Predictors of self-reported research engagement and academic-career interest amongst medical students in the United Kingdom: a national cross-sectional survey.

BACKGROUND: We hypothesised that the gender/ethnic disparities and reductions in the UK academic-clinician workforce stem from research experience in medical school. This study investigated the factors influencing research engagement and academic-career interests among UK medical students. METHODS: Using a 42-item online questionnaire, a national multicentre cross-sectional survey of UK medical students was conducted over 9 weeks in the 2020/21 academic year. Multiple binary logistic and zero-inflated negative binomial regressions were used to evaluate associations between the predictor variables and research engagement (yes/no), number of research projects conducted, and academic-career interest (yes/no). P < 0.05 was considered statistically significant. RESULTS: In total, 1573 students participated from 36 medical schools. No ethnic/gender differences in research engagement were observed. However, compared to men, women had a 31% decrease in the odds of being interested in an academic-clinician career [odds ratio (OR): 0.69; 95% confidence interval (CI): 0.52, 0.92]. Positive predictors of interest in academia were being a PubMed-indexed author (OR: 2.19; 95% CI: 1.38, 3.47) and having at least one national/international presentation (OR: 1.40; 95% CI: 1.04, 1.88). Career progression was the primary motivating factor (67.1%) for pursuing research, whereas limited awareness of opportunities (68.0%) and time constraints (67.5%) were the most common barriers. CONCLUSION: There were no ethnic differences in research engagement or academic-career intent. Although there were no gender differences in research engagement, female students were less likely to be interested in an academic career. This could be tackled by providing targeted opportunities to increase research productivity and self-efficacy in medical schools. Key messages: What is already known on this topic: There has been a decline in the number of academic clinicians, with a disproportionate gender and ethnic representation in the academic workforce. Engaging medical students in research activities during their medical training could mitigate the declining number of academic clinicians. Differential attainment occurs in medical school and persists after graduation. What this study adds: Although there were no gender/ethnic differences in research engagement amongst UK medical students, our study suggests that female students were less likely to be interested in pursuing an academic career. Time constraints, a lack of awareness of opportunities, and difficulty in finding research supervisors/mentors were the most common barriers to research engagement, whereas PubMed-indexed authorship was the strongest positive predictor of interest in an academic career. How this study might affect research, practice, or policy: Medical schools should facilitate the selection of good-quality research mentors that would provide adequate support to ensure that their students' works are published in peer-reviewed journals. Medical schools should employ local research officers to increase students' awareness of research opportunities.

Predictors of self-reported research self-efficacy and perception of research amongst medical students in the United Kingdom: a national cross-sectional survey.

PURPOSE: There has been a decline in the number of academic clinicians in the UK, and there are ethnic/gender disparities in the academic workforce. Higher research self-efficacy (RSE) and a positive perception of research (PoR) amongst students are associated with a higher motivation to engage in academic medicine. Hence, this study aimed to determine the factors that influence RSE and PoR amongst UK medical students. METHODS: This is a multicentre cross-sectional survey of medical students in 36 UK medical schools in the 2020/21 academic year. Multiple linear regression was used to investigate the association between students' demographics and RSE/PoR. P-values less than a Bonferroni-corrected significance level of .05/28 = .0018 were considered statistically significant. RESULTS: In total, 1573 individuals participated from 36 medical schools. There were no ethnic differences in PoR or RSE scores. Although there were no gender differences in PoR, female students had lower RSE scores than male students (adjusted ß = -1.75; 95% CI: -2.62, -0.89). Research experience before medical school (adjusted ß = 3.02; 95% CI: 2.11, 3.93), being in the clinical training phase (adjusted ß = 1.99; 95% CI: 1.09, 2.90), and completing a degree before medical school (adjusted ß = 3.66; 95% CI: 2.23, 5.09) were associated with higher RSE. CONCLUSION: There were no associations between the predictor variables and PoR. Female students had lower self-reported RSE scores. Future studies should investigate the role of targeted research mentorship in improving RSE amongst female medical students.

Extracellular Vesicles Potentiate Medulloblastoma Metastasis in an EMMPRIN and MMP-2 Dependent Manner.

Extracellular vesicles (EVs) have emerged as pivotal mediators of communication in the tumour microenvironment. More specifically, nanosized extracellular vesicles termed exosomes have been shown to contribute to the establishment of a premetastatic niche. Here, we sought to determine what role exosomes play in medulloblastoma (MB) progression and elucidate the underlying mechanisms. Metastatic MB cells (D458 and CHLA-01R) were found to secrete markedly more exosomes compared to their nonmetastatic, primary counterparts (D425 and CHLA-01). In addition, metastatic cell-derived exosomes significantly enhanced the migration and invasiveness of primary MB cells in transwell migration assays. Protease microarray analysis identified that matrix metalloproteinase-2 (MMP-2) was enriched in metastatic cells, and zymography and flow cytometry assays of metastatic exosomes demonstrated higher levels of functionally active MMP-2 on their external surface. Stable genetic knockdown of MMP-2 or extracellular matrix metalloproteinase inducer (EMMPRIN) in metastatic MB cells resulted in the loss of this promigratory effect. Analysis of serial patient cerebrospinal fluid (CSF) samples showed an increase in MMP-2 activity in three out of four patients as the tumour progressed. This study demonstrates the importance of EMMPRIN and MMP-2-associated exosomes in creating a favourable environment to drive medulloblastoma metastasis via extracellular matrix signalling.