Keywords
Grants, Organized Financing, Mentoring, Peer, Interprofessional
This article is included in the Research on Research, Policy & Culture gateway.
Grants, Organized Financing, Mentoring, Peer, Interprofessional
Over the past three decades there has been a decline in research funding (Alberts et al., 2014). The funding that is distributed in many disciplines goes to better established scientists and large, highly networked institutions (Szell & Sinatra, 2015; Traynor & Rafferty, 1999). Yet, research is an important element for early career faculty promotion in healthcare disciplines (Yeh et al., 2015). One solution that has been successful at larger institutions is self-organized peer mentoring (Johnson et al., 2011). This short report describes a year-long seminar at a small, isolated teaching center designed to expose early-career interprofessional faculty to basic research principles and then to facilitate small group peer mentoring in order that they might obtain their first research awards.
The Boise Veterans Affairs Medical Center (VAMC) provides primary, secondary, and specialty care to over 28,000 veterans each year in an outpatient system that includes five community-based outreach clinics around the state, a 46-bed hospital, an 11-bed inpatient substance abuse treatment center, and a collocated 28-bed nursing home. Boise VAMC has affiliations with the University of Washington School of Medicine (600 miles away), Gonzaga University Nurse Practitioner program (400 miles away), Idaho State University School of Pharmacy (250 miles away) and Boise State University School of Nursing. The facility maintains multiple training programs, including a nurse practitioner residency, pharmacy PGY 1 and PGY 2 residencies, psychology internship and postdoctoral residency, and an internal medicine residency.
Our local research office, The Boise VA Office of Research and Development, determined that our outcome data collection would constitute Quality Improvement work and would be considered exempt from IRB approval. The data collected was provided voluntarily by the group participants who gave permission to publish the results in a de-identified format.
Being a small academic facility, far from our major affiliates, and without a deep and rich network of research mentors, we decided to create a grant writing program with the following objectives:
1) Help interprofessional junior clinician educators obtain their first research or program development/evaluation funding.
2) Create a small group of peer-mentors with the experience to recapitulate this effort with future cohorts.
We developed a year-long program that consisted of four kick-off seminars delivered weekly followed by dividing into small project groups of three that collaborated to refine their questions and methods and share the work of information gathering such as grant opportunities, where to find online human subjects forms, etc. Each group reported back to the larger group approximately monthly during ‘works in progress’ (WIP) meetings.
The kick-off seminars were developed by a biostatistician (RT) and a local mentor (CSS) with previous success in obtaining National Institutes of Health, Veterans Affairs (VA), and foundation research funding as well as large program grants. They used a “flipped classroom” format with a research article covering the topic for the session handed out ahead of time to focus and stimulate class discussion and small group interaction. The topics and structure of these seminars are provided in Table 1.
Seminar Title | Topics | Handouts | Articles for Discussion |
---|---|---|---|
The research question | Sharing potential research questions. Discuss research paradigms - Reductionist - Constructivist - Realist | Identifying your research question Summary of research paradigms Research paradigm examples | Wong et al. (1) Realist Methods. |
Research versus QI & Program Evaluation | Is this research? Example-based discussion pointing out key elements. - Intent to generalize - Design (randomization, double-blind, etc.) - Both can publish! | VHA operations decision tree Squire 2.0 Guidelines (3) | Sanders et al. (2) Producing useful evaluations in medical education. |
Experimental versus Quasi-experimental designs | When you can’t do an RCT due to cost, ethics, or other constraint, how can you control for confounders? | Table 1 & Table 2. Campbell & Stanley STROBE guidelines (5) Decision tree approach to analytic techniques | VanderWeele & Ding (4) Sensitivity analysis, E-values. |
Intro to Qualitative Research | - Overall concepts - Study designs - Sampling strategy - Analytical methods - Adjudication - Software support | Qualitative research summary Data from actual study. Small groups analyze for themes. | Inui (6) The virtue of Qualitative and Quantitative research. |
(1) Wong G, et al. (2012). Realist methods in medical education research: What are they and how can they contribute. Medical Education;46:89–96.
(2) Sanders, J., Brown, J., & Walsh, K. (2017). Producing useful evaluations in medical education. Education for Primary Care, 28, 137–140.
