- •Foreword
- •Contents
- •Contributor Current and Past Positions: Association for Academic Surgery
- •Contributors
- •Academic Surgeons as Bridge-Tenders
- •Types of Surgical Research
- •Going Forward
- •Selected Readings
- •Introduction
- •Preparation Phase
- •Assistant Professor
- •Job Search
- •The First Three Years
- •Career Development Awards (CDAs)
- •Contemplating a Mid-Career Move?
- •Approaching Promotion
- •Associate Professor and Transition to Full Professor
- •Conclusion
- •Selected Readings
- •Introduction
- •Reviewing the Literature
- •Developing a Hypothesis
- •Study Design
- •Selected Readings
- •Introduction
- •The Dual Loyalties of the Surgeon-Scientist
- •Human Subjects Research
- •Informed Consent
- •Surgical Innovation and Surgical Research
- •Conflict of Interest
- •Publication and Authorship
- •Conclusion
- •References
- •Sources of Error in Medical Research
- •Study Design
- •Inferential Statistics
- •Types of Variables
- •Measures of Central Tendency and Spread
- •Measures of Spread
- •Comparison of Numeric Variables
- •Comparison of Categorical Values
- •Outcomes/Health Services Research
- •Steps in Outcomes Research
- •The Basics of Advanced Statistical Analysis
- •Multivariate Analysis
- •Time-to-Event Analysis
- •Advanced Methods for Controlling for Selection Bias
- •Propensity Score Analysis
- •Instrumental Variable (IV) Analysis
- •Summary
- •Selected Readings
- •Transgenic Models
- •Xenograft Models
- •Noncancer Models
- •Alternative Vertebrate Models
- •Selected Readings
- •Overview
- •Intellectual Disciplines and Research Tools
- •Comparative Effectiveness Research
- •Patient-Centered Outcomes Research
- •Data Synthesis
- •Overview
- •Intellectual Disciplines and Research Tools
- •Disparities
- •Quality Measurement
- •Implementation Science
- •Patient Safety
- •Optimizing the Health Care Delivery System
- •Overview
- •Intellectual Disciplines and Research Tools
- •Policy Evaluation
- •Surgical Workforce
- •Conclusion
- •References
- •Introduction
- •What Is Evidence-Based Medicine?
- •Evidence-Based Educational Research
- •Forums for Surgical Education Research
- •Conducting Surgical Education Research
- •Developing Good Research Questions
- •Beginning the Study Design Process
- •Developing a Research Team
- •Pilot Testing
- •Demonstrating Reliability and Validity
- •Developing a Study Design
- •Data Collection and Analysis
- •Surveys
- •Ethics
- •Funding
- •Conclusions
- •Selected Readings
- •Genomics
- •Gene-Expression Profiling
- •Proteomics
- •Metabolomics
- •Conclusions
- •References
- •Selected Readings
- •Introduction
- •Why Write
- •Getting Started
- •Where and When to Write
- •Choosing the Journal
- •Instructions to Authors
- •Writing
- •Manuscript Writing Order
- •Figures and Tables
- •Methods
- •Results
- •Figure Legends
- •Introduction
- •Discussion
- •Acknowledgments
- •Abstract
- •Title
- •Authorship
- •Revising Before Submission
- •Responding to Reviewer Comments
- •References
- •Selected Readings
- •Introduction
- •Origins of the Term
- •Modern Definition and Primer
- •Transition from Mentee to Colleague
- •Mentoring Risks
- •Conclusion
- •References
- •Selected Readings
- •The Career Development Plan
- •Choosing the Mentor
- •Writing the Career Development Plan
- •The Candidate
- •Research Plan
- •Final Finishing Points About the Research Plan
- •Summary
- •References
- •Introduction
- •Decisions, Decisions!
- •Mission Impossible: Defining a Laboratory Mission or Vision
- •Project Planning
- •Saving Money
- •Seek Help
- •People
- •Who Should I Hire?
- •Advertising
- •References
- •Interviews
- •Conduct a Structured Interview
- •Probation Period
- •Trainees
- •Trainee Funding
- •Time Is on Your Mind
- •Research Techniques
- •Program Leadership
- •Summary
- •Selected Readings
- •Introduction
- •Direct Evidence
- •Indirect Evidence
- •Burnout
- •Prevention of and Recovery from Work–Life Imbalance
- •Action Plan for Finding Balance: Personal Level
- •Action Plan for Finding Balance: Professional Level
- •Conclusion
- •References
- •Introduction
- •Time Management Strategies
- •Planning and Prioritizing
- •Delegating and Saying “No”
- •Action Plans
- •Activity Logs
- •Scheduling Protected Time
- •Eliminating Distractions
- •Buffer Time
- •Goal Setting
- •Completing Large Tasks
- •Maximizing Efficiency
- •Get Organized
- •Multitasking
- •Think Positive
- •Summary
- •References
- •Selected Readings
- •Index
210 F.E. Nwariaku
Probation Period
Most institutions have a probation period during which you can terminate employment without a long process of documentation. Always confirm with the HR department when this period ends and be sure to address any performance deficiencies with the employee prior to the end of probation. Trainees are considered different and may not be subject to the same rules; however, there are mechanisms to address performance issues with a trainee through the Student Office, Postgraduate School or Office.
