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Hildt E, Laas K, Miller CZ, Taylor S. Student views on the culture of STEM research laboratories: Results from an interview study. Account Res 2024; 31:100-137. [PMID: 35912949 DOI: 10.1080/08989621.2022.2109018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In this article, we present the results of 30 ethnographic interviews in which we asked STEM graduate and undergraduate students at a Midwest university in the United States about topics related to the culture of their research group, how group members communicate and interact, and their experience with ethical issues that arise within the laboratory. Here we focus on the culture of research laboratories and describe the key categories that emerged through analysis, including communication, community structure, governance, and collaboration that influence and shape lab culture. We also consider the critical role of the principal investigator (PI) to influence conditions in the lab that facilitate or inhibit lab culture and the subsequent effects on student feelings and behaviors, interpersonal communication, collaboration, work output, and ethics. Our findings suggest that the quality of research and the wellbeing of the lab members depend not only on purely scientific factors and routine research practices but are also dependent on the culture of the lab as it manifests in interpersonal relationships. The interviews reveal the critical role students ascribe to the PI in shaping the lab culture. Based on this study, we suggest how ethical lab cultures might be encouraged.
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Affiliation(s)
- Elisabeth Hildt
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Kelly Laas
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Christine Z Miller
- Design Management, School of Business Innovation, Savannah College of Art and Design, Atlanta, Georgia, USA
| | - Stephanie Taylor
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, Illinois, USA
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2
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McIntosh T, Antes AL, Schenk E, Rolf L, DuBois JM. Addressing serious and continuing research noncompliance and integrity violations through action plans: Interviews with institutional officials. Account Res 2024; 31:991-1023. [PMID: 36896610 PMCID: PMC10493235 DOI: 10.1080/08989621.2023.2187292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023]
Abstract
Serious and continuing research noncompliance and integrity violations undermine the quality of research and trust in science. When researchers engage in these behaviors, institutional officials (IOs) often develop corrective action plans. Ideally, such plans address the root causes so noncompliance or research integrity violations discontinue. The aim of this study was to identify what IOs perceive as causes and action plan activities typically prescribed. We conducted semi-structured in-depth interviews with 47 IOs at research institutions across the U.S. including: institutional review board and institutional animal care and use committee chairs and directors, chief research officers, research compliance and integrity officers, and institutional conflicts of interest chairs and directors. The most common root causes identified were: 1) lack of knowledge or training, 2) failure to provide research team supervision, and 3) researcher attitudes toward compliance. The most common action plan activities include: 1) retraining in compliance or research integrity, 2) follow-up and hands-on involvement with the researcher, and 3) mandated oversight or mentoring. Because the most commonly identified action plan activities fail to adequately address the majority of root causes, our findings suggest a need for IOs to rethink existing approaches to action plan development to more effectively target root causes.
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Affiliation(s)
- Tristan McIntosh
- Bioethics Research Center, Washington University School of Medicine in St. Louis, Saint Louis, MO, USA
| | - Alison L Antes
- Bioethics Research Center, Washington University School of Medicine in St. Louis, Saint Louis, MO, USA
| | - Emily Schenk
- Bioethics Research Center, Washington University School of Medicine in St. Louis, Saint Louis, MO, USA
| | - Liz Rolf
- Bioethics Research Center, Washington University School of Medicine in St. Louis, Saint Louis, MO, USA
| | - James M DuBois
- Bioethics Research Center, Washington University School of Medicine in St. Louis, Saint Louis, MO, USA
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3
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Solomon ED, Antes AL, Cheng SY, Crollard N, Chiu YL, DuBois JM, McIntosh T. Seeking help as a strategy for ethical and professional decision-making in research: Perspectives of researchers from East Asia and the United States. Account Res 2024:1-23. [PMID: 38828607 DOI: 10.1080/08989621.2024.2360945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/23/2024] [Indexed: 06/05/2024]
Abstract
Background: A person's cultural background shapes how they interpret and navigate problems. Given that large numbers of international researchers work and train in the U.S. we sought to better understand how researchers use the decision-making strategy of seeking help to navigate ethical and professional challenges.Methods: Participants (N = 300) were researchers working or training in the U.S. who were born in East Asia (EA) or born in the U.S. They completed a screening survey; then a subset completed think-aloud interviews (n = 66) focused on how they would respond to three hypothetical research scenarios.Results: Thematic analysis of the transcripts showed that seeking help was a commonly endorsed strategy, with some nuances between groups. Themes included seeking help in the form of getting advice, seeking someone to help solve the problem, and gathering information. Endorsement of the seeking help strategy frequently depended on participants' relationships; desiring to seek help from people they trusted. Notably, EA participants tended to prefer seeking help in ways that avoided reputational harm to others.Conclusion: A better understanding of how researchers from different cultural backgrounds use decision-making strategies can inform how to make educational programs more inclusive and comprehensive to more effectively develop researchers' ethical and professional decision-making skills.
