Health Science Programs Research Articles

Sex-specific associations between cerebrospinal fluid inflammatory marker levels and cognitive function in antiretroviral treated people living with HIV in rural Uganda

People with HIV (PWH) taking antiretroviral therapy (ART) have persistent cognitive impairment. The prevalence of cognitive impairment is higher in women with HIV (WWH) compared to men with HIV (MWH), possibly due to sex differences in immune function. Here we report sex differences in cerebrospinal fluid (CSF) immune markers in relation to cognitive performance. A subset of 83 PWH on ART (52% WWH; mean age = 37.6 years, SD = 7.9) from the Rakai community cohort study Cohort and Rakai Health Sciences Program supported clinics in rural Uganda completed a neuropsychological (NP) assessment and a lumbar puncture. CSF was used to measure 16 cytokines/chemokines. Individual NP test z-scores were generated based on local normative data. A series of least absolute shrinkage and selection operator (lasso) regressions examined associations between CSF inflammatory markers and NP outcomes. Overall, there were no sex differences in CSF inflammatory marker levels. However, MWH displayed more associations between inflammatory markers and cognitive performance than WWH. Among MWH, inflammatory markers were associated with a number of cognitive domains, including attention, processing speed, fluency, executive function, learning and memory. MIP-1β, INF-γ, GM-CSF, IL-7 and IL-12p70 were associated with multiple domains. Among WWH, few inflammatory markers were associated cognition. Degree of associations between CSF inflammatory biomarkers and cognitive performance varied by sex in this young, ART-treated, Ugandan cohort. Further investigation into sex-specific inflammatory mechanisms of cognitive impairment among PWH is warranted to inform sex-specific management strategies.

Establishing a Pilot Interprofessional Education (IPE) Program in a Higher Education Institution (HEI) in the Philippines

A pilot interprofessional education (IPE) program in the Philippines has been initiated in a private higher education institution by three Filipinos who were formally trained in IPE from a World Health Organization (WHO) Collaborating Centre for Research and Training on IPE. Guided by the WHO educator and curricular mechanisms on IPE and an understanding of the local context, a four-stage action plan was created for the pilot IPE program, which involved 10 health science programs. The experience from the initial implementation was challenging and required perseverance as well as inclusive leadership. Nevertheless, the program’s accomplishments such as continuous faculty training in IPE, constant communication among faculty members and students on IPE, and an inter-university collaboration to host the first-ever local IPE conference were noted. The article concludes with lessons learned from the pilot IPE program and future directions in further contributing to the growth and sustainability of IPE programs in the Philippines.

Creating an instrument to measure perceptions about access to health-related higher education programmes in South Africa

Background: The South African government has created countless policies that support the need to admit and graduate students who had been excluded from health-science programmes in higher education settings during the apartheid era. Objective: to develop a questionnaire that could be used by various stakeholders to obtain their perceptions about access to health sciences education in higher education settings. Method: A mixed methods design was used; the qualitative stage allowed for the identification of themes while the quantitative stage used measurement theory, to develop an instrument based on those themes. Results: The overarching theme was Achieving equity of access for success is multi-factorial and has diverse and complex challenges and eight sub-themes emerged which were used to create a 17-item questionnaire that has good content validity and reliability (Cronbach alpha=.767). Conclusion: Further psychometric testing with larger, more diverse samples will result in a refined instrument that can be administered to various stakeholder groups, such as current and potential health sciences students and faculties, and used in programme evaluation. Health science programmes can use the instrument to measure access within different disciplines and possible changes over time as innovations are piloted. Different health sciences programmes can be compared and contrasted and objective data can be used to make systematic organizational changes.

