Recommended reading from Anne Taylor-Vaisey: Here are some abstracts for this series from Medical Teacher. I am also including links to the PubMed full records. Click on the links and you will see the MeSH terms, as well as Related Articles.

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Curry M, Smith L. Twelve tips for authoring on-line distance learning medical post-registration programmes. Med Teach 2005; 27(4):316-321.

Abstract: With innovation and creativity, almost anything can be delivered and assessed on-line. Successful on-line distance learning puts the needs of the learner first, and is characterized by the quality and clarity of learning and support materials, together with good tutorial and support networks. This in turn depends upon trained authors and implementation of relevant quality assured systems and processes. These pragmatic tips outline the main points, which should help prospective on-line developers and authors.

PubMed

Ker JS, Dowie A, Dowell J, Dewar G, Dent JA, Ramsay J et al. Twelve tips for developing and maintaining a simulated patient bank. Med Teach 2005; 27(1):4-9.

Abstract: Simulated patients have become almost indispensable in the education and training of health care professionals. Their contribution to the creation of a safe, yet realistic, learner centred environment is invaluable. Their support in enabling learners at all stages of their professional careers to develop both competence and confidence through repeated practice helps to ensure that learning from real patients can be maximized. A simulated patient bank can enable tracking and training of simulated patients to be coordinated in an effective and efficient way both for patients and learners. This paper shares experiences of developing a simulated patient bank against the background of changes in health care delivery and education and training. Twelve tips to developing and maintaining a simulated patient bank have been identified. The tips focus on the needs of the simulated patient bank and ensure that training is at an appropriate level for the learners, patient care is not compromised and simulated patients feel they are valued members of the educational team.

PubMed

Lockyer J, Ward R, Toews J. Twelve tips for effective short course design. Med Teach 2005; 27(5):392-395.

Abstract: Short courses are commonly used by physicians to stay up-to-date and acquire new skills for practice. Unfortunately, many short courses are not designed to maximize their impact on practice as they fail to acknowledge how people learn and change. Designers of effective short course planning should pay attention to writing outcomes based objectives; conducting needs assessments; determining the optimal content, resources, speakers and format; preparing ancillary materials (handouts and pre- and post-course assessments); and preparing speakers and evaluation. This paper discusses how each of the components of the curriculum design can be used to enhance the learning experience and obtain the desired course outcomes.

PubMed

Smith L, Curry M. Twelve tips for supporting online distance learners on medical post-registration courses. Med Teach 2005; 27(5):396-400.

Abstract: There is an increased interest in online distance learning programmes targeted at medical professionals as they are often marketed as providing an ideal way to study due to the flexibility to access high quality materials anywhere, any time and any place. Traditionally, however, online distance learning programmes have low retention rates. Online distance learners are distinctive students who have more constraints than traditional face-to-face students such as time issues as many are working full-time and have family commitments. Lack of student support has been identified as a major factor in students dropping out of online distance learning courses. This article examines the characteristics of a good support system for online distance learning courses and provides practical advice on implementation from development through to evaluation.

PubMed

Azer SA. Becoming a student in PBL course: twelve tips for successful group discussion. Med Teach 2004; 26(1):12-15.

Abstract: Problem-based learning (PBL) serves as an educational method to foster self-directed learning, integration across disciplines, small-group learning and decision-making strategies. The approach is student centred. During the discussion of a PBL case there are a number of important issues to be considered by students, such as keeping ground rules, knowing their roles, keeping group dynamics, becoming a purposeful learner, planning how to use tutors’ feedback to enhance group discussion and boost student’s learning skills, as well as striving to become a winning team. This paper provides 12 practical tips to PBL students to enhance their skills in discussing a case in their group.

PubMed

Dent JA. Twelve tips for developing a clinical teaching programme in a day surgery unit. Med Teach 2003; 25(4):364-367.

Abstract: Healthcare policy in the UK is moving towards an expansion in day care services. As it becomes increasingly difficult to deliver clinical teaching to undergraduates in traditional inpatient venues, opportunities must be sought in ambulatory care. The proposed increased activity of day surgery units provides one such resource for the development of a structured clinical teaching programme. This paper highlights 12 tips for the preparation, delivery and evaluation of a clinical teaching programme in the day surgery unit. It describes the implications for staff and resources and indicates the educational opportunities that can be provided.

PubMed

Howe A. Twelve tips for developing professional attitudes in training. Med Teach 2003; 25(5):485-487.

