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J Best Pract Health Prof Divers. Author manuscript; available in PMC 2017 August 10. Published in final edited form as: J Best Pract Health Prof Divers. 2016 ; 9(1): 1178–1187.
Translational Research Training at Various Levels of Professional Experience to Address Health Disparities Montez Lane, MPH1, Ronny Bell, PhD1, Brenda Latham-Sadler, MD1, Catherine Bradley, BS1, Judy Foxworth, PhD, PT, OCS2, Nancy Smith, DPT, PT, GCS2, A. Lynn Millar, PhD, PT, FACSM2, Kristen G. Hairston, MD1, Bernard Roper, PhD1, and Allyn Howlett, PhD1 1Maya
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Angelou Center for Health Equity (MACHE), Wake Forest School of Medicine (WFSM), Winston-Salem, North Carolina
2Department
of Physical Therapy, Winston Salem State University (WSSU), Winston-Salem, North Carolina
Abstract
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Translational research addressing health disparities brings interventions and medical discoveries into clinical practice to improve health outcomes. However, academic researchers’ and clinicians’ lack of understanding of methodologies limits the application of basic science to clinical settings. To solve the problem, a multidisciplinary collaboration from two academic institutions offered a workshop building on translational research methodologies to clarify the measures and interventions needed to address health disparities from a research perspective. Three two-day workshops targeted underrepresented minority participants whose research experience and professional development varied. The evaluation surveys administered after the three workshops indicated that workshop 1 which focused on translational and educational research increased participants’ knowledge, and made all participants think critically about the subject. Training opportunities focused on translational research can enhance researchers and clinicians’ confidence and capabilities to address health disparities.
Keywords Health Disparities Research; Interprofessional Training; Mentoring Underrepresented Minority Junior Faculty; Postbaccalaureate Education; Postdoctoral Scholars; Translational Research
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INTRODUCTION Translational research that addresses health disparities brings evidence-based, scientifically proven interventions, tools, and medical discoveries into practice (Fleming et al., 2008b; Woolf, 2008). However, a lack of understanding of methodologies and interdisciplinary approaches has limited both clinical and academic translational research (Fleming et al., 2008b). To ensure that underserved racial and ethnic minority researchers have a foundation in these concepts that will increase their skills and ability to conduct research on health
Corresponding Author: Montez Lane, Wake Forest School of Medicine, Maya Angelou Center for Health Equity, Medical Center Blvd., Winston-Salem, NC 27157 ([email protected]).
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disparities, we developed a summer series comprised of three, two-day intensive workshops in an interactive classroom setting. Each specifically addressed research methodologies and professional development skills essential for investigating health disparities and evaluating strategies to promote health equity (Table 1). A postworkshop evaluation instrument was developed to determine the overall effectiveness and outcomes of the workshops. Overall results showed an increase in knowledge and skills in the key topics covered.
Author Manuscript
The goal of workshop 1 was to increase participants’ knowledge of translational and educational research methodologies, among those considered important for conducting translational research in health disparities by other programs (Robinson et al., 2013; Rubio et al., 2010), as a basis for subsequent research. Sessions were designed to allow researchers to develop strategies to identify and investigate health disparities and testable approaches to promote health equity. They focused on the fundamentals of translational, qualitative, and interprofessional research, strategies for research success, and the value of networking and collaboration (Table 2). The outcomes of the evaluation of workshop 1 supported the effectiveness of training underrepresented minority researchers in translational methods, increasing their number to increase health disparities research.
METHODS Content delivery and participants
Author Manuscript
An advisory board of faculty from neighboring academic institutions organized the workshops, according to a road map for remediating health disparities. The three overarching themes are: 1) detecting — defining and measuring health disparities in vulnerable populations; 2) understanding — identifying what determines health disparities at various levels; and 3) reducing—intervening strategies evaluating results, changing policy, and translating research. We selected this model because it focuses and orients research in the context of the healthcare system and the external social and environmental factors that can contribute to racial/ethnic health disparities (Kilbourne et al., 2006). Table 1 lists the topics covered in the three workshops. Workshop 1 focuses on translational research and key concepts for successful collaboration. It was collaboratively developed and taught by basic science and clinical/translational research faculty from two academic institutions: an academic medical center and a minorityserving allied health professions school. The content covered key concepts and examples of translational research and addressed the participants’ varying educational needs.
