International online mentorship for translational researchers.

BACKGROUND: Translational researchers (TRs) fulfill various roles across clinical, educational, and research domains with the ultimate goal of positively impacting patients. Mentorship has been recognized as an important means of career support for TRs, particularly when navigating the complex translational research pipeline and adapting to evolving roles. In response, the Erasmus + PATHWAY project developed and piloted an extra-curricular online preparatory course and mentorship program in 2019 and 2020 to help TRs build mentorship skills, develop their careers, and create online peer-to-peer learning opportunities. METHODS: To assess the pilot online mentorship program, a longitudinal exploratory mixed method study was conducted. RESULTS: Mentees and mentors from both years reported that they joined the program to learn mentorship skills, gain career support, and expand their (international) network. Analysis of evaluation forms indicated that the online preparatory course was evaluated largely positively, with participants suggesting improvements for future iterations. Results of a follow-up survey in 2022 revealed that mentorship was considered helpful in supporting TRs' work in translational research, and an online mentorship program was useful, provided it included interactive online training, multiple mentee-mentor matching rounds, compatible time zones and professional experience for matched pairs, active program moderation with offline activities, and effective online tools. CONCLUSIONS: This study revealed the mentorship needs of TRs and their recommendations for international online mentorship. The innovative PATHWAY program's online format, mentee-driven matching, and preparatory training for both mentees and mentors contribute to the development of mentorship for the general translational community that could potentially have broader applications, especially in a post-COVID-19 environment.

What Are We Made For? Mobilizing Medical Education Research for Impact.

ABSTRACT: During the past several decades, medical education research has advanced in many ways. However, the field has struggled somewhat with translating knowledge into practice. The field has tremendous potential to generate insights that may improve educational outcomes, enhance teaching experiences, reduce costs, promote equity, and inform policy. However, the gap between research and practice requires attention and reflection. In this commentary, the authors reflect on ways that medical education researchers can balance relevance and rigor, while discussing a potential path forward. First, medical education research can learn from implementation science, which focuses on adopting and sustaining best practices in real-world settings. Second, gaining a deeper understanding of the complex and dynamic ways that medical education contexts may influence the uptake of research findings into practice would facilitate the translation and mobilization of knowledge into practical settings. Third, moving from unilateral knowledge translation to participatory knowledge mobilization and engaging diverse stakeholders as active participants in the research process can also enhance impact and influence research findings. Overall, for medical education research to effect meaningful change, it must transition from producing generalizable findings to generating context-specific insights and embracing participatory knowledge mobilization. This shift will involve rethinking traditional research approaches and fostering collaboration with knowledge users to cocreate and implement innovative solutions tailored to their unique settings.

Training physicians in motivational communication: An integrated knowledge transfer study protocol.

OBJECTIVE: While behavior change counseling (BCC) targeting health risk behaviors has shown efficacy for improving patient health outcomes, barriers to knowledge translation have resulted in poor uptake among health care providers (HCPs). This article outlines the development of a new BCC training framework for HCPs, from inception to readiness for efficacy testing. It provides an example of integrated knowledge translation (iKT) used in alignment with the obesity-related behavioral intervention trials model. METHOD: (a) A modified Delphi process identified essential BCC skills for HCPs; (b) a survey assessed HCP attitudes and training needs; (c) an online competency assessment tool was developed using iKT mixed methods; (d) a training program was developed and refined using a logic model; and (e) the program was optimized using iterative rounds of participant feedback. A future proof-of-concept trial (f) will determine the program's readiness for full efficacy testing. RESULTS: A Delphi panel (n = 46) identified 11 core BCC competencies for HCPs, defining "motivational communication." The HCP survey (n = 80) showed willingness to devote 4 hr to introductory training in BCC. The Motivational Communication Competency Assessment Test (MC-CAT: an online, interactive evaluation tool) and a motivational communication training program (MOTIVATOR: accredited for continuing education by the Royal College of Physicians and Surgeons of Canada) were collaboratively developed with knowledge users. The optimization process (n = 11) provided key feedback, with minor changes being made to the program. CONCLUSIONS: In developing a new BCC framework, obstacles to BCC implementation were addressed through an iterative iKT process. This should improve eventual intervention uptake. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The road less traveled: Developing pharmacist clinician-scientists through divergent training pathways.

