Journal of Pediatric Psychology, Vol. 28, No. 2, 2003, pp. 123-134
© 2003 Society of Pediatric Psychology
Training Graduate-Level Pediatric Psychology Researchers at Case Western Reserve University: Meeting the Challenges of the New Millennium
Case Western Reserve University School of Medicine and Rainbow Babies and Children's Hospital
All correspondence should be sent to Dennis Drotar, Department of Pediatrics, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, Ohio 44106-6038. E-mail: dxd3{at}po.cwru.edu.
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Abstract |
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Objective To describe the challenges in training graduate-level pediatric psychology researchers for successful careers and to discuss solutions. Methods We reviewed experiences in training graduate students at Case Western Reserve University to identify key challenges in research training and potential strategies to meet them. Results We identified the following key challenges: stimulating graduate students' career interest in pediatric psychology research; teaching students about the pragmatic challenges of conducting research in pediatric settings, specialized research design, and data analytic issues; helping students to develop essential research skills; developing opportunities for student research-related collaborations; helping students develop professional identities as researchers; and developing and supporting their research careers beyond graduate school. Conclusions Useful strategies for meeting these challenges include involving an interdisciplinary faculty in research training; developing specialized training methods that focus on critical research skills such as writing and data analysis; peer support; and involvement with multiple mentors who are successful researchers. Pediatric psychologists should also develop opportunities for the next generation of researchers by facilitating research job options and leadership opportunities.
Key words: research training; mentoring; pediatric psychology.
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Introduction |
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TopAbstractIntroductionDescription of the Evolution...Defining Features of the...Seven Key Challenges in...Tensions and Obstacles in...Thoughts About Generalizable...Conclusions and Implications:...References |
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Research, a core activity of pediatric psychologists, spans a wide spectrum of topics and populations (Roberts, 1995
). Surveys have documented that pediatric psychologists devote
a significant percentage of their professional time to research and value it
highly (Drotar, Sturm, Eckerle, &
White, 1993). Moreover, research is critical to the continued
development of the field of pediatric psychology
(Drotar, 1997). Research
advances form the basis for practice and teaching. One example is the series
on empirically supported treatments published by the Journal of Pediatric
Psychology.
The professional advancement of pediatric psychologists in academic
settings also depends on the quantity and quality of their research and
scholarly accomplishments. Psychologists who achieve success and leadership
roles in these settings are generally accomplished researchers. Moreover,
research in pediatric psychology, especially interdisciplinary research, is
important to public health because it can extend scientific knowledge in ways
that can significantly affect the health of children and families
(National Academy of Science,
1994; National Advisory Mental Health Council, 1999). Finally, the
future research agenda for pediatric psychology involves the need to address
unanswered questions. What are the most effective interventions for children
with behavioral problems in primary care? What are the most effective
interventions to promote adherence to treatment and illness management in
pediatric chronic illness? What are effective strategies for prevention in
important public health problems—injury, violence, obesity? What are the
most effective strategies to assess relevant health and mental health
outcomes? What are the primary risk and protective factors that underlie the
psychological and health outcomes of pediatric populations?
For these reasons, training issues
(Brown & Roberts, 2000),
including training the next generation of researchers, have been identified as
primary challenges for the future of pediatric psychology (Drotar,
1993,
1994), as well as for other
disciplines (Center for Advancement of
Health, 1999). Consequently, we need to identify the critical
issues involved in training researchers, the obstacles to such training, and
research training models that will best equip future pediatric psychologist
researchers for successful careers.
Several authors have described the content of graduate, internship, and
postdoctoral programs in pediatric psychology
(La Greca, Stone, Drotar, & Maddux,
1988; La Greca, Stone, &
Swales, 1989; Routh & La
Greca, 1990) and identified training programs whose graduates have
frequently joined the Society of Pediatric Psychology (SPP;
Routh, 1988). Yet, to our
knowledge, no previous reports have articulated the specific challenges in
training graduate students to conduct research in pediatric psychology or have
made specific recommendations to enhance the quality and impact of such
training. A task force of the SPP has recently completed a comprehensive set
of recommendations for training in pediatric psychology, but these do not
focus specifically on graduate research training (Spirito et al., this
issue).
The need for such a description also derives from several other sources.
These include the highly specialized nature and demands of psychological
research in pediatric settings and potential future constraints on the career
development of pediatric psychology researchers. For example, research with
pediatric populations requires pediatric psychologists to collaborate with
physicians and other professionals and manage significant setting-based
constraints that influence study design and data collection (Drotar,
1989,
2000b). Research in pediatric
psychology also requires specialized knowledge and experience with
interdisciplinary collaboration as well as a range of methodologies (Drotar,
1994,
2000a), including intervention
(Brown & Roberts, 2000;
Drotar, 1997;
Roberts, 1988) and prevention
research (Roberts, 1991).
