Cultivating Research Skills During Clinical Training to Promote Pediatric-Scientist Development.
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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.
Published Version (Please cite this version)
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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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.
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 2021, 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.
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;
Dr. Cunningham is a pediatric infectious diseases physician who has focused her research on the prevention and treatment of HIV infection in children. She has also played important roles in evaluation of vaccines for other infectious diseases and recently has worked on Ebola virus treatment studies. She is currently working on studies of active and passive immunization to prevent HIV transmission in neonates born to HIV infected women.
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.
Molecular genetics of glomerular disease
Genetic risk factors for childhood onset idiopathic nephrotic syndrome
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