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Affiliation(s)
- Erin D Solomon
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Alison L Antes
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Shih-Ying Cheng
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Jane Addams College of Social Work, University of Illinois Chicago, Chicago, IL, USA
| | - Nikia Crollard
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Yi-Lun Chiu
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - James M DuBois
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tristan McIntosh
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
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4
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Kiwanuka GN, Bajunirwe F, Alele PE, Oloro J, Mindra A, Marshall P, Loue S. Public health and research ethics education: the experience of developing a new cadre of bioethicists at a Ugandan institution. BMC MEDICAL EDUCATION 2024; 24:1. [PMID: 38172860 PMCID: PMC10763195 DOI: 10.1186/s12909-023-04974-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
Research ethics education is critical to developing a culture of responsible conduct of research. Many countries in sub-Saharan Africa (SSA) have a high burden of infectious diseases like HIV and malaria; some, like Uganda, have recurring outbreaks. Coupled with the increase in non-communicable diseases, researchers have access to large populations to test new medications and vaccines. The need to develop multi-level capacity in research ethics in Uganda is still huge, being compounded by the high burden of disease and challenging public health issues. Only a few institutions in the SSA offer graduate training in research ethics, implying that the proposed ideal of each high-volume research ethics committee having at least one member with in-depth training in ethics is far from reality. Finding best practices for comparable situations and training requirements is challenging because there is currently no "gold standard" for teaching research ethics and little published information on curriculum and implementation strategies. The purpose of this paper is to describe a model of research ethics (RE) education as a track in an existing 2-year Master of Public Health (MPH) to provide training for developing specific applied learning skills to address contemporary and emerging needs for biomedical and public health research in a highly disease-burdened country. We describe our five-year experience in successful implementation of the MPH-RE program by the Mbarara University Research Ethics Education Program at Mbarara University of Science and Technology in southwestern Uganda. We used curriculum materials, applications to the program, post-training and external evaluations, and annual reports for this work. This model can be adapted and used elsewhere in developing countries with similar contexts. Establishing an interface between public health and research ethics requires integration of the two early in the delivery of the MPH-RE program to prevent a disconnect in knowledge between research methods provided by the MPH component of the MPH-RE program and for research in ethics that MPH-RE students are expected to perform for their dissertation. Promoting bioethics education, which is multi-disciplinary, in institutions where it is still "foreign" is challenging and necessitates supportive leadership at all institutional levels.
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Affiliation(s)
- Gertrude N Kiwanuka
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Francis Bajunirwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul E Alele
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph Oloro
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Arnold Mindra
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Patricia Marshall
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Sana Loue
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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5
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Roje R, Reyes Elizondo A, Kaltenbrunner W, Buljan I, Marušić A. Factors influencing the promotion and implementation of research integrity in research performing and research funding organizations: A scoping review. Account Res 2023; 30:633-671. [PMID: 35531936 DOI: 10.1080/08989621.2022.2073819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Promoting and implementing research integrity is considered the joint responsibility and effort of multiple stakeholders in the research community. We conducted a scoping review and analyzed 236 research articles and gray literature publications from biomedical sciences, social sciences, natural sciences (including engineering), and humanities that dealt with the factors that may positively or negatively impact the promotion and implementation of research integrity. Critical appraisal of evidence was performed for studies describing interventions aimed at research integrity promotion in order to provide insight into the effectiveness of these interventions. The results of this scoping review provide a comprehensive taxonomy of factors with positive or negative impact and their relatedness to individual researchers, research performing and funding organizations, and the system of science. Moreover, the results show that efforts for fostering and promoting research integrity should be implemented at all three levels (researcher, institution, system) simultaneously to deliver greater adherence and implementation of research integrity practices. Although various educational interventions aiming at research integrity promotion exist, we were not able to conclude on the effectiveness of explored interventions due to the methodological quality issues in the studies.
