Introduction
Developmental origins of health and disease (DOHaD) research is inherently multidisciplinary in nature, comprising efforts from fundamental through to human clinical and social sciences. A major aim of DOHaD research is that sound scientific evidence culminates in improved lifecycle health and policy for societal impact. This aligns closely with the aim of translational research (TR). Translational research is required for lifecycle health promotion and disease prevention because, despite increased knowledge on early influential factors and later health and disease trajectories, Reference Abdul-Hussein, Kareem and Tewari1,Reference Stephenson, Heslehurst and Hall3 we have not observed a similar increase in implementation of this knowledge into health care or policy. Reference Hanson, Poston and Gluckman4 Translational research offers an opportunity to bridge research gaps that arise from traditional scientific approaches, thus maximising the potential for scientific findings to reach the population(s) that can most benefit from the discoveries. In practical terms, a translational approach focuses on systems-level understanding of (complex) problems and the ability to pursue a holistic vision. Reference Gilliland, White and Gee5,Reference Tsevat and Smyth6 This can contribute to forward movement on “wicked” problems, although a TR approach alone will not completely solve all grand challenges. Despite the need for more TR, there is a dearth of talent with unique skills to understand and undertake this type of work, largely because the training opportunities designed for pursuing TR and career paths are lacking. Just as TR provides a systems-level understanding of research problems, there must be a systems-level approach to training future translational researchers
Here we bring attention to the importance of TR in a lifecycle approach to health and the challenges and opportunities facing trainees interested in becoming translational researchers. We feel strongly that TR should be a focus for DOHaD trainees, as collaboration in multidisciplinary teams can lead to diverse skill development, broader networking opportunities, and ultimately, novel solutions for health promotion and disease prevention across the lifecycle. Through a workshop presented at the DOHaD World Congress 2022, and supported by prior literature, we sought to understand trainees’ motivations for pursuing TR, their perspectives on the advantages TR holds over traditional research approaches, and the challenges faced as a trainee in this field. Further, we aimed to identify opportunities to improve the research training pipeline and career lifecycle for those interested in TR, and make recommendations to meet these goals at the level of the trainee, institution, and scientific society.
What is translational research?
Translational research is the movement of fundamental scientific discoveries into practice/policy/societal impact. 7 Translational research involves taking findings from fundamental science (e.g., cellular and animal models), and translating those studies into research involving people with lived experience, followed lastly by mobilisation and dissemination to stakeholders, such as patients, families, communities, caregivers, and policy influencers. 7 Evidence from TR has shown how excessive and persistent adversity early in life can overload biological systems and have long-term consequences for an individual’s health, Reference Auvin, Dozières-Puyravel and Avbersek8,Reference Vidale and Campana9 and the resulting implications for health care and policy. Reference DeSocio10 Translational research ultimately supports an environment of innovation by bringing together a community of stakeholders across disciplines and sectors, and with varied experiences, to ask new questions, develop and test new ideas, and implement and evaluate these, in an effort to solve complex problems.
Why is translational research important for (lifecycle) health?
A multidisciplinary approach is important for health research because it engages researchers and other stakeholders beyond traditional disciplinary silos. This process helps develop new or reframed questions about complex health challenges, and application and integration of advanced and varied research methods. Reference Woolf11 Ultimately, this supports the execution of thorough, multi-faceted studies. Reference Marantz, Keller and Meagher12 Eventually, such studies and teams improve disease prevention, expedite diagnosis/treatment, Reference Woolf11 and enrich population health. Reference Marantz, Keller and Meagher12 Further, evidence from the National Center for Advancing Translational Sciences transformative research programmes demonstrates the role that TR can play in reducing systemic bottlenecks. Reference Faupel-Badger, Vogel, Austin and Rutter13 A key barrier to implementing research findings is uptake by professionals and policy makers. 7 Minimising these bottlenecks helps to boost innovations that support public health demands. Reference Faupel-Badger, Vogel, Austin and Rutter13
What does a translational researcher look like?
A proposed set of traits has been suggested as important for a researcher to possess to be effective at TR including: boundary crosser, domain expert, team player, process innovator, skilled communicator, systems thinker and rigorous researcher. Reference Gilliland, White and Gee5 While any of these competencies could apply to a skilled investigator, it is the full range of these skills, possessed by one individual, that is crucial to TR. Reference Gilliland, White and Gee5,Reference Faupel-Badger, Vogel, Austin and Rutter13
Current challenges
Traditional training programmes (typically at the graduate and postdoctoral levels) are often not tailored to TR career paths, and there is not a singular path one can follow to become a translational researcher, which further obscures this career trajectory. Reference Faupel-Badger, Vogel, Austin and Rutter13 With uncertainty surrounding how to approach a TR career pathway, research continuity and implementation may be reduced, ultimately compromising research impact. Knowing that TR is important to DOHaD research, we wanted to discuss what current trainees in DOHaD thought about TR and their ideas on how they can best be supported by their mentors, institutions, and societies.