Beyond their need to learn specialized methodologies, the pediatric
psychology researchers of the future need to learn to manage threats to their
career development. For example, pediatric psychologists in academic medical
settings face increasing pressures to support their own salaries and research
activities (Drotar et. al.,
1993; Williams & Kohout,
1999). To develop and sustain their careers in any employment
setting, the pediatric psychology researchers of the future need complex
skills to sustain their scholarly productivity, including the ability to
publish; to conduct collaborative, interdisciplinary research; and to obtain
and successfully manage research grants
(Brown, 2000;
Drotar, 2000a).
Despite its value, such training is by no means routine in graduate training programs in pediatric psychology. In 1990, Routh and La Greca found that only five universities of those surveyed had any specialized graduate training tracks in pediatric psychology. It was not clear which, if any, of these programs had specialized research training tracks in pediatric psychology.
Published writings on the professional development of pediatric psychologists have focused on clinical or professional training and have been silent about critical issues and potential options for the content and process of graduate research training in this field. To address this need, this article defines key challenges in training graduate students to conduct research with pediatric populations, describes how the graduate training psychology program in pediatric psychology at Case Western Reserve University (CWRU) has developed ways to meet these challenges, and considers general implications for training graduate researchers in pediatric psychology to achieve success in the new millennium.
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Description of the Evolution and Current Context of the Training Program at CWRU |
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This description of challenges is based mostly on our experience in research training in one university-based program with close ties to a large academic pediatric setting and a track record of funding for research training (Drotar, 1998
). Nevertheless,
this program evolved slowly in incremental steps. We briefly describe the
setting of the program.
The pediatric psychology training program at CWRU creates
scientist-practitioners and provides an organized training sequence for
students who have identified a career interest in pediatric populations.
Pediatric psychology is a specialized track within the child clinical
psychology program, which includes six students at any time (see
Drotar, 1998, for more
detail). The program began in 1972 when the senior author took a position as a
psychologist in a university-affiliated pediatric hospital, Rainbow Babies and
Children's Hospital. Initial training efforts began with undergraduates who
volunteered to participate as research assistants on projects and then
graduate students who observed case conferences, consultation, and clinical
work in the setting, and then completed a year-long clinical placement in the
pediatric hospital. Graduate research training began with students doing
master's or dissertation research projects with pediatric populations starting
in 1976 and continuing sporadically until 1987, when an institutional research
training grant in pediatric psychology was awarded to CWRU. This provided
funds, tuition stipends, and research-related costs for students (n =
4) and facilitated the recruitment and program development. The program
director's (Drotar) involvement within the department also evolved from
peripheral adjunct faculty status to a faculty member who chairs
dissertations, participates in departmental planning, and votes on relevant
decisions.
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Defining Features of the Research Training Program in Pediatric Psychology at CWRU |
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The definition of pediatric psychology that guides this training program broadly focuses on research and practice with pediatric populations in medical settings as well as the health, including prevention-based care, of children outside of medical settings (Roberts & McNeal, 1995
). In accord with this definition, students have
experiences in a range of hospital and community settings other than Rainbow
Babies and Children's Hospital, including experience in primary care. Students
in the pediatric psychology track do more clinical training in pediatric
settings and also have opportunities for additional research-related
experiences with faculty (psychologists and pediatricians) in the department
of pediatrics. In addition, students in the pediatric psychology program have
the following didactic experiences: the pediatric psychology seminar, ongoing
throughout the course of the students' training, includes topics in
specialized research methodology, consultation in pediatrics, and also
regularly involves pediatric faculty as well as faculty from the university as
guest lecturers; the writer's workshop; and data-analytic seminars
(Drotar, 2000c). These
seminars are open to (but not required of) students in the clinical child
psychology program. |
Seven Key Challenges in Training Researchers in Pediatric Psychology |
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Our collective experience as students and mentors who train graduate student researchers in pediatric psychology has led us to identify seven key challenges:
- stimulating students' career interest in pediatric psychology research;
- teaching graduate students about research-related collaboration, medical
settings, and pediatric populations;
- training in specialized research design and data-analytic methods relevant
to pediatric populations;
- developing opportunities for graduate student—initiated research and
collaborations in pediatric settings;
- helping graduate students to develop critical research skills;
- developing the professional identities of graduate students as pediatric
psychology researchers; and
- sustaining and supporting students' research careers beyond graduate
school.
