An Academic Research Coach: An Innovative Approach to Increasing Scholarly Productivity in Medicine
BACKGROUND: Academic faculty who devote most of their time to clinical work often struggle to engage in meaningful scholarly work. They may be disadvantaged by limited research training and limited time. Simply providing senior mentors and biostatistical support has limited effectiveness.
OBJECTIVE: We aimed to increase productivity in scholarly work of hospitalists and internal medicine physicians by integrating an Academic Research Coach into a robust faculty development program.
DESIGN: This was a pre-post quality improvement evaluation.
SETTING: This was conducted at the University of Washington in faculty across three academic-affiliated hospitals and 10 academic-affiliated clinics.
PARTICIPANTS: Participants were hospitalists and internists on faculty in the Division of General Internal Medicine at the University of Washington.
INTERVENTION: The coach was a 0.50 full time equivalent health services researcher with strong research methods, project implementation, and interpersonal skills. The coach consulted on research, quality improvement, and other scholarship.
MEASUREMENTS: We assessed the number of faculty supported, types of services provided, and numbers of grants, papers, and abstracts submitted and accepted.
RESULTS: The coach consulted with 49 general internal medicine faculty including 30 hospitalists who conducted 63 projects. The coach supported 13 publications, 11 abstracts, four grant submissions, and seven manuscript reviews. Forty-eight faculty in other departments benefited as co-authors.
CONCLUSION: Employing a dedicated health services researcher as part of a faculty development program is an effective way to engage clinically oriented faculty in meaningful scholarship. Key aspects of the program included an accessible and knowledgeable coach and an ongoing marketing strategy.
© 2019 Society of Hospital Medicine
METHODS
The coach initiative was implemented in the Division of General Internal Medicine at the University of Washington. The Division has over 200 members (60 hospitalists), including clinical instructors and acting instructors, who have not yet been appointed to the regular faculty (clinician-educators and physician scientists), and full-time clinical faculty. Division members staff clinical services at four area hospitals and 10 affiliated internal medicine and specialty clinics. Eligible clients were all Division members, although the focus of the initial program targeted hospitalists at our three primary teaching hospitals. Fellows, residents, students, and faculty from within and outside the Division were welcome to participate in a project involving coaching as long as a Division faculty member was engaged in the project.
Program Description
The overall goal of the coach initiative was to support the scholarly work of primarily clinical Division members. Given our focus was on clinical faculty with little training on research methodology, we did not expect the coach to secure grant funding for the position. Instead, we aimed to increase the quality and quantity of scholarship through publications, abstracts, and small grants. We defined scholarly work broadly: clinical research, quality improvement, medical education research, and other forms of scientific inquiry or synthesis. The coach was established as a 0.50 FTE position with a 12-month annually renewable appointment. The role was deemed that of a coach instead of a mentor because the coach was available to all Division members and involved task-oriented consultations with check-ins to facilitate projects, rather than a deeper more developmental relationship that typically exists with mentoring. The Division leadership identified support for scholarly activity as a high priority and mentorship as an unmet need based on faculty feedback. Clinical revenue supported the position.
Necessary qualifications, determined prior to hiring, included a PhD in health services or related field (eg, epidemiology) or a master’s degree with five years of experience in project management, clinical research, and study design. The position also called for expertise in articulating research questions, selecting study designs, navigating the IRB approval process, collecting/managing data, analyzing statistics, and mentoring and teaching clinical faculty in their scholarly endeavors. A track record in generating academic output (manuscripts and abstracts at regional/national meetings) was required. We circulated a description of the position to Division faculty and to leadership in our School of Public Health.
Based on these criteria, an inaugural coach was hired (author C.M.M.). The coach had a PhD in epidemiology, 10 years of research experience, 16 publications, and had recently finished a National Institutes of Health (NIH) career development award. At the time of hiring, she was a Clinical Assistant Professor in the School of Dentistry, which provided additional FTE. She had no extramural funding but was applying for NIH-level grants and had received several small grants.
To ensure uptake of the coach’s services, we realized that it was necessary to delineate the scope of services available, clarify availability of the coach, and define expectations regarding authorship. We used an iterative process that took into consideration the coach’s expertise, services most needed by the Division’s clinicians, and discussions with Division leadership and faculty at faculty meetings across hospitals and clinics. A range of services and authorship expectations were defined. Consensus was reached that the coach should be invited to coauthor projects where design, analysis, and/or substantial intellectual content was provided and for which authorship criteria were met.12 Collegial reviews by the coach of already developed manuscripts and time-limited, low-intensity consultations that did not involve substantial intellectual contributions did not warrant authorship.12 On this basis, we created and distributed a flyer to publicize these guidelines and invite Division members to contact the coach (Figure 1).
The coach attended Division, section, and clinical group meetings to publicize the initiative. The coach also individually met with faculty throughout the Division, explained her role, described services available, and answered questions. The marketing effort was continuous and calibrated with more or less exposure depending on existing projects and the coach’s availability. In addition, the coach coordinated with the director of the Division’s faculty development program to cohost works-in-progress seminars, identify coach clients to present at these meetings, and provide brief presentations on a basic research skill at meetings. Faculty built rapport with the coach through these activities and became more comfortable reaching out for assistance. Because of the large size of the Division, it was decided to roll out the initiative in a stepwise fashion, starting with hospitalists before expanding to the rest of the Division.
Most faculty contacted the coach by e-mail to request a consultation, at which time the coach requested that they complete a preconsultation handout (Figure 2). Initial coaching appointments lasted one hour and were in-person. Coaching entailed an in-depth analysis of the project plan and advice on how to move the project forward. The coach provided tailored scholarly project advice and expertise in research methods. After initial consultations, she would review grant proposals, IRB applications, manuscripts, case report forms, abstracts, and other products. Her efforts typically focused on improving the methods and scientific and technical writing. Assistance with statistical analysis was provided on a case-by-case basis to maintain broad availability. To address statistically complex questions, the coach had five hours of monthly access to a PhD biostatistician via an on-campus consulting service. Follow-up appointments were encouraged and provided as needed by e-mail, phone, or in-person. The coach conducted regular reach outs to facilitate projects. However, execution of the research was generally the responsibility of the faculty member.
