Careers In Clinical Research Research Articles

Implementing a clinical academic career pathway in nursing; criteria for success and challenges ahead

Abstract Following the United Kingdom Clinical Research Collaboration’s (UKCRC) (2007) recommendations on careers in clinical research, there has been growing anticipation in the United Kingdom about the real potential for establishing career pathways for nurses and allied health professionals that will enable them to combine a focus on both clinical and academic roles. However, it is recognized that the implementation of this initiative will require charting largely untested waters, with issues ranging from establishing joint University: health service employment contracts, to harmonizing clinical and research roles and ensuring sustainability of funding for clinical academic posts. This paper will outline the implementation of a pilot clinical academic career initiative, which has been modelled on the UKCRC framework. We will illuminate the processes and structures employed and reflect on the factors that appear critical to the successful establishment of a clinical academic career pathway. Additionally, our experience has enabled us to identify challenges that will need to be addressed by a range of stakeholders if clinical academic careers are to flourish and deliver their potential at a national level as a modern career option for nurses and allied health professionals.

Clinical academic research careers in nursing: towards global nursing

Abstract Clinical academic research careers for nurses in the United Kingdom (UK) described in the Finch Report (2007) signals an important milestone in nursing research, education and practice. Unique aspects of this UK initiative is that it not only provides various awards for nurse research career pathways, but it also provides resources to establish infrastructure and positions for nurses to conduct research, teach, and practice in the clinical setting. Such an initiative merits serious consideration for its globalization.

Clinical academic research careers in nursing: towards global nursing

Clinical academic research careers in nursing: towards global nursing

Keeping clinicians in clinical research: the Clinical Research/Reproductive Scientist Training Program

In recent years the need for translational and clinical research has increased, whereas the number of physicians involved in clinical research has diminished. There is clearly a need for formalized academic training in the quantitative and methodologic principles of clinical research in reproductive medicine. The Clinical Research/Reproductive Scientist Training Program (CREST), a program supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the Clinical Research Training Program (CRTP) at Duke University, and the American Society for Reproductive Medicine (ASRM), meets this existing need. In addition, this program is specifically designed for physicians in private or academic clinical practice in reproductive medicine. Innovative programs such as CREST encourage the practicing physician to engage in clinical research while maintaining an active role in clinical practice. Participants in the program receive didactic on-line training from the CRTP and attend intensive weekend seminars at the National Institutes of Health (NIH) as well as CREST seminars at the annual meeting of the ASRM. Successful participants in the program receive a Certificate in Clinical Research from the CRTP. The program's goal is to provide practicing physicians with the tools and research credentials that will facilitate collaborations with investigators involved in large clinical trials.

How to Launch a Successful Career in Clinical Research

Preparing for a career in academic medicine is both challenging and rewarding. Most trainees need guidance to successfully navigate the period of training and early years as a faculty member....

Five key principles of a successful clinical research career in infectious diseases

Many talented physicians enter fellowship training in infectious diseases with the ambition to pursue an academic career that includes investigation. Although many embark on laboratory research projects during their research training years, our experience is that most are drawn toward clinical research. For these physicians with extensive bedside training, clinical research has the immediate appeal of clinical relevance. It is often perceived as a natural extension of their expertise. However, as their training ensues, physicians quickly realize the complexity involved in garnering the essentials to success: continued didactic training, securing research funding, publishing results, and most importantly, adjusting to the relatively slow pace of achievement. Additional hurdles for the clinical investigator include learning the process of protocol review by institutional review boards and developing close collaborative relationships with data collectors, data managers, data analysts, and biostatisticians. Without proper mentorship and preparation, many talented individuals become despondent, feel inadequate, and search for alternative career paths. For many young investigators, it is not clear how to develop such a career and avoid common pitfalls. Based on our combined experiences as mentees and mentors, we have outlined fi ve key principles to a successful career in infectious diseases clinical research.