Stimulating Students' Career Interest in Pediatric Psychology
Research
One of the primary challenges in training researchers in pediatric
psychology is attracting talented students. Opportunities for undergraduates
to learn about pediatric psychology are especially important because this
field is not routinely represented in departments of psychology, either in
undergraduate courses or in the research interests of faculty who help shape
the career interests of undergraduates.
How can pediatric psychologists meet the challenge of making their research
known to undergraduates? We have used a number of strategies to meet this
challenge, such as guest lectures to undergraduates on relevant pediatric
psychology topics, a course focusing on the needs of the hospitalized child,
independent study research, volunteer experiences, and paid work on faculty or
graduate student research. Graduate students excited about their own research
are among the best ambassadors to attract others into the field of pediatric
psychology. Graduate students specializing in pediatric psychology can serve
as mentors for undergraduate students by giving seminars on topics such as
stress and coping, psychological aspects of chronic illness, and by providing
opportunities for undergraduates to participate in their research. These
experiences have been well received by undergraduates and also provide
important opportunities for graduate students to supervise the work of others
(Drotar, 2000b).
Though some students develop an interest in pediatric psychology as undergraduates, this is by no means a universal entry point into this field, so other methods of exposure to the field are important. For example, postgraduate research experiences that involve working closely with a pediatric psychologist or other professionals as a co-ordinator or research assistant can realistically expose students to preparing abstracts and presentations, manuscripts for publication, and grant proposals. Finally, those graduate school students unfamiliar with pediatric psychology can also develop an interest in the field through didactic courses or by working on pediatric psychology research.
Teaching Graduate Students About Research-Related Collaboration,
Medical Settings, and Pediatric Populations
Research in pediatric psychology inevitably requires collaboration with
pediatric colleagues and members of other professions (Drotar,
1993,
1995). Consequently,
successful pediatric psychology researchers have generally learned to assume
collaborative roles (e.g., as consultant to pediatric colleagues conducting
research, as principal investigator of research that involves pediatric
colleagues, or as co-investigator in a research team). To collaborate
successfully, one needs to understand each of these potential roles as well as
the perspectives of different professional colleagues, especially
pediatricians, concerning research.
Research with pediatric populations usually takes place outside of a
laboratory setting in a hospital or clinic. For this reason, pediatric
psychology researchers need to know the advantages and constraints of data
collection in pediatric settings and how these factors affect research design
and implementation (Drotar et al.,
2000). Students need to have hands-on experience in collecting
data in pediatric settings. To conduct research informed by clinical practice,
students need to know about pediatric conditions, relevant symptoms,
complications, and medical management. Graduate students can benefit from the
comprehensive reviews of research and clinical issues in pediatric populations
contained in the Handbook of Pediatric Psychology
(Roberts, 1995) and
Sourcebook of Pediatric Psychology (Olson, Mullins, Gillman, &
Chaney, 1994).
One successful didactic approach in our setting is to invite pediatricians who are research or clinical collaborators to lecture students about their expertise, which may involve a specialized area of pediatrics or population (e.g., pediatric oncology), or a broader focus, such as primary care. Experienced pediatric colleagues are highly credible mentors, and their presentations often address difficult questions: What psychological issues are associated with particular pediatric conditions? What do pediatricians want most from a psychologist who works with this population? What are critical research needs with a specialized population? Such lectures not only inform graduate students concerning pediatricians' perspectives about psychological research needs but also provide an excellent introduction to a pediatric population's clinical characteristics (e.g., symptoms, natural histories, and clinical management). In addition to hearing from experienced pediatricians, students can also benefit from lectures and discussions with experienced pediatric psychologist researchers who describe their collaborative work with pediatric colleagues and specific roles in their current research collaborations.
Although didactic presentations about consultation and collaboration are helpful, they should be supplemented by clinical experiences in providing psychological consultation, assessment, and intervention, especially with populations that reflect students' primary research interests. We have found that matching students' research interests with a particular population (e.g., quality of life of children with cancer) with their experiences in clinical placements (e.g., clinical consultation in pediatric oncology) can be useful. Such targeted clinical experiences help students develop and refine their research questions and put them in close collegial contact with potential research collaborators.