Abstract: This article is based on a workshop run at AMEE Lisbon, building on work from previous conferences and reported in Medical Teacher (Howe, 2002a). The 30 workshop participants were particularly asked to address the question ‘What would you consider essential to include in a medical education curriculum that wishes to teach and assess professional development?’. This question was posed without further constraints, ie. regardless of whether undergraduate or postgraduate, the country or situation of the participant, and the type of setting in which they worked. Participants were invited to consider all aspects of the question, and no assumption was made about the need to reach a consensus. The workshop divided into two groups and shared ideas. This paper presents the main emergent points from discussion, for interest and further collaboration; the level of agreement was considerable, consistent with the peer reviewed literature (Howe, 2002b). The conclusions are therefore shared in the ‘Twelve Tips’ format as a pragmatic framework for those wishing to review their own curriculum with reference to professional development (PD) issues, or when setting up new opportunities.

PubMed

Ramani S. Twelve tips to improve bedside teaching. Med Teach 2003; 25(2):112-115.

Abstract: Bedside teaching has long been considered the most effective method to teach clinical skills and communication skills. Despite this belief, the frequency of bedside rounds is decreasing and it is believed that this is a major factor causing a sharp decline in trainees’ clinical skills. Several barriers appear to contribute to this lack of teaching at the bedside and have been discussed extensively in the literature. Concern about trainees’ clinical skills has led organizations such as the American Council for Graduate Medical Education (ACGME) and the WHO Advisory Committee on Medical training to recommend that training programs should increase the frequency of bedside teaching in their clinical curricula. Although obstacles to bedside teaching are acknowledged, this article in the ‘12 tips’ series is a detailed description of teaching strategies that could facilitate a return to the bedside for clinical teaching.

PubMed

Henderson E, Berlin A, Freeman G, Fuller J. Twelve tips for promoting significant event analysis to enhance reflection in undergraduate medical students. Med Teach 2002; 24(2):121-124.

Abstract: The facilitation of reflection and development of reflective abilities are increasingly considered to be an important component of professional development (Eraut, 1994). It is known that students find the process of reflection difficult and that it does not come naturally to all, requiring a safe trusting environment in which students can develop with staff support (Woodward, 1998). The structured and deliberate review of significant events has been advocated as a useful way to encourage reflection (Brookfield, 1990). These tips are based on recent research, which revealed that students’ difficulties with significant event analysis arise from a range of unforeseen emotional reactions or conflicts. We pass on our tips for minimizing these conflicts and enhancing the reflective and creative aspects of significant event analysis.

PubMed

Howe A. Twelve tips for community-based medical education. Med Teach 2002; 24(1):9-12.

Abstract: Teaching and learning in primary care and community settings is now a very common aspect of most medical trainings, and there is a growing expertise and evidence base related to the contribution of primary care practice to the reform of medical education. This article in the ‘12 tips’ series touches on both practical and political aspects of community-based medical education, addressing the context in which this contribution has developed, its impacts to date, and some core essentials of effective educational practice.

PubMed

Montemayor LL. Twelve tips for the development of electronic study guides. Med Teach 2002; 24(5):473-478.

Abstract: With recent advances in technology, electronic study guides are becoming extraordinary management, learning and assessment tools in the teaching-learning process, replacing printed study guides. The educational advantages they offer are listed here. During the elaboration of an electronic study guide, there are important issues to consider, such as the student’s capabilities in the use of electronic media, the type of software to be used, proper authorizations and accessibility, the inclusion of all information and links needed, as well as a clear explanation on the use of the software. This paper offers twelve useful tips for the development of electronic study guides.

PubMed

Reeves S, Koppel I, Barr H, Freeth D, Hammick M. Twelve tips for undertaking a systematic review. Med Teach 2002; 24(4):358-363.

Abstract: The need to underpin health and education with a firm evidence base is of increasing significance. Systematic review offers an effective approach to critically assessing research in order to understand its overall impact on practice. Based on 5 years’ experience undertaking systematic reviews of interprofessional education, this paper offers guidance for researchers and practitioners about to embark upon systematic review work.

PubMed

Wadoodi A, Crosby JR. Twelve tips for peer-assisted learning: a classic concept revisited. Med Teach 2002; 24(3):241-244.

