Cultivating Research Skills During Clinical Training to Promote Pediatric-Scientist Development.

Abstract

Physician-scientists represent a critical component of the biomedical and health research workforce. However, the proportion of physicians who spend a significant amount of effort on scientific research has declined over the past 40 years. This trend has been particularly noticeable in pediatrics despite recent scientific work revealing that early life influences, exposures, and health status play a significant role in lifelong health and disease. To address this problem, the Duke University Department of Pediatrics developed the Duke Pediatric Research Scholars Program for Physician-Scientist Development (DPRS). The DPRS is focused on research training during pediatric residency and fellowship. We aim to provide sufficient research exposure and support to help scholars develop a research niche and scholarly products as well as identify the career pathways that will enable them to achieve their research goals. Herein, we describe the DPRS's organizational structure, core components, recruitment strategies, and initial results, and we discuss implementation challenges and solutions. Additionally, we detail the program's integration with the department's residency and fellowship training programs (with particular reference to the challenges of integrating research into small- to medium-sized residency programs) and describe the development and integration of related initiatives across Duke University School of Medicine. The program served as the basis for 2 successful National Institutes of Health Stimulating Access to Research in Residency (R38) applications, and we hope it will serve as a model to integrate formalized research training for residents and fellows who wish to pursue research careers in academic medicine.

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Description

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Citation

Published Version (Please cite this version)

10.1542/peds.2019-0745

Publication Info

Hurst, Jillian H, Katherine J Barrett, Matthew S Kelly, Betty B Staples, Kathleen A McGann, Coleen K Cunningham, Ann M Reed, Rasheed A Gbadegesin, et al. (2019). Cultivating Research Skills During Clinical Training to Promote Pediatric-Scientist Development. Pediatrics, 144(2). pp. e20190745–e20190745. 10.1542/peds.2019-0745 Retrieved from https://hdl.handle.net/10161/19249.

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Scholars@Duke

Hurst

Jillian Hurst

Assistant Professor in Pediatrics

Children's Health & Discovery Initiative:
The prenatal period, infancy, childhood, and adolescence, represent critical time periods of human development that include more developmental milestones than any other period of the lifespan. Conditions during these developmental windows – including biological, social, economic, health, and environmental factors – have a profound impact on lifelong health. The Children’s Health and Discovery Initiative (CHDI) was founded on the hypothesis that interventions early in life will improve population health across the lifespan. To this end, the overarching goal of the CHDI is to create a robust coalition of multidisciplinary investigators and a pipeline of infrastructure, data, and research projects focused on developing innovative approaches to identifying and modulating early life factors that impact lifelong health and well-being.

Intersections of the upper respiratory microbiome, environmental exposures, and childhood respiratory infections
Early life exposure to and colonization with microbes has a profound influence on the education of the immune system and susceptibility to viral and bacterial infections later in life. My research is focused on the influence of the upper respiratory microbiome on the development of recurrent respiratory infections, including acute otitis media (AOM), the leading cause of antibiotic prescriptions and healthcare consultations among children. Importantly, some children develop recurrent infections that are thought to be linked to dysbiosis of the nasopharyngeal microbiome. My overarching goals are to identify alterations in the upper respiratory microbiome associated with AOM and to elucidate host factors and exposures that predispose some children to the development of recurrent AOM episodes.

Staples

Betty Boyd Staples

Professor of Pediatrics

Betty Staples, MD graduated from medical school at the University of Maryland School of Medicine.  She completed residency training in Pediatrics at Duke University Hospital, in Durham, NC.  Subsequently, she completed one additional year as a General Pediatrics Fellow focusing on the care of adolescents and the treatment of eating disorders. She continues to work clinically with the Duke Center for Eating Disorders.  She also teaches residents in the outpatient clinic and on the inpatient service as a general pediatrician.
Dr. Staples has focused much of her career and scholarship on graduate medical education.  She was Associate Director for the Duke pediatric residency program for 5 years before serving as Program Director for 12 additional years.  During that time, she completed the Academic Pediatric Association's Educational Scholars Program which is a three-year mentorship-based program focused on clinician scholars.  Shortly thereafter she helped to establish the Pediatric Resident Burnout-Resilience Study Consortium (PRB-RSC) a network of up to 65 pediatric residency programs and over 3500 pediatric residents which has studied the epidemiology and risk factors contributing to burnout and protecting resilience since 2016.  This work intersects closely with the Civility Champions project as burnout and resilience are major factors that affect the learning environment and the wellbeing of faculty and trainees.  Under the supervision of the steering committee, the PRB-RSC has had 12 publications with several more projects currently underway.
In November 2020, Dr. Staples became Associate Director of Graduate Medical Education for Duke Health System.  She continues to work on issues to improve the learning environment for trainees at Duke and nationally.  

 

McGann

Kathleen Anne McGann

Professor of Pediatrics

Pediatric Infectious diseases; Pediatric HIV: Prevention of mother to child transmission of HIV

Medical Education; Pediatric Education; Pediatric Medical Student, Residency and Fellowship Training Programs; 

Reed

Ann Marie Reed

Samuel L. Katz Distinguished Professor of Pediatrics

I have spent my career caring for children with autoimmune disorders and immune dysfunction.  I have focused my work caring for children with juvenile dermatomyositis and auto inflammatory disorders.  I have overseen a research program for 24 years studying the  genetics and cause of human autoimmune disease, focused on dermatomyositis in children and adults. The long-term goal of my research team is to develop new biomarkers of diseases to identify those predisposed to develop disease, as well as monitor disease activity and response to treatment. My team makes extensive use of genomics, gene expression, protein expression and immunohistochemical techniques to study the inflammatory and non-inflammatory aspects of dermatomyositis diseases. Other autoimmune disease processes, including systemic lupus and vasculitis, have been focused on as well.

Permar

Sallie Robey Permar

Adjunct Professor in the Department of Pathology

Dr. Permar's work focuses on the development of vaccines to prevent vertical transmission of neonatal viral pathogens. She has utilized the nonhuman primate model of HIV/AIDS to characterize the virus-specific immune responses and virus evolution in breast milk and develop a maternal vaccine regimen for protection against breast milk transmission of HIV. In addition, Dr. Permar's lab has advanced the understanding of HIV-specific immune responses and virus evolution in vertically-transmitting and nontransmitting HIV-infected women, defining maternal immune responses that may protect against neonatal transmission of HIV. Importantly, Dr. Permar has established a nonhuman primate model of congenital CMV infection adn is using this model to establish the maternal immune responses that are necessary for protection against placental virus transmission. Finally, Dr. Permar is studying the impact and prevention of postnatal CMV transmission in preterm infants.


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