identity (OR = 4.0) and having mentors that foster independence (OR = 1.8) were significantly associated with confidence in career progression. Higher science identity was also significantly associated with confidence in overcoming professional barriers (OR = 2.3) and intent to continue studying in a field related to biomedical sciences (OR = 3.3). Higher age (OR = 2.3) and higher science identity (OR = 4.2) were significantly associated with intent to continue research training. Discussion Science identity and mentoring play key roles in self-efficacy in career advancement and career commitment. These factors may contribute to retention of underrepresented early-career biomedical researchers.
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Affiliation(s)
- Maya S. Thakar
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
| | - Audrey J. Murrell
- College of Business Administration, University of
Pittsburgh, Pittsburgh, PA,
USA
| | - Natalia E. Morone
- Department of Medicine, Boston University Chobanian &
Avedisian School of Medicine, Boston, MA,
USA
- Boston Medical Center, Boston, MA,
USA
| | - Chantele Mitchell Miland
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
| | - Gretchen E. White
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
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Rubio DM, Mayowski C, Meagher EA, Patino CM, Thakar MS, Welch JL, White GE. Customized Career Development Platform (CCDP) for clinical and translational researchers: A pragmatic cluster-randomized controlled trial. J Clin Transl Sci 2023; 7:e259. [PMID: 38229889 PMCID: PMC10790233 DOI: 10.1017/cts.2023.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Early-stage clinical and translational researchers who set and track career goals, milestones, and progress are successful in career development. We aimed to determine the effectiveness of the Customized Career Development Platform (CCDP), an online individual development plan (IDP), versus the traditional IDP template in improving research success and career satisfaction. Methods We conducted a pragmatic cluster-randomized controlled trial of 340 scholars and trainees at 27 US academic healthcare institutions. The primary outcome was number of published manuscripts 24 months post-intervention. Secondary outcomes included the number of grant proposals submitted and funded, job satisfaction, and level of communication with mentors. An analysis of CCDP participants assessed proficiency level for the 14 Clinical and Translational Science Award (CTSA) competencies. Data were analyzed using intention-to-treat. Results Participants were mostly female (60.3%) and Caucasian (67.2%); mean age was 34 years. Twenty-four months following the intervention, the CCDP versus traditional IDP groups showed a similar number of publications (9.4 vs 8.6), grants submitted (4.1 vs 4.4) and funded (1.3 vs 2.0), and job satisfaction score (3.6 vs 3.7). The CCDP group had higher odds of discussing communication (OR = 2.08) and leadership skills (OR = 2.62) and broadening their network (2.31) than the traditional IDP group. The CCDP arm reported improvements in 9 of the 14 CTSA competencies. Conclusion The CCDP offers CTSA hubs an innovative alternative to traditional IDP tools. Future studies are needed to elucidate why the CCDP users did not fully appreciate or adopt the functionality of the online platform.
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Affiliation(s)
- Doris M. Rubio
- Institute for Clinical Research Education,
University of Pittsburgh Schools of the Health Sciences,
Pittsburgh, PA, USA
| | - Colleen Mayowski
- Institute for Clinical Research Education,
University of Pittsburgh Schools of the Health Sciences,
Pittsburgh, PA, USA
| | - Emma A. Meagher
- Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA,
USA
| | - Cecilia M. Patino
- Keck School of Medicine, University of Southern
California, Los Angeles, CA,
USA
| | - Maya S. Thakar
- Institute for Clinical Research Education,
University of Pittsburgh Schools of the Health Sciences,
Pittsburgh, PA, USA
| | - Julie L. Welch
- Indiana University School of Medicine,
Indianapolis, IN, USA
| | - Gretchen E. White
- Institute for Clinical Research Education,
University of Pittsburgh Schools of the Health Sciences,
Pittsburgh, PA, USA
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3
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Norman MK, Radomski TR, Proulx CN, Rubio DM, Alston TL, Mayowski CA. Time to act: A rubric-based approach for institutionalizing justice, equity, diversity, and inclusion. J Clin Transl Sci 2023; 7:e172. [PMID: 37745936 PMCID: PMC10514682 DOI: 10.1017/cts.2023.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 09/26/2023] Open
Abstract
Attacks on minoritized communities and increasing awareness of the societal causes of health disparities have combined to highlight deep systemic inequities. In response, academic health centers have prioritized justice, equity, diversity, and inclusion (JEDI) in their strategic goals. To have a sustained impact, JEDI efforts cannot be siloed; rather, they must be woven into the fabric of our work and systematically assessed to promote meaningful outcomes and accountability. To this end, the University of Pittsburgh's Institute for Clinical Research Education assembled a task force to create and apply a rubric to identify short and long-term JEDI goals, assess the current state of JEDI at our Institute, and make recommendations for immediate action. To ensure deep buy-in, we gathered input from diverse members of our academic community, who served on targeted subcommittees. We then applied a three-step process to ensure rapid forward progress. We emerged with concrete actions for priority focus and a plan for ongoing assessment of JEDI institutionalization. We believe our process and rubric offer a scalable and adaptable model for other institutions and departments to follow as we work together across academic medical institutions to put our justice, equity, diversity, and inclusion goals into meaningful action.
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Affiliation(s)
- Marie K. Norman
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Thomas R. Radomski
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chelsea N. Proulx
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tasha L. Alston
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Colleen A. Mayowski
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Proulx CN, Rubio DM, Norman MK, Mayowski CA. Shut Up & Write!® builds writing self-efficacy and self-regulation in early-career researchers. J Clin Transl Sci 2023; 7:e141. [PMID: 37396813 PMCID: PMC10308422 DOI: 10.1017/cts.2023.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction High writing self-efficacy and self-regulation are tied to publication and grant submission. Writers with these attributes are more productive. We investigated whether participating in a Shut Up & Write!®-style intervention (SUAW) would produce statistically significant gains in writing self-efficacy and self-regulation when comparing pre-post-participation surveys. Methods Forty-seven medical students, TL1/KL2, and early-career faculty from across the USA expressed interest in participating, with 37 completing the pre-survey. We conducted (on Zoom) a 12-week SUAW series and measured the effect using a pre-post survey adapted from the Writer Self-Perception Scale. Paired t-tests (α = 0.05) were conducted on three subscales to test for significant differences between pre- and post-test means. The subscales reflected writing attitudes, writing strategies, and avoiding writing distractions. Subscales showed acceptable internal consistency with Cronbach's alphas of 0.80, 0.71, and 0.72, respectively. Results Twenty-seven participants attended at least one session. Of these, 81% presented as female, and 60% were from NIH-defined Underrepresented Backgrounds and/or were from Minority-Serving Institutions. Twenty-four completed both the pre- and post-surveys. Sixty percent previously participated in an activity similar to SUAW. We found significant improvements in writing attitudes (p = 0.020) and writing strategies (p = 0.041) for those who previously participated. For those who had not previously participated, we found improved writing strategies (p = 0.002). Eighty percent were very satisfied/satisfied with SUAW. Discussion Researchers have tied writing self-efficacy and self-regulation to timely publication and grant submission. We found significant gains in self-efficacy and self-regulation, suggesting that participation in a SUAW-style intervention may increase writing productivity.
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Affiliation(s)
- Chelsea N. Proulx
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marie K. Norman
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Colleen A. Mayowski
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Thakar MS, Mitchell-Miland C, Morone NE, Althouse AD, Murrell AJ, Rubio DM, White GE. Perseverance and consistency of interest in underrepresented post-doctoral fellows and early-career faculty. J Clin Transl Sci 2023; 7:e100. [PMID: 37250996 PMCID: PMC10225262 DOI: 10.1017/cts.2023.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Underrepresented researchers face more challenges than their well-represented counterparts. Perseverance and consistency of interest are associated with career success in well-represented physicians. Therefore, we examined associations of perseverance and consistency of interest with Clinical Research Appraisal Inventory (CRAI), science identity, and other factors related to career success among underrepresented post-doctoral fellows and early-career faculty. Methods This is a cross-sectional analysis of data collected from September to October 2020 among 224 underrepresented early-career researchers at 25 academic medical centers in the Building Up Trial. We used linear regression to test associations of perseverance and consistency of interest scores with CRAI, science identity, and effort/reward imbalance (ERI) scores. Results The cohort is 80% female, 33% non-Hispanic Black, and 34% Hispanic. The median perseverance and consistency of interest scores were 3.8 (25th-75th percentile: 3.7,4.2) and 3.7 (25th-75th percentile: 3.2, 4.0), respectively. Higher perseverance was associated with a higher CRAI score (β = 0.82; 95% CI = 0.30, 1.33, p = 0.002) and science identity (β = 0.44; 95% CI = 0.19, 0.68, p = 0.001). Higher consistency of interest was associated with a higher CRAI score (β = 0.60; 95% CI = 0.23, 0.96, p = 0.001) and higher science identity score (β = 0.20; 95% CI = 0.03, 0.36, p = 0.02), while lower consistency of interest was associated with imbalance favoring effort (β = -0.22; 95% CI = -0.33, -0.11, p = 0.001). Conclusions We found that perseverance and consistency of interest are related to CRAI and science identity, indicating that these factors may positively influence one's decision to stay in research.