Author Manuscript
Participants attended lectures, joined in group discussions, completed reading and online video lecture assignments, and, by the end of the session, prepared a research plan with a faculty research advisor/mentor. The teaching faculty were all actively engaged in their research subject area, professionally successful based on publications and grant history, and experienced in graduate education. Participants were recruited from three institutional research training and professional development programs for underrepresented minority and economically disadvantaged early career scholars. They were either 1) post baccalaureate students starting an MS program
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with limited or no research experience (Post-Bac); or 2) postdoctoral scholars and junior faculty (nontenured assistant professors) with two or more years of experience in basic science research beyond the PhD (JrFac). Most of the graduate students received a formal course grade through the Graduate School. The junior faculty were recruited through an application process based on their specific interest in health disparities research. All participants had career goals in the academic biomedical sciences or healthcare delivery fields. Table 3 presents demographic data on the participants. The workshop series was delivered to members of both groups during the summers of 2014 and 2015.
PROCEDURES AND MEASURES
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Within two months of completing the workshop and homework, participants were invited by email to respond to an online survey via Research Electronic Data Capture (RedCap), an internet application for managing online surveys and databases. Informed consent was signed electronically prior to linking to the survey. Of the total 42 participants in the 2014 and 2015 workshops, 38 completed the survey, representing a response rate of 90 percent. Respondents were categorized as either Post-Bac (26) or JrFac (12). For each topic covered, participants were asked to self-evaluate their level of understanding before and after the workshop from “very low” to “very high”. They indicated how well each topic made them think critically on a scale from “needs improvement” to “excellent”. Qualitative responses were elicited by asking them to identify a “take-away” message and the most and least valuable topics. The research design and survey instrument were approved by the Institutional Review Board before we conducted the study. All who contributed to its planning, implementation, and evaluation were certified in human subjects research by their respective institutions.
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To assess whether providing content training on translational research to researchers and clinicians at various professional levels would increase their capacity to address health disparities, we measured their perceptions of knowledge gained and critical thinking generated on the topics of translational research, strategies for research success, qualitative research, interprofessional research, and the value of collaboration. The topics of conducting clinical trials and educational research were not systematically evaluated because the 2014 and 2015 sessions covered different aspects of these subjects. We did not evaluate competency in the professional development skills addressed, including mentor-mentee relationships, oral communication skills, writing and publication, team effort on projects, and appreciation of statistics.
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FINDINGS Workshop 1 focused on translational, educational, and qualitative research to provide a foundation for investigating health disparities. Topics were selected to expand participants’ understanding of translational research beyond any basic science research they might have conducted; for example, basic concepts, strategies for success, qualitative research, interprofessional research, and collaboration and networking. Table 4 reports participants’ perceptions of the knowledge gained from the workshop.
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Regarding the translational research overview, 70 percent of Post-Bac participants reported very low to moderate knowledge before the session, but afterward, only 35 percent did, and 66 percent reported high or very high understanding. At the JrFac level, 25 percent reported very low to low before and no one did so afterward; 33 percent reported high to very high knowledge before and 83 percent afterward. For the session on strategies for research success, 57 percent of the students reported low or very low knowledge before, but 8 percent afterward; 46 percent reported high or very high knowledge after the session. However, 75 percent of the JrFac group reported high or very high knowledge before and after the session. This finding probably reflects their basic science research experience.
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Half of Post-Bacs and 59 percent of JrFac reported that the session on interprofessional research made them think critically. Before the session, 27 percent of Post-Bacs reported low or very low knowledge compared to only 4 percent afterward. The percentage reporting high or very high knowledge increased from 19 to 66. Again, 67 percent of JrFac reported high or very high knowledge both before and after the session. Based on the responses to open-ended questions, participants in both groups reported that the session on qualitative research was the most valuable, and 39 percent of Post-Bacs and 25 percent of JrFac indicated that it made them think critically. Before this session, 35 percent of Post-Bacs reported low or very low knowledge; only 8 percent did so after the session. Those reporting high or very high knowledge went up from 19 percent before to 39 percent after. None of the JrFac reported low or very low knowledge of qualitative research; 50 percent reported high or very high knowledge at the outset, which increased to 75 percent after the session.
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Participants at both levels of research experience, identified the topic of collaboration and networking as the most valuable, and 50 percent of Post-Bacs and 42 percent of JrFac reported that it elicited critical thinking about engagement in collaborative research. Before the session, 27 percent of Post-Bacs reported low or very low knowledge; after the session, none did. Those reporting high or very high knowledge increased from 19 percent to 58 percent. Of the JrFac, none reported low or very low knowledge; high or very high knowledge increased from 84 percent before to 91 percent after.
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The common themes gleaned from the qualitative feedback shared in the open-ended question responses further support the importance of translational research concepts highlighted in Table 4. The Post-Bacs indicated a few key take-aways: “collaboration in research is very important and helps to strengthen research study in many different fields” and “need for collaboration as funding becomes scarce.” JrFac also recognized that importance of collaboration and indicated that the session “improved methods to network and collaborate in interdisciplinary relationships.” Several JrFac acknowledged that the qualitative research topic was most valuable to them. Additionally, Post Bacs felt that the networking and collaboration topic was most valuable.