Interleukin-2 Inducible T-Cell Kinase: A Potential Prognostic Biomarker and Tumor Microenvironment Remodeling Indicator for Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) is the dominant type of primary liver cancer, which leads to the fourth-ranked common cause of cancer-related death worldwide. The highly heterogeneous tumor microenvironment (TME) contributes to poor prognosis, particularly tumor recurrence of HCC. There is still a great challenge to illuminate the complicated modulation of TME during HCC progression. Methods: In the current study, RNA expression data and clinical-pathological data of HCC patients were downloaded from The Cancer Genome Atlas (TCGA) database. The immune and stromal scores of the samples were calculated using ESTIMATE algorithm and DEGs were obtained by comparison of low- and high-score groups. Intersection of hubgenes in protein-protein interaction (PPI) network and factors correlated with survival from univariate COX regression analysis were applied to screen out the key DEGs. The proportion of tumor-infiltrating immune cells (TICs) and stromal components were evaluated using CIBERSORT algorithm. Further Gene Set Enrichment Analysis (GSEA) and correlation analysis were carried out to elucidate the relation between ITK and TIC composition. Findings: The Immune score and Estimate score were proved to be significantly correlated with long-term recurrence-free survival (RFS) of HCC patients. 197 DEGs were carried out based on the Immune and Stromal scores. Two factors including interleukin-2 inducible T-cell kinase (ITK) and HLA Class II histocompatibility antigen DRB5 (HLA-DRB5) were identified as key DEGs. Further analysis proved that ITK was the most powerful DEG to evaluate the clinical-pathological characteristics and outcomes of HCC patients.The results of GSEA revealed that genes in the high ITK subgroup were enriched in inflammatory-immunological terms. CIBERSORT analysis for the proportion of TICs indicated that activated CD4+ memory T cells, CD8+ T cells, and M1 Macrophages were positively correlated with ITK expression, while plasma cells, resting natural killer (NK) cells, activated dendritic cells, activated NK cells, naive CD4+ T cells and resting mast cells were negatively correlated with ITK expression. Interpretation: Our work identified ITK as a novel indicator for tumor recurrence and microenvironment remodeling in HCC, and provide a potential therapeutic target for HCC treatment. Funding Statement: National ST National Natural Science Funds for Distinguished Young Scholar of China (No. 81625003); Key Program, National Natural Science Foundation of China (No. 81930016); Key Research & Development Plan of Zhejiang Province (No. 2019C03050); Youth Program of National Natural Science Foundation of China (No.81702858); Medical and health science and technology program of Zhejiang Province (No.2018256286) Declaration of Interests: None.

Professional Development for PreK-12 Teachers in Health Science Content Using a “Train and Equip” Approach: 28 Years’ Experience

From 1991-2019 at the University of Arkansas for Medical Sciences (UAMS), 202 different faculty individuals, from each of the five UAMS colleges, volunteered to offer 120 different workshops in health science content to 22,731 PreK-12 teachers and some school nurses in the Partners in Health Science (PIHS) program. Participants consumed 83,488 hrs. of professional development. Workshops were held at UAMS or in 39 communities in the state. Workshops provided each participant with a “take home” Resource Kit (RK) containing topic-appropriate materials, supplies and/or items of equipment, used in the workshop, intended to foster replication of workshop experiences in the teacher’s home classroom. Short-term, i.e. same day evaluations indicated a high degree of satisfaction with the workshops. Long-term (6 months or longer after a workshop) evaluations covering a 10-year time span (1991-2001) discovered that a large number of the participants who attended more than one PIHS workshop performed new experiments/demonstrations for their students – a strong sustainability factor because it could last for a participant’s entire teaching career. Pre vs. posttest data recorded a gain in knowledge from 1737 participants in several workshops ranging from 14.8% correct to 29.8%. Extramural funding was consistent, but varied over the duration of the program.

Professional Development within Bachelors Programs: Addressing the Needs of a Diverse Student Population Entering Health Care

Following graduation from an undergraduate institution, students have the perception that they have the skills necessary to be successful in the workforce and/or graduate studies, however employers and professors do not agree. Professional development during undergraduate studies may help bridge the gap between student and employer/professor perceptions. Based on the discrepancies in post-graduation readiness perception and the number underrepresented minorities in health care and post-graduate studies, the Bachelor of Health Sciences (BSHS) program at Rush University established a professional development program with the goal of providing students seminars that enhance their professional and social skills. Offering a professional development program ensures that students gain and maintain relevant academic and non-academic competencies that will support them in their academics and prepare them for their professional careers, which can be particularly effective for students from diverse racial and ethnic backgrounds and students studying within a diverse cohort. Surveys were conducted to determine the perception of effective and usefulness of each seminar as well as utility of the tools provided to students in each seminar during their academic and professional career. Overall, the professional development seminar series improved student utilization and application of tools provided at each seminar to improve student perception of readiness and gain confidence in their academic and professional development. The seminars also positively influenced formation of diverse relationships, as many of the tools provided were used in personal and social situations. A dynamic professional development program can provide useful tools and improve readiness perception in a diverse student population within an undergraduate program. As graduate programs and companies across the country continue to expand their diversity initiatives, professional development during undergraduate studies becomes even more relevant as it addresses their ability to be successful and resilient. Keywords: Professional Development, Diversity, Bachelors, Health Care DOI: 10.7176/JEP/11-29-02 Publication date: October 31 st 2020

