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Effectiveness of a 1-Year Resident Training Program in Clinical Research: A Controlled Before-and-After Study

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Abstract

Background

To increase the number of clinician scientists and to improve research skills, a number of clinical research training programs have been recently established. However, controlled studies assessing their effectiveness are lacking.

Objective

To investigate the effectiveness of a 1-year resident training program in clinical research.

Design

Controlled before-and-after study. The training program included a weekly class in clinical research methods, completion of a research project, and mentorship.

Participants

Intervention subjects were 15 residents participating in the 1-year training program in clinical research. Control subjects were 22 residents not participating in the training program.

Measurements and Main Results

Assessments were performed at the beginning and end of the program. Outcomes included methodological research knowledge (multiple-choice progress test), self-assessed research competence, progress on publications and grant applications, and evaluation of the program using quantitative and qualitative methods.

Results

Intervention subjects and controls were well matched with respect to research experience (5.1 ± 2.2 vs 5.6 ± 5.8 years; p = .69). Methodological knowledge improved significantly more in the intervention group compared to the control group (effect size = 2.5; p < .001). Similarly, self-assessed research competence increased significantly more in the intervention group (effect size = 1.1; p = .01). At the end of the program, significantly more intervention subjects compared to controls were currently writing journal articles (87% vs 36%; p = .003). The intervention subjects evaluated the training program as highly valuable for becoming independent researchers.

Conclusions

A 1-year training program in clinical research can substantially increase research knowledge and productivity. The program design makes it feasible to implement in other academic settings.

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References

  1. Wyngaarden JB. The clinical investigator as an endangered species. N Engl J Med. 1979;301:1254–9.

    Article  PubMed  CAS  Google Scholar 

  2. Schrier RW. Ensuring the survival of the clinician-scientist. Acad Med. 1997;72:589–94.

    Article  PubMed  CAS  Google Scholar 

  3. Nathan DG. Careers in translational clinical research—historical perspectives, future challenges. JAMA. 2002;287:2424–7.

    Article  PubMed  Google Scholar 

  4. Nathan DG. The several Cs of translational clinical research. J Clin Invest. 2005;115:795–7.

    Article  PubMed  CAS  Google Scholar 

  5. Association of American Medical Colleges (AAMC). Promoting translational and clinical science: the critical role of medical schools and teaching hospitals. Report of the AAMC’s task force II on clinical research. Washington, DC: Association of American Medical Colleges; 2006.

    Google Scholar 

  6. Phillipson EA. Is it the clinician-scientist or clinical research that is the endangered species? Clin Invest Med. 2002;25:23–5.

    PubMed  Google Scholar 

  7. Khadaroo RG, Rotstein OD. Are clinician-scientists an endangered species? Barriers to clinician-scientist training. Clin Invest Med. 2002;25:260–1.

    PubMed  Google Scholar 

  8. Sung NS, Crowley WF, Genel M, et al. Central challenges facing the national clinical research enterprise. JAMA. 2003;289:1278–87.

    Article  PubMed  Google Scholar 

  9. Solomon SS, Tom SC, Pichert J, Wasserman D, Powers AC. Impact of medical student research in the development of physician-scientists. J Investig Med. 2003;51:149–56.

    PubMed  Google Scholar 

  10. Gallin EK, Le Blancq SM. Launching a new fellowship for medical students: the first years of the Doris Duke Clinical Research Fellowship Program. J Investig Med. 2005;53:73–81.

    PubMed  Google Scholar 

  11. Mark AL, Kelch RP. Clinician scientist training program: a proposal for training medical students in clinical research. J Investig Med. 2001;49:486–90.

    Article  PubMed  CAS  Google Scholar 

  12. Hebert RS, Levine RB, Smith CG, Wright SM. A systematic review of resident research curricula. Acad Med. 2003;78:61–8.

    Article  PubMed  Google Scholar 

  13. Hartmann M, Wild B, Herzog W, et al. Der klinische Forscher in der psychosozialen Medizin: status, Kompetenzen und Leistungen [Working as a clinician-scientist in psychosocial medicine: Status, skills and research productivity]. Psychother Psychosom Med Psychol. 2007 (in press).

  14. Phillipson EA. Clinical/research residency programs for the clinician scientist. Clin Invest Med. 1997;20:259–60.

    PubMed  CAS  Google Scholar 

  15. Centre for Higher Education (CHE) and DIE ZEIT. Centre for Higher Education (CHE) / DIE ZEIT university ranking. Available at: http://www.daad.de/deutschland/hochschulen/hochschulranking/06544.en.html. Accessed July 27, 2007.

  16. Deutsche Forschungsgemeinschaft. DFG Förder-Ranking Medizin 2003. [German Research Foundation: research funding ranking]. Available at: http://www.dfg.de/ranking/archiv/ranking2003/institutionen/Wc879d5f312ae.html. Accessed July 6, 2007.

  17. Focus Online. Focus Uni-ranking 2007. Available at: http://www.focus.de/wissen/campus/hochschulen. Accessed July 27, 2007.