Trainees
The primary role of the trainee in a research program is to learn. The concept is that during their trainee period, they will learn how to:
•Ask important questions
•Choose appropriate experimental methods designed to provide answers to those questions
•Develop and hone their analytical skills to provide reasonable analysis of their observations
•Develop skills to synthesize the often varying observations into a conclusion
•Learn to communicate their ideas to peers, supervisors, and the general scientific audience
The last part involves learning presentation and grant writing skills as well as writing skills. It is OUR responsibility to ensure that these skills are developed. Therefore implicit in your decision to accept a student or postdoctoral fellow in your research program is the agreement to provide all the above training. This also requires significant time commitment to instruct, support, teach, and supervise trainees. Because of this commitment some scientists suggest that brand new investigators should refrain from taking students or trainees for several years after they start the laboratory.
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Also a bad experience for any trainee may not only turn them off science forever, but negatively impacts your ability to recruit bright and hardworking trainees in the future. Having said that, students are perhaps the most exciting to have in the laboratory. They are usually scientifically “innocent,” eager to learn, and often ask questions that lead down previously unexplored scientific paths. In general, undergraduate students enjoy learning basic experimental methods such as ELISA assays, microscopy, and electrophoresis gels. These experiments allow them to fail and learn to solve technical problems without using up expensive reagents or jeopardizing valuable specimens.
In contrast graduate students and postdoctoral fellows are usually more experienced and can attack more complex scientific problems with more sophisticated assays. A specific group of postdoctoral trainees is the clinical resident who takes time from their clinical training to learn about scientific research methods. Unlike the PhD-seeking postdoctoral fellows, many clinical residents often desire a robust publication record in a relatively short time. They may face stiff competition when they apply to clinical subspecialty fellowships, and the publication record improves their chances of securing admission. It is certainly prestigious to have a “resident in the lab”. However, we recommend that the surgeon-scientist be as objective as possible keeping the interest of the resident in the forefront of all discussions during this process. Several questions that need to be asked include:
•Is this the appropriate training for the resident?
•Is this the appropriate time for them to take the time to train?
•Are they committed to a lifelong career in scientific investigation or are they just curious?
•What is their clinical track record? In this instance, past activity is usually an indicator of future performance.
•Are their expectations realistic? Two to three publications each year (one laboratory and one or two clinical papers) is reasonable. Four to five good-quality publications is difficult but outstanding if accomplished.
212 F.E. Nwariaku
This group of trainees also has specific needs. Some of them may choose to engage in low-level clinical activity such as moonlighting while in the lab, or they may take time to travel for interviews. Different groups address these issues differently. However, it is crucial for the surgeon-scientist to set clear expectations BEFORE the trainee is accepted. Most scientists understand that the primary reason for spending additional time training to become a clinician-scientist is so that they can learn the above-mentioned methods. This requires a significant time and effort commitment. We discourage residents who do not grasp this concept from spending additional time in research training. A frequently asked question by trainees is the duration of their research training. Most training programs expect their residents to spend 1–2 years engaged in research. This decision can be made together with the trainee; however in our opinion, many projects that address important questions require at least 2 years to acquire the necessary information and publish it.Regardless of the skill level of trainees, it is important to remind ourselves that they all require instruction and mentoring.
Trainee Funding
Trainee funding can be a challenge for young scientists. However many major institutions have training grants in Departments that may not be the primary department of the investigator. We recommend that you contact the Office of Grants Management and get a list of training grants. Some clinical departments can also support the salary for trainees as part of their educational mission. However you will need to ask the Department Chair or Research Vice Chair. Lastly, many professional organizations such as the Association for Academic Surgery, Society of University Surgeons, and specialty societies in vascular, colorectal, oncologic, cardiovascular,and orthopedic surgery have established funding programs for student or postdoctoral trainees. Information on these programs can usually be found on the society websites.
Regardless of the source of funding, the process needs to commence early. We recommend that trainees are identified
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and proposals submitted no later than a full year prior to the proposed start date. This allows the research programs enough time to prepare to receive the trainees, and also time to review research proposals and develop the research projects. It is crucial to communicate directly and clearly with the potential trainee and their residency program director during the entire process. It can be disheartening to prepare for a whole year to receive a trainee, and secure funding only to find out that the residency training program cannot afford to release the resident for the training period.
Time Is on Your Mind
Many managers describe the concept that time is our most precious resource.Therefore, it is crucial to learn, understand, and practice great time management. Workshops and symposia about time management abound. Some institutions provide free workshops on time management to increase the efficiency of their employees. Take advantage of these, if your institution has one of these programs.
Whether we like it or not, academic productivity is judged by the number and quality of published papers and grants. Our product is discovery and new knowledge in the health sciences. Therefore our academic time should be spent on activities that facilitate increased production. Some writers discuss the investment of time. For instance, spending time reading papers, rearranging your laboratory, etc., may not directly lead to increased productivity, but time spent training staff on complex experiments can yield great returns in the future.
Research Techniques
A common pitfall early in one’s career is the love affair with specific research techniques. Some investigators are enamored with a particular new technique. It is important to remember that research techniques are tools. Just like a hammer or screwdriver, each technique has advantages and weaknesses.