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Affiliation(s)
- Rea Roje
- Department of Research in Biomedicine in Health, University of Split School of Medicine, Split, Croatia
| | - Andrea Reyes Elizondo
- Centre for Science and Technology Studies (CWTS), Leiden University, Leiden, The Netherlands
| | - Wolfgang Kaltenbrunner
- Centre for Science and Technology Studies (CWTS), Leiden University, Leiden, The Netherlands
| | - Ivan Buljan
- Department of Research in Biomedicine in Health, University of Split School of Medicine, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine in Health, University of Split School of Medicine, Split, Croatia
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6
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Resnik DB, Lee E, Jirles B, Smith E, Barker K. For the "good of the lab": Insights from three focus groups concerning the ethics of managing a laboratory or research group. Account Res 2023; 30:199-218. [PMID: 34591708 PMCID: PMC8964830 DOI: 10.1080/08989621.2021.1983799] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To obtain some exploratory, qualitative data on ethical issues and values in managing a research laboratory, we conducted three focus groups with experienced investigators and laboratory managers. After validating the focus group transcripts for accuracy, two coders used deductive and inductive coding to develop themes from the text. Participants regarded ethics as important in managing a laboratory (or research group) for various reasons, ranging from conducting research with integrity to exhibiting leadership and promoting an ethical research climate. Participants identified many different types of ethical issues that arise in managing a research laboratory, including issues involving the management people, financial and material resources, projects, and data. An overarching ethical dilemma identified by participants was balancing the desire for productivity against apparently competing values, such as treating people fairly and promoting the wellbeing of individuals. Participants also indicated that graduate and post-graduate education and training did not prepare them to deal with the ethical, financial, interpersonal, and other issues related to managing a research laboratory, and that communication and leadership are crucial to managing a research laboratory ethically.
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Affiliation(s)
- David B Resnik
- Bioethicist, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Edith Lee
- Office of Fellows' Career Development, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Bill Jirles
- Program Analyst, Office of Policy, Planning and Evaluation, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Elise Smith
- Assistant Professor of Preventative Medicine and Community Health, University of Texas Medical Branch, Galveston, TX
| | - Kathy Barker
- Clinical Assistant Professor, University of Washington, Seattle, WA
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7
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Chen KC, Hester LL. A dramatized method for teaching undergraduate students responsible research conduct. Account Res 2023; 30:176-198. [PMID: 34559573 DOI: 10.1080/08989621.2021.1981871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Worldwide, undergraduate science and pre-medical students are encouraged to participate in authentic active learning lab work and undergraduate research experiences. Unfortunately, these experiences rarely include training in science or research ethics. Although several governmental and scientific organizations have called for increased training in responsible research conduct, relatively few studies report on the effectiveness of different pedagogical approaches. Too often science ethics socialization and training is limited to conversations with individual mentors. This paper describes how viewing an interactive theatrical presentation of several research misconduct scenarios was associated with an increase in first-year students' self-assessed understanding of the topics addressed: proper treatment of data images, respect for animal protocols, authorship considerations, and plagiarism issues. There was no decrease in self-reported responsible conduct of research (RCR) knowledge for students surveyed 10 weeks, as compared to 2 weeks, after the science ethics presentations. RCR test question scores showed only a slight decrease in correct answers from 2 to 10 weeks. Theatrical presentation is an inexpensive yet engaging approach that provides students with a chance to actively consider the importance of RCR and the complexities of contexts surrounding ethics decisions before starting a research career.
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Affiliation(s)
- Kuei-Chiu Chen
- Department of Premedical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar.,New York, USA
| | - Laurel L Hester
- National Science Foundation, Alexandria, USA.,Previously Division of Natural Sciences and Mathematics, Keuka College, Keuka Park, USA
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8
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Whaley AL, Mesidor JK. Teaching publication ethics to clinical psychology doctoral students: case-based learning and semi-structured interview strategies. ETHICS & BEHAVIOR 2023. [DOI: 10.1080/10508422.2023.2169829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
| | - Jean Kesnold Mesidor
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine
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9
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Solomon ED, Mozersky J, Goodman M, Parsons MV, Baldwin KA, Friedrich AB, Harris JK, DuBois JM. A randomized implementation trial to increase adoption of evidence-informed consent practices. J Clin Transl Sci 2022; 7:e28. [PMID: 36721403 PMCID: PMC9884547 DOI: 10.1017/cts.2022.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes. Methods We conducted a 1-year trial with clinical research professionals in the USA (n = 1284) who have trials open to older adults or focus on Alzheimer's disease. We randomized participants to receive information on ECPs via receiving a toolkit with a social media push (intervention) or receiving an online learning module (active control). Participants completed a baseline survey and a follow-up survey after 1 year. A subset of participants was interviewed (n = 43). Results Participants who engaged more with the toolkit were more likely to have tried to implement an ECP during the trial than participants less engaged with the toolkit or the active control group. However, there were no significant differences in the adoption of ECPs, intention to adopt, or positive attitudes. Participants reported the toolkit and social media push were satisfactory, and participating increased their awareness of ECPs. However, they reported lacking the time needed to engage with the toolkit more fully. Conclusions Using an implementation science approach to increase the use of ECPs was only modestly successful. Data suggest that having institutional review boards recommend or require ECPs may be an effective way to increase their use.
