Table 2.

Lessons learned, organized by three overarching themes

Overarching Theme	Lesson Number	Description
Theme 1. Determining how best to serve practitioner-investigators and to integrate their practical clinical expertise into studies.	1	Practitioners will readily contribute ideas for projects, but these require close collaboration with academic researchers to refine them into researchable questions.
	2	The practical expertise of practitioner-investigators on the Executive Committee will become evident when they 1) reject study ideas that they consider impractical, not of widespread interest, or not likely to be quickly translated into daily clinical practice and 2) provide feedback about drafts of the grant application and data forms.
	3	Many practitioners feel isolated and enjoy interaction with other practitioners during and after network meetings; these meetings offer opportunities to translate research into practice because some p-i's serve as change agents.
	4	Practitioner-investigators respond more positively to findings presented by other p-i's than by academic researchers.
	5	Many practitioners welcome opportunities to present findings in a broad range of venues.
	6	Practitioner-investigators are very curious about how results from their practice compare to other practices.
	7	Remuneration must convey to practitioners that the network respects and values their time.
	8	Practitioners will use the remuneration amount in a variety of ways.
	9	Recent graduates can effectively add to the diversity of p-i's in the network.
Theme 2. Determining how best to engage dental patients as research participants.	10	PBRN patients will be responsive to a broad range of informed consent processes, and their reaction can help influence IRBs to simplify these processes.
	11	Information and remuneration must convey that patients’ participation is valued; patients will return questionnaires at a high rate even if required to return them after they leave the office.
Theme 3. Determining how best to develop and implement studies.	12	Academic researchers who are new to the PBRN research context have to become educated regarding how to adapt their studies to the PBRN context and to learn that clinicians drive the process, not them. This may cause delays in the grant application process, field testing, and study implementation.
	13	Practitioner-investigators who are new to the PBRN research context have to become educated about the necessity to standardize the data collection process.
	14	It is helpful to have latitude in how a practice can implement the informed consent and data collection processes.
	15	Answering questions to improve clinical practice requires careful consideration of the best study design; randomized clinical trials are not always the best such design.
	16	Even though they have completed all the steps required for certification to do studies, not all p-i's and their staff are going to effectively complete studies that they begin.
	17	It is important to design data collection forms that can be easily understood. Clear graphics and color coding help make data collection forms more readily understood. If possible, data forms are best limited to two or three pages per clinical encounter. Research staff and investigators must be held to deadlines when asked to provide suggestions for forms design or this will unduly delay implementation.
	18	Practices may not be willing to be responsible for electronic data entry unless it can be done readily as part of the routine dental care process.
	19	Even when data forms are customized to electronic health records, delays can occur due to data extraction and data transfer.
	20	Although many practitioners are open to doing studies in quick succession, few will want to do more than one new study at any one time.
	21	Even with recent training on a particular protocol, close monitoring is always advisable. Although all practitioners and staff can be trained on a particular protocol, it is best to identify a key contact person who will take responsibility for following proper study protocol.
	22	The Data Coordinating Center must be prepared to provide multiple methods of data collection even within single studies.
	23	Poor economic conditions can substantially affect patient recruitment rates for some studies, so enrolling more practitioners than originally planned will be necessary to end data collection by the planned date.