Abstract: Peer-assisted learning (PAL) is a useful learning method. PAL is learning through active help of peer group members. PAL is increasingly being used in medical education although documented experience to date is limited. A PAL programme has been instigated and run by students at a Scottish medical school. The experience has resulted in the formulation of 12 tips to running PAL. These 12 tips cover organizational issues, tutor selection, training the tutor, and running and evaluating the sessions. It is hoped that these tips will be useful in the initiation and running of PAL programmes in other institutions.

PubMed

Dent JA, Ker JS, Angell-Preece HM, Preece PE. Twelve tips for setting up an ambulatory care (outpatient) teaching centre. Med Teach 2001; 23(4):345-350.

Abstract: The ambulatory care setting is becoming an increasingly important environment for clinical teaching. This reflects the changing focus of healthcare delivery with more procedures and patient treatment being delivered in this setting. Maximizing learning opportunities for students without compromising patient care has never provided a greater challenge. This paper shares 12 educational tips for developing an ambulatory care teaching centre where both students and patients benefit from a protected yet realistic clinical setting.

PubMed

Hartley S, Gill D, Walters K, Bryant P, Carter F. Twelve tips for potential distance learners. Med Teach 2001; 23(1):12-15.

Abstract: Distance learning courses are becoming popular among medical professionals due to their flexibility, allowing minimal disruption to personal and professional commitments. The ability to continue professional duties, allied to the reduced cost of distance learning courses, also makes them attractive to institutions looking to develop the skills of their staff. However the nature of distance learning courses means that they are often of long duration and many students fail to maintain motivation while working in isolation. This is reflected by high non-completion rates. This article outlines issues that all students planning a distance learning course should consider, relating to choice of course, time management, funding and adjusting to the different nature of distance learning. The authors advise developing a support network for distance learning students, either in person or electronically, to increase motivation and completion.

PubMed

Toohey S, Watson E. Twelve tips on choosing Web teaching software. Med Teach 2001; 23(6):552-555.

Abstract: Experimentation with the new technology of web-based teaching has meant that many medical schools are using more than one software system for delivery. In the medical faculty at the University of New South Wales at the end of 1999, three different software packages (WebTeach, Top Class and Learning Space) were used for mediating teaching and learning on the web. The type of applications for which web-based teaching is used also varied widely. They ranged from a distance-education coursework masters programme delivered via the web, to the provision of additional resource materials and case discussions to supplement undergraduate classes on campus. Once web-based teaching moves out of the experimental phase and into the mainstream there is usually pressure to standardize on one software system. This has the advantage of limiting costs for training and support but it may require some compromise on functionality. Faced with the need to limit the number of software packages in use at UNSW the published comparisons of web software (Landon, 2001; University of California at Berkeley; 2001; Marshall University, 2001; Murdoch University, 2001) were first investigated. These show in broad terms what each package will do but often lack sufficient detail to determine whether the package will meet specific requirements. To get a better idea of how different software packages operate under the pressure of day-to-day teaching, 15 academic course coordinators, instructional designers and educational developers from six Australian universities who are involved in designing and delivering web courses were interviewed. The authors also joined online user groups and asked questions of international users. The aim was to find out what strengths and weaknesses they had found in the packages they used and whether they would make the same choice again. The authors were particularly interested to find out what questions they would ask when considering a new package. The twelve tips that follow summarize their advice to those considering the choice of a web teaching package.

PubMed

Steinert Y. Twelve tips for using role-plays in clinical teaching. Med Teach 1993; 15(4):283-291.

PubMed

Steinert Y. Twelve tips for using videotape reviews for feedback on clinical performance. Med Teach 1993; 15(2-3):131-139.

PubMed

Harden RM. Twelve tips to encourage better teaching. Med Teach 1992; 14(1):5-9.

PubMed

Steinert Y. Twelve tips for conducting effective workshops. Med Teach 1992; 14(2-3):127-131.

PubMed

Harden RM. Twelve tips on using double slide projection. Med Teach 1991; 13(4):267-271.

Abstract: Double slide projection is not a technique that everyone will choose to use. It is a technique, however, which does offer the lecturer a number of advantages and it is not difficult to implement in the average lecture theatre. Careful consideration, however, must be given to the use to which the two projection system is to be put. In this paper 12 tips are given in the use of double slide projection and 10 possible uses for double slide projection are described. Three ways in which the lecturer can control the slide changes are presented.

PubMed

MacLean I. Twelve tips on providing handouts. Med Teach 1991; 13(1):7-12.