Training in Specialized Research Design and Data-Analytic Methods
Relevant to Pediatric Populations
The complex, ever-changing field of pediatric psychology research requires
researchers to learn about a wide range of methods and design issues, some not
well represented in typical graduate curricula. A potential short list
includes intervention research design (e.g., design and implementation of
randomized, controlled clinical trials of interventions with pediatric
populations); program evaluation in pediatric settings; specialized
measurement issues with pediatric populations (e.g., adherence to treatment,
pain, functional status, and quality of life) and new assessment methods
(Quittner, 2000); and
specialized data-analytic methods such as qualitative analysis and methods of
analyzing data from prospective studies (e.g., growth curve analysis).
How can such specialized research training be incorporated successfully in a graduate training program? One option is to develop specialized courses and seminars that teach students about relevant methods (e.g., applied research methodology, data-analytic methods). Because teaching about highly specialized data-analytic methods can place a formidable burden on individual mentors and on programs, such specialized courses and seminars may be taught as a lecture series. A guest lecture or team teaching model also has the advantage of familiarizing students with experienced researchers in their setting and enhancing student opportunities for additional mentoring. For example, one of our research seminars on data-analytic methods featured experienced researchers who presented practical issues in applying methods (e.g., qualitative analysis, growth curve analysis, factor analytic approaches, etc.) to their data. These lecturers were asked to address the following questions. When are these data-analytic methods appropriate? What are the benefits and problems involved in using them? Can you provide illustrations of how these methods are used based on data from your research? The purpose of this course was to teach students about methods to enable them to use statistical consultation effectively rather than to facilitate their mastery of these methods. We have also found that additional methods-based courses in related fields, (e.g., epidemiology, anthropology) may also be helpful to graduate students interested in a research career in pediatric psychology.
Developing Opportunities for Graduate Student—Initiated
Research and Research-Related Collaborations in Pediatric Settings
Knowledge and skill development in pediatric psychology research are best
developed in the context of real-life projects. Consequently, students need
ample opportunities to initiate and conduct their own research, as well as
collaborate with faculty and staff in pediatric settings. The success of such
student-faculty collaboration depends on the success of the match between
faculty mentors and students. This match is facilitated in several ways.
First, students apply to the pediatric psychology training program to work
with a primary research mentor, usually a pediatric psychologist. Prospective
mentors and other faculty, as well as current students, interview applicants
to determine whether there is a suitable fit between the students' interests
and the program. Once students are admitted into the program, they work with a
number of faculty (e.g., psychologists and pediatricians in the department of
psychology and school of medicine) who are their secondary mentors for
research projects. To help them identify secondary mentors, students are given
information about ongoing faculty research projects and their availability to
students. The primary mentor also works with students to help them identify
faculty members who are a good match for their interests and research
projects.
Depending on student and faculty interest and experience, secondary faculty
mentors might have several roles in student research, ranging from a more
narrow one (e.g., helping to recruit populations) to a more collaborative one
that involves mutual planning of a new research project. As an example of the
latter role, one student in our program became particularly interested in the
impact of work-related stress on pediatric residents. She was helped to
identify a pediatric faculty member with similar research interests and worked
with her on a pilot study. Their collaboration led to the development of a
master's thesis that documented the effects of call duty on residents'
psychological distress (Berkoff &
Rusin, 1991) and to a dissertation that described the effects of
resident gender and personality style on health behaviors and psychological
status (Berkoff & Drotar,
1994).
Helping Graduate Students to Develop Critical Research Skills
One research training challenge is for mentors and programs to provide
repeated opportunities for students to obtain supervised experience in
skill-based learning in multiple areas critical to their subsequent career
development (e.g., manuscript writing, data analysis, etc.) under supervision.
Individual mentoring is critically important, but it may not be sufficient to
foster the extensive skill development needed for a successful research
career. For this reason, students need other training experiences designed to
enhance students' scholarly writing and editing and their abilities to develop
grant proposals, data-analytic skills, and collaborative skills and
knowledge.
Methods to Enhance Scholarly Writing and Editing. One
useful method to facilitate students' scholarly writing skills in our program
is a writers' workshop seminar, structured as follows. First, students select
a writing project (e.g., proposals for master's and dissertation research,
review articles, research-based manuscripts) for which they want feedback. For
each meeting, one or more students agree to make progress on their writing
projects and distribute them to the instructor and classmates 1 week before
the workshop meeting for review (Drotar,
2000c).
The main didactic method of the seminar is peer- and instructor-written and oral reviews of student writing projects, designed to provide honest and constructive comments to facilitate revisions. Free-ranging peer and instructor critiques may include specific suggestions for reworking and rephrasing text as well as strategies for conceptualizing research problems. Students then modify their manuscripts in response to critique and bring them back to the group for subsequent review until the projects are completed.