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DISCUSSION
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This workshop is the first in a series of three designed to teach researchers how to identify and investigate health disparities and to develop and test interventions and strategies to promote health equity. The Evaluation Committee of the Association for Clinical Research Training considered competencies for translational science (Rubio et al., 2010), and our program comprises many of their curricular recommendations. Workshop 1 lays the groundwork for health disparities research, describing fundamental translational methods and strategies, and developing the necessary professional skills. The take-away message articulated by participants at both experiential levels can be summarized as “Translational research is multidisciplinary,” and “Collaboration across disciplines and communication between health professionals are intrinsic to translational research success.” The concept of synergy in multidisciplinary, collaborative research has been identified as crucial to advances in health disparities research (Fleming et al., 2008a; 2008b). It should be noted that these first two years were a pilot of topics to be included in this introduction to health disparities research training program. Thus, our limitations are the limited time of development and participant size. We plan to make modification to future content that can keep pace with both research trends as well as the moving targets in health disparities. We found that graduate students without prior research experience could be brought to the level of postdoctoral trainees and junior faculty in grasping concepts grounded in basis science research. Both groups increased their knowledge of research methods beyond the scope of basic science. All the students, just beginning their careers in the biomedical sciences, better understood all the topics considered important for translational and clinical research. A recently described curriculum (Robinson et al., 2013) emphasized the importance of interprofessional interactions in training graduate students in translational science. Our workshop both covered and embodied this insight through a curriculum designed and delivered by clinical and basic science faculty from diverse healthcare delivery and research backgrounds.
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JrFac who had engaged in basic science research at the PhD level carried over their expertise and understanding to the new topics important for translational research. The sessions provided them greater insight into the use of qualitative research methods and the value of collaboration with health care providers. Analyses of successful mentoring programs for underrepresented minority faculty identify instruction on research skills as vital to retention and advancement (Beech et al., 2013; Rodriguez, Campbell, Fogarty, & Williams, 2014). Our workshop can also enhance competencies in teaching undergraduate students in the science-technology-engineering-mathematics (STEM) fields about translational research to orient the next generation of healthcare professionals and researchers toward interprofessional collaborative interactions (Manson, Martinez, Buchwald, Rubio, & Moss, 2015). This workshop series addresses a national need to increase the number and capacity of underrepresented minority health professionals (Grumbach & Mendoza, 2008; Sullivan Commission, 2004). These scholars can make invaluable contributions to the clinical healthcare community by investigating health disparities and testing interventions that promote health equity. At the graduate level, our curriculum is expected to increase the
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likelihood of success in medical school (Grumbach, 2011) and the pool of clinicians trained to participate in translational health disparities research. At the junior faculty level, it is expected to facilitate translational research projects by stimulating interprofessional collaboration between academic and clinical researchers and training the next generation of researchers by example. A survey of mentoring programs for early underrepresented minority faculty at academic medical centers indicated that only half reported training in research methods (Beech et al., 2013). A longitudinal evaluation approach (Lee et al., 2012) will determine the effectiveness of this program in enhancing the career trajectory of participants and promoting health equity education and translational research.
References
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Beech BM, Calles-Escandon J, Hairston KG, Langdon SE, Latham-Sadler BA, Bell RA. Mentoring programs for underrepresented minority faculty in academic medical centers: A systematic review of the literature. Academic Medicine. 2013; 88:541–549. [PubMed: 23425989] Fleming ES, Perkins J, Easa D, Conde JG, Baker RS, Southerland WM, Norris KC. Addressing health disparities through multi-institutional, multidisciplinary collaboratories. Ethnicity and Disease. 2008a; 18:S2–S7. Fleming ES, Perkins J, Easa D, Conde JG, Baker RS, Southerland WM, Norris KC. The role of translational research in addressing health disparities: A conceptual framework. Ethnicity and Disease. 2008b; 18:S2–60. Grumbach K. Commentary: Adopting postbaccalaureate premedical programs to enhance physician workforce diversity. Academic Medicine. 2011; 86:154–157. [PubMed: 21270550] Grumbach K, Mendoza R. Disparities in human resources: Addressing the lack of diversity in the health professions. Health Affairs (Millwood). 2008; 27:413–422. Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ. Advancing health disparities research within the health care system: A conceptual framework. American Journal of Public Health. 2006; 96(12):2113–2121. [PubMed: 17077411] Lee LS, Pusek SN, McCormack WT, Helitzer DL, Martina CA, Dozier AM, Rubio DM. Clinical and translational scientist career success: Metrics for evaluation. Clinical and Translational Science. 