Methods
A workshop titled Building strong health and career trajectories through translational research was developed and led at the DOHaD World Congress 2022 in Vancouver, British Columbia (by KLC). During the workshop, trainee/early career participants (predominantly graduate-level, however, participants ranged from undergraduate to new professors) first discussed the core skills required to be a translational researcher in DOHaD. Then, participants were asked to brainstorm around the following key questions: (1) What motivates our curiosity about TR and our desire to do this type of work? (2) What are the advantages of TR, over what you/we normally do to solve health and scientific problems? (3) What are the advantages of careers in/related to TR, over careers in fundamental or clinical research? (4) What are the challenges to doing TR? (5) How can your mentors and this society (DOHaD International Society) better serve you to engage in this research and/or build a career in/adjacent to TR? (6) Practically speaking, how do you do TR in DOHaD/lifecycle health? Notes were captured by five anonymous notetakers. Participants were also given questions to reflect on why they were interested in becoming translational researchers and how mentors in DOHaD research areas can support those who want to be translational researchers. The notes captured during the workshop were then independently reviewed by three co-authors (MW, AMJO, SB), who identified and synthesised key themes that emerged in response to each brainstorming question. Participants were aware they were in an interactive session where anonymized discussions/notes would be captured and may be collated in a meeting summary for publication, and were invited to participate in the summary write-up.
Results
Skills required to be a translational researcher in DOHaD
Workshop attendees first discussed the foundational skills required for TR in DOHaD, which we summarised into six categories (Fig. 1a). The core skills for TR identified during the workshop included being an associator, defined as the ability to conceptualise and understand challenges as multi-level and interconnected complex systems, and being a knowledge mobiliser, who can communicate scientific findings in accessible and useable ways to inform decision making. Disciplinary expertise in a relevant research area and the ability to work at the interface of at least two fields, as well as interdisciplinary thinking skills, were also highlighted as key skillsets for TR. Lastly, being a collaborative individual who values input from, and works well with, diverse and multidisciplinary teams, and being adaptable and resilient throughout a career path that is not typically well-worn, were also noted as key skills for TR. These skills are in alignment with, yet extend, core competencies previously identified. Reference Paganotti and Chidume14
Trainee perspectives on translational research in DOHaD. ( a ) Skills required to be a translational researcher in DOHaD. ( b ) Trainee perspectives on translational research, generated through breakout group discussions at the DOHaD World Congress 2022 trainee days. EDI, equity, diversity, and inclusion; TR, translational research.
Trainee perspectives on translational research from breakout group discussions
Four categories emerged from the six questions posed to workshop attendees: (1) Motivation to pursue TR, (2) Advantages of TR, (3) Challenges of TR, and (4) Supports needed for TR trainees (Fig. 1b).
Trainee motivations to pursue TR included a desire to ensure their work has an impact, and an interest in seeing their research findings be implemented (i.e., ensure their work has maximum meaning). Trainees also expressed an interest in solving complex issues through multidisciplinary collaboration that incorporates equity, diversity and inclusion (EDI) principles.
When discussing the advantages of TR, trainees noted that TR could provide a quicker route to problem-solving if implementation is considered from the beginning of the research pipeline. Multidisciplinary teams/large collaborations may lead to better solutions (or may even be required to find solutions) and more widely translatable (or generalisable) research. These multidisciplinary teams could result in greater creativity in approaching research questions (because of the scope of research focus and the diverse collaborations). Lastly, there may be opportunities to seek grants from multiple sources (depending on how the application is packaged).
Considering challenges in TR, trainees expressed that their departments and/or fields are often sequestered, resulting in difficulties finding a position that fulfils their interest in multidisciplinary science and TR. Additionally, it was noted that it can be challenging to find a programme/supervisor who can train across fields or who engages in TR themselves. Further, the time to train across multiple domains could take longer (or require a different structure) than the typical graduate programme allows. With respect to possible careers in TR, having more TR-focused training could lead to being spread too thin, or having a broad, but shallow, understanding of one’s core research area. It is also challenging to choose the right path for a career in TR because there are many possible directions, but no established trainee-to-researcher/career pipeline.
When identifying the supports needed for TR trainees, in-person networking events or workshops geared towards TR were noted. Trainees also expressed that scientific societies could offer funding opportunities to gain experiences in other labs and research groups. Mentors could help their mentees by having check-ins about the mentee’s career path, and to discuss their purpose/motiviation in pursuing (translational) research. Further, mentors could provide training to other trainees and help them access training resources (which may otherwise be cost prohibitive). Mentors should share their networks to help trainees make connections and start building their own network. These actions, on behalf of mentors and scientific societies, could help fulfil trainees’ desire to make TR a core part of the graduate and postdoctoral experience.
