research at the fms - university of the west indies · 2019-03-12 · student research...
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ResearchattheFMS:CurrentStatusandFutureDirections
DonaldT.Simeon,PhD
GuestLectureattheFMS,UWI,StAugustine
January24,2017
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Acknowledgments
• Interviews• L.Baboolal• B.Bassaw• C.Carrington• C.Charles• D.Dan• G.Hutchinson• L.Jaisingh (MOH)• R.Naidu• C.Oura• K.Sealey (MOH)• TSeemungal
• Reports• D.Crichlow• E.Greenidge• M.Lewis• S.Roberts
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Overview• Currentstatus
• Structure
• Researchoutputanduptake
• ChallengesandOpportunities
• Futuredirections
• Approachestoincreaseresearchoutputanduptake
• Systemic,targeted,collaborations
• Conclusion
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CurrentStatusofResearch
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Structure• DeputyDean– ResearchandGraduateStudies• ResearchEthicsCommittee
• ResearchClusters• TropicalMedicine:InfectiousDiseases• Lifestyle-relatedNCDs• Dementia,NeuroscienceandMentalHealth• PublicHealth(Vet,MedandDental)• NaturalProductsandHerbalMedicine• EthnicityandHealth• Surgery
• Othersgroups,individualsinallSchools
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ResearchOutput• Publications(primaryproxy)
• ResearchDegrees
• Othermeasures
• Conferencepresentations
• Innovation– patents,etc.
• Proposalspreparedandsubmittedforfundingor
implemented
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Methodology• Numberofpublications• Sourcesofdata
• PubMed(T&T,UWIandFMSassearchterms)
• AnnualFacultyreports(2010-2015)
• Limitations• Inconsistencies– duplications;omissions
• QualityofJournals
• Studentresearch• FocusonPhDandMPhilDegrees
• Others
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Publications1990– 2015(AllT&T– PubMed)
0
20
40
60
80
100
120
140
160
180
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
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SourceofPubMedT&TPublications2010-2015
UWI (Faculties) #ofPublications %
MedicalSciences 360 65
ScienceandTechnology 21 4
SocialSciences 10 2
FoodandAgriculture 8 1
HumanitiesandEducation 4 1
NonUWI 151 27
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FMSPublications2010-2015(PubMedandFacultyReports)
38
5447
55
87
78
5156
61 6356
42
89
110 108
118
143
120
0
20
40
60
80
100
120
140
160
2010 2011 2012 2013 2014 2015
PubMed OtherPublicationsfromFacultyReport Total
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DisparitybetweenPubMedandFacultyReports
• AuthorsnotreportedasbeingaffiliatedtoFMSinsomepublications
• JournalsnotindexedinMedlinedatabase• NewJournals,peer-reviewprocess
• Books
• DisciplinesnotcoveredbyPubMed• IndexMedicus:medicine,nursing,dentistry,veterinarymedicine,healthcaresystems,preclinicalsciences
• Multi-disciplinaryresearchteams
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FMSPublications,bySchool
0
10
20
30
40
50
60
70
80
90
100
2010 2011 2012 2013 2014 2015
MEDICINE VETERINARY PHARMACY DENTISTRY NURSING
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PublicationsbySchool2010-2015
0
50
100
150
200
250
300
350
400
450
MEDICINE VETERINARY PHARMACY DENTISTRY NURSING
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No.ofAcademicstaff,bySchool
School NumberMedicine 82
VeterinaryMedicine 28
Dentistry 17
Nursing 10
Pharmacy 10
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No.ofPublicationperAcademicStaff(2010- 2015)
8.20
4.94
4.50
2.65
0.60
4.68
0.00
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
Pharmacy Medicine VeterinaryMedicine Dentistry Nursing AllFMSStaff
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JournalswithMostPublications(2010-2015)
JOURNAL No.
%of
Total
Impact
Factor
WestIndianMedicalJournal 89 12.9 0.29
ArchivesofPhysiologyand
Biochemistry 12 1.7 2.05
InternationalJournal of SurgeryCase
Reports 8 1.2 0.63
BritishMedicalJournalCaseReports 7 1.0 0.32
PanAmericanJournalofPublicHealth 6 0.9 0.56
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StudentResearch
• Undergraduateresearch• YR02SchoolofMedicine
• Verysuccessful,prizesatCHRC,publications,etc.