An Investigation of Secondary School STEM Subjects as Predictors of Academic Performance in Tertiary Level Health Sciences Programs

Tertiary institutions are experiencing an increased number of enrolments, with students varying in their demographics, previous education, and academic achievement. This relative increase in undergraduate enrolments in Australia has not translated to an increase in student retention or graduate numbers. This prompts the need to explore predictors of academic performance for tertiary students to identify those most at risk of underperforming. This study aimed to investigate the relationship between secondary school subject completion and undergraduate grade point average (GPA). A cohort of 709 secondary school students entering undergraduate health science courses between 2012 and 2015 at an Australian university were investigated. Completion of Mathematics 3C3D, Physics, Chemistry and Physical Education Australian Tertiary Admission Rank (ATAR) subjects were significantly associated with GPA. In a subset of 458 students, longitudinal analysis revealed completion of secondary school Mathematics 3C3D was a significant predictor of academic performance over the duration of the tertiary health science courses. The results suggest that completion of advanced secondary school mathematics, but not physical sciences, is predictive of student achievement. This outcome further supports the need for improved uptake and completion of advanced mathematics in secondary school.

Convergent Validity Testing of a Value-Achievement-Cost Motivation Survey for 12th Grade Female Career and Technical Education Health Sciences Students for Use in Serious Simulation Games

A Value-Achievement-Cost (VAC) Survey was psychometrically tested to continue to establish its predictive utility for future research with 12th grade female Career and Technical Education (CTE) health science classroom cohorts of less than 50 students. In this study, a 10-construct, 46-item VAC Survey was administered to 31 college-bound 12th grade female students who had self-selected themselves to participate in a year-long, dual enrollment, CTE health science program. The VAC Survey was used to measure student motivation associated with science in general, health sector science learning, and playing health sciences-related games. Convergent validity was established in nine of the ten constructs by comparing the Cronbach alpha coefficients of the 10-construct, 46-item VAC Survey compared to the same instrument previously tested with a similar CTE health science student cohort (n = 37). Internal consistency for these nine VAC Survey constructs were strong with Cronbach alpha coefficients between 0.80 and 0.93. This study has provided additional psychometric evidence that reinforces the VAC Survey's construct validity and internal consistency. The study further supports the predictive utility of the instrument to measure 12th grade female CTE health sciences student motivation associated with science in general, health sector science learning, and playing health sciences-related games.

A systematic review of reflective practice questionnaires and scales for healthcare professionals: a narrative synthesis

ABSTRACT Reflective Practice (RP) is considered a crucial component of personal and professional learning. RP is regarded as a way that professionals learn from experience to understand and enhance their practice by responding appropriately to self-reflection. Despite playing a crucial role in healthcare settings, there is little agreement on how to assess RP. This study aims to systematically review self-rating instruments that assess RP in healthcare professionals. Peer review articles assessing RP in healthcare professionals using a self-rating instrument, published in English between 1998 and 2018 from PubMed, CINAHL, and PsychInfo databases, were considered for inclusion. Eighteen papers were appraised, the strengths and weaknesses of the measures were discussed in accordance with an adapted critical appraisal checklist. In general, all self-report instruments included in this review were potentially generalisable to healthcare professionals or health science programmes with some adaptation. Given the limited evidence for other measurement scales, the Reflective Questionnaire and Self-Reflection and Insight Scale are recommended for measuring RP within healthcare settings. Future research developing a standardised tool for the review of mixed-method, heterogeneous, questionnaire studies is strongly recommended.

Working together in clinical pathology: An interprofessional education initiative for dentistry, oral health, and medical laboratory science teachers and students.