Improving Balance in Regulatory Oversight of Research in Children and Adolescents

The current regulatory environment, designed to protect children, imposes barriers to research in children that are a deterrent to high-quality clinical research in minors. This article summarizes the special procedures necessary to obtain approval for research in healthy children that poses more than minimal risk according to the code of federal regulations (45 CFR 46.407 and 21 CFR 50.54). The operational realities of the process are illustrated by the case of the most recent research protocol to be reviewed under these rules. The current process poses obstacles to future studies of complex research questions in children and adolescents that require unaffected controls, such as the relationship of adolescent anovulatory disorders to adult illness. It is concluded that current regulatory procedures, while protecting children, increase the potential for the neglect of important research needs of children and are a disincentive to pursuit of a career in clinical research for young clinicians. Suggestions are made for improving the balance between the need for research in children and adolescents and its regulation.

Clinical Research Training: Scientific Literacy for the Twenty-First Century

Clinical Research Training: Scientific Literacy for the Twenty-First Century

Assessing Research Self-Efficacy in Physician-Scientists: The Clinical Research APPraisal Inventory

Between 1980 and 1993, only 19% of medical school graduates chose faculty appointments with research responsibilities. Women and minorities represent only a small fraction of these, despite their growing numbers. The authors' goal is to study the effects of human agency, particularly self-efficacy, on the career development of physician researchers, especially women and people of color; therefore, we developed a reliable and valid inventory for assessing clinical research self-efficacy in a population of physicians training for clinical research careers. Scale items were pooled from expert knowledge, relevant literature, and existing inventories to create a 92-item Clinical Research Appraisal Inventory that was factor analyzed and refined to include 88 items. Although instruments have been developed to successfully assess research self-efficacy, this is the first instrument designed to assess self-efficacy in the clinical research domain using a population of academic physicians.

Evidence‐based practice in psychology: Perceptions of graduate students in scientist–practitioner programs

The evidence-based practice movement in psychology (EBPP) is a relatively recent initiative to improve client care by integrating the best available research evidence with clinicians' expertise in the context of patient values and preferences. As this movement gains momentum in the field of psychology, training programs will likely need to modify their curricula to include training in the process of EBPP. An online survey was conducted of clinical psychology graduate students in programs that identified themselves as having a scientist-practitioner or clinical science model (N = 1,195). Understanding of, experiences with, attitudes towards, and training in EBPP was assessed. Students had a generally favorable view of psychology's move toward EBPP. Although students reported a moderate amount of exposure to and experiences with EBPP, misunderstandings about the principles of EBPP were prevalent. Compared to students planning primarily clinical practice careers, students planning primarily clinical research careers were more favorable towards EBPP, expected EBPP to be more influential in their future careers, and were more likely to use research, but less likely to use client preferences to guide treatment planning. Recommendations for modifying training programs to promote EBPP are discussed.

JASN Moves On

Beginning July 1, 2007, JASN will come under the direction of a new editor-in-chief, Dr. Eric Neilson, and a new editorial team selected by him. Reflecting that changeover, next month JASN will appear in a new style and format with new categories, new features, and new directions. It is time for

The Gastroenterology Core Curriculum, Third Edition

The Gastroenterology Core Curriculum, Third Edition

Opportunities and Challenges at NIDDK in Digestive Diseases Research

Opportunities and Challenges at NIDDK in Digestive Diseases Research

Making the Choice Between Academic Oncology and Community Practice: The Big Picture and Details About Each Career.

How do you choose a career path? Can you change the one you’re on? Unless oncologists have walked both paths, it is difficult to understand the differences between academic and community practice careers beyond differences in call schedules and misconceptions about compensation. Most oncology trainees have little exposure to community oncologists. In many communities the competition between the town (private practice) and gown (academia) has done little to facilitate mutual understanding, and often creates negative perceptions of community practice among academic trainees. Further, even after 2 or 3 years of fellowship, it is rare for trainees to sit with a faculty member and discuss the requirements of a clinical research career. The literature on this topic is helpful but sparse.1

Viewing clinical research career development through the lens of social cognitive career theory.

Issues such as, over commitment, insufficient time, and lack of funding, threaten physicians' entry and sustainability in a research career pathway. Social cognitive career theory is presented as a conceptual framework to critically examine the limitations of the National Institutes of Health's (NIH) efforts to promote the career development of physician-scientists. Special attention is given to the unique challenges of promoting this career pathway for women and underrepresented minorities. The authors propose enhanced recommendations for the career development of physician-scientists and research questions for future studies and program development aimed at advancing the nation's efforts to promote clinical research.