• 32 groupprojectsduring2015-2016academicyear
• OtherSchools• Groupvs.individualprojects
• Graduatestudents• DM
• 13programs,requireresearchprojects
• 170studentsenrolledduring2015-2016
• MPH• Requireresearchprojects
• 25 studentsenrolled2015-2016
• MSc• 5 programswith32students
enrolled2015-2016
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ResearchDegrees• Pre-ClinicalSciences• 12currentlyenrolled(7PhD,5MPhil)
• Biochemistry(6),MolecularGenetics(5),Physiology(1)
• 7graduatedbetween2012-2015• 5PhDs– averageduration8.8years• 2MPhils– averagetime4.5years• Challengesidentified
• Procurementofresearchmaterials
• Lackofreagents,resourcesandequipment• Lackofadequatesupervision
• Para-clinicalSciencesandVetSchool• AlsohaveMPhilandPhDstudents
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ResearchUptake• UWIStrategicPlan
• Sharingoffindingswithkeystakeholders
• Clinicalpractice• LeddevelopmentofCaribbeanGuidelinesforAsthma,DepressionandMaternalCareinPregnancy.AlsocontributedtoDMandHypertension
• Informhealthpolicyandprogramming• Nodataavailable
• Innovations• Nodataavailable
• Researchcitations• Notexamined
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CurrentStatus:Summary• Structure
• Inplace,timeforreview?• ResearchClusters
• Collaborations– Departments,Schools,Faculties,campuses,external• Researchawards– atregionalandnationallevels
• Productivity• IncreasingnumberofpublicationsbutnotinallSchools• Notallstaffmembersequal
• Fewwithmanypublicationsandmanywithveryfew?
• Studentresearchhaspotentialforstrengthening
• Uptake• Contributiontoclinicalpractice• Policyimpactandinnovationunclear
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ChallengesandOpportunities
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Challenges
• Lackoftechnicalsupport• Statistician,epidemiologist,RAs,post-docs
• MaintenanceofLabfacilitiesandequipment
• Administrativesupportforgrantmanagement• RoleofOfficeofResearchDevelopmentandKnowledgeTransferisunclear
• BursaryandLegalOffice• Notverysupportiveingrantreporting/communication
• EthicsapprovalfromMOHandRHAs• Unstructuredsystem– causesdelays
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Challenges
• Inadequatetimeforresearch• Heavyteachingandserviceloads
• Limitedfunding• Conductofresearch• Alsoneededforpublicationfees
• Needforresearchskillstraining• Insufficientcapacityinresearchdesignandmethodology
• Conversionofcompletedresearchtopublications
• Researchculture
• Insufficientmentoring
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Opportunities• Attractiveforinternationalcollaboration• Increaseinfundingopportunities• Shareexpertiseandbuildlocalcapacity
• Exchangeprogrammese.g.students
• Geography• Tropicalbutveryaccessible
• Diseaseprofile• HighratesofNCDs• Infectioussuchasvectorborne,HIV,etc.
• Ethnicdistribution/Biologicalandculturaldiversity• Goodnaturallabforgeneticandotherresearch
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Opportunities
• Scopeformulti-disciplinaryresearch• WithinFMSandwithotherFaculties
• OtherUWICampuses,regionallyandinternationally
• Experiencedstaff• Internationalcollaboratorsandgrants• Canengageinmorestructuredmentorship
• MOHisawillingpartner• Researchuptakeandfunding
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FutureDirections
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TheWayForward• StrengthentheresearchsystemattheFMS
• EstablishmentofaResearchCentre
• Specificinterventionstoincreaseresearchoutput
• Moresupportforstudentresearch
• Strengthenframeworksforcollaborations• IncludingwiththeMOHandregionalinstitutions
• Strengthensystemsforresearchuptake
Strengthentheresearchculture
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HealthResearchSystems
thepeopleandstructuresthatgovern,manage,
demand,generate,communicateoruseresearch
evidencetopromote,restore,improveormaintainthe
stateofhealthanddevelopment
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Attributesoffunctionalhealthresearchsystems
• Stewardship
• Financing
• DevelopingandSustainingResearchCapacity
• KnowledgeProduction,TranslationandUtilization
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• Stewardship• vision(policy),priorities(agenda),coordination,ethicalstandards• planningandexecution
• FinancingFunction• Secureresearchfunds• Grantwritingcapacity
• DevelopingandSustainingResearchCapacity• Build,strengthenandsustainthehumanandphysicalcapacitytoconducthealthresearch
• KnowledgeProduction,TranslationandUtilization• Producescientificallyvalidatedresearchoutputs• Translateandcommunicateresearchtoinformhealthpolicy,healthpractice,andpublicopinion
• Promotetheuseofresearchtodevelopinterventionstoimprovehealth(innovations)
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AResearchCentreattheFMS• Raisedmanytimesinthepast– recentproposals
• EmergingInfectiousandLifestyle-relatedDiseasesResearchCentre
• CentreforEmergingDiseasesandGlobalHealth(C-EDGE)
• Bestapproach• SpecializedUnitorAll-Inclusive?
• CaribbeanInstituteforHealthResearch(CAIHR)• FormerlyTMRI.SpecializedunitsatMonaandCaveHill;similarapproachisbestforStAugustine?
