December 6, 2011 - The first meeting of the California CTSA Education Consortium was held at UC San Diego on September 28. It was the culmination of many months of planning by Dr. Dilip V. Jeste, Director of the Education Division of the UCSD Clinical and Translational Research Institute, and his colleagues. All eight CTSA-funded institutes in California—at five University of California campuses and three private institutions—were represented by their Education Directors. As noted by Dr. Gary S. Firestein, Dean and Associate Vice Chancellor of Translational Medicine and Director, UCSD Clinical and Translational Research Institute, the size of the group is ideal for accomplishing collective goals—large enough to allow cross-fertilization of ideas, but small enough to be efficient. Indeed, the daylong meeting ended with the identification of the first working groups.
The complete list of Education Directors is as follows: Joel Diamant, MD, The Scripps Research Institute; Steven Goodman, MD, MHS, PhD, Stanford; Deborah Grady, MD, MPH, UC San Francisco; Dilip V. Jeste, MD, UC San Diego; Carol Mangione, MD, MSPH, UCLA; Frederick Meyers, MD, MACP, UC Davis; Oladele Ogunseitan, MD, UC Irvine; and Jonathan Samet, MD, MS, University of Southern California. Also in attendance were other faculty and staff members who have ongoing roles in their education divisions.
Presenters described their KL2, CREST curriculum program, TL1, and other pipeline components, including successful approaches to infrastructure: an administrative umbrella over all K programs; recognition of the need for a brick-and-mortar place for education with one-stop shopping; and a comprehensive online home for all educational and training opportunities, with course descriptions, evaluations, and locations of classes. Regarding pedagogy, the multidisciplinary approach has been successful (e.g., UCLA’s breast cancer conference and Stanford’s biodesign program). UCSF is moving away from the traditional classroom experience, and toward small student groups focused on projects. Scripps offers innovative courses and a certificate on wireless medicine. Along these lines, attendees recognized the growing importance of social media and digital devices in instruction. Some institutes, such as those at UC Davis and UC Irvine, have formalized the training of their mentors; the latter also awards Distinguished Mentors.
California CTSAs use a variety of ways to reach and retain learners from underrepresented groups. Recognizing the importance of engaging such students early, UCSD operates the HS-STAR (High School-Summer Training in Aging Research) program at its on-campus high school (Preuss), while UC Irvine uses the COSMOS (California State Summer School for Mathematics and Science) program. Further down the pipeline, all undergraduates in health sciences at UC Berkeley are encouraged to enroll in the UCSF Pre-Health Undergraduate Program (PuP; a summer clinical research training program). The M-STREAM (Medical students’ Sustained Training and Research Experience in Aging and Mental health) program at UCSD attracts medical students from all over the U.S. to specialties that are particularly needed in underserved communities.
The challenges that are particularly relevant to California CTSAs include the need for training programs to better reflect California’s rich racial and ethnic diversity, and the administrative obstacles to setting up collaborations between UC campuses. Funding for new researchers is difficult all across the nation at this time; this poses unique challenges for the current recipients of the institutional KL2 awards. It is increasingly difficult for them to receive independent funding.
Participants voiced the need for developing regional cross-training resources; e.g., curriculum (informatics, tele-training, genomics, comparative effectiveness research, diagnostic markers) and a shared database of available online courses. The California Consortium also needs a mechanism for handing off early-stage students and seamlessly monitoring those who transfer to other CTSAs. Other needs include: a cooperative pipeline for increasing diversity; a mentoring database; identification of external reviewers using a “broker” at each CTSA; common metrics for evaluation; new standards for academic appointment and advancement; and improvement of the general public’s literacy on the benefits of translational research.
In order to increase diversity among students and trainees, CTSAs need to start early, and revisit their entire K-16 pipelines, because there are not many underrepresented minorities in medical school. Even after enrolling trainees, the problem of “leaky pipelines” remains. Mentoring needs to be improved and expanded, especially since some education programs find it difficult to draw mentors in. Many attendees felt that pedagogy needs to be revamped, as medical students vote with their feet. Better research on education and training is needed, including new ideas for exploiting face time; perhaps nontraditional approaches, such as immediate feedback (“clickers” in the classroom) should be considered. In all of these areas, California CTSAs would benefit from sharing best practices.
Based on these discussions, the California CTSA Education Consortium generated a list of possible collaborations, from which three initial working groups were formed: (1) KL2 Working Group, chaired by Joel Dimsdale of UC San Diego, to develop common metrics for these programs; (2) Online Learning Working Group, chaired by Deborah Grady of UCSF, which will address both synchronous and asynchronous learning; and (3) Mentoring Working Group, chaired by Fred Meyers of UC Davis, for which Maureen Curran of UC San Diego will help collect data on mentoring programs. The California Education Directors look forward to embarking on new collaborations, and on sharing the insights they gain with other members of the national CTSA consortium.
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