Building a Child Health Clinician Scientist Training Program For the Future

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Building a Child Health Clinician Scientist
Training Program For the Future

• Norman D. Rosenblum MD, FRCPC
• Principal Investigator
• Canadian Child Health Clinician Scientist Program

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Outline

• Issues that motivated the establishment of the
  CCHCSP
• CCHCSPs 3 main objectives
• What are they
• How are we doing
• Priorities for the next 12 months

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Formation of the CCHCSPKey Motivating Factors

• The national deficiency of research in child and
  youth health
• The national deficiency of child and youth health
  researchers
• Regional disparities in research and human
  resources
• Training scientists in silos may be
  counterproductive to solving the health and
  illness problems of Canadians
• The lack of a national training agenda and
  standards for training

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Factors That Have Inhibited Clinicians to Train
As Scientists

• Enticing research experiences during clinical
  phase
• Salary support during research phase
• Perception of career opportunities as clinician
  researchers
• Relevance of clinical training to future career -
  isolation vs. creative interchange
• Institutions and support of clinician-researchers

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Preexisting Clinician Scientist Training
ProgramsLessons Learned

• Training of clinicians with a fire-in-the-belly
  to the state-of-the-art in science can generate
  clinician scientists with excellent potential for
  sustained research careers
• Career development program can provide a critical
  post-PhD period of research development that
  positions the clinician researcher for success in
  a highly competitive environment

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• Career scientists from all clinical disciplines
  are needed to identify critical gaps in knowledge
  and lead research
• Cross-talk between scientific disciplines among
  researchers with diverse clinical training is
  needed to advance research.
• Enhance the capacity to perform research in all
  regions of Canada the range and breadth of
  clinical practice provides a huge opportunity.

A CIHR strategic transdisciplinary training
program for the next generation of clinician
scientists in child and youth health for
Canada.
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Canadian Child Health Clinician Scientist
Program Objectives

• Increase the number of career scientists in child
  and youth health in Canada.
• Train within an interdisciplinary training model
  - enhance the capacity of scientists to create
  new knowledge that will translate into improved
  health.
• Facilitate a seamless developmental pathway
  extending from candidate trainee to trainee to
  junior faculty to mentor and leader.

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CCHCSP Overall Strategy
I N D E P E N D E N C E !
Rising Researchers Doctoral Postdoctoral Caree
r Development
Interdisciplinary Learning Experiences
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Objective 1 Identify, Recruit, and
Train Identify and Recruit - Strategies

• Identification
• Centre Leaders
• Web Site/Program Staff
• Multidisciplinary communication strategy
• Pre-training programs
• Rising Researcher Support Program
• Rising Researchers at National and Mini Symposia

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Objective 1 Identify, Recruit, and
Train Identify and Recruit - Results (2002-2004)

• Rising Researcher Support Program - 4
  individuals funded
• Rising Researchers at National Symposia
• 43 from 11 Universities
• 2004 - 6 clinical disciplines, 58 from one
  discipline
• 11/43 applied/applying to CCHCSP training paths
• Rising Researchers at Mini-Symposia
• 25 from 5 Universities
• 6 clinical disciplines, 45 from one discipline
• 22/25 new to program
• Partnership with Pediatric Scientist
  Development Program
• repatriation of Canadians training in the USA
• Applicants to CCHCSP Doctoral, PDF or CD training
  paths
• Total 34, five disciplines (57 MDs)
• Applicants, not previously RRs 24

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Objective 1 Identify, Recruit, and Train Select
- The Selection Committee

• All members are well-funded Senior Scientists
• Victor Han MD, Chair
• Stephanie Atkinson PhD, RD
• Bill Avision PhD
• Joe Byrne PhD
• Sylvain Chemtob MD, PhD
• Johanna Darrah PhD
• Shoo Lee MD, PhD
• Bonnie Stevens MScN, PhD
• Bill Hay, Jr. MD
• Broad disciplinary and geographic representation
• Evaluate written application and interview a
  subset of highly ranked applicants
• Provide a written evaluation of the application
  and interview (as appropriate)

UWO Medicine Pillar I, II McMaster
U Nutrition Pillar I, II UWO Sociology Pillar
III Dalhousie Psychiatry Pillar II, III U
Montreal Medicine Pillar I, II U
Alberta Physio Pillar II UBC Medicine Pillar II,
III U Toronto Nursing Pillar II, III U
Colorado Medicine Pillar I, II
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Objective 1 Increase The Number Of Career
Scientists In Child And Youth Health In Canada
Annual Formative Evaluation
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Objective 2 Train Within An Interdisciplinary
Training Model

• Leadership
• Executive 3 clinical disciplines, Pillars 1, II
• Selection 5 clinical disciplines Pillars I, II,
  III
• Trainees
• Rising Researchers 6 clinical disciplines
• Applicants for training 5 clinical disciplines
• Funded trainees 4 clinical disciplines, Pillars
  I, II

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Objective 2 Train Within An Interdisciplinary
Training Model