• Focusonstrengths,existingclusters,gaps….• Fordiscussion
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FMSResearchCentre• Agendaguidedby
• Regionalpriorities– HealthResearchAgendafortheCaribbean
• Nationalpriorities– collaborationwiththeMOH• UWIpriorities(StrategicPlan)• NeedtopromotemoreInnovation
• Funding• Grantwriting– internationallycompetitiveproposals• MOH
• Addressnationalprioritiese.g.RDIgrants• FromDevelopmentagenciessuchasIDB,%ofbudgetforresearch
• UWIOfficeofResearch• InternationalopportunitiessuchasEULAC,NWO,etc.
• Privatesectore.g.banks,Bhagwansingh,Methanex
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TargetedInterventions
• ToincreasethequantityandqualityofresearchattheFMS
• Basedonneedsandevaluations• Someidentifiedindiscussionswithstaff
• Resultsof2001FMSStaffSurvey• Targetedallacademicstaffwith88%responserate
• Researchproductivity,Challenges,Funding
• Literaturereview• Systematicreviewsofsuccessfulstrategies
• ReasonsforrejectionofmanuscriptsbytopJournals
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SpecificInterventions
• Buildcapacity- trainingworkshopstoaddress• Researchskills– studydesigns,methodology• Writingskills(proposalsandmanuscripts)
• Technicalresources– biostatistician,epidemiologist,researchassistants,etc.
• Peersupport– mentors,coaches
• Incentives- protectedtimeforresearch,funding,awards,publicationcosts,performance-basedculture
• On-linefacilities– EQUATORNetworkhttp://www.equator-network.org
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InitiativesimplementedinResidencyprogramme
Alweis etal2015
Demonstratedsuccessovertimewithinterventionsincluding:• Researchdirector• Journalclub• Seminars• Protectedtime• Staff– hiredabiostatistician• Definingresearchrequirementsinjobdescription• Mentoring• Celebratingresidentsuccesses• Incentiveplans(rewardproductiveresidents)
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ResearchOutputoftheProgramme
Alweis etal2015
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StudentResearch• Reviewincorporationofresearchinalltrainingprogrammes• Canbestrengthenedwithmoretechnicalsupport
• ChallengeswithResearchDegreesforPre-Clinicalidentified
• Needforevaluation• Publications– numberandqualityintermsofduration,etc.• Researchuptake• Follow-upaftercompletionofDegrees• Roleofpost-docs,exchangeprogrammes,etc.
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StrengtheningCollaborations• UWI
• WithinFMS• Needtosharewhateachisdoing– FacultyResearchDayisagoodfacility
• OtherFaculties– HEU,SALISES,Behavioural Sciences,Engineering
• OtherCampuses includingCAIHR,CDRC
• Otherregionalpartners• SuchasWINDREF,PAHO
• International• Facilitategreateraccesstofunding,technicalexperience
• ShouldalsoincludeSouth-South– countriessuchasBrazil(EULAC)
• Needforinfrastructuralsupporttofacilitateeaseofcommunication
• Needtoshowcasework– highimpactpublications,conferences
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CollaborationswiththeMOH• SupporttoMOHtodevelopresearchagenda
• MOUbetweenMOHandUWItobeestablished• Focusonoperational/healthservicesresearch
• ConductedbyUWIstudents(andstaff)
• DatabasesbeingestablishedatMOH
• FundingusuallyavailablefromMOH• E.g.currentIDBfundsforNCD• Budgetlineforresearch• Researchcommitteetobeestablishedforresearchgrants• Historyofcollaboration– e.g.NESTT,BOLD,Dementia
• Forumtoshareresearchfindingsandresearchinterests• WithMOHpolicymakersandpolicyinfluencers
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ResearchUptake• Outreachmustbeapriority
• RoleinKnowledgeTranslation• Goingbeyondpublicationsandscientificreports• CollaborationssuchaswithMcMastersHealthForum
• Innovation• CollaborationswithIndustry
• Herbalmedicines,MedicalMarijuana,etc.
• Apps,patentsforclinical/diagnostic/screeningtechniques,instruments,etc.
• Publications• Needtoimprovethenumbersinhighimpactjournals
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StrategiestoImprovePublicationsSystematicreviewcomprising9articles(FranzandAmosun,2011)
• Successfulinterventionsincluded:• Writingsupportgroups
• Writingcourses
• Writingretreats
• Writingcoaches
• Combinationsoftheabove
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InConclusion• Excellentresearchbeingconductedandproductivityisincreasing• RoomforimprovementasnotallSchoolsoracademicstaffmembersareatacceptablelevels
• Opportunitiesformoreinternalandexternalcollaborations• Potentialformoreresearch,ofhigherqualityandimpact• Bothsystemicandtargetedapproachesareneeded,includingmoretechnicalsupport• Needforgreaterfocusonresearchuptakeandinnovation