This article was migrated. The article was marked as recommended. Introduction. In the health professional education literature, there is a need for information about the teaching and learning of medical laboratory sciences for clinical practice. The goal of this reflection-on-practice is to describe how an orofacial pathology interprofessional education (IPE) initiative was designed and implemented. Innovation. The designers of this initiative were teachers from dentistry, oral health, and medical laboratory science. The designers used six interprofessional competencies (patient-centred care, role clarification, team functioning, collaborative leadership, communication, and cultural practice) to guide their construction of teaching and learning resources. The initiative required students to work collaboratively with a given patient case to develop a differential diagnosis, prepare a treatment plan, present their case to classmates and staff members, and describe how they worked together to address the orofacial pathology in their case. Evaluation. The designers collected and considered evaluation information including the learning resources used, logistical arrangements for the initiative, and evaluation data from students via an anonymous 10-item questionnaire. Students rated statements that addressed the six interprofessional competencies and provided written comments about the initiative. Outcomes. In general, the 18 students agreed strongly with all statements except for cultural practice. Written comments about the initiative were positive and indicated that students appreciated learning about their own discipline and that of other professionals in the context of providing oral healthcare involving orofacial pathology. What next? Given the acceptability of this initiative to the designers, facilitators, and students, the next step is to consider the feasibility of scaling-up this small voluntary IPE initiative into a permanent component of the dentistry, oral health, and medical laboratory science programmes. Aspects to consider include staffing, scheduling, assessment, and cultural perspectives.

Queen's University Faculty of Health Sciences.

Queen's University Faculty of Health Sciences.

The public health emergency of climate change: how/are Canadian post-secondary public health sciences programs responding?

The Intergovernmental Panel on Climate Change recently issued a statement that the fate of human society and human health is at serious risk of catastrophic impacts unless we take bold action to keep global warming under 1.5°C. In 2015, the CanadianPublicHealthAssociation noted emerging efforts to embrace intersectoral approaches to global change in public health research and practice. In this study, we question the extent to which Canadian Graduate Public Health Sciences Programs have kept pace with these efforts to see climate change surface as a new frontier for training the next generation of researchers and practitioners. Semi-structured interviews (19) were conducted with Department Heads (or equivalents) of graduate-level Public Health Sciences Programs at 15 Canadian universities concerning the place of climate change in their respective curricula. Interviews were designed to elicit participants' institutional perspectives on the importance of climate change in the Public Health Sciences and identify perceived challenges and opportunities. Despite wide recognition among participants that climate change is a public health "crisis", very few reported having substantive curricular engagement on the topic. Key challenges identified were lack of resources, organizational issues, and political barriers. Key opportunities to adapt curricula to address this new frontier in Public Health were faculty interest and expertise, cross-disciplinary collaboration, and pressure from the institution. Our findings provide evidence for post-secondary Public Health Sciences Programs to understand the need to address their own sluggishness when what is needed are bold, even radical, shifts to existing curricula.

For a Healthy (and) Higher Education: Evidences from Learning Outcomes in Health Sciences

Increased recognition of outcomes, or competency-based education, has evolved across higher education on health sciences. However, there is significant diversity in the current study of Portuguese programmes. Considering learning outcomes (LO) as indicators of knowledge, skills, abilities, attitudes and the understanding that the student will gain as a result of an educational experience, this study aims to explore which LO are emphasised on the study programmes of health sciences in Portugal. Through a qualitative methodology, carried out through MAXQDA software, all LO of all Portuguese health sciences study programmes submitted to quality accreditation to the Portuguese Agency for Assessment and Accreditation of Higher Education (A3ES) since 2009 until 2016 were analysed. Although specific knowledge was the most referenced LO, transversal skills were also emphasized, such as critical and reflexive analysis/critical thinking, research, ability to organize and plan and professional ethics. Significant differences were found between LO selection when the analysis was made by comparing the diverse study programmes. This required assortment of knowledge and skills seems to reflect not only the specificities of each health science programme but also the challenging demands on professionals in the 21st century, along with the necessary changes imposed by society, fostering intercultural understanding, tolerance, mutual respect and an ethic of global citizenship and shared responsibility, crucial enablers of educational development for all in the scope of the 2030 Agenda for Sustainable Development.

A cross-cultural integrative health interprofessional practice model using innovative case study and academic hispanic community partnership approaches

Three graduate health science programs at a liberal arts university collaborated with a Hispanic senior community center to develop a program to address the needs of the transforming healthcare del...