2012; 5:400–407. [PubMed: 23067352] 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. Clinical and Translational Science. 2015; 8:568–572. [PubMed: 26271774] Robinson GF, Erlen JA, Rubio DM, Kapoor WN, Poloyac SM. Development, implementation, and evaluation of an interprofessional course in translational research. Clinical and Translational Science. 2013; 6:50–56. [PubMed: 23399090] Rodriguez JE, Campbell KM, Fogarty JP, Williams RL. Underrepresented minority faculty in academic medicine: A systematic review of URM faculty development. Family Medicine. 2014; 46:100–104. [PubMed: 24573516] Rubio DM, Schoenbaum EE, Lee LS, Schteingart DE, Marantz PR, Anderson KE, Esposito K. Defining translational research: Implications for training. Academic Medicine. 2010; 85:470–475. [PubMed: 20182120] Sullivan Commission. Missing Persons: Minorities in the Health Professions. W. K. Kellogg Foundation; 2004. Woolf SH. The meaning of translational research and why it matters. JAMA. 2008; 299:211–213. [PubMed: 18182604]
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Table 1
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Workshop series to develop translational research fundamentals, knowledge base, and professional skills important for health disparities research. Workshop
Educational Content
Professional Skills
1. Conducting Translational and Educational Research
defining translational research, clinical trials, interprofessional research, qualitative research, and educational research; choosing among statistical procedures
demonstrating clear written and oral communication; maximizing the mentormentee relationship
2. Detecting and Understanding Health Disparities
defining and quantifying health disparities; evaluating landmark reports; examining the social and health-system determinants of healthcare disparities
evaluating implicit bias and critical thinking in health research ethics; adjusting to group dynamics; practicing public speaking
3. Promoting Health Equity
developing organizational and community intervention points, strategies for policy intervention, platforms for community engagement; and incorporating service learning into the educational structure
developing problem-solving skills; adjusting to group dynamics, communicating clearly in writing
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Table 2
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Translational Research Topic Content Topic Area
Learning Objectives
Translational Science Overview
Understand the need for translational research Describe the basic concepts of translational research Understand how translational research is implemented nationally and locally Describe some examples of translational research
Strategies for Research Success
Generate a hypothesis from observations Create a research design to test the hypothesis Tightly focus the project Understand the importance of interpreting results and identifying artifacts Understand the reiterative nature of hypothesis generation and testing
Interprofessional Research
Identify a rationale for interprofessional research, teaching, and collaboration
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Understand the development of interprofessional collaboration and teaching Describe skills and knowledge needed for interprofessional research and education State core competencies needed for interprofessional education and research Discuss a strategy for interprofessional research and collaboration Identify ways to disseminate interprofessional research Qualitative Research
Understand the discipline of Qualitative Inquiry Understand why researchers would use qualitative methodology Articulate the epistemology and philosophical orientation of qualitative inquiry Understand the theoretical frameworks used in qualitative methods Select an appropriate strategy for collecting qualitative data in translational or biomedical research Articulate a methodology for qualitative data collection
Collaboration and Networking
Understand why collaboration is important for both new and seasoned investigators
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Describe several types of collaborations and collaborative agreements Understand common disputes and the value of written agreements For several examples of collaborations, describe their initiation, development, submission of funding requests, and outcomes in clinical care.
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Table 3
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Demographic Data on Workshop Participants
Sex
Racial/Ethnic affiliation
Economically disadvantaged or first-generation college
Post-Bac
JrFac
Female
15
9
Male
16
3
Black
20
9
White
6
3
Hispanic
3
3
Asian & Pacific Islander
2
0
12
Not determined
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Collaboration and Networking
Qualitative Research in Health Disparities
Interprofessional Research
Strategies for Research Success
Translational Science Overview
4% 0%
After
4%
After
Before
8%
0%
Before
8%
After
4%
After
Before
15%
0%
After
Before
15%
Before
Very Low
0%
23%
4%
27%
4%
19%
4%
42%
4%
35%
Low
42%
54%
54%
46%
31%
54%
46%
31%
31%
39%
Moderate
42%
15%
27%
15%
58%
15%
35%
8%
54%
4%
High
PostBac (N = 26)
15%
4%
12%
4%
8%
4%
12%
4%
12%
8%
Very High
0%
0%
0%
0%
0%
0%
0%
17%
0%
8%
Very Low
0%
0%
0%
0%
0%
0%
05
0%
0%
17%
Low
8%
17%
25%
50%
33%
33%
25%
8%
17%
47%
Moderate
JrFac (N = 12)
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Knowledge level as perceived by participants before and after workshop.
58%
67%
50%
42%
33%
25%
50%
58%
33%
8%
High
33%
17%
25%
8%
33%
42%
25%
17%
50
25%
Very High
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Table 4 Lane et al. Page 10
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J Best Pract Health Prof Divers. Author manuscript; available in PMC 2017 August 10. Published in final edited form as: J Best Pract Health Prof Divers. 2016 ; 9(1): 1178–1187.