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Affiliation(s)
- Maya S. Thakar
- Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania, USA
| | - Chantele Mitchell-Miland
- Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania, USA
| | - Natalia E. Morone
- General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston Medical Center, Boston, Massachusetts, USA
| | - Andrew D. Althouse
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Audrey J. Murrell
- College of Business Administration, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania, USA
| | - Gretchen E. White
- Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania, USA
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White GE, Proulx CN, Morone NE, Thakar MS, Murrell AJ, Althouse AD, Rubio DM. A Mixed-Methods Analysis of Gender and Career Status Differences in the Impact of the COVID-19 Pandemic on Underrepresented Postdoctoral Fellows and Early-Career Faculty. Acad Med 2022; 97:1824-1831. [PMID: 36449920 PMCID: PMC9696762 DOI: 10.1097/acm.0000000000004948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The lack of racial and ethnic diversity in the biomedical workforce is pronounced and those from underrepresented backgrounds encounter more challenges than their majority counterparts. The extent of the impact of the COVID-19 pandemic on early-career investigators from underrepresented backgrounds is not yet fully understood. To examine the impact of the pandemic on underrepresented early-career biomedical researchers, this study evaluated differences in productivity, research, and psychological well-being by gender and career status. METHOD This was a cross-sectional analysis of preintervention data, collected in September-October 2020, from 220 participants enrolled in the Building Up a Diverse Biomedical Research Workforce study. Participants were from 25 academic medical centers in the United States and were underrepresented early-career researchers. The primary outcomes were agreement on a 5-point Likert scale with pandemic impact statements (e.g., "The COVID-19 pandemic has impacted my ability to conduct research"). Thematic analysis was conducted on responses to 2 open-ended questions assessing the pandemic's impact. RESULTS Most participants were female (79.9%), of non-Hispanic/Latinx/Spanish origin Black/African American (33.2%) or Hispanic/Latinx/Spanish origin (34.1%), and early-career faculty (53.4%). Over half of participants agreed or strongly agreed that the COVID-19 pandemic impacted their ability to work (55.7%) and conduct research (70.7%). Themes from qualitative analysis suggested lower research productivity, concerns about the academic job market and funding, and psychological distress due to the pandemic. Women were more likely to attribute lost productivity and psychological distress to homeschooling and childcare responsibilities. Postdoctoral fellows were concerned about more competition for fewer academic positions. CONCLUSIONS In this study of early-career underrepresented biomedical researchers, the impact of the COVID-19 pandemic was widely felt by participants, varying by gender and career status. For those postdoctoral fellows and early-career faculty who are underrepresented, it is critical for institutions to offer flexibility in their positions.
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Affiliation(s)
- Gretchen E. White
- G.E. White is assistant professor, Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania
| | - Chelsea N. Proulx
- C.N. Proulx is research and evaluation specialist, Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania
| | - Natalia E. Morone
- N.E. Morone is associate professor, General Internal Medicine, Boston University School of Medicine, and Boston Medical Center, Boston, Massachusetts
| | - Maya S. Thakar
- M.S. Thakar is a graduate student researcher, Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania
| | - Audrey J. Murrell
- A.J. Murrell is professor, College of Business Administration, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Andrew D. Althouse
- A.D. Althouse is assistant professor, Center for Clinical Trials and Data Coordination, Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Doris M. Rubio
- D.M. Rubio is professor, Institute for Clinical Research Education, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania
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Bredella MA, Rubio DM, Attia J, Kelly TH, McIntosh S, Meagher EA, Pusek S, Rubio M, Tsevat J, Umans JG. The Virtual CTSA Visiting Scholar Program to Support Early-Stage Clinical and Translational Researchers: Implementation and Outcomes. Acad Med 2022; 97:1311-1316. [PMID: 35263302 PMCID: PMC10732303 DOI: 10.1097/acm.0000000000004645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In addition to restrictions on conducting research, COVID-19-related travel bans and scientific meeting cancellations have negatively affected scholars in the Clinical and Translational Science Award (CTSA) Mentored Career Development Award (KL2) program. In response, a national virtual visiting scholar program was developed to provide opportunity for KL2 scholars to be virtual visiting professors at another CTSA hub, meet faculty and scholars, and expand networks and build collaborations. This article describes the design and short-term outcomes of the virtual CTSA Visiting Scholar Program. In 2020, a working group designed core program elements and developed an application and selection process. Anonymized surveys were sent to scholars post visit and to scholars and program directors 6 months post visit to evaluate their experience and solicit suggestions for improvements. Between November 2020 and May 2021, 56 KL2 scholars and 27 hubs participated. Forty-five (80.4%) participating scholars responded to the initial survey. Nearly all scholars (44, 97.7%) agreed their experience was valuable. All respondents indicated they would recommend the program to other KL2 scholars. For the 6-month survey, the response rate was 87.5% (49/56). Within 6 months of their visit, 36 (73.5%) respondents had contacted at least one person at the host hub and for 17 (34.7%) respondents, new collaborations with the host hub ensued. Twenty-five of 27 (92.6%) host hubs responded to the survey. Most (21, 84.0%) agreed that hearing visiting scholar talks was valuable to their own scholars and 23 (92%) indicated likelihood of their hub participating in future round of the program. The virtual Visiting Scholar Program provided KL2 scholars an opportunity to virtually visit another CTSA hub, present their research, and meet with faculty and other scholars to expand their networks. Although geared to KL2 scholars, this model is potentially generalizable to other nationally coordinated career development programs.
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Affiliation(s)
- Miriam A Bredella
- M.A. Bredella is professor of radiology, vice chair, Department of Radiology, Massachusetts General Hospital, and director, KL2/Catalyst Medical Research Investigator Training Program, Harvard Catalyst, The Harvard Clinical and Translational Science Center, Harvard Medical School, Boston, Massachusetts
| | - Doris M Rubio
- D.M. Rubio is professor of medicine, biostatistics, bioinformatics, and clinical and translational science, assistant vice chancellor for clinical research education and training, Health Sciences, director, Institute for Clinical Research Education, and director, KL2, Team Science, and Workforce Development, Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacqueline Attia
- J. Attia is health project coordinator, Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Thomas H Kelly
- T.H. Kelly is Robert Straus Professor and chair, Department of Behavioral Science, College of Medicine, associate dean for research and PhD faculty affairs, College of Nursing, and director, KL2 and Workforce Development, Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky
| | - Scott McIntosh
- S. McIntosh is associate professor and survey team faculty lead, Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Emma A Meagher
- E.A. Meagher is professor of medicine and pharmacology, director, Translational Research Education, Institute for Translational Medicine and Therapeutics, and vice dean, Clinical Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susan Pusek
- S. Pusek is director, Education Programs, North Carolina TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mercedes Rubio
- M. Rubio is program director, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland
| | - Joel Tsevat
- J. Tsevat is professor of medicine, Joaquin G. Cigarroa, Jr., MD, Distinguished Chair, director, ReACH Center, director, KL2 Program, University of Texas Health Science Center at San Antonio, and professor of population health, Dell Medical School, University of Texas at Austin, and Institute for the Integration of Medicine and Science, Center for Research to Advance Community Health, Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jason G Umans
- J.G. Umans is KL2 program director, Georgetown-Howard Universities Center for Clinical and Translational Science, associate professor of medicine and of obstetrics and gynecology, Georgetown University, Washington, DC, scientific director, Biomarker, Biochemistry and Biorepository Core, and scientific director, Field Studies Division, MedStar Health Research Institute, Hyattsville, Maryland
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Mayowski CA, Norman MK, Proulx CN, Hamm ME, Martin MK, Zellers DF, Rubio DM, Levine AS. Evaluation of two longitudinal faculty leadership training programs: behavioral change and institutional impact. J Health Organ Manag 2022; ahead-of-print. [DOI: 10.1108/jhom-03-2022-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeBuilding leadership skills among faculty in academic medicine is essential, yet professional development programs focused on leadership are not always attentive to the needs of faculty on diverse career pathways or at differing career stages—nor are they often rigorously assessed. Evaluations commonly focus on participant satisfaction and short-term learning but not behavior change and institutional impact, which are difficult to assess but arguably more meaningful. Given the substantial time and money invested in these programs, more rigorous evaluation is critical.Design/methodology/approachThe authors evaluated an intensive, shared leadership-focused training program for early-career and mid-career faculty, offered by the University of Pittsburgh’s School of Medicine over the course of a year. They administered a pre/post-program assessment of confidence in key skill areas, and conducted semi-structured interviews with 21 participants between 1–4 years after program completion.FindingsParticipants in both programs showed statistically significant improvement (p < 0.001) on every item measured in the pre/post-test. Analysis of the interviews revealed indications of substantial behavior change as well as institutional impact. The evaluation also suggested particular benefits for female professionals.Originality/valueThe authors conducted a long-term assessment of leadership training focused on career pathway and career stage and found that it (a) prompted both positive behavioral change and institutional impact and (b) suggested benefits for female faculty in particular, which could potentially help to eliminate gender-based disparities in leadership in academic medical centers.