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Affiliation(s)
- Erin D. Solomon
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jessica Mozersky
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Melody Goodman
- School of Global Public Health, New York University, New York, NY, USA
| | - Meredith V. Parsons
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Kari A. Baldwin
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Annie B. Friedrich
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jenine K. Harris
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - James M. DuBois
- Bioethics Research Center, Washington University School of Medicine, St. Louis, MO, USA
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10
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Chou C, Lee YH. The Development of a Literacy-Based Research Integrity Assessment Framework for Graduate Students in Taiwan. SCIENCE AND ENGINEERING ETHICS 2022; 28:66. [PMID: 36508039 DOI: 10.1007/s11948-022-00401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 09/12/2022] [Indexed: 06/17/2023]
Abstract
Graduate education is a critical period in shaping and fostering graduate students' awareness about the importance of responsible conduct of research and knowledge and skills in doing good science. However, there is a lack of a standard curriculum and assessment framework for graduate students in Taiwan. The aim of this study was to develop a literacy-based research integrity (RI) assessment framework, including five core RI areas: (1) basic concepts in RI, (2) RI considerations in the research procedure, (3) research ethics and research subject protection, (4) publication and authorship, and (5) conflict of interest. The five areas were derived through a comprehensive review of major topics and areas covered in existing research integrity education and training programs and were rated by RI experts with adequate content validity. Test items on the five core areas were developed across three literacy levels: remembering and understanding, applying and analyzing, and evaluating and creating. Seven thousand and eighty-seven graduate-level trainees took an 18-unit RI course covering the five RI areas. Upon finishing the course, trainees completed a computer-based RI assessment randomly selected from 26 RI testing booklets. The design of test items followed the mastery-oriented assessment principles to promote trainees' learning of RI with adaptive assessment feedback. Results showed that the items in the RI assessment had adequate discrimination and low difficulty level. Thus, the RI assessment can be used to assess a range of trainees' RI literacy and can provide the most information in identifying trainees in need of more instruction or alternative training. The low guessing parameters also indicated the online RI assessment had an appropriate control of test exposure and cheating prevention. Higher education authorities can use this framework to assess graduate students' RI literacy based on a standard curriculum and prepare them for conversations about the responsible conduct of research for RI culture-building.
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Affiliation(s)
- Chien Chou
- Institute of Education, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - Yuan-Hsuan Lee
- Department of Education and Learning Technology, National Tsing Hua University, 521 Nanda Rd., Hsinchu City, Taiwan.
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11
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Abstract
Concern over social scientists' inability to reproduce empirical research has spawned a vast and rapidly growing literature. The size and growth of this literature make it difficult for newly interested academics to come up to speed. Here, we provide a formal text modeling approach to characterize the entirety of the field, which allows us to summarize the breadth of this literature and identify core themes. We construct and analyze text networks built from 1,947 articles to reveal differences across social science disciplines within the body of reproducibility publications and to discuss the diversity of subtopics addressed in the literature. This field-wide view suggests that reproducibility is a heterogeneous problem with multiple sources for errors and strategies for solutions, a finding that is somewhat at odds with calls for largely passive remedies reliant on open science. We propose an alternative rigor and reproducibility model that takes an active approach to rigor prior to publication, which may overcome some of the shortfalls of the postpublication model.
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Affiliation(s)
- James W Moody
- Department of Sociology, Duke University, Durham, North Carolina, USA
- Duke Network Analysis Center, Duke University, Durham, North Carolina, USA
| | - Lisa A Keister
- Department of Sociology, Duke University, Durham, North Carolina, USA
- Duke Network Analysis Center, Duke University, Durham, North Carolina, USA
- Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
| | - Maria C Ramos
- Interdisciplinary Social Science Program, Florida State University, Tallahassee, Florida, USA
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12
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Tackett S, Sugarman J, Ng CJ, Kamarulzaman A, Ali J. Developing a competency framework for health research ethics education and training. JOURNAL OF MEDICAL ETHICS 2022; 48:391-396. [PMID: 33811112 PMCID: PMC8486875 DOI: 10.1136/medethics-2021-107237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/15/2021] [Accepted: 03/21/2021] [Indexed: 05/26/2023]
Abstract
Health research ethics (HRE) training programmes are being developed and implemented globally, often with a goal of increasing local capacity to assure ethical conduct in health-related research. Yet what it means for there to be sufficient HRE capacity is not well-defined, and there is currently no consensus on outcomes that HRE training programmes should collectively intend to achieve. Without defining the expected outcomes, meaningful evaluation of individual participants and programmes is challenging. In this article, we briefly describe the evolution of formal education in HRE, articulate the need for a framework to define outcomes for HRE training programmes, and provide guidance for developing HRE competency frameworks that define outcomes suited to their contexts. We detail critical questions for developing HRE competency frameworks using a six-step process: (1) define the purposes, intended uses and scope of the framework; (2) describe the context in which practice occurs; (3) gather data using a variety of methods to inform the competency framework; (4) translate the data into competencies that can be used in educational programmes; (5) report on the competency development process and results and (6) evaluate and update the competency framework. We suggest that competency frameworks should be feasible to develop using this process, and such efforts promise to contribute to programmatic advancement.