PURPOSE: Professional organizations have emphasized the growing need for pharmacists to possess advanced research skills; however, there is a scarcity of training programs aimed at nurturing clinician-scientists. This report outlines 3 critical care-focused research programs, each offering a unique approach to training clinician-scientists. SUMMARY: Limited resources and formalized programs are available to bridge the gap between the demand for and availability of skilled clinician-scientists. Several programs have stepped forward to share their experiences in establishing and executing training initiatives aimed at cultivating skilled clinician-scientists in the critical care practice space. CONCLUSION: Enhancing the development of clinician-scientists for clinical and translational research is necessary in the critical care clinical pharmacy community.

Implementation and Evaluation of a National Well-Being Curriculum for KL2 Scholars.

Introduction: The study aimed to pilot test a well-being curriculum for KL2 scholars to be used across the Clinical and Translational Science Award consortium. Methods: Between November 2022, and May 2023, 36 KL2 scholars from 25 hubs participated in the program. The General Well-Being Index for U.S. Workers and the Patient Reported Outcomes Measurement Information System (PROMIS-29) were completed by scholars before and after the program. Results: Postparticipation, there was a trend of improvement in the domains of well-being, sleep, anxiety, and fatigue. Conclusion: Implementing a virtual synchronous well-being curriculum allowed the scholars to connect across the consortium and improve their well-being.

Transfusion Camp Rwanda 2023: A train-the-trainer workshop establishing locally driven leadership in knowledge translation and sustainability in transfusion medicine education.

BACKGROUND AND OBJECTIVES: Blood transfusion is performed daily in hospitals. Gaps exist between transfusion guidelines and day-to-day clinical care. These gaps are prevalent in resource-limited settings due to scarce continuing medical education. Transfusion Camp Rwanda aims to bridge this gap by (1) delivering context-appropriate up-to-date education, (2) teaching participants how to independently deliver a case-based curriculum and (3) identifying strategies to promote change in transfusion practice in Rwanda. MATERIALS AND METHODS: In May 2023, a multidisciplinary team from Canada and Rwanda carried out a Transfusion Camp train-the-trainer workshop for clinicians from all five provinces in Rwanda. Participants attended in-person lectures, seminars and workshop group discussions on the implementation of the Rwanda National Directives on Rational Use of Blood and Blood Components. Course feedback was based on the Kirkpatrick Model of Training and Evaluation. RESULTS: Fifty-one physicians and laboratory technicians participated in the course. Confidence in caring for patients based on transfusion guidelines was self-rated as 'excellent' by 23% of participants before and 77% after, while 84% reported they planned to teach Transfusion Camp to others and 100% responded that they will apply course content to clinical practice. Workshop groups recommended strategies to improve transfusion medicine practice in Rwanda in four domains: Communication, Institutional Approval, Practice Audits and Education. CONCLUSION: Transfusion medicine education in Rwanda using a train-the-trainer approach was well-received by participants and allowed for a more detailed understanding of the local medical and educational environment. These observations can inform the further expansion of the Transfusion Camp Rwanda project.

The Translational Science Conundrum for Junior Investigators.

KNOWLEDGE TRANSFER STATEMENT: The challenges and recommendations outlined in this commentary will serve as steppingstones to process the concepts of translational science, facilitate training for future scientists, and serve as an approach for the early investigators in the field of translational science.

Developing Entrustable Professional Activities for the Training of Translational Scientists: A Modified Delphi Study.

PURPOSE: Improved training for translational scientists is important to help address the waste of resources and irreproducibility of research outcomes in current translational medicine. However, there are a lack of training programs that cover the full range of knowledge and skills translational scientists need to develop, and many translational research training programs struggle to develop competency frameworks and assessment tools. Entrustable professional activities (EPAs) have been successfully implemented to link competencies with everyday practice in training health care professionals but have not yet been developed for research training. The purpose of the current study was to develop EPAs for translational scientists that could be used for their training and assessment and help increase the transparency and reproducibility of research outcomes and methods by providing best practices for translational research. METHOD: In 2019, a modified Delphi technique, preceded by a focus group held in 2018 using a nominal group technique, was used to reach consensus on EPA titles and content among an international panel of 22 translational experts. Mean, standard deviation, and level of agreement were calculated after each round. Consensus was defined as ≥ 80% agreement. RESULTS: Consensus was reached on 89% of the items after the first round and 100% after the second round. The final list of EPAs consists of 17 EPAs divided over 7 sections. CONCLUSIONS: The concept of EPAs is new to the field of research training. The 17 EPA titles and their descriptions developed in this study may be used as a framework for improved training for translational scientists with the ultimate goal to contribute to closing the gap between bench and bedside, reducing resource waste in science, and increasing the reproducibility of research outcomes.

Embedding Learning in a Learning Health Care System to Improve Clinical Practice.

