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Comprehensive RCR Training in Clinical Research Ethics: A CTSA Consortium Study

Explore the implementation of Responsible Conduct of Research (RCR) training in Clinical and Translational Science Award (CTSA) programs, detailing instructional activities and materials used, highlighting the interdisciplinary efforts and funding sources.

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Comprehensive RCR Training in Clinical Research Ethics: A CTSA Consortium Study

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  1. ORI Conference on Research on Research Integrity May 16, 2009An Inventory of RCR Instructional Activities and Training Materials in the CTSA Consortium Elizabeth Heitman, PhD Center for Biomedical Ethics and Society Vanderbilt University Medical Center James M. DuBois, PhD, DSc Alexander A. Kon, MD Department of Health Care Ethics Department of Pediatrics Saint Louis University (WUSTL CTSA) University of California, Davis Debie Schilling Nicholas H. Steneck, PhD Clinical & Translational Science Center Research Ethics & Integrity Program UC Davis Health System University of Michigan

  2. Disclosure and Acknowledgements The members of the Educational Materials group have no financial conflicts of interest to disclose related to this project. This work was made possible by a supplement award to Grant # UL1 RR024146 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The Delphi project was funded by a grant from the Office of Research Integrity to Dr. DuBois. We are grateful for the participation of the many experts who served on the 4 Delphi panels and the members of the CTSA institutions who participated in the survey. 2

  3. Clinical and Translational Science Award (CTSA) Consortium • Funded by National Center for Research Resources (NCRR) • First round of funding in 2006 • Now 39 academic health centers in 23 states • Goal to fund ~ 60 sites • Most 2009 awards pending

  4. CTSA Replaces Other Federal Grants • General Clinical Research Centers (GCRCs) • Institutional research training programs • e.g., K30, T32, T12

  5. CTSA Structure

  6. Aims of the CTSA Program: • Improve the way that biomedical research is conducted across the country • Reduce the time that it takes for laboratory discoveries to become clinical treatments • Engage communities in clinical research • Train the next generation of clinical and translational researchers

  7. www.ctsaweb.org

  8. Research Ethics in the CTSA • All CTSA sites have a funded research ethics component • Significant variability or activities under and support for the research ethics component • Key personnel effort versus cost sharing • Effort ranges from 0.1 to > 3 FTEs

  9. Four groups responsible for research ethics and RCR education: • Education and Career Development Key Function Committee (ECD KFC) • Clinical Research Ethics Key Function Committee (CRE KFC) • Regulatory Knowledge Key Function Committee (RK KFC) • CTSA Consortium Child Health Oversight Committee

  10. Clinical Research Ethics Key Function Committee (CRE-KFC) • 1 voting member from each CTSA site • NIH members (1/3 of total committee) • Others may join as non-voting members

  11. CRE KFC Subcommittees • Educational Materials • Operations • Consultation • Governance (temporary) • Pediatric Research Ethics Workgroup • (under Child Health Oversight Committee) • Alternative IRB Model Pilots • (under Regulatory Knowledge KFC) • Research on Research Ethics (new)

  12. Educational Materials Subcommittee • Alexander Kon (UC Davis) • James DuBois (SLU/Washington U) • Elizabeth Heitman (Vanderbilt) • Nicholas Steneck (U Michigan) • Jon Merz (U Penn) • John Sadler (UT-Dallas) • Rhonda Kost (Rockefeller) • Ross McKinney (Duke) • Richard Sharp (Case Western)

  13. Education and Career Development KFC Defining Core Competencies for Trainees • Nick Steneck offered to draft ethics/RCR competencies. • CRE Education Materials Group Proposed: • 8 Core Competencies in Clinical Research Ethics • 10 Core Competencies in RCR/Research Integrity

  14. Competencies under Review • Too many competencies? • Difference between ethics and RCR? • Need active, measurable verbs (Bloom’s taxonomy) • How many levels of competence?

  15. Standard Progression Masters-level competencies Doctoral-level competencies CTSA Progression MS MD PhD MSCI / MPH Postdoctoral fellowship Junior faculty Senior faculty Competencies under Review

  16. Supplemental Award Project Team • Alexander Kon (UC Davis) • Debie Schilling (UC Davis) • James DuBois (SLU/Washington U) • Elizabeth Heitman (Vanderbilt) • Nicholas Steneck (U Michigan)

  17. One-Year Supplemental Award • RCR activity survey at 38 CTSA sites • Inventory novel educational materials • Available online through CTSpedia • Indexed and searchable • Textbook content analysis • White paper on RCR education for clinical and translational researchers

  18. Email survey sent to 3 identified KFC members at each CTSA: • Clinical research ethics KFC • Education and career development KFC • Regulatory knowledge KFC Responses from all 38 CTSAs – 79 total 1-5 respondents per CTSA 18

  19. Main survey questions: • Do you have an RCR course under your CTSA? • Who is primarily responsible for RCR education under your CTSA? • Who is required to take the CTSA RCR course? • What format do you use for RCR training? • What materials do you use for RCR training? • What original RCR training materials have you developed for use within your CTSA? May we post them? 19

  20.  Who is primarily responsible for RCR education? • Specific responses under analysis • Conflicting responses among multiple responses from individual CTSAs • No clear sense of “ownership” of RCR education at many CTSAs or across CTSAs

  21. Do you have an RCR course under your CTSA ? N = CTSA Yes 24 (63%) Outside CTSA 9 (24%) No RCR 1 ( 3%) Other 4 (10%) I don't know 0

  22. Who is required to take the CTSA RCR course? Trainees (T32, K12, K30) 31 (82%)All PIs 12 (32%)All research personnel 9 (28%)All residents 10 (26%) All post-docs 21 (55%) Other 18 (47%)

  23. What format do you use for RCR training? In-person course 34 (90%) On-line training course 19 (50%) CITI RCR 11 Other online 7 No answer 1 Other (journal club, etc.) 9 (24%)

  24. What textbook do you use for RCR training? Beach, 1996 2 ( 5%) Bulger et al., 2002 2 ( 5%) W/HHMI, 2006 4 (11%) Emanuel et al. 2003 4 (11%) Macrina, 2005 6 (16%) NAS, 1995 4 (11%) Shamoo & Resnik, 2003 4 (11%) Steneck, 2007 6 (16%) Other 3 ( 8%) No textbook 19 (50%)

  25. What original RCR training materials have you developed for use within your CTSA? May we post them? Syllabus or reading list 20 (53%) PowerPoint presentation 20 (53%) Cases for discussion 19 (50%) Video 5 (13%) OK to post 20 (53%)

  26. RCR Education Materials From CTSAs for Clinical and Translational Research on CTSPedia http://twiki.library.ucsf.edu/do/view/CTSpedia/WebHome

  27. Content Analysis for Key Topics Eight* textbooks, one online course, and all submitted original materials are being indexed, using 53 topics in 7 core areas from DuBois et al. Delphi survey(under consideration for J Res Admin, Fall 2009)

  28. Ongoing activitiesto be completed by July 1, 2009: • CTSPedia Research Ethics website development • White paper: Standards for RCR education for clinical and translational research and necessary support • Second supplement?

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