Therapeutic Response of Patients with Chest Tightness Variant Asthma: A One-Year Multicenter, Prospective Real-Life Study

Background: Although asthmatic patients with chest tightness as their only presenting symptom (chest tightness variant asthma, CTVA) have clinical characteristics of eosinophilic airway inflammation similar to those of classic asthma (CA), the response of CTVA to treatment regimens used for CA is unclear. Methods: To explore the clinical course and response of 96 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists in a 52-week multicenter, prospective, real-life study. Findings: After 52 weeks of treatment with therapy regimens used for CA, the 5-point Asthma Control Questionnaire (ACQ-5) scores decreased markedly from 1·34±0·88(before treatment; V0) to 0·97±0·70 (4 weeks, V1), 0·83±0·72 (13 weeks, V2), 0·73±0·76 (26 weeks, V3), and 0·76±0·79(52 weeks, V4) ( P <0·01), while the Asthma Quality of Life Questionnaire (AQLQ) scores increased from 5·76±0·76 (V0) to 6·24±0·60(V3) and 6·14±0·60(V4) ( P <0·01). The Self-rating Anxiety Scale(SAS) score improved as evidenced by a decrease from 41·44±10·24 (V0) to 37·61±11·41 (V2) and 37·67±8·07 (V4) ( P <0·01). Diurnal variation in peak expiratory flow (PEF) and the bronchial provocation test were improved at one year. However, forced expiratory volume (FEV1) andnitric oxide levels in exhaled breath (FeNO) showed no improvement. Interpretation CTVA patients showed a good clinical response to anti-asthma treatments, and the treatment effects may be related to theseverity of CTVA. Interpretation: CTVA patients showed a good clinical response to antiasthma treatments, and the treatment effects may be related to the severity of CTVA. Trial Registration: ClinicalTrials.gov identifier: NCT 03237221 Funding: 1.This study was supported by the Zhejiang Medical and Health Science and Technology program from Health Commission of Zhejiang Province (WKJ2014-ZJ-01412). 2.This work was funded by the Precision Medicine Research of The National Key Research and Development Plan of China (2016YFC0905800). 3.This study was supported by the program for the Key Site of National Clinical Research Center for Respiratory Disease, the Key ScienceTechnology Innovation Team of Zhejiang Province (2011R50016). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the Institutional Review Board for Human Studies of Second Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China).

Vitamin D deficiency contribute to the development of preeclampsia through increased sFlt‐1 production and impaired vascular function

Preeclampsia (PE) is a pregnancy‐specific syndrome that affects 5~8% pregnancies and is a leading cause of maternal and neonatal morbidity and mortality. Although the underlying mechanism remains unclear, PE is widely accepted to be induced, in part, by uteroplacental ischemia, which leads to increased antiangiogenic factors, such as sFlt‐1, which antagonizes the angiogenic factors, causing widespread vascular dysfunction. Vitamin D deficiency (VDD) is a widespread public health issue, and increasing studies suggested that VDD is a possible risk factor for the development of PE; however, the underlying mechanism that contributes to the increased risk of preeclampsia in vitamin D deficient patients is not clear. We tested the hypothesis that vitamin D deficiency contributes to the development of PE in a placental ischemic rat model by increasing sFlt‐1 production and impairing vascular function. We first induced VDD in Sprague‐Dawley rats (DYET 119273 vs 110842, Dyets Inc., USA) prior to RUPP (Reduced Uterine Perfusion Pressure) surgery on gestational day (GD) 14. Blood pressure was monitored via carotid catheter. On GD19, uterine arteries were harvested to determine vascular reactivity on a wire myograph. We found that RUPP surgery significantly increased mean arterial blood pressure as expected(Ctrl+Sham, n=12, 102±10 mmHg; Ctrl+RUPP, n=12, 117±11 mmHg; P&lt;0.01), and this was significantly enhanced by vitamin D deficiency (VDD+RUPP, n=12, 136±11 mmHg; P&lt;0.01). Plasma sFlt‐1 concentrations were significantly increased in VDD rats (n=12, 117±15 pg/mL) compared to the control group(n=12, 49±17 pg/mL)(P&lt;0.05), and VEGF concentrations were significantly decreased(Ctrl, n=12, 1899±371 pg/mL; VDD, n=6, 1071±249 pg/mL, P&lt;0.05). VDD induced endothelial dysfunction in uterine arteries (% relaxation, control, n=6, 95±7%; VDD, n=6, 37±11%, P&lt;0.05). The circulating biomarkers for endothelial dysfunction also significantly increased. The E‐Selectin increased from 5166±1217 pg/mL to 5756±1053 pg/mL (P&lt;0.05). The ICAM‐1 levels increased from 3.15±1.03 ng/mL to 3.50±0.94 ng/mL (P&lt;0.05). The VCAM‐1 level increased from 44±13 ng/mL to 53±11 ng/mL (p&lt;0.05). These results suggest that vitamin D deficiency contributes to the onset of preeclampsia by increased sFlt‐1 production and impaired vascular function.Support or Funding InformationThis research was supported by the National Natural Science Foundation of China (81601318) and Shandong Province Health and Medical Science and Technology Program (2016WS0668), Weifang Medical University (No. 2017BSQD11).