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9
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Smyth SS, Coller BS, Jackson RD, Kern PA, McIntosh S, Meagher EA, Rubio DM, Sandberg K, Tsevat J, Umans JG, Attia J, Baker HL, Nagel JD, McMullen CA, Rosemond E. KL2 scholars' perceptions of factors contributing to sustained translational science career success. J Clin Transl Sci 2021; 6:e34. [PMID: 35433037 PMCID: PMC9003634 DOI: 10.1017/cts.2021.886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Identifying the most effective ways to support career development of early stage investigators in clinical and translational science should yield benefits for the biomedical research community. Institutions with Clinical and Translational Science Awards (CTSA) offer KL2 programs to facilitate career development; however, the sustained impact has not been widely assessed. Methods A survey comprised of quantitative and qualitative questions was sent to 2144 individuals that had previously received support through CTSA KL2 mechanisms. The 547 responses were analyzed with identifying information redacted. Results Respondents held MD (47%), PhD (36%), and MD/PhD (13%) degrees. After KL2 support was completed, physicians' time was divided 50% to research and 30% to patient care, whereas PhD respondents devoted 70% time to research. Funded research effort averaged 60% for the cohort. Respondents were satisfied with their career progression. More than 95% thought their current job was meaningful. Two-thirds felt confident or very confident in their ability to sustain a career in clinical and translational research. Factors cited as contributing to career success included protected time, mentoring, and collaborations. Conclusion This first large systematic survey of KL2 alumni provides valuable insight into the group's perceptions of the program and outcome information. Former scholars are largely satisfied with their career choice and direction, national recognition of their expertise, and impact of their work. Importantly, they identified training activities that contributed to success. Our results and future analysis of the survey data should inform the framework for developing platforms to launch sustaining careers of translational scientists.
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Affiliation(s)
- Susan S. Smyth
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | | | | | | | | | | | - Joel Tsevat
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | | | - Heather L. Baker
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Joan D. Nagel
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | | | - Erica Rosemond
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
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10
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Norman MK, Proulx CN, Rubio DM, Mayowski CA. Reducing tensions and expediting manuscript submission via an authorship agreement for early-career researchers: A pilot study. Account Res 2021:1-14. [PMID: 34743618 PMCID: PMC9117566 DOI: 10.1080/08989621.2021.2002693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Authorship can be a source of tension on research teams, in academic/industry collaborations, and between mentors/mentees. Authorship misconduct is prevalent among biomedical researchers, and disputes about authorship can generate tensions that have the potential to disrupt professional relationships and damage careers. Early-career researchers may experience particular challenges navigating authorship both because of inexperience and power differentials; in effect, they lack the language and confidence to have these conversations and may feel unwilling to challenge the status quo. The authors implemented an Authorship Agreement for use when collaborating on a manuscript and hypothesized that using this agreement would reduce authorship tensions and speed time to manuscript submission by helping early-career investigators manage authorship conversations more effectively. The authors surveyed trainees (n = 65) on the prevalence of authorship-related tensions and compared the results from the first survey in 2017 to the final survey in 2020. The decrease in tensions around meeting deadlines was significant (z = 2.59, p = 0.010). The authors believe the effect of an Authorship Agreement on authorship-related tensions has not previously been investigated. This work extends what is known about the prevalence of commonly cited authorship tensions, and provides evidence of the effectiveness of steps that can be taken to alleviate them.
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Affiliation(s)
- Marie K Norman
- School of Medicine Pittsburgh, Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chelsea N Proulx
- School of Medicine Pittsburgh, Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Doris M Rubio
- School of Medicine Pittsburgh, Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Colleen A Mayowski
- School of Medicine Pittsburgh, Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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11
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Doyle JM, Morone NE, Proulx CN, Althouse AD, Rubio DM, Thakar MS, Murrell AJ, White GE. The impact of the COVID-19 pandemic on underrepresented early-career PhD and physician scientists. J Clin Transl Sci 2021; 5:e174. [PMID: 34721892 PMCID: PMC8545843 DOI: 10.1017/cts.2021.851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
Underrepresented minorities have higher attrition from the professoriate and have experienced greater negative impacts of the COVID-19 pandemic. The purpose of this study was to compare the impact of COVID-19 on the lives of 196 early-career physician-scientists versus PhD researchers who are underrepresented in biomedical research. Participants in the Building Up study answered questions on the impact of the COVID-19 pandemic on their personal and professional lives, and a mixed-methods approach was used to conduct the analysis. While most participants experienced increases in overall stress (72% of PhD researchers vs 76% of physician-scientists), physician-scientists reported that increased clinical demands, research delays, and the potential to expose family members to SARS-CoV-2 caused psychological distress, specifically. PhD researchers, more than physician-scientists, reported increased productivity (27% vs 9%), schedule flexibilities (49% vs 25%), and more quality time with friends and family (40% vs 24%). Future studies should consider assessing the effectiveness of programs addressing COVID-19-related challenges experienced by PhD researchers and physician-scientists, particularly those from underrepresented backgrounds.
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Affiliation(s)
- Jamie M Doyle
- Division of Clinical Innovation, National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - Natalia E. Morone
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Chelsea N. Proulx
- Institute for Clinical Research Education, General and Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Andrew D. Althouse
- Department of General Internal Medicine, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, General and Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Maya S. Thakar
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Gretchen E. White
- Institute for Clinical Research Education, General and Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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12
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Talbert PY, Perry G, Ricks-Santi L, Soto de Laurido LE, Shaheen M, Seto T, Kumar D, Quarshie A, Thakar M, Rubio DM. Challenges and Strategies of Successful Mentoring: The Perspective of LEADS Scholars and Mentors from Minority Serving Institutions. Int J Environ Res Public Health 2021; 18:6155. [PMID: 34200278 PMCID: PMC8200946 DOI: 10.3390/ijerph18116155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 11/17/2022]
Abstract
Mentoring continues to be a salient conversation in academia among junior and senior faculty and administrators. Mentors provide guidance and structure to junior faculty so that they can meet their academic and professional goals. Mentors also convey skills in balancing life and academic pursuits. Therefore, the purpose of this descriptive study was to provide additional insight from a training program called Leading Emerging and Diverse Scientists to Success (LEADS) regarding successful strategies and challenges of mentoring relating to lessons learned from the scholars and mentees' perspective. The LEADS program provided multiple training platforms to increase skills and knowledge regarding research to promote expertise in grant writing and submission for funding opportunities among diverse scientists. These findings reinforce the knowledge about the value of a mentor in helping define the research pathway of their mentee and underscoring the importance of mentoring.
