2015 Workforce Development Mee5ng. Janice Gabrilove, MD

Transcription

1 2015 Workforce Development Mee5ng Janice Gabrilove, MD

2 K to R Work Group Established by Educa8on KFC (EdKFC) in 2012, based on topics of importance to membership K to R Transi8on Work Group Renamed Mentored to Independent Inves8gator 30 members of EdKFC volunteered to serve as par8cipants on this working group

3 Ahluwalia, Jasjit (UMN) BarreI, Diana (South Carolina) Beyer, Daniel (Case Western) Beyer, Eric (Chicago) Blumberg, Henry (Emory) Brown, Abigail (Vanderbilt) Chaplin, David (Birmingham) Coller, Barry (Rockefeller) Delgado, Pedro (U Texas at San Antonio) DiMeglio, Linda (IND) Fleming, Michael (Northwestern) Hartmann, Katherine (Vanderbilt) Holloway, Bob (Rochester) Luban, Naomi (CNMC) Merchant, Carol (NCATS) Morris, Cynthia (OHSU) Nguyen- Novotny, My Linh (Cornell) Pa8no- SuQon, Cecilia (USC) Reynolds, Brian (Duke) Robinson, Georgeanna (PiIsburgh) Schlesinger, Sarah (Rockefeller) Schmitz, Leslie (UWashington) Schmitz, Leslie (UWashington) Schwartz, Lisa (CNMC) SlaQery, Angie (Northwestern) Sood, Akshay (UNMHSC) Sweeney, Carol (Utah) Torner, James (Iowa) Toto, Robert (UTSW) Tsevat, Joel (Cincinna5) Weinberger, Morris (UNC) Yin, Helen (UTSW) Zwanziger, Jack (Illinois) Fair, Alecia (CTSA)

4 Goals: Mentored to Independent Inves5gator Work Group To iden(fy individual, program and ins(tu(onal a6ributes which enhance or detract from the successful transi(on of Mentored (KL2/K12) Trainees to Independent Inves(gators across CTSA ins(tu(ons, and to delineate specific challenges confron(ng: Underrepresented minori-es Women Clinical Scien-sts with pa-ent care responsibili-es Basic Scien-sts conduc-ng transla-onal research Other Allied Health Care Professionals

5 Projects Undertaken To Conduct an in depth literature/systema(c review Delineate common features of established &/or published ini8a8ves designed to foster the transi8on from Mentored to Independent Inves8gator across disciplines Led by Heln Yin, PhD and Rob Toto, MD, UTSW To Survey current KFC members regarding mentored scholars' transi(on to independent research at Clinical and Transla(onal Science Award (CTSA) Ins(tu(ons, in order to: Delineate ins8tu8onal prac8ces to facilitate transi8on Describe metrics for success of this transi8on Learn about program leaders' percep8ons of factors that support or serve as barriers to, this transi8on; and Describe research career transi8ons of scholars supported by CTSA KL2 programs Led by Carol Sweeney, PhD, University of Utah

6 Projects Undertaken To Conduct a Qualita(ve Research Study focused On KL2 Scholar percep(ons of what promotes or successful transi(on and career development. aimed to interview 40 former KL2 or K12 scholars from approximately eight CTSA ins8tu8ons. awarded an R01 or R01- equivalent as Principal Inves-gator within 2 years of the end of their K award, or have been scored in the top quar-le in an R01 or R01- equivalent applica-on not applied for independent funding (R01 or R01- equivalent) or whose applica-on has been triaged, and who are without independent funding two years aler the end of their K award. Led By Georgeanna Robinson, Ed.

7 In Depth Literature Review Findings Mentoring (mul8disciplinary) Protected Time Early exposure to research methodology K to R Programs Ins8tu8onal Culture shibs fostering & rewarding team science Unknowns; Future Direc5ons Best mentoring methods to foster success Delineate essen8al vs supplemental Leadership training

8 EdKFC Member Survey: M to I Transi5on Divided into Two Parts Part I: KFC Member s percep8ons (barriers, KL2 Scholar aqributes * & metrics of successful transi8on) & Ins-tu-onal prac-ces (resources, infrastructure, policies etc.) Pre & Post CTSA award Part II: KL2 (excluding K12) Scholar progress & accomplishments Describe experience of recent scholars Determine factors associated with success Descrip-ve sta-s-cs & mixed effects regression * Shea et all, 2011: Bland & Ruffin, 1992; Bland & Schmitz, 1986

9 Part I 87% response (52/67 Ins8tu8ons) Ins8tu8onal Resources in place to support transi8on (>60%) Mentoring Plan & Mentorship Training, Mock Study Sec-on, Faculty Development Programs, Boilerplate language, Leadership Training Presence of resource awributed to CTSA funding: 50-70% Ed KFC top priority ins8tu8onal resource Bridge Funding (only 40%, with majority implemented pre- CTSA) Ins8tu8onally valued Metrics for Success CDA, RO1, mul8- PI grants, first authored publica8ons Somewhat value: Co- authorship, Author H- Index, team science par8cipa8on EDKFC member perceived Scholar aqributes associated with success Desire, dedica-on, passion, resilience, mentor interac-on Networking ranked much lower