PubMed

Harden RM. Twelve tips for organizing an Objective Structured Clinical Examination (OSCE). Med Teach 1990; 12(3-4):259-264.

PubMed

McAleer S. Twelve tips for using statistics. Med Teach 1990; 12(2):127-130.

PubMed

Biggs JS. Meetings: twelve tips for chairing a new committee. Med Teach 1989; 11(1):47-50.

PubMed

Laidlaw JM. Twelve tips for designing instructional text using desktop publishing. Med Teach 1989; 11(2):139-143.

PubMed

Laidlaw JM. Twelve tips for lecturers. Med Teach 1988; 10(1):13-17.

PubMed

Laidlaw JM. Exhibitions: twelve tips for exhibitors. Med Teach 1988; 10(2):133-137.

PubMed

Leiper JM. Twelve tips for using a public address system.  Med Teach 1988; 10(3-4):273-276.

PubMed

Laidlaw JM. Twelve tips on preparing 35 mm slides. Med Teach 1987; 9(4):389-393.

PubMed

Recommended reading from Anne Taylor-Vaisey: Physicians Answer More Clinical Questions and Change Clinical Decisions More Often With Synthesized Evidence: A Randomized Trial in Primary Care. Alper BS, White DS, Ge B. Ann. Fam. Med. 2005; 3(6):507-513.

PURPOSE Clinicians need evidence in a format that rapidly answers their questions. DynaMed is a database of synthesized evidence. We investigated whether primary care clinicians would answer more clinical que! stions, change clinical decision making, and alter search time using DynaMed in addition to their usual information sources.

METHODS Fifty-two primary care clinicians naive to DynaMed searched for answers to 698 of their own clinical questions using the Internet. On a per-question basis, participants were randomized to have access to DynaMed (A) or not (N) in addition to their usual information sources. Outcomes included proportions of questions answered, proportions of questions with answers that changed clinical decision making, and median search times. The statistical approach of per-participant analyses of clinicians who asked questions in both A and N states was decided before data collection.

RESULTS Among 46 clinicians in per-participant analyses, 23 (50%) answered a greater proportion of questions during A than N, and 13 (28.3%) answered more questions during N than A (P = .05). Finding answers that changed clinical decision making occurred more often during! A (25 clinicians, 54.3%) than during N (13 clinicians, 28.3%) (P = .01). Search times did not differ significantly. Overall, participants found answers for 263 (75.8%) of 347 A questions and 250 (71.2%) of 351 N questions. Answers changed clinical decision making for 224 (64.6%) of the A questions and 209 (59.5%) of the N questions.

CONCLUSIONS Using DynaMed, primary care clinicians answered more questions and changed clinical decisions more often, without increasing overall search time. Synthesizing results of systematic evidence surveillance is a feasible method for meeting clinical information needs in primary care.

Full text

Recommended reading from Anne Taylor-Vaisey: Determination of professional competency in a rapidly changing environment.

Wann S. Department of Cardiovascular Medicine, The Wisconsin Hospital, Milwaukee, Wisconsin.

J Am Coll Cardiol. 2005 Dec 6;46(11):1996-8. Epub 2005 Nov 9.

The recently published American College of Cardiology/American Heart Association/American College of Physicians Clinical Competency Statement for cardiac computed tomography/cardiac magnetic resonance (CCT/CMR) will be of great value to hospital medical staff organizations that grant privileges in the exciting new fields of CCT/CMR. More evidence is needed to document the number of hours of continuing medical education (CME) and minimum case loads required to maintain competence. This ongoing experience should be integrated into comprehensive imaging and clinical education, including vascular imaging as well as cardiac. Mandating hours of CME and minimum case loads does not, by itself, assure quality. Assessment of competency should employ measurable performance standards, identify areas needing improvement, and emphasize continuous quality improvement principles.

PMID: 16325030 [PubMed - in process]

From an editorial in the November 22 issue of CMAJ:

Clinical practice guidelines and conflict of interest

CMAJ  November 22, 2005; 173 (11):1297.

Anne Taylor-Vaisey.

This post courtesy of Anne Taylor-Vaisey:

Curr Surg. 2005 November - December;62(6):664-669.

Using the Morbidity and Mortality Conference to Teach and Assess the ACGME General Competencies.

Rosenfeld JC, St. Luke’s Hospital, Bethlehem, Pennsylvania.