Translational Research Training at Various Levels of Professional Experience to Address Health Disparities Montez Lane, MPH1, Ronny Bell, PhD1, Brenda Latham-Sadler, MD1, Catherine Bradley, BS1, Judy Foxworth, PhD, PT, OCS2, Nancy Smith, DPT, PT, GCS2, A. Lynn Millar, PhD, PT, FACSM2, Kristen G. Hairston, MD1, Bernard Roper, PhD1, and Allyn Howlett, PhD1 1Maya
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Angelou Center for Health Equity (MACHE), Wake Forest School of Medicine (WFSM), Winston-Salem, North Carolina
2Department
of Physical Therapy, Winston Salem State University (WSSU), Winston-Salem, North Carolina
Abstract
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Translational research addressing health disparities brings interventions and medical discoveries into clinical practice to improve health outcomes. However, academic researchers’ and clinicians’ lack of understanding of methodologies limits the application of basic science to clinical settings. To solve the problem, a multidisciplinary collaboration from two academic institutions offered a workshop building on translational research methodologies to clarify the measures and interventions needed to address health disparities from a research perspective. Three two-day workshops targeted underrepresented minority participants whose research experience and professional development varied. The evaluation surveys administered after the three workshops indicated that workshop 1 which focused on translational and educational research increased participants’ knowledge, and made all participants think critically about the subject. Training opportunities focused on translational research can enhance researchers and clinicians’ confidence and capabilities to address health disparities.
Keywords Health Disparities Research; Interprofessional Training; Mentoring Underrepresented Minority Junior Faculty; Postbaccalaureate Education; Postdoctoral Scholars; Translational Research
Author Manuscript
INTRODUCTION Translational research that addresses health disparities brings evidence-based, scientifically proven interventions, tools, and medical discoveries into practice (Fleming et al., 2008b; Woolf, 2008). However, a lack of understanding of methodologies and interdisciplinary approaches has limited both clinical and academic translational research (Fleming et al., 2008b). To ensure that underserved racial and ethnic minority researchers have a foundation in these concepts that will increase their skills and ability to conduct research on health
Corresponding Author: Montez Lane, Wake Forest School of Medicine, Maya Angelou Center for Health Equity, Medical Center Blvd., Winston-Salem, NC 27157 ([email protected]).
Lane et al.
Page 2
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disparities, we developed a summer series comprised of three, two-day intensive workshops in an interactive classroom setting. Each specifically addressed research methodologies and professional development skills essential for investigating health disparities and evaluating strategies to promote health equity (Table 1). A postworkshop evaluation instrument was developed to determine the overall effectiveness and outcomes of the workshops. Overall results showed an increase in knowledge and skills in the key topics covered.
Author Manuscript
The goal of workshop 1 was to increase participants’ knowledge of translational and educational research methodologies, among those considered important for conducting translational research in health disparities by other programs (Robinson et al., 2013; Rubio et al., 2010), as a basis for subsequent research. Sessions were designed to allow researchers to develop strategies to identify and investigate health disparities and testable approaches to promote health equity. They focused on the fundamentals of translational, qualitative, and interprofessional research, strategies for research success, and the value of networking and collaboration (Table 2). The outcomes of the evaluation of workshop 1 supported the effectiveness of training underrepresented minority researchers in translational methods, increasing their number to increase health disparities research.
METHODS Content delivery and participants
Author Manuscript
An advisory board of faculty from neighboring academic institutions organized the workshops, according to a road map for remediating health disparities. The three overarching themes are: 1) detecting — defining and measuring health disparities in vulnerable populations; 2) understanding — identifying what determines health disparities at various levels; and 3) reducing—intervening strategies evaluating results, changing policy, and translating research. We selected this model because it focuses and orients research in the context of the healthcare system and the external social and environmental factors that can contribute to racial/ethnic health disparities (Kilbourne et al., 2006). Table 1 lists the topics covered in the three workshops. Workshop 1 focuses on translational research and key concepts for successful collaboration. It was collaboratively developed and taught by basic science and clinical/translational research faculty from two academic institutions: an academic medical center and a minorityserving allied health professions school. The content covered key concepts and examples of translational research and addressed the participants’ varying educational needs.
Author Manuscript
Participants attended lectures, joined in group discussions, completed reading and online video lecture assignments, and, by the end of the session, prepared a research plan with a faculty research advisor/mentor. The teaching faculty were all actively engaged in their research subject area, professionally successful based on publications and grant history, and experienced in graduate education. Participants were recruited from three institutional research training and professional development programs for underrepresented minority and economically disadvantaged early career scholars. They were either 1) post baccalaureate students starting an MS program
J Best Pract Health Prof Divers. Author manuscript; available in PMC 2017 August 10.
Lane et al.
