Abstract
MD-PhD training programs train physician-scientists to pursue careers involving both clinical care and research, but decreasing numbers of physician-scientists stay engaged in clinical research. We sought to identify current clinical research training methods utilized by MD-PhD programs and to assess how effective they are in promoting self-efficacy for clinical research. The US MD-PhD students were surveyed in April-May 2018. Students identified the clinical research training methods they participated in, and self-efficacy in clinical research was determined using a modified 12-item Clinical Research Appraisal Inventory. Responses were received from 61 of 108 MD-PhD institutions. Responses were obtained from 647 MD-PhD students in all years of training. The primary methods of clinical research training included no clinical research training, and various combinations of didactics, mentored clinical research, and a clinical research practicum. Students with didactics plus mentored clinical research had similar self-efficacy as those with didactics plus clinical research practicum. Training activities that differentiated students who did and did not have the clinical research practicum experience and were associated with higher self-efficacy included exposure to Institutional Review Boards and participation in human subject recruitment. A clinical research practicum was found to be an effective option for MD-PhD students conducting basic science research to gain experience in clinical research skills. Clinical research self-efficacy was correlated with the amount of clinical research training and specific clinical research tasks, which may inform curriculum development for a variety of clinical and translational research training programs, for example, MD-PhD, TL1, and KL2.
Highlights
MD-PhD training programs train physician-scientists to pursue careers involving both clinical care and research, but decreasing numbers of physician-scientists stay engaged in clinical research
The survey asked for the name of their current institution, year of training, and method of clinical research training they had received as an MD–PhD student, with the following options: (1) none, (2) didactic coursework, (3) formal student practicum program, (4) clinical research training by a primary research mentor, and/or (5) other
Of the 647 participants who provided informed consent, 613 identified their year in program, 594 identified the type of clinical research training they have received, 504 participants answered at least one Clinical Research Appraisal Inventory (CRAI) question, and 500 answered all 12 CRAI questions
Summary
MD-PhD training programs train physician-scientists to pursue careers involving both clinical care and research, but decreasing numbers of physician-scientists stay engaged in clinical research. Training activities that differentiated students who did and did not have the clinical research practicum experience and were associated with higher self-efficacy included exposure to Institutional Review Boards and participation in human subject recruitment. Conclusions: A clinical research practicum was found to be an effective option for MD–PhD students conducting basic science research to gain experience in clinical research skills. Without building self-efficacy (confidence) for skills necessary to conduct clinical research, trainees and early career stage physician-scientists may not choose to pursue career pathways that utilize their combined clinical and research training skills [6]. One strategy for enhancing the engagement of MD–PhD trainees in clinical research is to provide clinical research experiences during training that develop self-efficacy for these research skills. Self-efficacy is generally accepted to be a positive predictor of scholarly productivity and research interest [10,11], studies have shown that the positive relationship between selfefficacy and performance may partially be explained as a function of performance’s influence
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