PROBLEM: In an ideal learning health care system (LHS), clinicians learn from what they do and do what they learn, closing the evidence-to-practice gap. In operationalizing an LHS, great strides have been made in knowledge generation. Yet, considerable challenges remain to the broad uptake of identified best practices. To bridge the gap from generating actionable knowledge to applying that knowledge in clinical practice, and ultimately to improving outcomes, new information must be disseminated to and implemented by frontline clinicians. To date, the dissemination of this knowledge through traditional avenues has not achieved meaningful practice change quickly. APPROACH: Vanderbilt University Medical Center (VUMC) developed QuizTime, a smartphone application learning platform, to provide a mechanism for embedding workplace-based clinician learning in the LHS. QuizTime leverages spaced education and retrieval-based practice to facilitate practice change. Beginning in January 2020, clinician-researchers and educators at VUMC designed a randomized, controlled trial to test whether the QuizTime learning system influenced clinician behavior in the context of recent evidence supporting the use of balanced crystalloids rather than saline for intravenous fluid management and new regulations around opioid prescribing. OUTCOMES: Whether spaced education and retrieval-based practice influence clinician behavior and patient outcomes at the VUMC system level will be tested using the data currently being collected. NEXT STEPS: These findings will inform future directions for developing and deploying learning approaches at scale in an LHS, with the goal of closing the evidence-to-practice gap.

Building the Next Generation of Researchers: Mentored Training in Dissemination and Implementation Science.

PROBLEM: Dissemination and implementation (D&I) science provides the tools needed to close the gap between known intervention strategies and their effective application. The authors report on the Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program-a D&I training program for postdoctoral or early-career cancer prevention and control scholars. APPROACH: MT-DIRC was a 2-year training institute in which fellows attended 2 annual Summer Institutes and other conferences and received didactic, group, and individual instruction; individualized mentoring; and other supports (e.g., pilot funding). A quasi-experimental design compared changes in 3 areas: mentoring, skills, and network composition. To evaluate mentoring and D&I skills, data from fellows on their mentors' mentoring competencies, their perspectives on the importance of and satisfaction with mentoring priority areas, and their self-rated skills in D&I competency domains were collected. Network composition data were collected from faculty and fellows for 3 core social network domains: contact, mentoring, and collaboration. Paired t tests (mentoring), linear mixed models (skills), and descriptive analyses (network composition) were performed. OUTCOMES: Mentors were rated as highly competent across all mentoring competencies, and each mentoring priority area showed reductions in gaps between satisfaction and importance between the 6 and 18 months post-first Summer Institute. Fellows' self-rated skills in D&I competencies improved significantly in all domains over time (range: 42.5%-52.9% increase from baseline to 18 months post-first Summer Institute). Mentorship and collaboration networks grew over time, with the highest number of collaboration network ties for scholarly manuscripts (n = 199) in 2018 and for research projects (n = 160) in 2019. NEXT STEPS: Building on study findings and existing literature, mentored training of scholars is an important approach for building D&I skills and networks, and thus to better applying the vast amount of available intervention evidence to benefit cancer control.

Building a System to Engage and Sustain Research Careers for Physicians.

There are increasing needs for physician-investigators to translate the rapid expansion of knowledge, technology/interventions, and big data into the clinical realm at a time of increasing age-related disabilities and communicable diseases. Yet, the number of physician-investigators has continued to decline, and only a small number of medical school graduates in the United States are actively engaged in research. This problem may be particularly pronounced in small- and medium-sized academic institutions due to more limited educational and mentoring infrastructure. Neither efforts by the federal government nor isolated institutional programs alone have been effective yet in solving this problem. This article describes an integrated institutional strategy undertaken at Penn State College of Medicine that is focused on developing and sustaining a physician-investigator workforce. Key elements of this strategy are new programs to close gaps in the professional life cycle of physician-investigators, dedicated senior leaders collaborating with an experienced and diverse advisory committee, and a data-driven approach to programmatic evaluation. In this article, the implementation of integrated institutional programs including Institutional Mock Review for evaluation of grant proposals before submission, physician-scientist faculty mentoring, and effort matching programs are described. Detailed tactics are offered for tailoring these programs to a particular institution's background to maximize both efficiency and sustainability. The overarching strategy includes engaging multidisciplinary faculty as mentors and mentees, partnering with both clinical and basic science departments, integrating new programs with established approaches, and cultivating an emerging generation of physician-investigators as near-peer mentors and future leaders. This approach may serve as a useful paradigm for building an environment to nurture junior physician-investigators at other mid-sized academic institutions and may also have value for larger institutions in which there is fragmentation of the efforts to sustain the research careers of physicians.