• Curriculum
• Cases that bridge scientific disciplines
• Supported by web-based modules
• Research design and analysis
• Research Ethics
• Mentoring
• Intellectual Property, Integrity, Law
• Tools of Research
• Discussed in multidisciplinary centre-based
  groups -
• 5 active centers to date
• 69 active participants from 6 clinical
  disciplines
• Mini-symposia - research challenges
• 2 Symposia to date - Halifax and Winnipeg
• 13 and 16 attendees, respectively
• 4 clinical disciplines represented at each

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Objective 3 A Seamless Developmental Pathway
Requirements

• Training
• Identification, Recruitment and Training
• Career Support
• Institutional Transformation
• National framework for child and youth health
  research

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Objective 3 A Seamless Developmental Pathway
Innovations

• Partnership with Paediatric Chairs of Canada
• Partnership with Pediatric Scientist Development
  Program
• Partnership in National Child and Youth Health
  Coalition
• Paediatric Chairs of Canada (PCC)
• Council of Canadian Child Health Research (CCCHR)
• CCHCSP
• Canadian Paediatric Society
• Canadian Association of Paediatric Health Centres
  (CAPHC)

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The PCC - HSC Foundation PSDP CCHCSP
Partnership

• NIHs most successful program
• Outcome 48 become PI on one or more NIH RO1
  Awards
• 4 Canadians presently in program

CANADIAN PAEDIATRIC RESIDENT
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Objective 3 A Seamless Developmental Pathway
National Child and Youth Health Coalition

• Overall goals
• stimulate new knowledge development, promote the
  application of this knowledge to practice,
  training and education and strengthen national
  advocacy to improve the health and health care of
  children and youth.
• First step establish Canadian infant, child and
  youth health indicators

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CCHCSP Is A Grant Supported Experiment

• Renewal of Our Funding Is Dependent On Our
  Productivity

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Canadian Child Health Clinician Scientist Program
Logic Model
Components - main groups of activities
Recruitment
Training Program for Trainees
Partnerships
Trainee Selection
Awards Program for Rising Researchers
Marketing
Curriculum
Research
Face-to-face
Online
Mentorship
Target Audience -groups served by the program
-Selection Committee -Program Manager -Centre
Leaders -Applicants
-Child and youth health community in
Canada -Potential funders
-Potential trainees -Executive Committee -Mentors
-Selection Committee -Partner
Centres -Centre Leaders
-Trainees -Facilitators -Partner
Centres -Mentors -Centre
Leaders -Selection Committee -Program
Committee -Executive Committee
-Funding -Access to expertise and learning
opportunities
-Completed applications -Program
Manager -Centre Leaders
-Applicants -Selection Committee
-Funding -Institutional Commitment
-Website -Program Manager -Posters/Letters/Promoti
on packages -Centre Leaders/Mentors/Facilitators -
National Symposia -Funding for Rising Researchers
-Presentations by CCHCSP Leaders -Time and
commitment to participate in coalitions -Financial
resources (business plans) -Representation of
CCHCSP Leaders on coalitions
Face-to-Face Curriculum -Video Conferencing -Centr
e based groups (interactive educational
sessions) -Mini-Symposia -National
Symposia Online Curriculum -Web based educational
modules (8 modules)
Inputs -resources that need to be invested
-Research office space -Protected research time
(90 doc, post doc and 75 career development)
-Local review and pre-selection of applicants in
some centres -Submit applications to National
office -Ensure application is acceptable/complete
-Assign and send each application to a
reviewer -Chair of Selection Committee and
Program Manager get ratings of each
applicant -Schedule a teleconference about
applicants with Selection Committee -Determine
which applicants will be selected for interviews
based on assigned scores (above
cut-off) -Complete a review of each applicant
(strengths and weaknesses) and send to
applicants -Conduct interviews with those
selected with a standardized set of
questions -Make recommendations about applicants
by consensus (Interview committee) -Review
recommendations and summative score of each
interviewee (Selection Committee) -Make
recommendations about final selection to Chair of
Executive -Interviewees informed about whether
they are selected
Marketing -Distribute promotional materials
(posters, letters) to child and youth research
centres in Canada and child and youth
partners -Centre leaders to promote program in
different professions/fields at their own
centre -Provide information on program and award
guidelines (website) -Distribute promotional
materials to potential applicants (Program
Manager) -Responds to questions of potential
applicants (Program Manager) Mentorship -Educate
potential trainees about the program and
personally mentor these potential trainees
(Centre Leaders and researchers) -Invite
potential trainees to National Symposia for
further mentoring and education Awards Program
for Rising Researchers -Explore specific aspects
of child and youth health research -Identify a
research mentor (Rising Researchers) -Design a
research program as a basis for the application
to the CCHCSP or another program (Rising
Researchers) -Participate in the National
Symposia
-Trainees conduct research in area of
interest -Trainees write, present and defend
research proposal -Mentors provide discipline
specific training to trainee

• Strategic Partnerships
• CCHCSP Leaders will present to the child health
  community in Canada and other
• Actively participate in coalition building
• Invite Canadians participating in PSDP to come to
  symposia
• Fundraising
• -Write proposals for funding
• -Present proposals for funding
• -Write progress reports for receiving continued
  funding