PURPOSE: The weekly Morbidity and Mortality (M&M) conference, a Residency Review Committee on Surgery required conference, is a hallmark of general surgery residency training. This conference has been used traditionally to teach and assess the ACGME General Competencies of patient care and medical knowledge. The author’s department has changed the format of their weekly M&M conference so that it enables them to teach and assess residents also in terms of the ACGME General Competencies of practice-based learning and improvement, professionalism, interpersonal and communication skills, and systems-based practice.

METHODS: Each Monday the chief resident on each teaching service compiles a list of patient discharges and deaths for the previous week. Although all deaths are presented, only significant patient complications are selected for the following week’s M&M conference. This 2-week preparation period enables the resident, who was primarily involved in the care of the patient, to thoroughly review the case and prepare his/her presentation. At the conference, the resident presents the patient’s history and discusses the complication or death, not only in terms of the patient care provided (traditional M&M model), but also it analyzes the case in terms of health-care systems problems that may have contributed to the patient’s morbidity and/or mortality; patient safety issues; communication problems with the patient, family, or other health-care workers; and ethnic or ethical issues related to the care provided. The case is then reviewed by faculty surgeons. Again, not only is the patient care critiqued, but also systems problems, communication problems, and ethical dilemmas. Each resident who presents a case at the M&M conference also completes a practice-based improvement log. This form analyzes the patient’s outcome including factors leading to the complication and/or mortality, opportunities for systems improvement, patient safety or communication problems, ethnic or ethical issues, what the resident would do different in his/her practice, and references consulted for this case. These forms are reviewed with the resident by the Residency Director and become part of the resident’s portfolio.

CONCLUSION: The restructuring of the M&M conference so that a case is analyzed with all ACGME General Competencies has made the M&M conference more interesting and has improved the educational aspects of the conference. Analyzing a case according to the various ACGME General Competencies has provided another method to teach these competencies to their residents and a tool to determine whether the residents are meeting the competencies.

PMID: 16293508 [PubMed - as supplied by publisher]

That’s what the the Pri-Med Research Clinical Outcomes Study found, anyway. From the press release:

In a nationwide study to determine the influence of continuing medical education on primary care, Pri-Med Research found that significant changes in clinical practice behavior occur across the range of therapeutic areas covered at the CME programs. Among participants, 98% report using clinical information acquired at the program in their practice, and 86% continued to agree that the CME experience was a valuable use of their time, even weeks after the program was held.



The Pri-Med Research Clinical Outcomes Study surveyed primary care practitioners attending Pri-Med Updates conferences in 55 cities across the US throughout 2004. To measure changes in practice behavior resulting from the CME learning experience, participants were surveyed two weeks prior to the conference and four-to-six weeks after the event. The study addressed the diagnosis and treatment of thirteen conditions commonly presented in primary care, across a spectrum from cardiovascular and respiratory diseases to clinical depression, diabetes and gastrointestinal disorders.

Among practitioners surveyed, a significant increase could be seen for both knowledge and adherence to clinical standards (a 15% and 13% increase, respectively) based on information presented at the CME program. Furthermore, confidence in treating patients increased an average of 16%.




“Self reported changes in knowledge, application of best practice standards and confidence in treatment have an immediate impact on patient care and clinical outcomes,” Alan Lotvin, MD, president of Pri-Med, said. “It is clear evidence that effective CME translates directly into better healthcare.”

Impact Varies Widely With Diagnosis




“Not surprisingly, the effect of CME in improving clinical practice behavior is more pronounced in relation to conditions primary care physicians encounter less frequently,” Marissa Seligman, Chief Clinical and Regulatory Affairs Officer, VP of Pri-Med Institute, said. “The study correlated reported changes in knowledge and application of clinical guidelines as well as confidence in treatment with the average number of patients seen each week across thirteen disease categories. The most significant changes in practice behavior were seen in less commonly treated conditions such as anemia, genitourinary infections, sleep disorders, neuropathic disorders, and sexual dysfunctions. For cardiovascular, gastrointestinal conditions and allergies, the greatest impact of CME can be seen in its ability to reinforce and expand knowledge among practitioners who regularly treat these conditions.”

This post courtesy of Anne Taylor-Vaisey: Here is an interesting article from the November 5 issue of BMJ:

 

Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources, Trisha Greenhalgh, Richard Peacock

BMJ  2005;331:1064-1065 (published 17 October 2005)

Objective To describe where papers come from in a systematic review of complex evidence.