(3) Squire 2.0 guideliens http://squirestatement.org/index.cfm?fuseaction=Page.ViewPage&PageID=471
(4) VanderWeele, T.J., Ding, P. (2017). Sensitivity analysis in observational research: Introducing the E-value. Annals of Internal Medicine, 167, 268–274.
(5) Strobe guidelines https://www.strobe-statement.org/fileadmin/Strobe/uploads/checklists/ STROBE_checklist_v4_combined.pdf
(6) Inui TS (1996) The virtue of qualitative and quantitative research. Ann Intern Med;125:770–771.
Following these seminars, the participants were divided into groups of three based on rough similarity of research questions and/or proposed methods. These groups decided how often to meet and how to support each other with moving forward on their projects.
Approximately monthly the large group had a WIP update. There was a report on the current state of each three-person group’s projects and any questions or barriers would be outlined. These sessions tended to distribute early expertise. For example, when one member discovered a new funding opportunity it was shared with the entire group. Or, if someone wondered how to navigate the IRB process, someone else who had navigated it would explain where the electronic forms were and offer to help. In addition, an early career faculty member from our affiliate, who had been a successful career development awardee, spoke to the group about the career development program and offered her contact information and assistance.
Twelve (12) participants started the grant writing program. This included five (5) physicians, four (4) psychologists, and three (3) pharmacists. All but two completed the series (both withdrew from the program due to competing demands). Ten (10) were within three years of being hired to the Boise VA, and ten were academically early career, having entry level faculty appointments. Most had completed programs with less emphasis on research (e.g., PsyD or PharmD versus PhD, fellowships with clinical versus research emphasis).
After completing the grant writing program, six of the remaining ten participants submitted at least one research grant or program evaluation proposal for a total of 10 proposals. Six of these proposals were funded (see Table 2).
This grant writing seminar and peer support group met the initial objectives of the program and had some unintended positive consequences. The majority of the completing group members submitted a grant application. For most this was their first attempt. Five of the funding applications transitioned from single profession applications to interprofessional applications as connections were made between attendees in their small groups and profession-specific expertise was identified. Because funding sources look for team-based applications from multiple professions (Wuchty et al., 2007), this consequence may have a positive impact on funding success as interprofessional teams at this facility create connections and expand expertise and project success.
Lessons learned include starting the seminar series earlier in the academic year. We started the seminars in mid-summer and this created unnecessary time pressure for proposal submissions, which are usually due in the fall. Also, we would now consider prior experience as a factor as we create the small groups of three.
Our next step involves further partnership with the Boise VAMC’s research department. The research department is interested in expanding the scope and number of research projects and our modest success has demonstrated value. Our research department has agreed to partner in the ongoing development and expansion of this group. This partnership will increase access to instructors from the IRB, VA Health Services Research and Development (HSR&D) office and other major funders of VA research, and the Office of Research Oversight, to discuss distinctions between program evaluation/quality improvement research. These opportunities for direct discussion and questions will be invaluable to the next round of beginning grant writers.
This project had some weaknesses. Because it was not designed as research, no systematic survey of participants (satisfaction, skill improvements, etc.) was obtained. Several topics were identified that might have made the project more effective including types of grants available, navigating the IRB, writing your letter of intent, and budgets. These should be incorporated into future versions.
Small, isolated teaching centers struggle to provide support for designing and submitting research grants for their early career faculty. Any experienced potential mentors are quickly overwhelmed with mentees. Yet, research is an important element for these same early career faculty’s success. This program of four orienting seminars, three-person project groups, and monthly works in progress meetings was successful in obtaining initial grants for individuals and group expertise that could guide future cohorts.
All data underlying the results are available as part of the article and no additional source data are required.
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Is the work clearly and accurately presented and does it cite the current literature?
Yes
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
Not applicable
Are all the source data underlying the results available to ensure full reproducibility?
No source data required
Are the conclusions drawn adequately supported by the results?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Medical education, career choice, diabetes, inter professional education.
Is the work clearly and accurately presented and does it cite the current literature?
Yes
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
Not applicable
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: QI, Patient Safety
Alongside their report, reviewers assign a status to the article:
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Version 1 08 Oct 20 |
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Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
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