Research Training in Psychiatry Residency: Strategies for Reform

Research Training in Psychiatry Residency: Strategies for Reform

Research Training in Psychiatry Residency: Strategies for Reform

Research Training in Psychiatry Residency: Strategies for Reform

The Challenges of Randomized Trials in Integrative Cancer Care

This Point-Counterpoint is the second of 2 articles on the topic of using randomized controlled trials to study integrative cancer therapies. The first, in the previous issue, explored questions on the validity— and wisdom—of proceeding with randomized trials on the great variety of therapies that make up integrative cancer care at this time. In discussing the able responses to that article, an important point was made with regard to randomized studies: for many types of integrative therapies, studies with randomized trials are actually premature. Early-stage phase I–/phase II– type trials are critical precursors to randomized studies of any therapy. Without proper preliminary trials, the design of randomized studies may be inadequate, and the effectiveness of therapies may be missed simply because of defects in experimental design. Such preliminary trials are lacking for many of the therapeutic modes used in integrative care. Thus, before we proceed with randomized trials for many therapies (and for many whole systems of integrative care), it will be necessary to complete some of the earlier stage trials so that we have the data needed to design randomized studies that will truly be able to answer the questions we wish to ask. Nevertheless, there are some therapeutic elements, as well as herbs and supplements, that may indeed be ready for randomized trials. Many of these comprise the individual complementary therapies that play roles in multidisciplinary integrative care. Examples of such therapies include massage, fish oil, art therapy, and others for which preliminary trials have indeed been done. It is the purpose of the present PointCounterpoint to explore more deeply some of the practical questions that arise in the implementation of randomized trials in integrative cancer care. While a number of these questions are probably wellunderstood by investigators already involved in integrative therapy research, they are questions that may plague those who are just starting out in this area. It is our hope that new investigators, and, especially, complementary and alternative medicine (CAM) practitioners who may be contemplating becoming involved in randomized trials, will benefit from the questions explored in this article. We have, again, a distinguished panel of respondents to these questions, whose answers explore topics ranging from the basic ethics of clinical research to how best to make sure CAM practitioners feel comfortable as part of a research team. Drs Andrea Cohen and Adrian Dobs generously rejoin us after contributing to the first Point-Counterpoint in this series. Dr Dean Ornish, who has been using randomized trials to investigate the impacts of integrative systems of care in the cardiac setting for well over a decade, shares with us some of the elements that went into the design of his present trial with a diet and lifestyle modification approach to early-stage prostate cancer. Finally, Dr Debu Tripathy, a member of the Advisory Board of this journal, shares insightful perspectives on both trial design and practical implementation of cancer studies from his career in clinical cancer research, as well as his innovative research in the application of Tibetan traditional medicine in cancer care. Andrea J. Cohen, MD, FRCPC, is an associate professor of medicine at the University of Colorado Health Sciences Center and the director of the Complementary and Alternative Medicine Research Program at the University of Colorado Cancer Center. Her laboratory conducts state-of-the-art clinical, translational, and basic research. Dr Cohen has conducted traditional molecular cancer research including topics in lung cancer on peptides, peptidases, endothelin autocrine loop, and methylation. Dr Cohen’s CAM interests include Indian and Chinese medicine, as well as mind-body medicine. She is Block et al

19th Annual Aventis Pharma Hypertension Research Clinical Fellowship Program Award

The purpose of this program and research award is to stimulate physicians-in-training to pursue a career in clinical research in hypertension. The research fellow must be conducting work in which he or she is the major senior investigator in any area of the researcher’s choice, including clinical or laboratory aspects of the hypertensive diseases. The fellow’s work would be supervised by the director of the research training program (the mentor), but the conduct of the investigation is primarily by the research fellow. The winning presentation receives $3,000, and the fellow’s mentor receives $25,000 to support the clinical investigative training of a …

Telfer B. Reynolds, M.D. (1921-2004)†

Telfer B. Reynolds, M.D. (1921-2004)†