Discussion
Here we provide the first report of DOHaD trainees’ perspectives on TR training and career paths. We identified key themes derived entirely from trainee/early career researcher feedback at a workshop presented at the DOHaD World Congress 2022. Notably, trainees and early career researchers have a high level of enthusiasm to pursue a career in TR, fuelled by their motivation to apply their skills and knowledge at a multidisciplinary level to solve complex issues in DOHaD. A significant portion of the feedback also covered the gaps and current challenges trainees and early career researchers are facing. The major challenges outlined include a lack of exposure to multiple disciplines, difficulty in identifying mentors (across disciplines and with TR experience/expertise), limited access to career development programmes/opportunities, and the concern for long-term job stability.
Although programmes to advance TR have already been initiated in a few places, these approaches must be developed by more institutes and adapted or tailored to create training frameworks that suit the unmet needs of trainees specific to the institution or scientific society. For example, our workshop participants noted that even in institutions that prioritise TR, there are few opportunities for trainees from fundamental sciences to participate in multidisciplinary projects (including clinical, social or policy). Moreover, often these TR programmes fail to define their objectives, expectations on trainee competencies, and evaluation metrics, and this ambiguity consequently leads to poor outcome assessments and experiences. Reference Rubio, Schoenbaum and Lee15 Workshop participants put forth several suggestions to help them acquire the skills needed to improve their competency in different domains of DOHaD TR, including TR-specific training through graduate programmes and obtaining funding to train in other laboratories. Importantly, the diverse backgrounds of trainees and early career researchers, Reference Rubio, Schoenbaum and Lee15 both in terms of education and experience, and their future career goals, necessitates the need to formulate a customisable training curriculum. This is a laborious and time-consuming approach, that risks the ambiguity already seen in related programmes and makes implementing such training difficult.
To illustrate the importance of offering core courses to help trainees understand TR, an online case study evaluated the impact of translational science training on students at different career stages and across different disciplines. Reference Vogel, Hussain and Faupel-Badger16 The study found that when compared against their baseline assessments of students’ knowledge of and interest in TR careers, there was a significant increase in these metrics after completing the training. Reference Vogel, Hussain and Faupel-Badger16 Similarly, a Multidisciplinary Translational Team (MTT) under the National Center for Advancing Translational Sciences (NCAT) programme, the Clinical Translational Science Awards (CTSA), which aimed to promote TR career development through MTT membership, assessed the outcomes of the MTT in a four-year follow-up evaluation. Findings showed higher TR-related competencies (e.g., research implementation, scientific communication, leadership, cross-disciplinary training) in trainees. Reference Ameredes, Hellmich and Cestone17 In addition to offering courses to trainees, there should be a focus on TR mentorship, due to the individualised nature of a TR trainee’s path. Therefore, TR mentors may benefit from programmes aimed at developing their mentorship skills. For example, a multicentre randomised controlled trial of a mentorship training programme (where mentees were blinded to the mentor’s training status) was conducted to evaluate the success of the programme in improving research mentoring skills for translational researchers. Reference Pfund, House and Asquith18 The programme was found to be highly effective in increasing mentoring competency, as rated by mentors’ self-reported scores and mentees’ reports of their mentor on a validated assessment. Reference Pfund, House and Asquith18 The mentors’ measured competencies included: communication with their mentee, establishing mentee expectations, assessing mentees’ research abilities, addressing diversity within mentoring relationships, fostering mentee independence, and promoting mentees’ career development. Collectively, these examples show the implementation of TR courses and investment in mentorship skills can improve trainee Reference Vogel, Hussain and Faupel-Badger16,Reference Ameredes, Hellmich and Cestone17 and supervisor/mentor Reference Pfund, House and Asquith18 competencies.
Advancing translational research: the role of equity, diversity and inclusion (EDI)
Integration of EDI in the TR workforce is another important aspect that was included in the participant feedback. In the last two decades, the NCAT and their CTSA programme has initiated efforts to prioritise the inclusion of EDI in both mentor training and the selection of mentees at different institutions and centres to improve the impact of TR outcomes. Reference Boulware, Corbie and Aguilar-Gaxiola19 These initiatives aim to implement training programmes with key themes including institutional buy-in, proactive recruitment efforts, an equitable application process, and high-quality, diverse mentorship. Reference Shay, Schmidt and Thurston20
A successful career in TR, particularly within the academic pathway, must focus on early training opportunities and life balance, including job security and stability. The academic culture for early career researchers and investigators still demands many compromises. This cohort often faces challenges weighing family planning against the prospect of maternity/paternity leave within a long PhD, little access to benefits, subsequent short (often two-year) contracts in highly competitive post-PhD award settings, and a degree of geographic mobility. This may add to an already demanding TR career path, which requires acquiring a wider range of skills and deeper knowledge in multiple disciplines, potentially protracting the time it takes to build expertise and competitive CVs and a network of TR collaborators. The consequence of these EDI challenges (although not specific to TR) may mean losing highly motivated and dedicated minds. Groups such as single parents or people with disabilities are especially affected by this as they have specific requirements towards their dependents or themselves.