  18. Healy C, Welchert A. Mentoring relations: a definition to advance research and practice. Educ Res. 1990;19:17–21.

    Google Scholar 

  19. Ramani S, Gruppen L, Kachur EK. Twelve tips for developing effective mentors. Med Teach. 2006;28:404–8.

    Article  PubMed  Google Scholar 

  20. Epstein RM. Assessment in medical education. N Engl J Med. 2007;356:387–96.

    Article  PubMed  CAS  Google Scholar 

  21. McCoubrie P. Improving the fairness of multiple-choice questions: a literature review. Med Teach. 2004;26:709–12.

    Article  PubMed  Google Scholar 

  22. Glaser R. Education and thinking: the role of knowledge. Am Psychol. 1984;39:193–202.

    Article  Google Scholar 

  23. Wass V, Van der Vleuten C, Shatzer J, Jones R. Assessment of clinical competence. Lancet. 2001;357:945–9.

    Article  PubMed  CAS  Google Scholar 

  24. Downing S. Assessment of knowledge with written test formats. In: Norman G, Van der Vleuten C, Newble D, eds. International Handbook of Reserach in Medical Education, Vol. 2. Dordrecht: Kluwer; 2002:647–2.

  25. Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65:S63–7.

    Article  PubMed  CAS  Google Scholar 

  26. Stagnaro-Green AS, Downing SM. Use of flawed multiple-choice items by the New England Journal of Medicine for continuing medical education. Med Teach. 2006;28:566–8.

    Article  PubMed  Google Scholar 

  27. Haladyna T. Developing and validating multiple choice test items. 3rd Ed. Mahwah, NJ: Lawrence Erlbaum Associates; 2002.

    Google Scholar 

  28. Verhoeven BH, Snellen-Balendong HA, Hay IT, et al. The versatility of progress testing assessed in an international context: a start for benchmarking global standardization? Med Teach. 2005;27:514–20.

    Article  PubMed  CAS  Google Scholar 

  29. Barbour RS. Making sense of focus groups. Med Educ. 2005;39:742–50.

    Article  PubMed  Google Scholar 

  30. Hauer KE, Teherani A, Dechet A, Aagaard EM. Medical students’ perceptions of mentoring: a focus-group analysis. Med Teach. 2005;27:732–4.

    Article  PubMed  Google Scholar 

  31. Rademakers J, Ten Cate TJ, Bar PR. Progress testing with short answer questions. Med Teach. 2005;27:578–82.

    Article  PubMed  CAS  Google Scholar 

  32. Vickers AJ. The use of percentage change from baseline as an outcome in a controlled trial is statistically inefficient: a simulation study. BMC Med Res Methodol. 2001;1:6.

    Article  PubMed  CAS  Google Scholar 

  33. Vickers AJ. Analysis of variance is easily misapplied in the analysis of randomized trials: a critique and discussion of alternative statistical approaches. Psychosom Med. 2005;67:652–5.

    Article  PubMed  Google Scholar 

  34. Hulley SB, Cummings SR, Browner WS, Grady D, Hearst N, Newman TB. Designing clinical research. An epidemiologic approach. 2nd ed. Philadelphia: Lippincott; 2001.

    Google Scholar 

  35. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.

    Google Scholar 

  36. DeHaven MJ, Wilson GR, O’Connor-Kettlestrings P. Creating a research culture: what we can learn from residencies that are successful in research. Fam Med. 1998;30:501–7.

    PubMed  CAS  Google Scholar 

  37. Schultz HJ. Research during internal medicine residency training: meeting the challenge of the Residency Review Committee. Ann Intern Med. 1996;124:340–2.

    PubMed  CAS  Google Scholar 

  38. Gill S, Levin A, Djurdjev O, Yoshida EM. Obstacles to residents’ conducting research and predictors of publication. Acad Med. 2001;76:477.

    Article  PubMed  CAS  Google Scholar 

  39. Kroenke K. Conducting research as a busy clinician-teacher or trainee. Starting blocks, hurdles, and finish lines. J Gen Intern Med. 1996;11:360–5.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgment

We thank the intervention and control subjects who made this study possible. The first author gratefully acknowledges the opportunity to participate in the “Clinical Investigator Training Enhancement (CITE) Program” of the Regenstrief Institute, Indiana University, Indianapolis, during a research fellowship funded by the Max-Kade-Foundation, New York, and the German Research Foundation (DFG) in 2003/2004.

Conflict of Interest Statement

None disclosed.

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Authors and Affiliations

  1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Hamburg-Eilbek (Schön Clinics), Hamburg, Germany

    Bernd Löwe MD, PhD

  2. Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Medical Center, Heidelberg, Germany

    Bernd Löwe MD, PhD, Mechthild Hartmann Dipl.-Psych., Beate Wild Dipl.-Math., Dipl.-Psych., Christoph Nikendei MD, Dorothea Niehoff Med.-Dok. & Wolfgang Herzog MD

  3. Regenstrief Institute for Health Care and Department of Medicine, Indiana University, Indianapolis, IN, USA

    Kurt Kroenke MD

  4. Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany

    Peter Henningsen MD

  5. Department of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany

    Stephan Zipfel MD

Authors
  1. Bernd Löwe MD, PhD
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  2. Mechthild Hartmann Dipl.-Psych.
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  3. Beate Wild Dipl.-Math., Dipl.-Psych.
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  4. Christoph Nikendei MD
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  5. Kurt Kroenke MD
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  6. Dorothea Niehoff Med.-Dok.
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  7. Peter Henningsen MD
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  8. Stephan Zipfel MD
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  9. Wolfgang Herzog MD
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Corresponding author

Correspondence to Bernd Löwe MD, PhD.

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Löwe, B., Hartmann, M., Wild, B. et al. Effectiveness of a 1-Year Resident Training Program in Clinical Research: A Controlled Before-and-After Study. J GEN INTERN MED 23, 122–128 (2008). https://doi.org/10.1007/s11606-007-0397-8

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  • DOI: https://doi.org/10.1007/s11606-007-0397-8

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