Page 3
Author Manuscript
with limited or no research experience (Post-Bac); or 2) postdoctoral scholars and junior faculty (nontenured assistant professors) with two or more years of experience in basic science research beyond the PhD (JrFac). Most of the graduate students received a formal course grade through the Graduate School. The junior faculty were recruited through an application process based on their specific interest in health disparities research. All participants had career goals in the academic biomedical sciences or healthcare delivery fields. Table 3 presents demographic data on the participants. The workshop series was delivered to members of both groups during the summers of 2014 and 2015.
PROCEDURES AND MEASURES
Author Manuscript
Within two months of completing the workshop and homework, participants were invited by email to respond to an online survey via Research Electronic Data Capture (RedCap), an internet application for managing online surveys and databases. Informed consent was signed electronically prior to linking to the survey. Of the total 42 participants in the 2014 and 2015 workshops, 38 completed the survey, representing a response rate of 90 percent. Respondents were categorized as either Post-Bac (26) or JrFac (12). For each topic covered, participants were asked to self-evaluate their level of understanding before and after the workshop from “very low” to “very high”. They indicated how well each topic made them think critically on a scale from “needs improvement” to “excellent”. Qualitative responses were elicited by asking them to identify a “take-away” message and the most and least valuable topics. The research design and survey instrument were approved by the Institutional Review Board before we conducted the study. All who contributed to its planning, implementation, and evaluation were certified in human subjects research by their respective institutions.
Author Manuscript
To assess whether providing content training on translational research to researchers and clinicians at various professional levels would increase their capacity to address health disparities, we measured their perceptions of knowledge gained and critical thinking generated on the topics of translational research, strategies for research success, qualitative research, interprofessional research, and the value of collaboration. The topics of conducting clinical trials and educational research were not systematically evaluated because the 2014 and 2015 sessions covered different aspects of these subjects. We did not evaluate competency in the professional development skills addressed, including mentor-mentee relationships, oral communication skills, writing and publication, team effort on projects, and appreciation of statistics.
Author Manuscript
FINDINGS Workshop 1 focused on translational, educational, and qualitative research to provide a foundation for investigating health disparities. Topics were selected to expand participants’ understanding of translational research beyond any basic science research they might have conducted; for example, basic concepts, strategies for success, qualitative research, interprofessional research, and collaboration and networking. Table 4 reports participants’ perceptions of the knowledge gained from the workshop.
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Lane et al.
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Regarding the translational research overview, 70 percent of Post-Bac participants reported very low to moderate knowledge before the session, but afterward, only 35 percent did, and 66 percent reported high or very high understanding. At the JrFac level, 25 percent reported very low to low before and no one did so afterward; 33 percent reported high to very high knowledge before and 83 percent afterward. For the session on strategies for research success, 57 percent of the students reported low or very low knowledge before, but 8 percent afterward; 46 percent reported high or very high knowledge after the session. However, 75 percent of the JrFac group reported high or very high knowledge before and after the session. This finding probably reflects their basic science research experience.
Author Manuscript
Half of Post-Bacs and 59 percent of JrFac reported that the session on interprofessional research made them think critically. Before the session, 27 percent of Post-Bacs reported low or very low knowledge compared to only 4 percent afterward. The percentage reporting high or very high knowledge increased from 19 to 66. Again, 67 percent of JrFac reported high or very high knowledge both before and after the session. Based on the responses to open-ended questions, participants in both groups reported that the session on qualitative research was the most valuable, and 39 percent of Post-Bacs and 25 percent of JrFac indicated that it made them think critically. Before this session, 35 percent of Post-Bacs reported low or very low knowledge; only 8 percent did so after the session. Those reporting high or very high knowledge went up from 19 percent before to 39 percent after. None of the JrFac reported low or very low knowledge of qualitative research; 50 percent reported high or very high knowledge at the outset, which increased to 75 percent after the session.
Author Manuscript
Participants at both levels of research experience, identified the topic of collaboration and networking as the most valuable, and 50 percent of Post-Bacs and 42 percent of JrFac reported that it elicited critical thinking about engagement in collaborative research. Before the session, 27 percent of Post-Bacs reported low or very low knowledge; after the session, none did. Those reporting high or very high knowledge increased from 19 percent to 58 percent. Of the JrFac, none reported low or very low knowledge; high or very high knowledge increased from 84 percent before to 91 percent after.
Author Manuscript
The common themes gleaned from the qualitative feedback shared in the open-ended question responses further support the importance of translational research concepts highlighted in Table 4. The Post-Bacs indicated a few key take-aways: “collaboration in research is very important and helps to strengthen research study in many different fields” and “need for collaboration as funding becomes scarce.” JrFac also recognized that importance of collaboration and indicated that the session “improved methods to network and collaborate in interdisciplinary relationships.” Several JrFac acknowledged that the qualitative research topic was most valuable to them. Additionally, Post Bacs felt that the networking and collaboration topic was most valuable.