Face-to-Face Curriculum -Develop cases of the
month for trainees -Trainees meet to discuss each
case -Trainees actively participate in
mini-symposia with interdisciplinary
focus -Trainees actively participate in National
Symposia (present, attend workshops,
network) -Trainees are evaluated on an annual
basis by Selection Committee at Symposia Online
Curriculum -Update online curriculum (8
modules) -Trainees complete online curriculum
Activities -specific ways that components are
applied
- of half days per week trainees dedicate to
research -High quality research outputs
-publications in peer reviewed journals
-other publications -grants funded and money
received (career development path)
-invited presentations -conference
presentations -research awards - of
times editor in a journal - recruited to faculty
positions
Strategic Partnerships - of partnerships -quality
of partners (groups that have influence and
leverage in the child and youth health system
such as CAPHC, Paediatric Chairs of Canada) - of
invitations to present - of presentations - of
symposia attendees from PSDP Fundraising -Money
received
Face-to-Face Curriculum - of Centres that have
face-to-face meetings with trainees to discuss
cases - of interdisciplinary training exercises
trainees took part in (centre specific and at
symposia) - of trainees with high quality
research presentations (ratings) Online
Curriculum - of times each trainee enters each
module - of trainees that have accessed resource
material - of trainees that have looked at the
twists in each cases - of times each trainee is
online
Outputs services or products developed/ provided

- of applications received for doctoral,
post-doctoral and career development paths - of
re-applicants for each training path - of
applicants from each training centre - of
applicants from the four CIHR pillars - of
applicants from different child/youth health
disciplines - of applicants that are interviewed
for each training path - of applicants from the
awards program for Rising Researchers selected as
a Trainee - of applicants selected for each
training path
Marketing - of potential applicants who are sent
information about CCHCSP - of potential
applicants who are sent information from
different child and youth health disciplines and
geographical areas - who are sent information
who dont apply - of people who visit
website Mentorship - of potential applicants who
are mentored who apply - of potential applicants
who are mentored and do not apply for the
program Awards Program for Rising Researchers -
of Rising Researchers who apply to CCHCSP
Face-to-Face Curriculum and Online Curriculum -To
increase sharing among trainees and faculty -To
increase knowledge about child and youth health
research fields and opportunities in Canada -To
develop effective interdisciplinary problem
solving skills among trainees (in at least one
training exercise) -To ensure trainees have
effective oral and written communication
(symposia presentation and annual report)
Short Term Outcomes desired results in 1 to 2
years
-To retain current partners -To have adequate and
sustained funding to address the vision of the
program -To increase the profile of child and
youth health in Canada -To put child and youth
health on the public agenda in a composite way
Marketing and Mentorship -To increase awareness
of the CCHCSP across child and youth health
disciplines -To increase awareness of the CCHCSP
among potential applicants -To increase the
number of applicants to the CCHCSP -To increase
the quality of applicants to the CCHCSP -To
recruit trainees from across child and youth
health disciplines Awards Program for Rising
Researchers -To increase the opportunities of
child health clinicians to engage in research
career planning -To increase the pool of
candidates for the training program To facilitate
the submission of fundable applications to the
training program To support promising researchers
in the child and youth health disciplines
-To ensure the selection of high quality trainees
from across child and youth health disciplines,
geographical areas and CIHR pillars are accepted
into the CCHCSP.
-To increase trainees confidence and interest in
conducting interdisciplinary research. -Trainees
show evidence of continued commitment to
developing a research career after the
program -To enhance interactions between trainees
and faculty members
Long Term Outcomes desired results in 5 years
-To expand the pool of individuals who aspire to
train as child and youth clinician
scientists. -To contribute to the establishment
of careers of child and youth clinician
scientists in Canada. -Trainees engage in
interdisciplinary research as established
investigators -Trainees are engaged in research
at a highly competitive level. -CCHCSP plays a
central role in advocating for and facilitating
research training in the child and youth health
fields in Canada.
GOAL ultimate direction of program
-To develop the next generation of clinician
scientists recruited from the diverse clinical
fields of child and youth health and trained to
lead health research with a transdisciplinary
perspective.
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Make-Or-Break Priorities During The Next Year

• Build and consolidate existing programs
• Identification and recruitment of clinicians from
  child health disciplines
• Productive training
• Participation in curriculum
• Enhance partnerships nationally and
  internationally to increase breadth and depth of
  resources and significance of program

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Twelve Month Targets

• More applicants from all child health disciplines
• 20 funded trainees steady state
• Productive training by existing trainees
• Multidisciplinary curriculum discussion groups in
  each major centre - add 4 more groups
• 2 mini-symposia
• The 3rd national symposium

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We Have Many People To Thank

• Program Staff
• Members of Executive Committee
• Chair and Members of Selection Committee
• Director of Curriculum and Module Developers
• Each Centre Leader
• Co-Chairs of this Symposium
• Our Partner Organizations and Institutes

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Comments and Questions