It should be noted that industry often appears to benefit from stable and more varied investment sources, clear mission statements, and career development schemes for their employees. Many academic institutions have recognised this and are now preparing early career researchers for non-academic career pathways, including through embedding academic-industry partnerships within PhD programmes or supporting internship opportunities with non-academic partners through graduate training centres. These opportunities to develop both soft and technical skills (e.g., leadership and data sciences) provide other career options to researchers. However, the trade-off may be the departure from a TR track for which they have trained for years.
Calls to action
Based on the workshop presentation and discussions, we present a call to action for trainees, their supervisors/mentors, and leaders in DOHaD/scientific societies to foster a path in, or adjacent to, TR, throughout a trainee’s academic training and career (see Table 1). We encourage trainees to engage in our 3Ts for Transforming Translational Research Training to better understand their strengths, needs, and opportunities related to a career in TR. We also suggest an initial set of recommendations for supervisors/mentors and scientific leaders to better support trainees in their TR research learning and career planning.
Call to action for trainees, supervisors/mentors, and DOHaD/scientific leaders to build strong career trajectories through translational research
CIHR, Canadian Institutes of Health Research; DOHaD, developmental origins of health and disease; EDI, equity, diversity and inclusion; STEMM, science, technology, engineering, maths, medicine; TR, translational research.
1 We suggest trainees and early career researchers use these questions to brainstorm and better understand their motivations for pursuing translational research and the environments and supports needed to engage in it throughout their career pipeline. Brain Mobility Awards: https://dohadsoc.org/trainees/#bma. Mitacs programmes: https://www.mitacs.ca/en/programs. Science to Business Network: https://www.s2bn.org/. CAPES-Print: https://propg.ufabc.edu.br/capesprint/. Emerging Leaders in the Americas Programme: https://www.educanada.ca/scholarships-bourses/can/institutions/elap-pfla.aspx?lang=eng. CIHR-funded Health Research Training Platforms: https://www.canada.ca/en/institutes-health-research/news/2022/03/health-research-training-platforms.html. UK Research and Innovation partnerships with the Medical Research Council: https://www.ukri.org/what-we-offer/browse-our-areas-of-investment-and-support/clinical-and-translational-research/. Examples provided are not an exhaustive list of training/funding opportunities.
2 Natural Sciences and Engineering Research Council of Canada’s guide on integrating equity, diversity and inclusion considerations in research: https://www.nserc-crsng.gc.ca/NSERC-CRSNG/Policies-Politiques/EDI_guidance-Conseils_EDI_eng.asp.
DOHaD trainees suggest the following steps to support their TR career development: Develop TR training programmes that, at their foundation, (1) offer core courses to help trainees understand the TR processes and core competencies of a translational researcher, (2) teach core competencies, including providing individualised training paths and mentorship/guidance, Reference Faupel-Badger, Vogel, Austin and Rutter13 and evaluation of competencies through experiential learning opportunities (e.g., through inter-lab collaborations directly related to one’s research project and/or as directed/independent studies), (3) demonstrate how a TR process can be applied to individual research projects Reference Tsevat and Smyth6,Reference Faupel-Badger, Vogel, Austin and Rutter13 through TR mentorship meetings, and (4) provide networking and collaboration opportunities to facilitate diverse career paths (particularly important as trainees engaging in this type of research may not have peers or advisors with this experience or knowledge departmentally, institutionally, or locally) (Table 1).
To conclude, we ask all trainees and early career researchers interested in pursuing TR to consider this question: How can your mentors and scientific society better serve you to engage in TR across your career lifecycle? Armed with your ideas, reach out to your supervisors, mentors, graduate programme directors, and society leaders to start the conversation about how you can be best supported!
Acknowledgements
The authors would like to thank the International Society for the Developmental Origins of Health and Disease and the DOHaD World Congress 2022 organising team for prioritising trainees at the 2022 meeting, and providing valuable workshops, including the one that informed this paper, to support trainee skills, knowledge and career development.
Author contribution
Conceptualisation: KLC. Methodology: KLC, MEO, MW, SB. Formal analysis: MEO, MW, SB, HS. Data curation/interpretation: MEO, MW, JNS, HS, AMJO, SB, KLC. Writing – original draft preparation: MEO. Writing – review and editing: KLC, MEO, SB, JNS, HS, MW, JNS, AMJO. Supervision: KLC. All authors have read and agreed to the published version of the manuscript.
Financial support
None.
Competing interests
None.
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