Abstract
OBJECTIVES
The primary objective was to identify the number of residency projects presented at the Pediatric Pharmacy Association (PPA) Bruce Parks Memorial Residency Showcase that were subsequently published. Secondary objectives included a comparison of subsequent publications after residency completion between those who did and did not publish their residency project and an analysis of factors associated with subsequent publications.
METHODS
This was a descriptive study including all pediatric-focused resident projects presented at the PPA Bruce Parks Memorial Residency Showcase from 2006 to 2015. Literature searches for all the pediatric-focused residency projects and any subsequent publications were performed. Data collection included residency type (i.e., postgraduate year 1 [PGY1], postgraduate year 2 [PGY2]), project category, and initial position after residency. A zero-inflated Poisson regression was used to analyze subsequent publication status while controlling for other factors. Statistical analyses were performed using SAS/STAT, with a priori p value < 0.05.
RESULTS
There were 434 projects presented by 401 residents. Seventy-four (17.1%) were published, with the majority being PGY2s (74.3%). Subsequent publications were identified for 162 residents (40.4%), with a higher percentage in those who published their pediatric-focused residency project versus those who did not, 59.5% versus 32.8%, p < 0.001. Factors associated with subsequent publications were those who published their residency project, initial position in academia, and PGY2s.
CONCLUSIONS
Of the residency projects presented at the showcase <20% were subsequently published. Those who published their residency research project were more likely to have subsequent publications. Future efforts should be taken to ensure that residents have the tools/confidence to independently publish their research/scholarship.
Keywords: pharmacy residents, publication rates, research
Introduction
The number of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residency programs are on the rise. In 2019, there were 3530 applicants that matched with a PGY1 Pharmacy residency program, and 1167 matched with a PGY2 program.1 The foundation of the American Society of Health-System Pharmacists (ASHP)-accredited residency training for PGY1 and PGY2 residents is primarily focused on patient-centered care.2,3 Aside from these direct patient care experiences, residents also participate in teaching and scholarly activities. All PGY1 and PGY2 residents are required to complete a quality improvement and/or research project to improve patient care or medication use.2,3 Formal research training is limited in Doctor of Pharmacy programs. Therefore, clinical research training during the PGY1 and PGY2 residency year provides residents with life-long skills that are relevant for their future practice experiences.4 By taking part in these projects, residents have the opportunity to not only increase their knowledge base, but to enhance critical thinking skills, improve management and communication styles, collaborate and integrate within an interprofessional medical team, and build a platform for future research.4 As part of the ASHP PGY1 and PGY2 goals and objectives, residents must present their final project orally at a regional or national conference and write-up the results in a manuscript suitable for publication.2,3 The research training varies considerably between residency programs due to the availability of research mentors, biostatistician support, and variation in patient populations. Due to these factors, the quality of residency projects may influence the suitability of the manuscript for publication.
In 2006, the Pediatric Pharmacy Association (PPA) established the Bruce Parks Memorial Residency Showcase allowing PGY1 and PGY2 pharmacy residents with a pediatric-focused project to present their final projects at the PPA Annual Meeting. Due to the heterogeneity of research training and research projects offered, the resident projects presented at the Bruce Parks Memorial Residency Showcase have varied on the suitability for publication. Authors of previous studies evaluating the publication rate of pharmacy residency projects have reported rates that varied from 4.2% to 11.4%.5–8 There is a paucity of data regarding the quality and pursuit of publication of pediatric-focused research projects. The purpose of this study was to determine the number of publications of pediatric-focused residency projects presented at the PPA Bruce Parks Memorial Residency Showcase. Further, an additional purpose was to determine if their research experience affected the likelihood of subsequent publications.
Methods
This descriptive study included all PGY1 and PGY2 pediatric-focused residency projects at the PPA Bruce Parks Memorial Residency Showcase between 2006 and 2015. The PPA Executive Director provided resident names and project titles that were presented at the Bruce Parks Memorial Residency Showcase. Abstracts for the presentations were also obtained, if available. The 2015 end date for study inclusion was selected in order to allow sufficient time for residency projects to be published, as the mean time to publication of residency projects has been reported as 2 years.8
Data Collection and Study Objectives. For each resident, the residency program and residency type (PGY1 versus PGY2) were collected. In addition, residency websites and social media sources were used to identify the initial position (i.e., clinical pharmacist, academia, community pharmacist, fellowship, other) after postdoctoral training for each resident. Data collected for the resident project included study design (e.g., retrospective, prospective), patient population (e.g., oncology, NICU, PICU, or non-patient care), and category of project. Project category was classified as quality improvement, clinical, pharmacokinetics/pharmacodynamics, epidemiology, stability analysis, and other. The study design, patient population, and category of projects were categorized as unknown if the abstract title was not included in the information obtained from PPA. Investigators also noted the number of similar resident projects (i.e., same medication and patient population) presented at the same conference.