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Affiliation(s)
- Patricia Y. Talbert
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC 20059, USA
| | - George Perry
- Department of Neurobiology, The University of Texas at San Antonio, San Antonio, TX 78249, USA;
| | | | - Lourdes E. Soto de Laurido
- Research Institute for Global Health Promotion and Health Education, School of Health Professions, University of Puerto Rico–Medical Sciences Campus, San Juan 00921, Puerto Rico;
| | - Magda Shaheen
- Department of Internal Medicine, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Todd Seto
- The Queen’s Medical Center, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USA;
| | - Deepak Kumar
- Julius Chambers Biomedical Biotechnology Research Institute (BBRI), Department of Pharmaceutical Sciences, North Carolina Central University, Durham, NC 27707, USA;
| | - Alexander Quarshie
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA;
| | - Maya Thakar
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
| | - Doris M. Rubio
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
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Spataro BM, Tilstra SA, Rubio DM, McNeil MA. Correlation of Coping, Mentorship, and Life Events with Burnout in Internal Medicine Residents. Med Sci Educ 2021; 31:573-579. [PMID: 34457912 PMCID: PMC8368755 DOI: 10.1007/s40670-021-01215-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/10/2021] [Indexed: 06/13/2023]
Abstract
Physician burnout is a widespread problem. We examined how coping, mentorship, and life events correlated with burnout in Internal Medicine Residents. We performed a cross-sectional study of survey data collected over multiple time points and used Spearman correlation of coping, mentorship, and life events to emotional exhaustion (EE) and cynicism (CYN). Burnout was assessed using the Maslach Burnout Inventory-General Survey (MBI-GS), coping skills were measured using the Brief COPE, mentorship with an institutional mentoring survey, and life events with a shortened Social Readjustment Rating Scale (SRRS). Two thousand one surveys were distributed to 616 residents from 2010 to 2015. There were 1144 cases of completion of both the Brief COPE and the MBI-GS (58%), 744 of the MBI-GS and the Mentoring survey (47%), and 1138 of the MBI-GS and Life Events Scale (57%). There were correlations between acceptance (ρ 0.1-0.24), denial (ρ 0.13-0.20), substance abuse (ρ 0.15-0.22), behavioral disengagement (ρ 0.18-.037), self-blame (ρ 0.27-0.45), self-distraction (ρ 0.18-0.32) and venting (ρ 0.15-0.47) and EE. There were correlations with acceptance (ρ 0.11-0.15), denial (ρ 0.18-0.26), humor (ρ 0.13-0.20), substance abuse (ρ 0.10-0.29), behavioral disengagement (ρ 0.19-0.40), self-blame (ρ 0.24-0.35), self-distraction (ρ 0.14-0.34) and venting (ρ 0.12-0.38) and CYN. There was a negative correlation between mentorship and EE (ρ - 0.15, - 0.18) and CYN (ρ - 0.30 to - 0.20). There were correlations between life events and EE (ρ 0.15-0.20) and CYN (ρ = 0.14-0.15). Maladaptive coping mechanisms, acceptance, and life stressors correlate with burnout in internal medicine residents and mentoring may be protective.
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Affiliation(s)
- Brielle M. Spataro
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA USA
- Department of Internal Medicine, UPMC Shadyside Hospital, North Tower, Room 311, 5230 Centre Avenue, Pittsburgh, PA 15232 USA
| | - Sarah A. Tilstra
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Doris M. Rubio
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Melissa A. McNeil
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA USA
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McCormack WT, Bredella MA, Ingbar DH, Jackson RD, Meagher EA, Morris CD, Nagel JD, Pusek S, Rubio DM, Sandberg K, Schnaper HW, Tsevat J, Umans JG, McIntosh S. Immediate impact of the COVID-19 pandemic on CTSA TL1 and KL2 training and career development. J Clin Transl Sci 2020; 4:556-561. [PMID: 33942017 PMCID: PMC7605410 DOI: 10.1017/cts.2020.504] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 01/22/2023] Open
Abstract
Clinical and Translational Science Award (CTSA) TL1 trainees and KL2 scholars were surveyed to determine the immediate impact of the COVID-19 pandemic on training and career development. The most negative impact was lack of access to research facilities, clinics, and human subjects, plus for KL2 scholars lack of access to team members and need for homeschooling. TL1 trainees reported having more time to think and write. Common strategies to maintain research productivity involved time management, virtual connections with colleagues, and shifting to research activities not requiring laboratory/clinic settings. Strategies for mitigating the impact of the COVID-19 pandemic on training and career development are described.
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Affiliation(s)
- Wayne T. McCormack
- Clinical & Translational Science Institute, Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Miriam A. Bredella
- Harvard Catalyst, The Harvard Clinical and Translational Science Center, Harvard Medical School, Boston, MA, USA
| | - David H. Ingbar
- Clinical and Translational Science Institute Research Education, Career Development, and Training Core, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Rebecca D. Jackson
- The Center for Clinical and Translational Science, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Emma A. Meagher
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Cynthia D. Morris
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Joan D. Nagel
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Susan Pusek
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn Sandberg
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - H. William Schnaper
- Northwestern University Clinical and Translational Sciences (NUCATS) Institute, Northwestern University, Chicago, IL, USA
| | - Joel Tsevat
- Institute for the Integration of Medicine and Science, Center for Research to Advance Community Health, Department of Medicine, Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jason G. Umans
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Scott McIntosh
- Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Rubio DM, Hamm ME, Mayowski CA, Nouraie SM, Quarshie A, Seto T, Shaheen M, Soto de Laurido LE, Norman MK. Developing a Training Program to Diversify the Biomedical Research Workforce. Acad Med 2019; 94:1115-1121. [PMID: 30768468 PMCID: PMC6764096 DOI: 10.1097/acm.0000000000002654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The National Institutes of Health has made considerable investments to diversify the biomedical research workforce. Towards this goal, the authors partnered with representatives from several minority-serving institutions (MSIs) to develop training for the next generation of researchers. To ensure the most effective training program, the authors conducted a needs assessment with junior and senior investigators from the partnering MSIs. In 2016, the authors conducted focus groups and interviews with 23 junior investigators as well as in-depth interviews with 6 senior investigators from the partnering institutions with the goal of identifying specific areas of training and support that would help junior investigators at MSIs develop and sustain research careers. The data were transcribed and coded, and thematic analysis was conducted. The authors determined four areas in which training and support were needed: training in the "informal curriculum" (skills not covered in traditional clinical research courses), protected time for research training, opportunities to create career-advancing work products, and networking opportunities. The themes that were identified informed the development of the LEADS (Leading Emerging and Diverse Scientists to Success) program. The program consists of 10 instructor-led online modules each lasting approximately one month in duration with weekly synchronous sessions. Scholars are expected to be able to devote at least 20% of their time to the program.
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Affiliation(s)
- Doris M Rubio
- D.M. Rubio is professor of medicine, biostatistics, nursing, and clinical and translational science, associate vice provost for faculty, and director, Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. M.E. Hamm is assistant professor of medicine and director, Qualitative, Evaluation, and Stakeholder Engagement Research Services, Center for Research on Health Care Data Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. C.A. Mayowski is assistant professor of medicine and clinical and translational science, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. S.M. Nouraie is associate professor of pulmonary medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. A. Quarshie is professor of community health and preventive medicine, Morehouse School of Medicine, Atlanta, Georgia. T. Seto is associate professor of medicine, University of Hawaii John A. Burns School of Medicine, and medical director, Non-Invasive Cardiology Laboratory, The Queen's Medical Center, Honolulu, Hawaii. M. Shaheen is associate professor of surgery, Charles R. Drew University of Medicine and Science, Los Angeles, California. L.E. Soto de Laurido is professor, School of Health Professions, director, Hispanics in Research Capability Endowment, and director, Research Institute for Global Health Promotion and Health Education, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico. M.K. Norman is associate professor of medicine and clinical and translational science and director, IDEA Lab, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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16
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Mayowski CA, Rubio DM, Norman MK. Encouraging Faculty to Teach Online: Leveraging Rogers's Diffusion of Innovation Theory. Acad Med 2019; 94:452. [PMID: 30431451 PMCID: PMC6425472 DOI: 10.1097/acm.0000000000002519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Colleen A Mayowski
- assistant professor of medicine and clinical and translational science, and assistant director for mentor training associate vice provost for faculty, codirector, Institute for Clinical Research Education (ICRE), and professor of medicine, biostatistics, biomedical informatics, nursing, and clinical and translational science associate professor of medicine and clinical and translational science, and director, IDEA Lab, ICRE, University of Pittsburgh School of Medicine
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Donovan AK, Linz DR, Rubio DM, McNeil MA, Spagnoletti CL. Teaching to Teach: An Effective and Feasible Teaching Curriculum for Internal Medicine Interns. South Med J 2018; 111:733-738. [DOI: 10.14423/smj.0000000000000908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Rubio DM, Mayowski CA, Norman MK. A Multi-Pronged Approach to Diversifying the Workforce. Int J Environ Res Public Health 2018; 15:E2219. [PMID: 30314271 PMCID: PMC6210473 DOI: 10.3390/ijerph15102219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 09/24/2018] [Accepted: 10/08/2018] [Indexed: 11/26/2022]
Abstract
The biomedical workforce continues to lack diversity, despite growing evidence demonstrating the advantages of diverse teams in workplaces for creativity and innovation. At the University of Pittsburgh Institute for Clinical Research Education, we have taken a multi-pronged, collaborative approach to enhance the diversity of our trainees and scholars. We started by implementing a program for postdoctoral fellows and junior faculty, the Career Education and Enhancement for Health Care Research Diversity (CEED) program. We then built on this program and created a sister program for medical students (CEED II). These two programs were intended to build a local community of diverse researchers. Following the success of these programs, we extended our efforts and pursued federal funding to establish other programs. Our first funded program was designed to teach leadership and career coaching skills to mentors who are committed to mentoring people from diverse backgrounds, the Professional Mentoring Skills Enhancing Diversity (PROMISED) program. We then partnered with minority serving institutions to create a fellowship in translational research skills training, Leading Emerging and Diverse Scientists to Success (LEADS), training in patient-centered outcomes research, Expanding National Capacity in PCOR through Training (ENACT), and a year-long fellowship to work with a specific mentor at Pitt, the Clinical and Translational Science (CTS) Fellowship (TL1). With recognition that much work remains to be done, we believe these programs represent a small but positive step toward diversifying the biomedical workforce.