The National Center for Advancing Translational Sciences' Intramural Training Program and Fellow Career Outcomes.

The National Center for Advancing Translational Sciences (NCATS) defines translational science as "the field of investigation focused on understanding the scientific and operational principles underlying each step of the translational process." A major goal of translational science is to determine commonalities across projects to identify principles for addressing persistent bottlenecks in this process. To meet this goal, translational scientists must be conversant in multiple disciplines, work in teams, and understand the larger translational science ecosystem. The development of these skills through translational science training opportunities, such as the translational science training offered by the NCATS intramural research program, prepares fellows for a variety of career options. The unique structure of the NCATS intramural program and the career outcomes of its alumni are described herein to demonstrate the distinct features of this training environment, the productivity of fellows during their time in training, and how this prepares fellows to be competitive for a variety of science careers. To date, the NCATS intramural research program has trained 213 people, ranging from high school to postdoctoral levels. These alumni have transitioned into a wide array of career functions, types, and sectors.

Evidence-based medicine and COVID-19: what to believe and when to change.

The COVID-19 pandemic has led to a surge of information being presented to clinicians regarding this novel and deadly disease. There is a clear urgency to collate, review, appraise and act on this information if we are to do the best for clinicians and patients. However, the speed of the pandemic is a threat to traditional models of knowledge translation and practice change. In this concepts paper, we argue that clinicians need to be agile in their thinking and practice in order to find the right time to change. Adoption of new methods should be based on clinical judgement, the weight of evidence and the balance of probabilities that any new technique, test or treatment might work. The pandemic requires all of us to reach a new level of evidence-based medicine characterised by scepticism, thoughtfulness, responsiveness and clinically agility in practice.

Medicina Traslacional en el Perú, generación de políticas y mejoras basadas en la evidencia / Translational medicine in Peru, policy making and evidence-based improvement

Introducción: la investigación traslacional es una rama de la ciencia de reciente creación, su objetivo principal es la aplicación del conocimiento que se genera de las investigaciones, que no quede formando parte de la literatura gris, en el papel o para unos pocos, sino que pueda servir a la mayor cantidad posible de individuos y/o poblaciones. Objetivo: determinar los avances que se han dado a lo largo de los últimos años en la aplicación de la medicina traslacional en Perú. Métodos: se realizó una búsqueda por conveniencia en bases de datos (Google Scholar, Pubmed). Se han brindado ejemplos de cómo la investigación traslacional en Perú puede aportar en gran medida a la mejora de realidades y problemáticas específicas, esto refuerza la necesidad de que las decisiones políticas deben basarse en la medicina basada en la evidencia. Resultados: la medicina traslacional en Perú enfrenta muchas dificultades, como lo son los recursos limitados, tiempo escaso para implementar la investigación formativa, carencia de modelos pedagógicos actualizados, docentes preparados en escuelas antiguas y con capacidad limitada para la educación médica continua; obstáculos que deben de superarse para poder asegurar que la ciencia -y por ende la sociedad- progresen. Conclusiones: en Perú, el avance de la medicina traslacional ha derivado en la generación de personal de salud más capacitado que ha proporcionado los medios para el desarrollo de múltiples políticas públicas. Dichas políticas en muchos casos han terminado plasmadas en normas, reglamentos y hasta leyes en el país(AU)

Introduction: translational research is a branch of science of recent creation. Its main aim is the application of the knowledge generated by research so that it will not become grey literature printed on paper or for the use of a chosen few, but serve as many people and/or populations as possible. Objective: determine the progress made in recent years in the application of translational medicine in Peru. Methods: a convenience search was conducted in the databases Google Scholar and PubMed. Examples are offered of the way in which translational research may greatly contribute to improve specific realities and problems in Peru. This reinforces the need that political decisions be based on evidence-based medicine. Results: translational medicine is faced with many difficulties in Peru, such as limited resources, scant time to implement training research, lack of updated pedagogical models, and teachers trained in old schools and with a limited capacity for continuing medical education. These hurdles should be overcome to ensure the progress of science and therefore of society as well. Conclusions: progress of translational medicine in Peru has resulted in the training of more skilled health personnel, providing the means for the development of multiple public policies. In many cases those policies have been included in standards, regulations and even laws in the country(AU)

Commentary: Establishing Scientific Rigor and Excellence in Implementation Science Training to Improve the Deployment of Evidence-Based Mental Health Services.