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Lane et al.
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DISCUSSION
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This workshop is the first in a series of three designed to teach researchers how to identify and investigate health disparities and to develop and test interventions and strategies to promote health equity. The Evaluation Committee of the Association for Clinical Research Training considered competencies for translational science (Rubio et al., 2010), and our program comprises many of their curricular recommendations. Workshop 1 lays the groundwork for health disparities research, describing fundamental translational methods and strategies, and developing the necessary professional skills. The take-away message articulated by participants at both experiential levels can be summarized as “Translational research is multidisciplinary,” and “Collaboration across disciplines and communication between health professionals are intrinsic to translational research success.” The concept of synergy in multidisciplinary, collaborative research has been identified as crucial to advances in health disparities research (Fleming et al., 2008a; 2008b). It should be noted that these first two years were a pilot of topics to be included in this introduction to health disparities research training program. Thus, our limitations are the limited time of development and participant size. We plan to make modification to future content that can keep pace with both research trends as well as the moving targets in health disparities. We found that graduate students without prior research experience could be brought to the level of postdoctoral trainees and junior faculty in grasping concepts grounded in basis science research. Both groups increased their knowledge of research methods beyond the scope of basic science. All the students, just beginning their careers in the biomedical sciences, better understood all the topics considered important for translational and clinical research. A recently described curriculum (Robinson et al., 2013) emphasized the importance of interprofessional interactions in training graduate students in translational science. Our workshop both covered and embodied this insight through a curriculum designed and delivered by clinical and basic science faculty from diverse healthcare delivery and research backgrounds.
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JrFac who had engaged in basic science research at the PhD level carried over their expertise and understanding to the new topics important for translational research. The sessions provided them greater insight into the use of qualitative research methods and the value of collaboration with health care providers. Analyses of successful mentoring programs for underrepresented minority faculty identify instruction on research skills as vital to retention and advancement (Beech et al., 2013; Rodriguez, Campbell, Fogarty, & Williams, 2014). Our workshop can also enhance competencies in teaching undergraduate students in the science-technology-engineering-mathematics (STEM) fields about translational research to orient the next generation of healthcare professionals and researchers toward interprofessional collaborative interactions (Manson, Martinez, Buchwald, Rubio, & Moss, 2015). This workshop series addresses a national need to increase the number and capacity of underrepresented minority health professionals (Grumbach & Mendoza, 2008; Sullivan Commission, 2004). These scholars can make invaluable contributions to the clinical healthcare community by investigating health disparities and testing interventions that promote health equity. At the graduate level, our curriculum is expected to increase the
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likelihood of success in medical school (Grumbach, 2011) and the pool of clinicians trained to participate in translational health disparities research. At the junior faculty level, it is expected to facilitate translational research projects by stimulating interprofessional collaboration between academic and clinical researchers and training the next generation of researchers by example. A survey of mentoring programs for early underrepresented minority faculty at academic medical centers indicated that only half reported training in research methods (Beech et al., 2013). A longitudinal evaluation approach (Lee et al., 2012) will determine the effectiveness of this program in enhancing the career trajectory of participants and promoting health equity education and translational research.
References
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Beech BM, Calles-Escandon J, Hairston KG, Langdon SE, Latham-Sadler BA, Bell RA. Mentoring programs for underrepresented minority faculty in academic medical centers: A systematic review of the literature. Academic Medicine. 2013; 88:541–549. [PubMed: 23425989] Fleming ES, Perkins J, Easa D, Conde JG, Baker RS, Southerland WM, Norris KC. Addressing health disparities through multi-institutional, multidisciplinary collaboratories. Ethnicity and Disease. 2008a; 18:S2–S7. Fleming ES, Perkins J, Easa D, Conde JG, Baker RS, Southerland WM, Norris KC. The role of translational research in addressing health disparities: A conceptual framework. Ethnicity and Disease. 2008b; 18:S2–60. Grumbach K. Commentary: Adopting postbaccalaureate premedical programs to enhance physician workforce diversity. Academic Medicine. 2011; 86:154–157. [PubMed: 21270550] Grumbach K, Mendoza R. Disparities in human resources: Addressing the lack of diversity in the health professions. Health Affairs (Millwood). 2008; 27:413–422. Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ. Advancing health disparities research within the health care system: A conceptual framework. American Journal of Public Health. 