Method Audit of how the 495 primary sources for the review were originally identified.

Results Only 30% of sources were obtained from the protocol defined at the outset of the study (that is, from the database and hand searches). Fifty one per cent were identified by “snowballing” (such as pursuing references of references), and 24% by personal knowledge or personal contacts.

Conclusion Systematic reviews of complex evidence cannot rely solely on protocol-driven search strategies.

 

Free full text

This post courtesy of Anne Taylor-Vaisey: Here are some items of possible interest from the current BMJ:

The need for outcome measures in medical education

Lambert Schuwirth, Peter Cantillon

BMJ 2005;331:977-978, doi:10.1136/bmj.331.7523.977

Doctors who write guidelines often have ties to the drug industry

Janice Hopkins Tanne

BMJ 2005;331:982, doi:10.1136/bmj.331.7523.982-a

What the educators are saying

Kevin W Eva, Val Wass

BMJ 2005;331:1006, doi:10.1136/bmj.331.7523.1006

ABC of health informatics: How computers help make efficient use of consultations

Frank Sullivan, Jeremy C Wyatt

BMJ 2005;331:1010-1012, doi:10.1136/bmj.331.7523.1010

This post courtesy of Anne Taylor-Vaisey: Published in the October 24 issue of the Archives of Internal Medicine are this editorial and study:

Benson AB, III. In search of evidence: Is there the will and a way? [editorial]. Arch Intern Med 2005; 165(19):2194-2195.

Excerpt: Scientifically, politically, economically and perceptually, there are growing demands by both society as a whole and the medical profession that evidence must drive clinical decision pathways. The best level of evidence as incorporated into clinical practice guidelines originates from randomized clinical trial data. For many years, the process of obtaining objective clinical data has been a path across a minefield. Even under the most optimal circumstances, obstacles confront most clinical research projects that can delay the reporting of important clinical information.

In this issue of the ARCHIVES, Embi et al present the use of the electronic health record (EHR)-based clinical trial alert (CTA) system to address the problem of rapid subject recruitment by physicians, one of the recognized obstacles that can delay successful completion of a clinical trial. Although the authors recognize the limitations of this particular CTA intervention, including a small number of physicians at a single institution, along with the use of a single EHR to test a single clinical trial, this article serves as an invitation to incorporate the evolving use of technology in the clinical practice setting to enhance all phases of the clinical research process.

Journal link

This post courtesy of Anne Taylor-Vaisey:

From today’s New England Journal of Medicine:

 

Zerhouni EA. Translational and clinical science — Time for a new vision. N Engl J Med 2005; 353(15):1621-1623.

Excerpt: It is the responsibility of those of us involved in today’s biomedical research enterprise to translate the remarkable scientific innovations we are witnessing into health gains for the nation. In order to address this imperative, we at the National Institutes of Health (NIH) asked ourselves:

What novel approaches can be developed that have the potential to be truly transforming for human health?

To help crystallize these ideas and develop tangible strategies to advance our efforts, three years ago the NIH initiated a series of consultations with the research community to define major scientific trends collectively, with th! e goal of identifying thematic areas that no single NIH institute or group of institutes could tackle alone, but that the whole of the NIH needed to address.

This effort led to the development of the NIH Roadmap for Medical Research,1 with three fundamental themes.

First, we identified the need to stimulate the development of novel approaches to unravel the complexity of biologic systems and their regulation, which we encapsulated in the “New Pathways to Discovery” theme.

Second, since progress is often made at the interface of preexisting disciplines, we explored ways to reduce the cultural and administrative barriers that often impede such research. To invoke an era in which scientists can cooperate in new and different ways, we drafted novel programs under the theme of “Research Teams of the Future.” One of these innovative programs is the Pioneer Award, in which the NIH provides unpreced! ented intellectual freedom to highly creative thinkers investigating problems of biomedical and behavioral importance.

Third, we heard resounding concern from basic, translational, and clinical researchers alike that their interactions were becoming more remote and difficult, that clinical research was increasingly less attractive to new investigators, and that clinician-scientists were moving away from patient-oriented research. It was clear that instigating renovations in translational and clinical science was paramount among the NIH’s immediate responsibilities. This led us to formulate the third Roadmap theme, “Re-engineering the Clinical Research Enterprise.”

Zerhouni E. The NIH Roadmap. Science 2003;302:63-72. [Abstract/Full Text] 

Free full text of the NEJM article

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