Real-world challenges continue to impede the dissemination, implementation and sustainment of high-quality, evidence-based practices, resulting in too many individuals not receiving the effective mental health care that they urgently need. The field of implementation science is poised to generate new solutions to address this important public health problem. Training a new generation of researchers in implementation science is one solution. The Implementation Research Institute (IRI) offers one approach to such training. The papers in this series, authored by some of the IRI graduates, illustrate the depth and breadth of the intellectual scope of IRI graduates' contributions to the implementation science field, chronicles important lessons learned, and underscores the IRI's training capacity. This commentary reflects upon the series in terms of a framework and themes that relate to core implementation science principles and to future research that corresponds to the National Institute of Mental Health research priorities and strategic plan.

Training Mentor-Mentee Pairs to Build a Robust Culture for Mentorship and a Pipeline of Clinical and Translational Researchers: The Colorado Mentoring Training Program.

The Colorado Mentoring Training program (CO-Mentor) was developed at the University of Colorado Anschutz Medical Campus in 2010, supported by the Colorado Clinical and Translational Sciences Institute. CO-Mentor represents a different paradigm in mentorship training by focusing equally on the development of mentees, who are valued as essential to institutional capacity for effective mentorship. The training model is unique among Clinical and Translational Science Award sites in that it engages mentors and mentees in an established relationship. Dyads participate in 4 day-long sessions scheduled throughout the academic year. Each session features workshops that combine didactic and experiential components. The latter provide structured opportunities to develop mentorship-related skills, including self-knowledge and goal setting, communication skills (including negotiation), "managing up," and the purposeful development of a mentorship support network. Mentors and mentees in 3 recent cohorts reported significant growth in confidence with respect to all mentorship-related skills assessed using a pre-post evaluation survey (P = .001). Mentors reported the most growth in relation to networking to engage social and professional support to realize goals as well as sharing insights regarding paths to success. Mentees reported the most growth with respect to connecting with potential/future mentors, knowing characteristics to look for in current/future mentors, and managing the work environment (e.g., prioritizing work most fruitful to advancing research/career objectives). CO-Mentor represents a novel approach to enhancing mentorship capacity by investing equally in the development of salient skills among mentees and mentors and in the mentorship relationship as an essential resource for professional development, persistence, and scholarly achievement.

Knowledge Translation in Dietetics: A Survey of Dietitians' Awareness and Confidence.

This study aimed to determine dietitians' familiarity with knowledge translation (KT), confidence in undertaking KT, and preferences for receiving KT training. An online questionnaire was designed and disseminated to all dietitians working across hospital and health services in Queensland, Australia, for completion over a 6-week period (April-May 2018). Of the 124 respondents, 69% (n = 85) reported being familiar with KT, but only 28% (n = 35) reported being confident in applying KT to their practice. Higher confidence was reported with problem identification, evidence appraisal, and adapting evidence to local context, compared with implementation, evaluation, and dissemination. Almost all respondents reported an interest in learning more about KT (n = 121, 98%), with a preference for easily accessible and short "snippets" of training aimed at beginner-intermediate level. Lack of management support, difficulty attending multi-day courses, cost, travel requirements, and lack of quarantined time were reported barriers to attending KT training. There is a high awareness and interest but low confidence in undertaking KT amongst dietitians. This highlights an opportunity for workforce development to prepare dietitians to be skilled and confident in KT. Training and support needs to be low-cost and multi-modal to meet diverse needs.

Evaluation of the Implementation Research Institute: Trainees' Publications and Grant Productivity.

With growth in the field of dissemination and implementation (D&I) research, there has been growth in capacity building, with many training opportunities. As such, it is important to continue to evaluate D&I research training programs. This paper reports the results of an evaluation of the Implementation Research Institute (IRI), a R25 funded by the National Institute of Mental Health with additional funding by the Department of Veterans Affairs (VA). The fourth cohort also had a supplement from the National Institute on Drug Abuse. Using bibliometrics data, we report on a quasi-experimental retrospective cohort study assessing whether the rates of scholarly productivity in D&I science of IRI fellows (those who applied and were accepted to the training) were greater than those who applied but were not accepted to IRI. Our findings show that Selected Applicants' odds of publishing in implementation science were higher for earlier alumni, starting at 12% 1 year out and increasing to 94% for those who were 4 years out from starting training. Chances for Non-Selected Applicants remained relatively stable, starting at 47% at 1 year and going to 33% at 4 years since their application, a pattern that was stable even after controlling for demographic characteristics. These results support the hypothesis that IRI is increasing the D&I research productivity of those selected to the program, and that our fellows are advancing the field of D&I compared to those investigators not selected to our institute. Our finding also indicates the importance of a 2-year training.