The writers' workshop seminar has proven successful not only in helping
students to complete a diverse set of writing projects but also in publishing
them (Drotar, 2000c). All
students who have participated in this seminar have published at least one
first-authored manuscript based on their research or review of research, and
many have published repeatedly in graduate school. The writers' workshop
seminar has also helped facilitate students' abilities to provide critical
written review to their colleagues' as well as their mentors' manuscripts.
Mentors' submissions of manuscripts to the writers' workshop "levels the
playing field" by communicating the message that everyone's writing can
benefit from critique. Students' skills as reviewers can also be enhanced by
having them prepare written critiques of manuscripts or published work and
compare them to those of colleagues and experienced reviewers.
Collaborative writing experiences with secondary mentors have provided
another useful vehicle to enhance the development of students' writing skills,
as well as an opportunity to experience different styles of writing and
critique. Such mentorship experiences have facilitated successful publication
of student research (e.g., Burgess et al.,
1999; Levi, Drotar, Yeates,
& Taylor, 1999). Students also receive training in preparing
written critiques of research submitted for publication.
Methods to Enhance Students' Abilities to Develop Grant
Proposals. Graduate students interested in research careers need to
develop their skills as writers of grant proposals as soon as possible in
their careers (Brown, 2000).
Toward this end, students in our program have been encouraged to submit
proposals to local university-affiliated foundations as well as national
sources, such as individual predoctoral research training proposals to the
National Institutes of Health (NIH).
The writers' workshop seminar and a formal course on grant writing have helped students refine their proposals. The grant writing course included didactic training in such issues as the process of submission and review at NIH and private foundations, what reviewers look for in different sections of the grant, how to respond to reviewers' critiques, and examples of successful and problematic grants. As part of the course, students prepare grant proposals that are reviewed and discussed in class and then submitted to funders. Most of our students have been successful in achieving funding for their research for small grants through local foundations or the American Psychological Association. Others have competed successfully for larger amounts of funding such as Individual National Research Service Awards from the NIH and a Lung Research Dissertation Grant from the American Lung Association. Students' success in achieving funding has not only provided direct incentives such as funds needed to cover relevant costs of data collection (e.g., payment of travel costs or incentives for research participants) but also has given students a valuable initial introduction to grantsmanship.
Methods to Enhance Data-Analytic Skills. Students also benefit from repeated opportunities to practice their skills in data analysis. We have students present data from their ongoing research to their peers and instructor as a work in progress and explore options for data reduction and analysis. To facilitate peers' understanding of their data, students have presented summaries and graphical representations, followed by group discussion. We have also involved faculty with expertise in data-analytic methods in such workshops to provide didactic training and consultation to students interested in using these methods.
Another potentially valuable approach to enhancing students' data-analytic
skills is to give them supervised practice in analyzing data sets gathered for
pediatric populations. Given the constraints of data collection for master's
and dissertation research, students rarely have opportunities to analyze data
from prospective studies or from very large samples. Consequently, this
valuable training experience for some of our students has led to publishable
work (e.g., Burgess et al.,
1999; Levi et al.,
1999).
Methods to Enhance Research-Related Collaborative Skills and
Knowledge. In our experience, students' research-related
collaborative skills are best developed by repeated practice under
supervision. We have found that students can benefit from opportunities to
participate in collaborative research projects with different faculty
colleagues to help them experience and appreciate mentors' and collaborators'
work styles, personalities, and research experiences. We have used an
apprenticeship model in which students are assigned to a research group led by
a pediatric psychologist or pediatrician, who is either a primary or secondary
mentor. Such experiences give students a revealing "behind the
scenes" involvement in the process of planning and implementing research
projects. As one example, we have involved students in an interdisciplinary
research project led by a pediatric oncologist/ethicist and designed to study
the informed consent process in clinical trials in pediatric cancer research
(Kodish et al., 2002).
Students have learned about the progress and problems in data collection in
this multisite study, helped to develop plans for data analysis, and helped to
prepare presentations and manuscripts. Such experiences also give students the
opportunity to learn firsthand about leadership and management of a research
project and to observe the work of an interdisciplinary research team.
Developing the Professional Identities of Graduate Students as
Pediatric Psychology Researchers
One of the most significant training-related challenges is to help graduate
students develop their professional identities as researchers. Pediatric
psychology features exciting clinical opportunities for students, some of whom
are initially drawn to this field because of their clinical interests. For
these students, both during and subsequent to graduate training, clinical
activities compete directly with research for their time, energies, and
professional development. The experience of early success in real-life
clinical encounters with children and families, especially with supportive
supervision, can be rewarding to students. In contrast, some students may feel
discouraged when they compare the immediate rewards of their clinical work
(e.g., having a good session with a client) to the demands and
longer-term rewards of research, such as publications. Consequently, some
students with talent for research may gravitate to clinical work and fail to
devote sufficient time and energy toward developing their research skills and
plans for research careers.