Publication status was determined and confirmed by 2 investigators performing systematic searches in MEDLINE, EMBASE, Google Scholar, and Scopus using residents' first and last names and relevant key terms from abstract titles from the month and year of the presentation through December 31, 2017. Searches that returned no citations or citations that were determined to not be the resident of interest were repeated using the names of other authors listed on the abstract, if available. In addition, if no citations were identified, social media sources and residency websites were used to confirm the identity of the resident in cases where a name change may have occurred (i.e., maiden versus married name). If another name was verified, the search was performed using this name. If no citations were found, a third investigator performed an independent systematic search using the search strategy listed above. If no citations were found after 3 independent searches, the project was identified as not published.
Data collected for published projects included the full journal citation, time from presentation to publication date, number of authors on publication, author order of resident, journal type (i.e., medical or pharmacy), and impact factor of journal. Journal impact factors were obtained for the year of publication, if available. In addition, the H-index score was collected for the resident author and each of the coauthors. The H-index is used to measure a researcher's contribution to the literature, including the significance and overall impact of research. The H-index score was obtained by entering each of the author names in the Scopus database. For all residents, whether their residency project was published or not, a second systematic literature search was performed by 2 investigators in MEDLINE, EMBASE, Google Scholar, and Scopus to identify subsequent publications after the completion of residency. The number of publications were recorded for each year starting from January in the first year after residency completion until December 31, 2017.
The primary objective of this study was to identify the number of residency research projects presented at the PPA Bruce Parks Memorial Residency Showcase that were subsequently published. Secondary objectives include an evaluation of the number of projects with a similar focus during the presentation year, characterization of the publications based on journal type and impact factor, and comparison of number of publications after residency completion between residents who did and did not publish their residency project. Additional secondary objectives included an analysis of factors associated with time to publication of their residency project and subsequent publications.
Statistical Methods. Study data were collected and managed using Research Electronic Data Capture (REDCap), version 10.0.1 (Nashville, TN) electronic data capture tools. REDCap is a secure, web-based software platform.10,11 Statistical analyses were performed using SAS/STAT software, version 9.4 (SAS Institute, Inc, Cary, NC), with an a priori p value < 0.05. Descriptive statistics were used to summarize the research project, article, and journal characteristics. Continuous data were reported as median (IQR) or mean ± SD based on distribution of the data. Comparisons of continuous data between those who published versus not published their residency project were made using Student t tests and Mann-Whitney U statistics, as appropriate. Comparisons of categorical data between groups were conducted with Pearson χ2, Exact Pearson χ2 or Fisher exact tests, as appropriate.
A stepwise Cox regression was used to analyze time to publication of their residency project. If the project was not published, then it was considered a censored observation, and the elapsed time from conference presentation to December 31, 2017, was used. Residency type, number of similar projects within conference year, conference year, and first position after residency were considered for inclusion and entered into the model if initial p < 0.25 and remained if p < 0.15. Adjusted hazard ratios (aHRs) and 95% CIs are reported as well as the probability of publishing faster than the reference group.
Zero-inflated Poisson (ZIP) regression was used to analyze subsequent publication status while controlling for other factors, due to the excess of residents who had zero publications. ZIP regression simultaneously generates both logit (subsequent publications versus no publications) and Poisson (for the number of subsequent publications) models. ORs and 95% CIs were generated. By default, ZIP generates the odds of having an outcome of zero in the logit model. ORs were converted to their reciprocal (i.e., odds of having at least 1 publication) for readability.
Results
A total of 434 projects were presented by 401 residents during the 10-year time frame. Thirty-two residents (8.0%) presented projects for both of their PGY1 and PGY2 residency years. The majority of projects were presented by females (83.6%) and PGY2 Pediatric Pharmacy residents (58.1%). An overall publication rate of 17.1% (n = 74) was identified during the study period; however, publication rates varied between the years and ranged from 0% to 33%. Table 1 provides a breakdown of the number of projects presented per conference year and the percent of projects that were published.
Table 1.