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Affiliation(s)
- Sean Tackett
- Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Adeeba Kamarulzaman
- Department of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Joseph Ali
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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13
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Solomon ED, Mozersky J, Wroblewski M, Baldwin K, Parsons M, Goodman M, DuBois JM. Understanding the Use of Optimal Formatting and Plain Language When Presenting Key Information in Clinical Trials. J Empir Res Hum Res Ethics 2022; 17:177-192. [PMID: 34410175 PMCID: PMC8712347 DOI: 10.1177/15562646211037546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent revisions to the Common Rule require that consent documents begin with a focused presentation of the study's key information that is organized to facilitate understanding. We surveyed 1,284 researchers working with older adults or individuals with Alzheimer's disease, supplemented with 60 qualitative interviews, to understand current use and barriers to using evidence-based formatting and plain language in key information. Researchers reported using formatting in 42% of their key information sections, and plain language in 63% of their key information sections. Perceived barriers included lack of knowledge, Institutional Review Board, other members of their team, and the burden associated with implementation. Education and training are required to increase adoption of the practices.
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Affiliation(s)
| | | | | | - Kari Baldwin
- Washington University School of Medicine in St. Louis (USA)
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14
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Solomon ED, English T, Wroblewski M, DuBois JM, Antes AL. Assessing the climate for research ethics in labs: Development and validation of a brief measure. Account Res 2022; 29:2-17. [PMID: 33517782 PMCID: PMC8333187 DOI: 10.1080/08989621.2021.1881891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The environment researchers work in influences their ethical decisions and behavior. A "climate" for research ethics in a research lab exists when members of the lab perceive that the group values and is committed to principles of research ethics. In this study, we aimed to develop a short, reliable and valid measure assessing perceptions of climate for research ethics at the lab level. The resulting measure, Lab Climate for Research Ethics, was developed using standard scale development guidelines. In a large sample of postdoctoral researchers (N = 570), we found preliminary evidence that the new measure has adequate internal consistency reliability. It was also correlated with an existing measure of climate for research ethics and was not correlated with social desirability, demonstrating evidence of construct validity. The new measure can be used in a variety of contexts, including research administrators seeking information about climate within labs across an institution and researchers who study lab environments.
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Affiliation(s)
- Erin D. Solomon
- Bioethics Research Center, Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Tammy English
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Matthew Wroblewski
- Bioethics Research Center, Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - James M. DuBois
- Bioethics Research Center, Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Alison L. Antes
- Bioethics Research Center, Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, Campus Box 8005, 4523 Clayton Avenue, St. Louis, MO, 63110
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15
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Ten Cate O. The Ethics of Health Professions Education Research: Protecting the Integrity of Science, Research Subjects, and Authorship. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:13-17. [PMID: 34524130 DOI: 10.1097/acm.0000000000004413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The author was invited to write a commentary on the ethics of health professions education research. Based on the author's own experiences, published guidelines, and discussions with international colleagues, the author found that research ethics can be roughly grouped into 3 distinct areas, each with its own distinct aims: protecting the integrity of science, protecting the integrity of research subjects, and protecting the integrity of authorship. The focus of this commentary is to provide some guiding thoughts on each of the 3 areas for mentors of emerging health professions education scholars. While any framing logic is arbitrary, the 3 areas of research ethics can be illustrated by 9 distinct breaches of ethical principles, ranging from outright fraud to strategic authorship practices, and 27 practical lessons for learners to counter these and shape ethical research conduct. In general, the international variations in habits, rules, and regulations do not strike the author as being substantially different, but there are cultural variations in terms of what is emphasized and regulated. The ethics of research in health professions education has developed quite extensively in the past few decades, following advances in biomedical and other research domains, and are now grounded in several useful and authoritative guidelines. At the end of the day, however, ethical research conduct is a matter of internalized rules and regulations that researchers must develop over time. Emerging scholars need both instruction and role models to develop their own moral compass to navigate the rules, regulations, and purposes of research ethics.
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Affiliation(s)
- Olle Ten Cate
- O. ten Cate is professor of medical education and senior scientist, Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands; ORCID: https://orcid.org/0000-0002-6379-8780
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Perceived barriers to assessing understanding and appreciation of informed consent in clinical trials: A mixed-method study. J Clin Transl Sci 2021; 5:e164. [PMID: 34589234 PMCID: PMC8453455 DOI: 10.1017/cts.2021.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Participants and research professionals often overestimate how well participants understand and appreciate consent information for clinical trials, and experts often vary in their determinations of participant’s capacity to consent to research. Past research has developed and validated instruments designed to assess participant understanding and appreciation, but the frequency with which they are utilized is unknown. Methods: We administered a survey to clinical researchers working with older adults or those at risk of cognitive impairment (N = 1284), supplemented by qualitative interviews (N = 60). Results: We found that using a validated assessment of consent is relatively uncommon, being used by only 44% of researchers who had an opportunity. Factors that predicted adoption of validated assessments included not seeing the study sponsor as a barrier, positive attitudes toward assessments, and being confident that they had the resources needed to implement an assessment. The perceived barriers to adopting validated assessments of consent included lack of awareness, lack of knowledge, being unsure of how to administer such an assessment, and the burden associated with implementing this practice. Conclusions: Increasing the use of validated assessments of consent will require educating researchers on the practice and emphasizing very practical assessments, and may require Institutional Review Boards (IRBs) or study sponsors to champion the use of assessments.