Even for the most highly motivated and talented students, the development of a research career needs to be nurtured over time in multiple ways, especially individual mentorship by successful researchers, involvement in multiple research projects with different research mentors, peer support for research activities, experiences in clinically relevant research, and involvement in conferences and scientific meetings.
Individual Mentorship by Successful Researchers. There is probably no substitute for individual mentorship in facilitating students' professional identities as researchers. When students see their mentors as actively engaged in and excited by research, they are more likely to want to emulate them. Pediatric psychology students are no exception. Moreover, close individual mentorship is a primary vehicle to teach key research-related skills such as manuscript preparation, proposal writing, and data analysis.
Involvement in Multiple Research Projects With Multiple Mentors. We have found that giving students opportunities to become involved in multiple research projects beyond their master's and dissertation research also facilitates their professional identities as researchers and provides experience in possible roles as researchers. For this reason, students in our program are strongly encouraged to participate in as many research projects as their time, interests, and energies allow in collaboration with faculty pediatricians or psychologists (see previous section).
Peer Support for Research Activities. Another key
ingredient of developing the professional identities of pediatric psychology
researchers is peer support, which serves many important functions
(Brown, 1997). By working
closely with their colleagues who share their interests, students experience
support and mentoring from their peers who are going through the same training
program, learning similar skills, and encountering similar challenges.
Developing opportunities for interaction among graduate students who have
different levels of experience and research expertise also gives senior
students a chance to model skills (e.g., writing and presentation) as well as
key research-related milestones, such as having a manuscript accepted for
publication, for their junior colleagues. Moreover, supportive peers are a
receptive audience to whom students can present their ideas for research, data
analysis, and manuscripts (Drotar,
2000c).
We have facilitated peer support for research activities through the
pediatric psychology seminar, which is on-going through the students' graduate
career, by encouraging student review and critique of colleagues' work through
the writers' workshop seminar (Drotar,
2000c), by pairing senior students with junior ones on projects,
and by having dedicated space, computer lab resources, and informal
student-faculty gatherings.
Experiences in Clinically Relevant Research. A concerted
focus on integrating research and practice in research training can underscore
the clinical relevance of research to students and also facilitate their
skills in program evaluation and intervention research. Formal course work and
didactic training can be used to help students appreciate the difficult
logistical problems in conducting clinically relevant research, including
intervention in clinical settings (Drotar
et al., 2000), the common threats to the validity of intervention
research and ways of managing them, and methodological issues in program
evaluation (Kelley, Nixon, & Bickman,
2000).
Engaging students in clinically relevant intervention research in pediatric
and community settings can provide exciting, challenging training experiences.
Examples of such research are the screening of economically disadvantaged
mothers for depression in a primary care pediatric clinic (Needlman et al.,
1999), outcomes of screening for behavioral problems in children seen by
primary care pediatric practitioners
(Riekert, Stancin, Palermo, & Drotar,
1999), and interventions for inner-city children with
hard-to-control asthma (Walders,
2001).
Involvement in Scientific Meetings and Conferences. Students also benefit from the experience of presenting their data and interacting with students and faculty at conferences such as the Florida Conference on Child Health Psychology or regional meetings such as the Great Lakes Society of Pediatric Psychology. Such meetings provide an excellent opportunity for students to meet faculty from other settings including those who share their research interests. Wherever possible, students' involvement in organizing meetings can give them other opportunities to meet faculty, connect with others in the field, and learn to participate in the professional culture of pediatric psychology.
Sustaining and Supporting Students' Research Careers Beyond Graduate
School
Clinical researchers, including pediatric psychology researchers, face
extraordinary challenges in developing and sustaining their careers
(Nathan, 1998). Students
interested in research careers need to appreciate that graduate training is
only the beginning of research training and the first link in a chain of
experiences that includes other critical steps such as postdoctoral research
training and research career development opportunities in their first job.
Postdoctoral Research Training. Beyond graduate training, another critical link in career development is research training at the postdoctoral level. Such training is necessary to equip researchers to be competitive for research funding either as an independent researcher or a mentored scientist (Drotar, Palermo, & Ievers-Landis, this issue). Consequently, all of our graduate students with strong research interests and talents have been strongly encouraged to pursue available postdoctoral research training opportunities and to carefully aim their research careers toward publishing their work and establishing a track record of research productivity.