10 Part II 914 Scholars at 48/62 (72%) eligible ins8tu8ons KL2 Scholar composi8on: Background: 68% medical doctors, 12% other clinical training; 19% non- clinicians Gender: 53% female; 47% male Race/Ethnicity: 12% URM (females comprised a higher propor-on: (p<0.0001) Success: # Fund: 60+% funded (addi(onal mentored + independent): 38.5% independent funding (including Scholars 2+ yrs aler KL2) Source of Independent peer reviewed Funding: 46% NIH; 54% Non NIH Specific a6ribute impact: No impact of gender or minority status; trainees from non- clinical disciplines were more successful (OR 2.05; 85% CI ) than clinicians

11 Grant awards received by mentored clinical and transla8onal scholars, by (A) year completed KL2 and (B) by prior clinical and/or PhD training Percent of Scholars (n=50) (n=121) (n=125) (n=99) (n=83) (n=80) >=5 Years Since Completed KL2 Percent of Scholars (n=346) (n=128) (n=83) Clinician Clinician w/phd PhD Clinical and PhD Training R01 or Other Indep. CDA and Indep. Career Dev. (CDA) None

12 Low funding lines despite excellent data Conflict with clinical responsibilities Realization that this is not the correct career path Lack of availability of bridge funding Research results of K award not significant Lack of adequate pilot data Lack of content relevant, R01 funded mentor Conflict with family responsibilities Lack of productivity, focus, or aptitude Unresponsive mentor Teaching burden Number of Respondents Mentored- to- Independent Transi8on Survey (unpublished data: do not cite) Barriers to Achieving Independent Funding

13 Rubio Model Rubio DM, Primack BA, Switzer GE, Bryce CL, Seltzer DL, Kapoor, WN. A comprehensive career-success model for physician scientists. Acad Med. 2011: 86(12):1571-6

14 Par5cipants 20 Independently funded 40 KL2 scholars 20 Not independently funded 9 CTSA- funded ins8tu8ons 10 women 10 men 10 women 10 men R01 or equivalent as PI, or scored in the top quar8le for an R01 applica8on Race Independently funded Not Independently funded White Asian 3 4 African American 0 1 Do not wish to iden5fy 1 3 Ethnicity Not Hispanic/La5no Hispanic/La5no 2 2 Do not wish to iden5fy 1 2 Purposeful sampling: 20 independently funded & 20 not independently funded Semi- structured interviews, mostly face- to- face; Deduc8vely and induc8vely coded

15 Personal Factors Persistence and resilience Ini8a8ve in career development Autonomy over work Balance between work and personal demands

16 Organiza5onal Factors Mentor & Mentorship Financial resources for true protected (me for research Ins(tu(onal resources and support Strong community of researchers Collabora8ve opportuni8es Good research facili8es and logis8cal support Ready access to relevant pa8ent popula8ons Opportuni(es for Networking

17 Challenges of Being Successful 11/20 independently funded par8cipants expressed a lack of confidence or clarity about their future career paths [Career path planning] seemed so much clearer during the K program, maybe because there s so much more inten8on and support around it. [It would be helpful] to have those processes of what your career plan is and making sure that you have milestones, in the same way that you did on the K program, where their development was very facilitated. It s made me ques8on a lot the feasibility of a research career and whether it s really going to work out. (Georgia, IF).

18 Not Independently Funded Par5cipants Personal/family issues Suffered tor-mentors Lacked protected time Lacked initiative or motivation to become a PI Slow starters Successful on alternative career paths = Promoted to associate professor

19 Conclusions Survey Response reflects considerable & noteworthy efforts reflec8ve of collegiality and coopera8on among CTSA Educa8onal Leaders (members of prior EdKFC) Ins8tu8ons have expanded support for the Mentored to Independent Inves8gator transi8on during their CTSA award periods. Shared percep8ons for areas of addi8onal investment have been iden8fied and provide food for thought. Considerable success, as measured by aqainment of addi8onal funding, has been achieved among this cadre of Scholars as a group Addi8onal CDAs is an important and cri8cal step toward transi8on to independence, especially for MDs. Need for managing protected 8me threatened by clinical responsibili8es need proac8ve monitoring Non- - NIH sources represent a large propor8on of first independent awards.

20 Thank You Members of the Mentored to Independent Inves8gator Working Group Carol Sweeney, PhD Georgeanna Robinson, Ed.D., Linda DiMeglio, Lisa Schwartz. EdD, MS & Jazjit Ahluwalia, MD, MPH, MS, Robert Toto, MD, Helen Yin, PhD & Carol Merchant, MD Members of the EdCD KFC Alecia Fair, DrPH, CCRP Melissa Begg, ScD Emma Meagher, MD Special thanks to Barry Coller, MD