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Affiliation(s)
- Doris M Rubio
- Institute for Clinical Research Education and Department of Medicine, School of Medicine, University of Pittsburgh, 200 Meyran Avenue, Suite 300, Pittsburgh, PA 15213, USA.
| | - Colleen A Mayowski
- Institute for Clinical Research Education and Department of Medicine, School of Medicine, University of Pittsburgh, 200 Meyran Avenue, Suite 300, Pittsburgh, PA 15213, USA.
| | - Marie K Norman
- Institute for Clinical Research Education and Department of Medicine, School of Medicine, University of Pittsburgh, 200 Meyran Avenue, Suite 300, Pittsburgh, PA 15213, USA.
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20
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Spataro BM, Tilstra SA, Rubio DM, McNeil MA. The Toxicity of Self-Blame: Sex Differences in Burnout and Coping in Internal Medicine Trainees. J Womens Health (Larchmt) 2016; 25:1147-1152. [PMID: 27732118 DOI: 10.1089/jwh.2015.5604] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Burnout is a significant problem facing internal medicine residents contributing to increased risk of depression and suicidal ideation. Coping mechanisms and burnout may differ based on sex. METHODS The study was a retrospective cross-sectional study of reported burnout and coping mechanisms used by internal medicine residents in June 2014 at a large academic center and its community affiliate. Two hundred eighty-five postgraduate year (PGY)-1, 2, 3, and 4 and incoming PGY-1 residents were surveyed. The Maslach Burnout Inventory-General Survey and Brief Coping Orientation to Problems Experienced were given to measure levels of burnout and frequency of use of coping mechanisms. Percentages of residents who met criteria for burnout and high levels on each of the subscales of emotional exhaustion, cynicism and professional efficacy, were calculated and stratified by sex. Chi-squared tests were used for statistical significance. Average frequency of use of each coping mechanism by sex was calculated with statistical significance determined by two sided t-tests. RESULTS There was a 69% completion rate (198/285) with 100 men and 98 women. Woman had higher levels of burnout (30% vs. 15%, p = 0.014) and emotional exhaustion (22% vs. 9%, p = 0.005). Women used the adaptive coping mechanisms of emotional support (p = 0.001) and instrumental support (p = 0.018) more frequently but also used the maladaptive coping mechanism of self-blame more frequently (p = 0.022). CONCLUSIONS Greater use of self-blame as a coping mechanism may be a major factor in the higher rates of burnout and emotional exhaustion in women resident physicians as compared to men. Educators must pay attention to use of self-blame by female residents and as it may be a red flag for resident distress.
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Affiliation(s)
- Brielle M Spataro
- 1 Division of General Internal Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,2 The Veteran's Administration Pittsburgh Healthcare System , Pittsburgh, Pennsylvania
| | - Sarah A Tilstra
- 1 Division of General Internal Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Doris M Rubio
- 1 Division of General Internal Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Melissa A McNeil
- 1 Division of General Internal Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
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Abstract
The aim of this study was to test whether a recently developed measure of Continuous Quality Improvement (CQI) implementation can provide health care researchers and administrators with a tool to assist in understanding and with developing an appropriate structure for improvement efforts in hospitals. Two hundred respondents from 40 Missouri hospitals completed a 28-item survey addressing 8 domains of CQI. Overall, hospital scores showed low implementation of a structure that supports improvement efforts. All survey domains showed acceptable psychometric results. Leadership proved to be the most important domain of CQI because it differentiated well between all levels of the scale. Because of its ease of administration and analysis, and its reliability, validity, and level differentiation results, the researchers recommend the widespread use of this tool to understand and develop a hospital's organizational structure to support improvement activities.
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Affiliation(s)
- Steven J Meurer
- Operations, St Mary Medical Center, Langhorne, PA 19047, USA.
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22
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Donovan AK, Wood GJ, Rubio DM, Day HD, Spagnoletti CL. Faculty Communication Knowledge, Attitudes, and Skills Around Chronic Non-Malignant Pain Improve with Online Training. Pain Med 2016; 17:1985-1992. [PMID: 27036413 DOI: 10.1093/pm/pnw029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Many physicians struggle to communicate with patients with chronic, non-malignant pain (CNMP). Through the use of a Web module, the authors aimed to improve faculty participants' communication skills knowledge and confidence, use of skills in clinical practice, and actual communication skills. SUBJECTS The module was implemented for faculty development among clinician-educators with university faculty appointments, outpatient clinical practices, and teaching roles. METHODS Participants completed the Collaborative Opioid Prescribing Education Risk Evaluation and Mitigation Strategy (COPE-REMS®) module, a free Web module designed to improve provider communication around opioid prescribing. Main study outcomes were improvements in CNMP communication knowledge, attitudes, and skills. Skills were assessed by comparing a subset of participants' Observed Structured Clinical Exam (OSCE) performance before and after the curriculum. RESULTS Sixty-two percent of eligible participants completed the curriculum in 2013. Knowledge-based test scores improved with curriculum completion (75% vs. 90%; P < 0.001). Using a 5-point Likert-type scale, participants reported improved comfort in managing patients with CNMP both immediately post-curriculum and at 6 months (3.6 pre vs. 4.0 post vs. 4.1 at 6 months; P = 0.02), as well as improvements in prescribing opioids (3.3 vs. 3.8 vs. 3.9, P = 0.01) and conducting conversations about discontinuing opioids (2.8 vs. 3.5 vs. 3.9, P < 0.001). Additionally, CNMP-specific communication skills on the OSCE improved after the curriculum (mean 67% vs. 79%, P = 0.03). CONCLUSIONS Experienced clinician-educators improved their communication knowledge, attitudes, and skills in managing patients with CNMP after implementation of this curriculum. The improvements in attitudes were sustained at six months. A Web-based curriculum such as COPE-REMS® may be useful for other programs seeking improvement in faculty communication with patients who have CNMP.
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Affiliation(s)
- Anna K Donovan
- *Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Gordon J Wood
- Palliative Medicine and Supportive Care Division, Northwestern Lake Forest Hospital Midwest Palliative & Hospice CareCenter, Glenview, Illinois
| | - Doris M Rubio
- Center for Research on Health Care Data Center, Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hollis D Day
- *Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Carla L Spagnoletti
- *Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Rubio DM, Blank AE, Dozier A, Hites L, Gilliam VA, Hunt J, Rainwater J, Trochim WM. Developing Common Metrics for the Clinical and Translational Science Awards (CTSAs): Lessons Learned. Clin Transl Sci 2015; 8:451-9. [PMID: 26073891 PMCID: PMC4626292 DOI: 10.1111/cts.12296] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The National Institutes of Health (NIH) Roadmap for Medical Research initiative, funded by the NIH Common Fund and offered through the Clinical and Translational Science Award (CTSA) program, developed more than 60 unique models for achieving the NIH goal of accelerating discoveries toward better public health. The variety of these models enabled participating academic centers to experiment with different approaches to fit their research environment. A central challenge related to the diversity of approaches is the ability to determine the success and contribution of each model. This paper describes the effort by the Evaluation Key Function Committee to develop and test a methodology for identifying a set of common metrics to assess the efficiency of clinical research processes and for pilot testing these processes for collecting and analyzing metrics. The project involved more than one-fourth of all CTSAs and resulted in useful information regarding the challenges in developing common metrics, the complexity and costs of acquiring data for the metrics, and limitations on the utility of the metrics in assessing clinical research performance. The results of this process led to the identification of lessons learned and recommendations for development and use of common metrics to evaluate the CTSA effort.
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Affiliation(s)
- Doris M Rubio
- Data Center, Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Arthur E Blank
- Department of Family and Social Medicine, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester, Rochester, New York, USA
| | - Lisle Hites
- Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Victoria A Gilliam
- Data Center, Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joe Hunt
- Indiana Clinical and Translational Sciences Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Julie Rainwater
- Clinical and Translational Science Center, University of California Davis, Sacramento, California, USA
| | - William M Trochim
- Department of Policy Analysis and Management, Cornell University, Ithaca, New York, USA
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Robinson GFWB, Moore CG, McTigue KM, Rubio DM, Kapoor WN. Assessing Competencies in a Master of Science in Clinical Research Program: The Comprehensive Competency Review. Clin Transl Sci 2015; 8:770-5. [PMID: 26332763 DOI: 10.1111/cts.12322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Competencies in Master of Science Clinical Research programs are becoming increasingly common. However, students and programs can only benefit fully from competency-based education if students' competence is formally assessed. Prior to a summative assessment, students must have at least one formative, formal assessment to be sure they are developing competence appropriate for their stage of training. This paper describes the comprehensive competency review (CCR), a milestone for MS students in Clinical Research at the University of Pittsburgh's Institute for Clinical Research Education. The CCR involves metacognitive reflection of the student's learning as a whole, written evidence of each competency, a narrative explaining the choice of evidence for demonstrating competencies, and a meeting in which two faculty members review the evidence and solicit further oral evidence of competence. CCRs allow for individualized feedback at the midpoint in degree programs, providing students with confidence that they will have the means and strategies to develop competence in all areas by the summative assessment of competence at their thesis defense. CCRs have also provided programmatic insight on the need for curricular revisions and additions. These benefits outweigh the time cost on the part of students and faculty in the CCR process.