2006; 96(12):2113–2121. [PubMed: 17077411] Lee LS, Pusek SN, McCormack WT, Helitzer DL, Martina CA, Dozier AM, Rubio DM. Clinical and translational scientist career success: Metrics for evaluation. Clinical and Translational Science. 2012; 5:400–407. [PubMed: 23067352] 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. Clinical and Translational Science. 2015; 8:568–572. [PubMed: 26271774] Robinson GF, Erlen JA, Rubio DM, Kapoor WN, Poloyac SM. Development, implementation, and evaluation of an interprofessional course in translational research. Clinical and Translational Science. 2013; 6:50–56. [PubMed: 23399090] Rodriguez JE, Campbell KM, Fogarty JP, Williams RL. Underrepresented minority faculty in academic medicine: A systematic review of URM faculty development. Family Medicine. 2014; 46:100–104. [PubMed: 24573516] Rubio DM, Schoenbaum EE, Lee LS, Schteingart DE, Marantz PR, Anderson KE, Esposito K. Defining translational research: Implications for training. Academic Medicine. 2010; 85:470–475. [PubMed: 20182120] Sullivan Commission. Missing Persons: Minorities in the Health Professions. W. K. Kellogg Foundation; 2004. Woolf SH. The meaning of translational research and why it matters. JAMA. 2008; 299:211–213. [PubMed: 18182604]
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Table 1
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Workshop series to develop translational research fundamentals, knowledge base, and professional skills important for health disparities research. Workshop
Educational Content
Professional Skills
1. Conducting Translational and Educational Research
defining translational research, clinical trials, interprofessional research, qualitative research, and educational research; choosing among statistical procedures
demonstrating clear written and oral communication; maximizing the mentormentee relationship
2. Detecting and Understanding Health Disparities
defining and quantifying health disparities; evaluating landmark reports; examining the social and health-system determinants of healthcare disparities
evaluating implicit bias and critical thinking in health research ethics; adjusting to group dynamics; practicing public speaking
3. Promoting Health Equity
developing organizational and community intervention points, strategies for policy intervention, platforms for community engagement; and incorporating service learning into the educational structure
developing problem-solving skills; adjusting to group dynamics, communicating clearly in writing
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Table 2
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Translational Research Topic Content Topic Area
Learning Objectives
Translational Science Overview
Understand the need for translational research Describe the basic concepts of translational research Understand how translational research is implemented nationally and locally Describe some examples of translational research
Strategies for Research Success
Generate a hypothesis from observations Create a research design to test the hypothesis Tightly focus the project Understand the importance of interpreting results and identifying artifacts Understand the reiterative nature of hypothesis generation and testing
Interprofessional Research
Identify a rationale for interprofessional research, teaching, and collaboration
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Understand the development of interprofessional collaboration and teaching Describe skills and knowledge needed for interprofessional research and education State core competencies needed for interprofessional education and research Discuss a strategy for interprofessional research and collaboration Identify ways to disseminate interprofessional research Qualitative Research
Understand the discipline of Qualitative Inquiry Understand why researchers would use qualitative methodology Articulate the epistemology and philosophical orientation of qualitative inquiry Understand the theoretical frameworks used in qualitative methods Select an appropriate strategy for collecting qualitative data in translational or biomedical research Articulate a methodology for qualitative data collection
Collaboration and Networking
Understand why collaboration is important for both new and seasoned investigators
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Describe several types of collaborations and collaborative agreements Understand common disputes and the value of written agreements For several examples of collaborations, describe their initiation, development, submission of funding requests, and outcomes in clinical care.
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Table 3
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Demographic Data on Workshop Participants
Sex
Racial/Ethnic affiliation
Economically disadvantaged or first-generation college
Post-Bac
JrFac
Female
15
9
Male
16
3
Black
20
9
White
6
3
Hispanic
3
3
Asian & Pacific Islander
2
0
12
Not determined
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Collaboration and Networking
Qualitative Research in Health Disparities
Interprofessional Research
Strategies for Research Success
Translational Science Overview
4% 0%
After
4%
After
Before
8%
0%
Before
8%
After
4%
After
Before
15%
0%
After
Before
15%
Before
Very Low
0%
23%
4%
27%
4%
19%
4%
42%
4%
35%
Low
42%
54%
54%
46%
31%
54%
46%
31%
31%
39%
Moderate
42%
15%
27%
15%
58%
15%
35%
8%
54%
4%
High
PostBac (N = 26)
15%
4%
12%
4%
8%
4%
12%
4%
12%
8%
Very High
0%
0%
0%
0%
0%
0%
0%
17%
0%
8%
Very Low
0%
0%
0%
0%
0%
0%
05
0%
0%
17%
Low
8%
17%
25%
50%
33%
33%
25%
8%
17%
47%
Moderate
JrFac (N = 12)
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Knowledge level as perceived by participants before and after workshop.
58%
67%
50%
42%
33%
25%
50%
58%
33%
8%
High
33%
17%
25%
8%
33%
42%
25%
17%
50
25%
Very High
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Table 4 Lane et al. Page 10
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