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Abstract
Researchers must conduct research responsibly for it to have an impact and to safeguard trust in science. Essential responsibilities of researchers include using rigorous, reproducible research methods, reporting findings in a trustworthy manner, and giving the researchers who contributed appropriate authorship credit. This "how-to" guide covers strategies and practices for doing reproducible research and being a responsible author. The article also covers how to utilize decision-making strategies when uncertain about the best way to proceed in a challenging situation. The advice focuses especially on graduate students, but is appropriate for undergraduates and experienced researchers. It begins with an overview of responsible conduct of research, research misconduct, and ethical behavior in the scientific workplace. The takeaway message is that responsible conduct of research requires a thoughtful approach to doing research in order to ensure trustworthy results and conclusions, and that researchers receive fair credit. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Alison L Antes
- Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Leonard B Maggi
- Department of Medicine, Division of Molecular Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
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Laas K, Taylor S, Miller CZ, Brey EM, Hildt E. Views on ethical issues in research labs: A university-wide survey. Account Res 2021; 29:178-201. [PMID: 33780303 DOI: 10.1080/08989621.2021.1910503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this article, we summarize the key findings of an exploratory study in which students and faculty completed a survey that sought to identify the most important ethical issues in STEM fields, how often these issues are discussed in research groups, and how often these ethical issues come up in the daily practice of research. Participants answered a series of open-ended and Likert-scale questions to provide a detailed look at the current ethical landscape at a private research university in the Midwest. The survey also looked at potential differences between faculty and undergraduate and graduate students' perceptions in answering these questions. The results indicate that while all community members tended to view issues that can be classified as research misconduct as the most important activities to avoid in STEM-related research, the level of discussion and actual witnessing of these practices was relatively low. The study points to a consensus among students and faculty about the important ethical issues in STEM and the need for more discussion and attention to be paid to communication, collaboration, and interpersonal relationships in the research environment.
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Affiliation(s)
- Kelly Laas
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago IL, USA
| | - Stephanie Taylor
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago IL, USA
| | | | - Eric M Brey
- Department of Biomedical Engineering, University of Texas, San Antonio TX, USA
| | - Elisabeth Hildt
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago IL, USA
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Azeroual O, Schöpfel J. Trustworthy or not? Research data on COVID-19 in data repositories. LIBRARIES, DIGITAL INFORMATION, AND COVID 2021. [PMCID: PMC8266768 DOI: 10.1016/b978-0-323-88493-8.00027-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The outburst of the COVID-19 pandemic has boosted the need for seamless, unrestricted, fast, and free access to the latest research results on the virus, on its treatment, prevention, protocols, and so on. Open access to publications and research data, suddenly, became self-evident, not only for researchers in life and medical sciences but also for politicians, journalists, and society as a whole. At the same time, this sudden awareness triggered another debate on the quality and, moreover, the trustworthiness of this mass of information made available most often without any form of quality control (peer review). Thousands of datasets from research on COVID-19 and related topics have already been deposited on data repositories. Our chapter discusses the issue of the quality and trustworthiness of research data in data repositories using examples from the ongoing pandemic. It offers insights into some fundamental concepts and summarizes recommendations for quality assurance and evaluation of research data.
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Abstract
The purpose of this paper is to analyze how current research information systems (CRIS) take into account ethical issues, especially in the environment of open science. The analysis is based on a review of the literature on research information management, CRIS, open science and research ethics. The paper provides a framework for the assessment of CRIS on two levels: are CRIS (= their data model, format, functionalities, etc.) compliant with ethical requirements from the research community, funding bodies, government, etc., i.e., can they appropriately process data on research ethics (protocols, misconduct, etc.), and which are the ethical issues of the development, implementation and usage of CRIS? What is the impact of new ethical requirements from the open science movement, such as integrity or transparency? Can CRIS be considered as ethical infrastructures or “infraethics”? Concluding this analysis, the paper proposes an empirical approach for further investigation of this topic. The originality of the paper is that there are very few studies so far that assess the implications of research ethics and open science on the CRIS.