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Affiliation(s)
| | | | - Kathleen M McTigue
- Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Medicine, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Doris M Rubio
- Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Medicine, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Wishwa N Kapoor
- Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Medicine, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Manson SM, Martinez DF, Buchwald DS, Rubio DM, Moss M. Vision, Identity, and Career in the Clinical and Translational Sciences: Building upon the Formative Years. Clin Transl Sci 2015; 8:568-72. [PMID: 26271774 DOI: 10.1111/cts.12316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This paper is the second in a five-part series on the clinical and translational science educational pipeline. It focuses on the role that Clinical and Translational Science Award (CTSA) programs can play in supporting science, technology, engineering, and math (STEM) education in primary and secondary schools, as well as in facilitating these interests during transition to undergraduate training. Special emphasis should be placed on helping to form and sustain an identity as a scientist, and on instilling the persistence necessary to overcome numerous barriers to its actualization. CTSAs can contribute to cementing this sense of self by facilitating peer support, mentorship, and family involvement that will reinforce early educational decisions leading to clinical and translational science research careers. Meanwhile, the interests, skills, and motivation induced by participation in STEM programs must be sustained in transition to the next level in the educational pipeline, typically undergraduate study. Examples of CTSA collaborations with local schools, businesses, interest groups, and communities at large illustrate the emerging possibilities and promising directions with respect to each of these challenges.
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Affiliation(s)
- Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado CTSI Education, Training and Career Development Pillar, University of Colorado, Aurora, Colorado, USA
| | - Dominic F Martinez
- Office of Inclusion and Outreach, Colorado CTSI Education, Training and Career Development Pillar, University of Colorado, Aurora, Colorado, USA
| | - Dedra S Buchwald
- Partnerships for Native Health, Institute for Translational Health Sciences, Regional Research Collaborations, University of Washington, Seattle, Washington, USA
| | - Doris M Rubio
- Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marc Moss
- Department of Medicine, Colorado CTSI Education, Training and Career Development Pillar, University of Colorado, Aurora, Colorado, USA
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Rubio DM, Robinson GFWB, Gilliam VA, Primack BA, Switzer GE, Seltzer DL, Kapoor WN. Characterization of investigators' approach to translational research: a qualitative study. Clin Transl Sci 2014; 7:441-6. [PMID: 25066780 DOI: 10.1111/cts.12196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Little is known about how investigators approach their research programs along the translational research continuum. Many consider the translational continuum to be linear, with research beginning at the bench and concluding with research at the bedside or in the community. We aimed to understand if translational investigators approach and view their research in this fashion. METHODS We conducted semistructured individual interviews with 16 graduates of the University of Pittsburgh's Multidisciplinary Clinical Research Scholars Program (KL2) in 2012. RESULTS Our research revealed three characteristic models. The first model we called "linear" and represented the traditional approach. The second we called "holistic"; these investigators began with central research questions and sought to explore them in every direction of translation, not necessarily taking linear steps. The third model we called "technical"; in this model, investigators focused on a unique technology or methodology and applied it across multiple research contexts. CONCLUSION This study found that there are multiple ways that translational investigators approach their research program. Better understanding of these models can help educators and mentors guide investigators so that they can be more productive in their clinical or translational research career.
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Affiliation(s)
- Doris M Rubio
- Institute for Clinical Research Education, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Abstract
The Caregiver Well-Being Scale (CWBS) is a 43-item instrument that was designed in the 1990s to help family caregivers, clinicians, and researchers identify areas ofcaregiver strength and areas in which additional support is needed. This article describes the development of a 16-item version of the CWBS and discusses the methods used in testing the psychometric properties of the shortened version in a sample of 493 family caregivers. It concludes that the shortened version is valid, reliable, and easier to use than the original version but has the same goals and continues to be applicable in research and clinical settings.
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Affiliation(s)
- Susan S Tebb
- School of Social Work, Saint Louis University, MO 63108, USA.
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Primack BA, Colditz JB, Cohen E, Switzer GE, Robinson GFWB, Seltzer DL, Rubio DM, Kapoor WN. Measurement of social capital among clinical research trainees. Clin Transl Sci 2013; 7:33-7. [PMID: 24118964 DOI: 10.1111/cts.12112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
While physical and human capital are established as important predictors of success among early-career clinical investigators, less is known about the role of social capital. The authors aimed to develop a brief scale to assess social capital in this population and test its reliability and validity. A three-item assessment was developed based on a conceptual framework and measures of social capital from other fields and was administered to 414 clinical research trainees at the University of Pittsburgh in 2007-2012. The measure exhibited good internal consistency reliability (α = 0.71) and a normal distribution. On a 10-point scale, mean social capital was 6.4 (SD = 1.7). Social capital was significantly associated with 7 of the 9 expected constructs: sex, age, confidence in research skills, work-related motivation, burnout, and social support. Exploratory multivariable regression analysis demonstrated that social capital was most strongly associated with higher research confidence (β = 0.35, p < 0.001), higher extrinsic motivation (β = 0.50, p = 0.003), and lower burnout (ptrend = 0.02). This three-item scale measures social capital in this population with adequate internal consistency reliability, face validity, and construct validity. This brief assessment provides a tool that may be valuable to benchmark social capital of clinical research trainees and to better contextualize programmatic and trainee outcomes.
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Affiliation(s)
- Brian A Primack
- Department of Medicine, Pediatrics, and Clinical and Translational Science, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Abstract
PURPOSE Although the National Institutes of Health (NIH) has made extensive investments in educational programs related to clinical and translational science (CTS), there has been no systematic investigation of the number and characteristics of PhD programs providing training to future leaders in CTS. The authors undertook to determine the number of institutions that, having had received NIH-funded Clinical and Translational Science Awards (CTSAs), currently had or were developing PhD programs in CTS; to examine differences between programs developed before and after CTSA funding; and to provide detailed characteristics of new programs. METHOD In 2012, CTS program leaders at the 60 CTSA-funded institutions completed a cross-sectional survey focusing on four key domains related to PhD programs in CTS: program development and oversight; students; curriculum and research; and milestones. RESULTS Twenty-two institutions had fully developed PhD programs in CTS, and 268 students were earning PhDs in this new field; 13 institutions were planning PhD programs. New programs were more likely to have fully developed PhD competencies and more likely to include students in medical school, students working only on their PhD, students working on a first doctoral degree, and students working in T1 translational research. They were less likely to include physicians and students working in clinical or T2 research. CONCLUSIONS Although CTS PhD programs have similarities, they also vary in their characteristics and management of students. This may be due to diversity in translational science itself or to the relative infancy of CTS as a discipline.
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Affiliation(s)
- Galen E Switzer
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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Spagnoletti CL, Bui T, Fischer GS, Gonzaga AMR, Rubio DM, Arnold RM. Implementation and evaluation of a web-based communication skills learning tool for training internal medicine interns in patient-doctor communication. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/cih.2009.2.2.159] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
BACKGROUND The Department of Veterans Affairs (VA) instituted the VA Women's Health Fellowship (VAWHF) Program in 1994, to accommodate the health needs of increasing numbers of female veterans and to develop academic leaders in women's health. Despite the longevity of the program, it has never been formally evaluated. OBJECTIVE To describe the training environments of VAWHFs and career outcomes of female graduates. DESIGN AND PARTICIPANTS Cross-sectional web-based surveys of current program directors (2010-2011) and VAWHF graduates (1995-2011). RESULTS Responses were received from six of seven program directors (86 %) and 42 of 74 graduates (57 %). The mean age of graduates was 41.2 years, and mean time since graduation was 8.5 years. Of the graduates, 97 % were female, 74 % trained in internal medicine, and 64 % obtained an advanced degree. Those with an advanced degree were more likely than those without an advanced degree to pursue an academic career (82 % vs. 60 %; P<0.01). Of the female graduates, 76 % practice clinical women's health and spend up to 66 % of their time devoted to women's health issues. Thirty percent have held a VA faculty position. Seventy-nine percent remain in academics, with 39 % in the tenure stream. Overall, 94 % had given national presentations, 88 % had received grant funding, 79 % had published in peer-reviewed journals, 64 % had developed or evaluated curricula, 51 % had received awards for teaching or research, and 49 % had held major leadership positions. At 11 or more years after graduation, 33 % of the female graduates in academics had been promoted to the rank of associate professor and 33 % to the rank of full professor. CONCLUSIONS The VAWHF Program has been successful in training academic leaders in women's health. Finding ways to retain graduates in the VA system would ensure continued clinical, educational, and research success for the VA women veteran's healthcare program.