Project Publication Rates by Year
| Year | Projects Presented, n | Published Projects, n (%) |
|---|---|---|
| 2006 | 14 | 4 (28.6) |
| 2007 | 15 | 0 (0) |
| 2008 | 18 | 6 (33.3) |
| 2009 | 29 | 6 (20.7) |
| 2010 | 26 | 2 (7.7) |
| 2011 | 40 | 4 (10) |
| 2012 | 61 | 16 (26.2) |
| 2013 | 65 | 9 (13.8) |
| 2014 | 77 | 16 (20.8) |
| 2015 | 89 | 11 (12.4) |
| Overall | 434 | 74 (17.1) |
Table 2 includes an overview of the characteristics of the residency research projects. Overall, the project design for a majority of projects was retrospective (89.9%), with the remainder being prospective (4.4%) or prospective with a historical control (1.1%). The project design was not identifiable based on the information provided for 20 studies (4.6%). A majority of projects were clinical (76.7%) and the most common patient populations evaluated were all pediatric patients (26.5%), NICU (17.5%), or PICU (16.1%). Of the clinical topics, the most common categories included infectious diseases (22.4%), cardiology/pulmonology (11.1%), and sedation/analgesia (10.1%). Nearly 13% of projects were categorized as quality improvement projects. When evaluated based on patient population, and category per conference year, 91 projects (21.0%) were noted to be similar to other projects presented at the same conference.
Table 2.
Characteristics of Residency Research Projects (N = 434)
| Characteristics | Number (%) |
|---|---|
| Project design | |
| Retrospective | 390 (89.9) |
| Not applicable/unknown | 20 (4.6) |
| Prospective | 19 (4.4) |
| Retrospective and prospective | 5 (1.1) |
| Patient population | |
| All pediatrics (general pediatrics, NICU, PICU) | 115 (26.5) |
| NICU | 76 (17.5) |
| PICU | 70 (16.1) |
| Hematology/oncology | 35 (8.1) |
| Outpatient/emergency department | 27 (6.2) |
| Other/unknown | 25 (5.8) |
| NICU and PICU | 24 (5.5) |
| Pulmonology | 24 (5.5) |
| No patient population | 14 (3.2) |
| General pediatrics | 12 (2.8) |
| Nephrology/transplant | 12 (2.8) |
| Category | |
| Clinical – infectious diseases | 97 (22.4) |
| Quality improvement | 56 (12.9) |
| Clinical – cardiology/pulmonology | 48 (11.1) |
| Clinical – sedation/analgesia | 44 (10.1) |
| Pharmacokinetics/pharmacodynamics | 36 (8.3) |
| Other/unknown | 26 (6.0) |
| Clinical – anticoagulants | 23 (5.3) |
| Clinical – gastroenterology/nutrition | 22 (5.1) |
| Clinical – hematology/oncology | 22 (5.1) |
| Clinical – unspecified | 21 (4.8) |
| Clinical – nephrology/endocrinology | 16 (3.7) |
| Clinical – antiepileptics | 14 (3.2) |
| Stability analysis | 6 (1.4) |
| Epidemiology | 3 (0.7) |
Table 3 includes characteristics of the 74 projects (17.1%) that were published. Of these, 55 (74.3%) were presented by PGY2 Pediatric residents and were published within a median (IQR) of 21.4 months (16.2–30.5) of residency completion, assuming that these residents had an expected date of completion of June. Forty-seven (63.5%) were published in a pharmacy journal and 27 (36.5%) in a medical journal. For those publications in journals with a documented impact factor (n = 39), the mean impact factor was 2.2 ± 0.8. A median of 5 authors were included on the publication, with the resident being listed as the primary author in 86.5% of the publications (Table 3).
Table 3.
Characteristics of Published Research Projects (n = 74)
| Characteristics | n (%) |
|---|---|
| Residency type | |
| PGY1 | 18 (24.3) |
| PGY2 | 55 (74.3) |
| Unknown | 1 (1.4) |
| Number of authors on publication | 5 (4–6)* |
| Author order of resident | |
| 1st author | 64 (86.5) |
| 2nd author | 5 (6.8) |
| 3rd author | 2 (2.7) |
| 4th author | 1 (1.4) |
| 5th author | 2 (2.7) |
| Journal type | |
| Pharmacy | 47 (63.5) |
| Medical | 27 (36.5) |
PGY1, postgraduate year 1; PGY2, postgraduate year 2
* Median (IQR).