Research Career Development Opportunities in the First Job.
A critical link in the chain of pediatric psychology researchers' career
development is the transition to the first job, which may make or break a
budding research career for several reasons. One reason relates to the
extraordinary and contradictory work-related demands, especially in medical
settings (Drotar, 1991,
1993). In some settings,
researchers are often expected to "hit the ground running" and
develop a research program at the same time that they may be expected to
support a significant portion of their salary. This expectation has some
obvious but highly undesirable consequences. For most junior researchers,
clinical work may be their only short-term option to generate salary support.
The paradox is that time- and energy-intensive demands of clinical work often
preclude the time and energy concentration needed to develop a research
career. One simply cannot manage a successful research career "on the
side." Consequently, to make a research career a realistic option, an
informed, long-range professional career development plan needs to include a
concentration on research as well as mentorship.
Students interested in careers in academic departments of psychology face a somewhat different set of challenges in the transition to their first job. For example, more protected research time is available for research, and start-up monies for research are generally more available in such settings than in academic health centers. Yet teaching loads can be formidable, especially for new faculty, who need to spend extensive time in course preparation and consequently need to negotiate to ensure sufficient time for research. Moreover, access to pediatric populations for research may be difficult depending on the physical proximity of medical settings to the university and local history of collaboration among faculty.
Students need to understand the critical importance of taking a position in a setting that has a strong mentoring and support program for career development in research. One resource that can be used by pediatric psychologists to develop their research careers is the NIH-sponsored Mentored Clinical Scientist Training program. This award is designed to promote research careers by providing salary support for new faculty to develop a mentored career development plan focused on specific clinical research.
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Tensions and Obstacles in Implementing Research Training in Pediatric Psychology |
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The specific strategies suggested to meet the challenges of graduate training for pediatric psychology researchers are not easy to implement. That is why they are challenges! The implementation of research training in our and other programs is inevitably affected by tensions and obstacles. Some of these are generic; that is, they involve every program. Others may depend on the specific characteristics of the setting.
Patient Care Demands in Pediatric Settings
It may be difficult, if not impossible, to develop and sustain any
research-related collaborations, let alone graduate research training, in
settings that focus primarily on patient care. Research has become
increasingly difficult to accomplish in some academic health centers because
of mandates to increase direct patient contact hours to counter lower and
lower reimbursement rates. These pressures can create significant
disincentives for faculty to carve out time for research and research
mentoring. We have tried to limit the impact of this barrier by making sure
that mentorship responsibilities are shared by multiple faculty.
Tensions Surrounding Specialized Training
The model here involves a highly specialized program with an intensive
research focus. Selection of a highly specialized program such as this one is
a tall order for many prospective students, especially those who have not been
exposed to pediatric psychology. Our training program would not be appropriate
for students who have not identified pediatric psychology as an interest.
Students' specialization in pediatric psychology research and practice also can isolate them from their peers in the graduate program. We have tried to counter this barrier by offering the pediatric psychology seminar to all students and also by providing funding for students in the clinical child psychology program to facilitate their work in pediatric psychology.
Time Demands of Specialized Training
Another problem that relates to the issue of specialization involves the
added time demands required by intensive research training. Given the
structure of our graduate program, it has not been possible to replace courses
or clinical experiences to accommodate the added time requirements of research
training. Students have to be prepared to manage these strenuous requirements.
The availability of stipends from the training grant, which obviates the need
to obtain a job outside the program, and the expectation that students devote
full time to the training program, including summers, have facilitated
students' commitment to the program and its special demands.
Training-Related Demands on Faculty
The research-intensive focus also places added demands on faculty,
especially at the program director's level for mentorship and teaching in the
seminar. To help manage these demands, we involve faculty from multiple
departments in the university, especially pediatrics, as well as practitioners
in the community, in some of the didactic teaching. Moreover, over the history
of the program, we have expanded the number of primary and secondary faculty
members.
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Thoughts About Generalizable Principles of Program Development |
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TopAbstractIntroductionDescription of the Evolution...Defining Features of the...Seven Key Challenges in...Tensions and Obstacles in...Thoughts About Generalizable...Conclusions and Implications:...References |
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On the one hand, because the setting and this program are by no means typical, the generalizability of some of these specific strategies may be limited. On the other hand, based on our discussions with researchers and students in other programs and settings, we believe that the principles of research training and implications for pediatric psychology may be generalizable as long as they are tailored to the resources and characteristics of individual programs.