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Fleming M, House S, Hanson VS, Yu L, Garbutt J, McGee R, Kroenke K, Abedin Z, Rubio DM. The Mentoring Competency Assessment: validation of a new instrument to evaluate skills of research mentors. Acad Med 2013; 88:1002-8. [PMID: 23702534 PMCID: PMC3727250 DOI: 10.1097/acm.0b013e318295e298] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE To determine the psychometric properties of the Mentoring Competency Assessment (MCA), a 26-item skills inventory that enables research mentors and mentees to evaluate six competencies of mentors: maintaining effective communication, aligning expectations, assessing understanding, addressing diversity, fostering independence, and promoting professional development. METHOD In 2010, investigators administered the MCA to 283 mentor-mentee pairs from 16 universities participating in a trial of a mentoring curriculum for clinical and translational research mentors. The authors analyzed baseline MCA data to describe the instrument's psychometric properties. RESULTS Coefficient alpha scores for the MCA showed reliability (internal consistency). The hypothesized model with its six latent constructs (competencies) resulted in an acceptable fit to the data. For the instrument completed by mentors, chi-square = 663.20; df = 284; P < .001; root mean square error of approximation (RMSEA) = 0.069 (90% CI, 0.062-0.076); comparative fit index (CFI) = 0.85; and Tucker-Lewis index (TLI) = 0.83. For the instrument completed by mentees, chi-square = 840.62; df = 284; P < .001; RMSEA = 0.080 (90% CI, 0.063-0.077); CFI = 0.87; and TLI = 0.85. The correlations among the six competencies were high: 0.49-0.87 for mentors, 0.58-0.92 for mentees. All parameter estimates for the individual items were significant; standardized factor loadings ranged from 0.32 to 0.81 for mentors and 0.56 to 0.86 for mentees. CONCLUSIONS The findings demonstrate that the MCA has reliability and validity. In addition, this study provides preliminary norms derived from a national sample of mentors and mentees.
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Affiliation(s)
- Michael Fleming
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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Abstract
The National Center for Advancing Translational Sciences (NCATS), a part of the National Institutes of Health, currently funds the Clinical and Translational Science Awards (CTSAs), a national consortium of 61 medical research institutions in 30 states and the District of Columbia. The program seeks to transform the way biomedical research is conducted, speed the translation of laboratory discoveries into treatments for patients, engage communities in clinical research efforts, and train a new generation of clinical and translational researchers. An endeavor as ambitious and complex as the CTSA program requires high-quality evaluations in order to show that the program is well implemented, efficiently managed, and demonstrably effective. In this paper, the Evaluation Key Function Committee of the CTSA Consortium presents an overall framework for evaluating the CTSA program and offers policies to guide the evaluation work. The guidelines set forth are designed to serve as a tool for education within the CTSA community by illuminating key issues and practices that should be considered during evaluation planning, implementation, and utilization. Additionally, these guidelines can provide a basis for ongoing discussions about how the principles articulated in this paper can most effectively be translated into operational reality.
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Affiliation(s)
- William M Trochim
- Department of Policy Analysis and Management, Cornell University, Ithaca, New York, USA.
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Robinson GFWB, Erlen JA, Rubio DM, Kapoor WN, Poloyac SM. Development, implementation, and evaluation of an interprofessional course in translational research. Clin Transl Sci 2013; 6:50-6. [PMID: 23399090 DOI: 10.1111/cts.12024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The advancement of research from basic science discovery to clinical application requires the extensive collaboration of individuals from multiple disciplines, therefore the ability to work as an effective interprofessional team is essential for researchers in clinical and translational science (CTS). Courses that build interprofessional skills are a key component in CTS education, but the development of these courses poses numerous administrative and educational challenges. This paper describes the processes of designing, implementing, and evaluating an innovative graduate-level course that combines online lectures and in-class facilitated group discussions to promote interprofessional interactions. The course offers students the opportunity to interact with and learn from individuals in a variety of disciplines, and it requires students to engage in interprofessional group work to meet the course objectives. During the past 4 years, 96 students from the schools of medicine, pharmacy, nursing, public health, and health and rehabilitation sciences at a large urban university have completed the course. The course has been well-received, with 87% of students rating its overall quality as excellent, good, or satisfactory. The course offers educators a model to teach graduate students the skills that are essential for becoming effective CTS researchers.
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Lee LS, Pusek SN, McCormack WT, Helitzer DL, Martina CA, Dozier AM, Ahluwalia JS, Schwartz LS, McManus LM, Reynolds BD, Haynes EN, Rubio DM. Clinical and translational scientist career success: metrics for evaluation. Clin Transl Sci 2012; 5:400-7. [PMID: 23067352 PMCID: PMC3476049 DOI: 10.1111/j.1752-8062.2012.00422.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Despite the increased emphasis on formal training in clinical and translational research and the growth in the number and scope of training programs over the past decade, the impact of training on research productivity and career success has yet to be fully evaluated at the institutional level. In this article, the Education Evaluation Working Group of the Clinical and Translational Science Award Consortium introduces selected metrics and methods associated with the assessment of key factors that affect research career success. The goals in providing this information are to encourage more consistent data collection across training sites, to foster more rigorous and systematic exploration of factors associated with career success, and to help address previously identified difficulties in program evaluation.
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Affiliation(s)
- Linda S. Lee
- Department of Biostatistics & Bioinformatics, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Susan N. Pusek
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wayne T. McCormack
- Pathology, Immunology & Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Deborah L. Helitzer
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Camille A. Martina
- Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Ann M. Dozier
- Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Jasjit S. Ahluwalia
- Department of Medicine and Center for Health Equity, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lisa S. Schwartz
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Linda M. McManus
- Departments of Pathology and Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Brian D. Reynolds
- Duke Translational Medicine Institute, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Erin N. Haynes
- Department of Environmental Health, Division of Epidemiology and Biostatistics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Doris M. Rubio
- Departments of Medicine, Biostatistics, Nursing, Institute for Clinical Research Education, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Abstract
With today's focus on the translation of basic science discoveries into clinical practice, the demand for physician-scientists is growing. Yet, physicians have always found it challenging to juggle the demands of clinical care with the time required to perform research. The Research on Careers Workgroup of the Institute for Clinical Research Education at the University of Pittsburgh developed a comprehensive model for career success that would address, and allow for the evaluation of, the personal factors, organizational factors, and their interplay that contribute to career success. With this model, leaders of training programs could identify early opportunities for intervening with potential physician-scientists to ensure career success. Through an iterative process described in this article, the authors identified and examined potential models for career success from the literature, added other elements determined to be significant, and developed a comprehensive model to assess factors associated with career success for physician-scientists. The authors also present examples of ways in which this model can be adapted and applied to specific situations to assess the effects of different factors on career success.
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Affiliation(s)
- Doris M Rubio
- Data Center, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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Primack BA, Dilmore TC, Switzer GE, Bryce CL, Seltzer DL, Li J, Landsittel DP, Kapoor WN, Rubio DM. Burnout among early career clinical investigators. Clin Transl Sci 2010; 3:186-8. [PMID: 20718821 DOI: 10.1111/j.1752-8062.2010.00202.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Burnout is a pervasive problem among clinicians. However, little is known about burnout among early career clinical investigators, who must balance clinical responsibilities with challenges related to research. We aimed to determine the prevalence of and demographic associations with burnout in a cohort of early career clinical investigators. A cross-sectional questionnaire was administered to 179 trainees at the University of Pittsburgh Institute for Clinical Research Education in 2007-2008. We used chi-square analyses and Fisher's exact test to determine whether associations between demographic characteristics and burnout were significant. Of the participants, 29 (16%) reported feeling burned out. Burnout was more prevalent among those over 35 years of age relative to their younger counterparts (29% vs. 13%, p= 0.01) and among females relative to males (22% vs. 10%, p= 0.03). With regard to race and ethnicity, burnout was most common among underrepresented minorities (30%) followed by Caucasians (18%) and Asians (3%); these differences were significant (p= 0.02). Considering the early career status of these research trainees, rates of burnout were concerning. Certain demographic subgroups-including older trainees, females, and underrepresented minorities-had particularly high rates of burnout and may benefit from interventions that provide them with skills needed to sustain successful clinical research careers. Clin Trans Sci 2010; Volume 3: 186-188.
