Melissa R. Arbuckle, MD, PhD is Co-Director of Resident Education in the Department of Psychiatry at Columbia. Dr. Arbuckle's interests focus on the role of medical education in advancing the translation of research into the practice of psychiatry. Dr. Arbuckle’s interest in medical education and translational research cuts across both T1 (bridging basic and patient-oriented research) and T2 research (bridging patient-oriented and population-based research). Dr. Arbuckle was an invited speaker at the Research in Residency meeting. Download Dr. Arbuckle’s ROCC Star profile.
Please describe the NIH funded R25 Research Track program "Priming the Pump: Training Physician-Scientists in Translational Neuroscience." What does the curriculum look like? What are the goals and measurable outcomes for the physician-scientist learners?
Our research track is an integrated four-year program which allows residents to have over 14 months of protected time for research while meeting the ACGME clinical training requirements for psychiatry. The research training program includes research mentorship, pilot funds for research projects, opportunities to attend and present work at national meetings, rotations through clinical research units, peer mentorship, and participation in research seminars. Throughout the training program research track residents are expected to meet specific milestones such as identifying a mentor and an area of focus, developing an initial research proposal, conducting pilot research, writing manuscripts, and applying for post-graduate fellowship training in research. The ultimate goal of this work is to help residents launch successful research careers as defined by high impact peer-reviewed publications, invitations to present their work at national meetings, and, most importantly, independent grant funding (such as an NIH K-award).
What are some of the barriers and keys to successfully developing and implementing an integrated research curriculum for residents?
Developing a research portfolio while meeting ACGME clinical training requirements is a challenge for trainees. Residents are often pulled in multiple directions. As a result, it is imperative that the program has a formal structure that provides research track residents with adequate research mentorship, financial support, and protected time. At the same time, it is important that protected time for research does not unfairly result in additional clinical work for other resident colleagues. Research track residents must also have sufficient clinical training to meet ACGME requirements to graduate and become board eligible. While meeting the demands of both clinical and research training, it is important to address the personal needs of research track residents, particularly the issues of financial strain. Residents committed to research careers face additional years of training with research fellowship stipends well below that of a clinical attending salary. In order to offset this financial challenge, we’ve been able to provide additional stipends to those research track residents who commit upfront to completing a research fellowship after training. A major key to our success has been the financial support of both the NIH (through an R25 grant) and private foundation funds.
Who is involved in the creation of the National Neuroscience Curriculum Initiative shared resources? Please describe the resources and the format of the tools available.
I serve as co-chair of the National Neuroscience Curriculum Initiative (NNCI) along with colleagues Drs. David Ross at Yale and Michael Travis at the University of Pittsburgh. The overarching aim of the NNCI is to create, pilot, and disseminate a comprehensive set of shared resources that will help train psychiatrists to integrate a modern neuroscience perspective into their clinical work. To date, the NNCI has developed six different teaching “modules” or approaches built on principles of adult learning. Each training module is intended to be implemented in a classroom setting but is adaptable for use in a range of learning environments. Courses posted online (www.NNCIonline.org) are accompanied by a comprehensive Facilitator’s Guide with detailed instructions for implementation, sample scripts that can be used in class, and additional teaching resources. As educators become familiar with these modules, they can use them as a framework to teach additional neuroscience content. As a national collaboration, we hope that participants will then contribute new teaching resources back to the NNCI to share with other educators. Since the formal launch of this initiative in March 2014, more than 30 residency programs have incorporated NNCI resources into their curricula and more than 200 individuals have signed up as members of the NNCI Learning Collaborative. In addition, we have received more than 50 submissions of new content that are currently under review.
What is the value of linking Quality Improvement (QI) strategies beyond GME into continuing medical education (CME).
The great majority of CME training is presented in a passive, lecture-based format aimed towards improving medical knowledge as opposed to directly addressing uptake of evidence-based practices. As a result, current methods for CME generally increase physicians’ knowledge without impacting clinical practice patterns. My research has focused on determining whether we can increase the uptake of evidence-based practices by pairing CME with QI strategies. More specifically, we aim to create CME training that not only improves medical knowledge but encourages physicians to think about the process of practice change and implementation as an integral component to continuing medical education.