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McIntosh T, Sanders C, Antes AL. Leading the people and leading the work: Practical considerations for ethical research. TRANSLATIONAL ISSUES IN PSYCHOLOGICAL SCIENCE 2020; 6:257-270. [PMID: 34660847 PMCID: PMC8519508 DOI: 10.1037/tps0000260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Scientific work is demanding and complex, requiring those leading research to be simultaneously innovative and ethical in their work. Along with this, those leading scientific teams need to be able to influence both the work being done and lab members doing the work. Thus, both leadership and management skills are necessary to navigating the organizational, social, and ethical components of the research process in order to do rigorous, ethical, and high-quality scientific work. This paper recommends a number of practices that leaders of research teams should engage in, including management behaviors for "leading the work" and leadership behaviors for "leading the people" that foster excellence and integrity in research labs. Researchers can take an intentional approach to leadership and management to create a robust environment for ethical research. Overall, a researcher's routine behaviors as leaders of their labs should establish a healthy work environment and promote effective interpersonal interactions among lab members. Further, the lab requires routine procedures and structure to provide adequate oversight of the research. This paper also addresses challenges that may arise when implementing leadership and management practices, along with strategies for overcoming these strategies. Avenues for future research and policy development related to leadership and management in scientific contexts are discussed.
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Affiliation(s)
- Tristan McIntosh
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO
| | - Chanda Sanders
- University of Oklahoma, Department of Psychology, Norman, OK
| | - Alison L. Antes
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO
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Antes AL, English T, Baldwin KA, DuBois JM. What Explains Associations of Researchers' Nation of Origin and Scores on a Measure of Professional Decision-Making? Exploring Key Variables and Interpretation of Scores. SCIENCE AND ENGINEERING ETHICS 2019; 25:1499-1530. [PMID: 30604356 PMCID: PMC6606404 DOI: 10.1007/s11948-018-0077-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 11/30/2018] [Indexed: 06/09/2023]
Abstract
Researchers encounter challenges that require making complex professional decisions. Strategies such as seeking help and anticipating consequences support decision-making in these situations. Existing evidence on a measure of professional decision-making in research (the PDR) that assesses the use of decision-making strategies revealed that NIH-funded researchers born outside of the U.S. tended to score below their U.S. counterparts. To examine potential explanations for this association, this study recruited 101 researchers born in the United States and 102 born internationally to complete the PDR and measures of basic personal values, values in scientific work, discrimination between the seriousness of rules in research, exposure to unprofessional research practices, and acculturation to American culture. Several variables were associated with PDR scores-discrimination between types of rules in research, exposure to unprofessional research practices, acculturation, and the basic personal values of power, security, and benevolence. However, only security, benevolence, acculturation, and rule discrimination were also associated with nation of origin. In multivariate models, the variance explained by these variables in accounting for the association of nation of origin and PDR scores was somewhat overlapping, thus, only security and benevolence remained as unique, statistically significant predictors. Thus, this study identified some important variables in the association of nation of origin and PDR, but more research is needed. In a secondary analysis to examine the "clinical significance" (the practical importance) of scores on the PDR, this study examined aggregated PDR score data from the present sample and past samples of investigators. This analysis identified scores that may suggest a concern versus those scores that may be interpreted as excellent, proficient, or marginal. Implications for training and mentoring, along with considerations for future research are discussed.
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Affiliation(s)
- Alison L Antes
- Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO, 63110, USA
| | - Tammy English
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Kari A Baldwin
- Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO, 63110, USA
| | - James M DuBois
- Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO, 63110, USA.
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Antes AL, Kuykendall A, DuBois JM. Leading for research excellence and integrity: A qualitative investigation of the relationship-building practices of exemplary principal investigators. Account Res 2019; 26:198-226. [PMID: 31033345 DOI: 10.1080/08989621.2019.1611429] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We conducted semi-structured, telephone interviews with 52 federally funded researchers nominated as exemplars for their integrity and professional conduct, and their scientific achievements. The aim was to identify the practices they report utilizing to build respectful relationships in their teams. We found four practices, holding meetings, providing supervision and guidance, encouraging shared ownership, and expressing values, which were also important to performing high-quality, compliant research, were essential to fostering relationships. The most common practice described for building relationships was actively and deliberately cultivating a positive team environment. Additionally, exemplars described the need to lead by example, tailor their approach to the needs of individuals, address interpersonal conflict, and hire team members cautiously. We also identified practices the exemplars reported as important to managing the demands of their work and found that encouraging shared ownership and tailoring to individuals supported this goal. Additional strategies related to prioritization and planning, seeking advice, engaging in self-care, and managing emotional reactions. Finally, we identified priorities guiding the exemplars' practices. Key priorities included providing outstanding mentoring, building collaborations and relationships, and engaging in discovery and innovation. Investigators require exceptional leadership skills but receive limited systematic leadership training. Addressing this gap would advance research excellence and integrity.