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Affiliation(s)
- Brian A Primack
- Department of Medicine, University of Pittsburgh School of Medicine, PA, USA.
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Barnato AE, Bost JE, Farrell MH, Lave JR, Arnold RM, Rubio DM, Angus DC. Relationship between staff perceptions of hospital norms and hospital-level end-of-life treatment intensity. J Palliat Med 2008; 10:1093-100. [PMID: 17985966 DOI: 10.1089/jpm.2006.0258] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are wide variations in hospital-level treatment intensity at the end of life that are not entirely explained by structural and market characteristics. Individual hospital microclimates must exist to perpetuate these practice variations. OBJECTIVES To determine whether a closed-ended survey based upon staff perceptions of informal norms regarding life prolongation, palliation, collaborative decision-making, and patient-doctor familiarity can identify hospital microclimates and to assess whether these norms are related to variation in end-of-life treatment intensity. DESIGN, PARTICIPANTS, AND MEASUREMENTS Retrospective analysis of hospital discharge data at 11 purposively sampled Pennsylvania hospitals linked to a self-administered survey of 139 administrative and clinical staff fielded during site visits in 2004; measurements included year 2000 and 2004 rates of intensive care unit (ICU) admission, mechanical ventilation (MV), and hemodialysis among terminal hospitalizations at each hospital; survey respondent demographics, role, experience, and perceptions of their hospital's context and norms of end-of-life decision-making and treatment. RESULTS The purposively sampled hospitals exhibited wide variation in rates of ICU admission (38.2%-84.4%), MV (13.7%-41.4%), and hemodialysis (0%-9.2%) among terminal admissions. All 139 administered surveys were returned for a response rate of 100%. For each of 4 factors created from 19 survey items, staff responses varied more between hospitals than within hospitals (p < or = 0.03). One factor, patient-doctor familiarity, was inversely correlated with terminal ICU admission (p < 0.001) and MV (p = 0.03). CONCLUSIONS Discrimination of differences in microclimates related to norms of treatment intensity at the end of life is feasible, but greater specificity of measurement will be required to explain objective measures of terminal admission treatment intensity.
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Affiliation(s)
- Amber E Barnato
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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Bost JE, Williams BA, Bottegal MT, Dang Q, Rubio DM. The 8-Item Short-Form Health Survey and the Physical Comfort Composite Score of the Quality of Recovery 40-Item Scale Provide the Most Responsive Assessments of Pain, Physical Function, and Mental Function During the First 4 Days After Ambulatory Knee Surgery with Regional Anesthesia. Anesth Analg 2007; 105:1693-700, table of contents. [DOI: 10.1213/01.ane.0000287659.14893.65] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
BACKGROUND Research that addresses whether residents are prepared to deliver preconception care and manage medical conditions in pregnant and postpartum women has been scarce since the publication of women's health competency guidelines for internists in 1997. PURPOSE To investigate current attitudes, training, and perceived preparedness in these areas and to explore relationships between resident characteristics and preparedness. METHODS A 62-item questionnaire was given to 105 internal medicine residents and recent graduates at two affiliated residency programs. RESULTS Eighty-five surveys were returned. Most respondents reported that they had minimal training and were unprepared in these areas but felt that learning these topics is important. Perceived preparedness correlated strongly with relevant didactic and clinical training but was not associated with gender, residency track, or career plan. CONCLUSIONS In light of published competency guidelines, internal medicine training programs should consider adding or increasing curricular content to improve residents' perceived preparedness to deliver care to reproductive-age and pregnant women.
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Abstract
The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted.
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Affiliation(s)
- Cheryl L Holt
- Health Communication Research Laboratory, School of Public Health, Saint Louis University, Missouri 63104, USA.
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Abstract
Researchers who study family caregiving have begun to recognize the need to broaden the realm of inquiry to include the exploration of the positive aspects of caregiving as well as conceptualizing caregiving on a continuum from the pre-caregiving phase through the post-caregiving phase. Additionally, researchers are urged to use control groups in research. This study complements the current trends by examining the positive aspects of caregiving among former caregivers. Specifically, the well-being of post-caregivers is compared to that of noncaregivers. Bivariate analyses examine the factors that are significantly different between former caregivers and noncaregivers. Results show that former caregivers have higher well-being than noncaregivers. In the multivariate model, only one subscale of well-being (basic needs) is different between the two groups. Implications of this research are discussed.
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Affiliation(s)
- D M Rubio
- Saint Louis University, Department of Research Methodology, St. Louis, Missouri, USA
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Abstract
The Caregiver Well-Being Scale measures caregiver well-being from a strengths-based perspective by assessing caregivers' basic human needs and satisfaction with activities of daily living. This article revisits the scale to examine further the scale's psychometric properties using a caregiver-only sample. Reliability is determined through internal consistency. Construct validity is supported through factorial validity with factor analysis. Criterion-related validity is established by examining the concurrent validity of the Well-Being Scale with a measure of depression. Using a sample of family caregivers, results suggest that the Well-Being Scale is a valid and reliable measure.
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Affiliation(s)
- M Berg-Weger
- School of Social Service, St. Louis University, MO 63103, USA.
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Kogo N, Rubio DM, Ariel M. Direction tuning of individual retinal inputs to the turtle accessory optic system. J Neurosci 1998; 18:2673-84. [PMID: 9502825 PMCID: PMC6793108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Neurons in turtle accessory optic system [basal optic nucleus (BON)] were recorded to study convergence of retinal afferents, using whole-cell patch electrodes in a reduced in vitro brainstem preparation with the eyes attached. BON cells primarily exhibit EPSPs from a contralateral retinal ganglion cell input and generate an output of action potentials. Visual responses were evoked by different directions of either full-field or local moving patterns. Direction tuning of action potentials was compared with that of EPSPs detected by passing the membrane voltage through an AC amplifier and window discriminator. This rough measure of retinal input indicated that the direction tuning of the full-field excitatory input from the retina matched that of the spike output for the same BON cell. Using local patterns within the receptive fields of the BON cells, it was estimated that one to four adjacent retinal inputs were being stimulated. The direction tuning of these inputs had preferred directions that were similar to that of the full-field spike output of the cell, irrespective of where the small window was placed within the receptive field. Because more than one retinal input may have been stimulated by the small stimulus window, subsets of those EPSPs that may represent responses of a single retinal afferent were identified based on their amplitude and rise time. Again, the preferred direction of those putative single retinal afferents matched the direction tuning of the spike output of the BON cell. These findings are discussed in terms of the formation of the retinal slip signal by the BON.
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Affiliation(s)
- N Kogo
- Department of Anatomy and Neurobiology, Saint Louis University, Saint Louis, Missouri 63104, USA
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Abstract
With challenges continuing to be presented to health care delivery, inappropriate out-patient service utilization is of utmost concern to all health care service providers. This study is an examination of the utilization patterns of 189 veterans in an urban Veterans Administration Medical Center (VAMC). Factors found to be related to high utilization of ambulatory care triage clinic services for veterans who had presented for at least two unscheduled visits in the past six months include: patient perception of health status; number of prescription medications; and social needs. Implications for social work practice, program development and research are discussed.
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Affiliation(s)
- M Berg-Weger
- Saint Louis University School of Social Service, MO 63103, USA.
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Bucholz KK, Shayka JJ, Marion SL, Lewis CE, Pribor EF, Rubio DM. Is a history of alcohol problems or of psychiatric disorder associated with attrition at 11-year follow-up? Ann Epidemiol 1996; 6:228-34. [PMID: 8827158 DOI: 10.1016/1047-2797(96)00002-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Although rarely available, detailed analyses of attrition in psychiatric surveys are important because surveys of this type might be more vulnerable to follow-up losses. In this report the demographic characteristics, as well as history of alcohol problems and psychiatric disorders of responders were compared to nonresponders in an 11-year follow-up study. Data revealed few differences between responders and nonresponders. Men, those less educated, and low users of medical care were more likely to be nonresponders, as were those reporting driving trouble when drinking or a history of barbiturate abuse or dependence. A history of other psychiatric disorders was not associated with nonresponse. Refusal conversion did not change the findings; those who were converted (25% of initial refusals) had demographic characteristics, symptoms of alcohol abuse, and psychiatric histories comparable to those who resisted conversion. These findings suggest that efforts to convert refusals to responders might not be necessary. The results also support community psychiatric research by providing evidence that those with a history of psychiatric disorder are not more difficult to recruit than their unaffected counterparts.
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Affiliation(s)
- K K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63108-3729, USA
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