Building Pre-Professional Students' Interprofessional Skills and Confidence: A Population Health Approach

Many graduates of health science programs lack the skills and confidence to incorporate multiple providers' perspectives when designing coordinated care outcomes. This longitudinal cross-sectional study used the Interprofessional Attitude Scale (IPAS) to study prelicensure nursing students' perceptions of interprofessional (IP) work. Between 2015 and 2018, IPAS scores and anecdotal data were collected for four consecutive semesters. Data suggest students' (n = 162) attitudes changed significantly toward teamwork, community centeredness, and biases with medium to large effect sizes (r = .33 to .51). Anecdotal findings echoed these shifts in student attitudes. There is no one ideal approach to build IP practice into curricula that is content saturated. With the shared commitment of IP faculty and the use of creative educational approaches, weaving IP processes into population health curricula encourages students to engage in IP work and develop the skills and confidence needed for IP practice. [J Nurs Educ. 2020;59(3):169-172.].

Self-efficacy in Teamwork and Entrepreneurship in University Students from Social and Health Sciences Programs

The purpose of the present descriptive study is to compare the profiles of perceived self-efficacy in teamwork and entrepreneurship between Health Sciences and Social Sciences university students. The total sample consists of 972 participants: 484 from the Health Sciences and 488 from the Social Sciences programs, with an average age of 18.68 years (SD = 1.52) and 18.48 years (SD = 1.26) respectively. A quantitative approach with a descriptive and transversal survey design was used. All the participants completed the Selfefficacy Teamwork and Entrepreneurship Scale. The results of the one-way multivariate analysis of variance, followed by one-way univariate analysis of variance, showed that the Social Sciences students reported statistically significant (p < .05) better perceived self-efficacy, desired self-efficacy and reachable self-efficacy in teamwork than the Health Sciences participants, while the students of health sciences are perceived with a greater possibility of improvement in their perceived self-efficacy. Regarding the entrepreneurship factor, the Social Sciences students reported statistically significant greater perceived self-efficacy, desired and reachable self-efficacy than their Health Sciences counterparts (p < .05).

Tertiary Anatomy and Physiology, A Barrier for Student Success

Anatomy and physiology courses are a foundation for numerous degrees, but experience some of the highest failure rates of all undergraduate health science programs (Higgins-Opitz &amp; Tufts, 2014). While interventions have been developed in an attempt to remediate this concerning phenomenon, there is a paucity of evidence to determine the reason anatomy and physiology courses pose such an obstacle to students, and whether there are reliable early determinants for student success in these courses. This review will discuss why this obstacle exists, and the factors that contribute to success and failure in undergraduate anatomy and physiology courses.

Modernizing the Methods and Analytics Curricula for Health Science Doctoral Programs.

This perspective provides a rationale for redesigning and a framework for expanding the graduate health science analytics and biomedical doctoral program curricula. It responds to digital revolution pressures, ubiquitous proliferation of big biomedical data, substantial recent advances in scientific technologies, and rapid progress in health analytics. Specifically, the paper presents a set of common prerequisites, a proposal for core computational and data analytic curriculum, and a list of expected outcome competencies for graduates of doctoral health science and biomedical programs. The manuscript emphasizes the necessity for coordinated efforts of all stakeholders, including trainees, educators, academic institutions, funding agencies, and policy makers. Concrete recommendations are presented of how to ensure graduates with terminal health science analytics and biomedical degrees are trained and able to continuously self-learn, effectively communicate across disciplines, and promote adaptation and change to counteract the relentless pace of automation and the law of diminishing returns.