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Affiliation(s)
- Alison L Antes
- a Division of General Medical Sciences , Washington University School of Medicine , St. Louis , MO , USA
| | - Ashley Kuykendall
- a Division of General Medical Sciences , Washington University School of Medicine , St. Louis , MO , USA
| | - James M DuBois
- a Division of General Medical Sciences , Washington University School of Medicine , St. Louis , MO , USA
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Antes AL, Kuykendall A, DuBois JM. The lab management practices of "Research Exemplars" that foster research rigor and regulatory compliance: A qualitative study of successful principal investigators. PLoS One 2019; 14:e0214595. [PMID: 31017929 PMCID: PMC6481787 DOI: 10.1371/journal.pone.0214595] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/17/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Conducting rigorous scientific inquiry within the bounds of research regulation and acceptable practice requires a principal investigator to lead and manage research processes and personnel. This study explores the practices used by investigators nominated as exemplars of research excellence and integrity to produce rigorous, reproducible research and comply with research regulations. METHODS Using a qualitative research design, we interviewed 52 principal investigators working in the United States at top research universities and the National Institutes of Health Intramural Research Program. We solicited nominations of researchers meeting two criteria: (1) they are federally-funded researchers doing high-quality, high-impact research, and (2) have reputations for professionalism and integrity. Each investigator received an initial nomination addressing both criteria and at least one additional endorsement corroborating criteria 2. A panel of researchers and our research team reviewed the nominations to select finalists who were invited to participate. The cohort of "Research Exemplars" includes highly accomplished researchers in diverse scientific disciplines. The semi-structured interview questions asked them to describe the routine practices they employ to foster rigor and regulatory compliance. We used inductive thematic analysis to identify common practices. RESULTS The exemplars identified a core set of 8 practices and provided strategies for employing them. The practices included holding regular team meetings, encouraging shared ownership, providing supervision, ensuring adequate training, fostering positive attitudes about compliance, scrutinizing data and findings, and following standard operating procedures. Above all, the use of these practices aim to create a psychologically safe work environment in which lab members openly collaborate to scrutinize their work and share in accountability for rigorous, compliant research. CONCLUSIONS Researchers typically receive limited systematic training in how to lead and manage their research teams. Training and education for principal investigators should include essential leadership and management practices and strategies that support doing high-quality research with integrity.
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Affiliation(s)
- Alison L. Antes
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Ashley Kuykendall
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - James M. DuBois
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, United States of America
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Plottel CS, Mannon L, More FG, Katz SD, Hochman JS. Design, implementation, and evaluation of PINDAR, a novel short program on GCP for academic medical center principal investigators conducting human subject research. J Clin Transl Sci 2018; 2:343-349. [PMID: 31404275 PMCID: PMC6676438 DOI: 10.1017/cts.2019.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 11/26/2022] Open
Abstract
The Principal INvestigator Development and Resources (PINDAR) program was developed at the NYU-H+H Clinical and Translational Science Award (CTSA) hub in response to a perceived need for focused good clinical practice (GCP) training designed specifically for principal investigators (PIs) performing human subject research. PINDAR is a novel 6-hour, instructor lead, participatory, in-person course for PIs developed de novo, piloted, and implemented. One hundred and seventeen faculty PIs participated in PINDAR from November 2016 through September 2018. All obtained mutual recognition for ICH E6 GCP training from TransCelerate Biopharma. PINDAR was well received by participant PIs, and feedback surveys have revealed a high degree of satisfaction with the program. Other CTSA hubs and research-intensive health systems should consider adopting a similar course focused on GCP for PIs.
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Affiliation(s)
- Claudia S. Plottel
- Department of Medicine, New York University School of Medicine, New York, New York, USA
- NYU-H+H Clinical Translational Science Institute, New York, New York, USA
| | - Lois Mannon
- Office of Science and Research (OSR), NYU Langone Health, New York, New York, USA
| | - Frederick G. More
- Office of Science and Research (OSR), NYU Langone Health, New York, New York, USA
- NYU College of Dentistry, New York, New York, USA
| | - Stuart D. Katz
- Department of Medicine, New York University School of Medicine, New York, New York, USA
- NYU-H+H Clinical Translational Science Institute, New York, New York, USA
| | - Judith S. Hochman
- Department of Medicine, New York University School of Medicine, New York, New York, USA
- NYU-H+H Clinical Translational Science Institute, New York, New York, USA
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Kornfeld DS. It's Time for Action on Research Misconduct. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1103. [PMID: 30044282 DOI: 10.1097/acm.0000000000002283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Donald S Kornfeld
- Professor emeritus of psychiatry and special lecturer, Columbia University College of Physicians and Surgeons, New York, New York;
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Hansen SL, Holetzek T, Heyder C, Wiesemann C. Stakeholder-Beteiligung in der klinischen Forschung: eine ethische Analyse. Ethik Med 2018. [DOI: 10.1007/s00481-018-0487-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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