How Do We Generate New Knowledge

1
How Do We Generate New Knowledge ?

• Norman D. Rosenblum MD, FRCPC
• Director, Canadian Child Health Clinician
  Scientist Program
• Associate Chair (Research), Department of
  Paediatrics
• University of Toronto

2
How Do We Generate New Knowledge ? Outline

• Domains of new knowledge
• Challenges to generating new knowledge
• Innovations in training
• Systems required to support research

3
Prevention, Control and CureAre Dependent
On.Generation of New Knowledge
Overriding Thesis
4
Generation of New Knowledge - Domains of Research

• Health promotion
• Disease mechanisms
• Translational solutions
• Clinical trials / observational studies
• Population research
• Health care services
• Policy development and implementation

5
Domains of ResearchCIHR Pillars

• Pillar Arena of Research
• Pillar I Biomedical
• Pillar II Clinical research
• Pillar III Health services and
  Systems
• Pillar IV Health of populations,
  societal and cultural dimensions of
  health

6
Child and Youth Health Research in Canada
Current Challenges

• 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
• The lack of a national training agenda and
  standards for training
• Depth and breadth of training
• Salary support during research training
• Life after training

7
While Clinicians are Uniquely Positioned to Play
a Key Role in Child and Youth Research, Their
Participation Has Been Inhibited- Everyone

• 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

8
How Are We To Generate New Knowledge?

• People
• Number and Target Audience
• The needed skills
• Training needed to generate the required skills
• Roles that facilitate using these skills
• The right context
• Institutions
• Community

9
Fostering Clinician Researchers Lessons Learned

• Strategic analysis of front-end investment
• 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
• Clinicians are remarkably positioned to lead
  touching patient research but not at lt50
  dedicated research level of activity
• Able to generate and sustain a laboratory-based
  research program at the gt 75 dedicated research
  level of activity
• Career development programs can provide a
  critical post-PhD period of research development
  that positions the clinician researcher for
  success in a highly competitive environment
• An important role for practioners in facilitating
  research

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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.

13 Academic Child Health Centres Partner
Universities
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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Canadian Child Health Clinician Scientist
Program 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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Increase The Number Of Career Scientists In
Child And Youth Health In Canada Progress
2002-2004
9 Universities 4 clinical disciplines
5 multidisciplinary curriculum groups
N 3
N 9

• Research Training
• Doctoral or Postdoctoral
• 90 dedicated research time
• 3-4 years of training
• Mentored
• Salary 70,000/yr.

• Career
• Development
• 75 dedicated
• research time
• max. 4 yrs.

Annual National Symposium - Big Tent Annual
Formative Evaluation
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A Seamless Developmental Pathway from Candidate
Trainee to Trainee to Junior Faculty to Mentor
and Leader People and Institutions

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

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Institutional TransformationsRequired Elements

• New knowledge generation as a core value
• Support of clinician researchers
• Multiple child health disciplines
• Equal value for different types of critical work
• Equal monetary value for equal work
• Systems that promote research-clinical
  cross-talk
• Links with systems beyond academia

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Institutions The Academic Health Sciences Centre
AHSC

• DEVELOP NEW THERAPIES
• SCIENTIST
• CLIN INV

• DELIVER STATE-OF-THE-ART THERAPIES
• CLIN SPECIALIST

• DEVELOP NEW EDUCATIONAL STRATEGIES
• EDUCATOR

• DELIVER EDUCATION
• TEACHER

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The Research ContinuumThe Vancouver Island Youth
Injury Prevention Model

• Program nature, causes, scope and prevention of
  injury
• CIHR Pillars III and IV
• CIHR funded group of investigators
• Research team also includes
• Youth
• Police
• Youth workers
• Clinical practioners

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Transformations - National Partnerships National
Child and Youth Health Coalition

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

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Generating New KnowledgeInnovations Needed -
Restated

• Research - a core and guiding value
• Big tent
• Silo breakdown
• Identification, recruitment, contextualized
  training paths
• Scientific excellence
• Institutional structures that promote
• National frameworks that promote

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How Do We Generate New Knowledge ? Summary

• Domains of new knowledge
• Challenges to generating new knowledge
• Innovations in training
• Systems developed/under development aimed at
  supporting research