Faculty Commitment and Leadership
One important series of questions concerns how to develop training programs
that meet the challenges in programs in different settings that have different
resources. Effective training programs of all sorts, including pediatric
psychology training, begin and end with faculty interest, expertise, and
leadership. Thus, there needs to be at least a single faculty member with
interest and knowledge of pediatric psychology who can then stimulate interest
among students, other faculty, and pediatricians in the community.
Developing Resources for Research and Training in Pediatric
Psychology
Given the requirements of training in pediatric psychology, it is clear
that program development is a team effort and develops gradually. One question
concerns who should be on the team and how should they be engaged. We
recommend a "cast the nets widely" approach that involves reaching
out to faculty in different programs and areas and also can allow individual
programs to capitalize on faculty- and setting-based strengths. Training
programs depend on the kind of collaborative relationships among faculty,
whether in a large medical setting or in a community setting, that take time
to develop and sustain. Some practitioners and researchers find it stimulating
to have students involved in their work, whereas others, especially those with
very hectic professional lives, may find it prohibitive. So it is important to
allow for and expect changes in specific supervisors and mentors.
Recruiting Students With Interest and Talent
A final critical ingredient of this training program generalizable to
others in pediatric psychology and other fields is, of course, the quality of
the students. Talented students excited by the challenges of pediatric
psychology will often help to create their own training opportunities and
facilitate good will among their supervisors. Moreover, talented students are
critical for the success of newly developing training programs, as they create
the good will on the part of supervisors to sustain their involvement.
Consequently, we spend much time and energy on student recruitment and depend
heavily on current students in this process.
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Conclusions and Implications: Promoting a Leadership Agenda for Research Training |
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TopAbstractIntroductionDescription of the Evolution...Defining Features of the...Seven Key Challenges in...Tensions and Obstacles in...Thoughts About Generalizable...Conclusions and Implications:...References |
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Recognizing that the methods described here are not the only ways to meet the challenges of research training, we invite others to describe methods that have worked in other settings. Moreover, data are very much needed to document the outcomes of pediatric psychology research training programs (e.g., students' success in achieving jobs as researchers, research productivity, and job satisfaction).
The challenges of developing the careers of researchers in pediatric
psychology will necessitate multifaceted strategies that transcend individual
programs. For example, SPP's continuing efforts to promote and recognize the
work of student researchers through research and dissertation awards have been
important, but may need to be expanded to include funding for junior
researchers. In addition, the "lessons learned" by successful
researchers need to be described in multiple venues (e.g., panels at
professional meetings or newsletters). The potential opportunities in
pediatric psychology for students at all levels need to be made visible in
coursesas well as in publications that describe graduate programs (e.g.,
Sayette, Mayne, & Norcross,
1999).
Another pressing need concerns expansion of job options for students who wish to pursue careers as pediatric psychology researchers. Some students' interests in research careers may be dampened by what they perceive as a limited market for researchers in this field. Mentors need to support the next generation of researchers by helping to create as many viable professional options for them to develop as researchers as possible.
The messages concerning the vision of the professional future of researchers in pediatric psychology that mentors provide their students may be influential in their careers. Are we encouraging, pessimistic, or only lukewarm about the prospects for our students' research careers and their potential to become successful researchers? Talented but worried students who are concerned about their professional futures as pediatric psychologists, let alone as researchers, have posed penetrating questions to us. "Will there be a job for me?" "Can I really expect to find a job that will fit with my research and professional interests?" To our minds, the proper "answer" to such important questions is to pose an alternative set of questions and challenges to our students and ourselves. We might want to ask our students (and help them answer) the following questions. How can they, as future leaders, best shape the future direction of pediatric psychology? How can they be best equipped by their mentors and training programs to use their talents to create their own research opportunities and professional niches? How can their research talents and training best address important public health problems? Those mentors and training programs that are the most successful in helping students address these questions will shape the future of research training in pediatric psychology well into the new millennium. We invite others to contribute descriptions of models of training pediatric psychology researchers that address these and other questions.
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Acknowledgments |
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We gratefully acknowledge the helpful editorial feedback on this manuscript from current students: Erika Burgess, Chantelle Nobile, Astrida Kaugars, Kristin Riekert, and Natalie Walders. Their own and their colleagues' dedication to their work and to pediatric psychology made this work possible. We also appreciate the assistance of Elisabeth Gordon, Natalie Walders, and Susan Wood in processing this manuscript. This work is supported by NIMH 18830: Research training in pediatric psychology.
Received March 20, 2001; revision received June 11, 2001; revision received August 1, 2001; accepted August 13, 2001
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