Subsequent publications were evaluated for all residents, regardless of publication status of their residency research project. Publications after residency were identified for 162 residents (40.4%). The rate of residents with subsequent publication varied by conference year, ranging from 14.6% in 2015 to 66.7% in 2008. The percent of residents with subsequent publications after residency graduation was higher in individuals who published their residency research project compared with those who did not, 44 (59.5%) versus 118 (32.8%), p < 0.001. Table 4 includes a comparison of subsequent publications based on years after residency completion between those who did and did not publish their residency project. Statistical differences in the percentage of residents who had subsequent publications were noted in the first 2 years and 5 to 9 years after residency completion, in favor of those who published their residency research project. However, for those with subsequent publications, there was no difference in the median (IQR) number of publications after residency graduation between those who did and did not publish their residency research project, 3 (1–5) versus 2 (1–4), p = 0.099.
Table 4.
Number of Residents With Subsequent Publications After Residency Completion Based on the Publication Status of Their Residency Project
| Conference Years Included | Year After Residency | Total Number of Residents With Subsequent Publications, n/ntotal (%) | Number of Residents With Subsequent Publications by Residency Project Status | ||
|---|---|---|---|---|---|
| Residency Project Published, n/npublished (%) | Residency Project Unpublished, n/nunpublished (%) | p value | |||
| 2006–2015 | 1st | 66/434 (15.2) | 23/74 (31.1) | 43/360 (11.9) | <0.001 |
| 2006–2015 | 2nd | 61/434 (14.1) | 21/74 (28.4) | 40/360 (11.1) | <0.001 |
| 2006–2014 | 3rd | 52/345 (15.1) | 14/63 (22.2) | 38/282 (13.5) | 0.079 |
| 2006–2013 | 4th | 46/268 (17.2) | 12/47 (25.5) | 34/221 (15.4) | 0.939 |
| 2006–2012 | 5th | 49/203 (24.2) | 14/38 (36.8) | 35/165 (21.2) | 0.042 |
| 2006–2011 | 6th | 36/142 (25.4) | 10/22 (45.5) | 26/120 (21.7) | 0.018 |
| 2006–2010 | 7th | 27/102 (26.5) | 10/18 (55.6) | 17/84 (20.2) | 0.002 |
| 2006–2009 | 8th | 23/76 (30.3) | 11/16 (68.8) | 12/60 (20.0) | <0.001 |
| 2006–2008 | 9th | 14/47 (29.8) | 6/10 (60.0) | 8/37 (21.6) | 0.019 |
| 2006–2007 | 10th | 5/29 (17.2) | 1/4 (25.0) | 4/25 (16.0) | 0.553 |
| 2006 | 11th | 4/14 (28.6) | 2/4 (50.0) | 2/10 (20) | 0.521 |
Residents who published their residency research project (n = 74) were divided into 2 groups, no subsequent publications (n = 30) and ≥ 1 subsequent publication (n = 44). For these individuals, resident and publication characteristics were compared between groups. Table 5 includes a comparison of these groups. There were no differences between groups regarding the impact factor of the journal, time to publish the residency research project, the number of authors on the publication, or the author order for the resident on the publication. However, the initial position after residency differed with a greater percentage of those with subsequent publications obtaining a position in academia, 20.5% versus 3.3%, p = 0.03. In addition, the median coauthor H-index was statistically higher for those residents with subsequent publications, 16.5 versus 11.0, p = 0.042.
Table 5.
Subanalysis of Published Residency Research Projects by Subsequent Publication Status
| Characteristics | No Subsequent Publications (n = 30) | Subsequent Publications (n = 44) | p value |
|---|---|---|---|
| Residency type, n (%) | |||
| PGY1 | 11 (36.7) | 7 (15.9) | 0.059 |
| PGY2 | 19 (63.3) | 36 (81.8) | |
| Unknown | 0 (0) | 1 (2.3) | |
| First position after residency, n (%) | |||
| Clinical pharmacist | 29 (96.7) | 35 (79.5) | 0.03 |
| Academic (professor) | 1 (3.3) | 9 (20.5) | |
| Time to publish residency research project, n (%), yr | |||
| ≤1 | 4 (13.3) | 6 (13.6) | 0.524 |
| 1–2 | 12 (40.0) | 23 (52.3) | |
| >2 | 14 (46.7) | 15 (34.1) | |
| Journal type for residency project publication, n (%) | |||
| Pharmacy | 3 (10.0) | 13 (29.5) | 0.045 |
| Medical | 27 (90.0) | 31 (70.5) | |
| Impact factor of journal for residency project publication, mean ± SD | 2.351 ± 0.949 | 2.129 ± 0.791 | 0.435 |
| Number of authors on publication, median (IQR) | 5 (4–7) | 5 (3–6) | 0.222 |
| Author order of resident, n (%) | |||
| 1st author | 23 (76.7) | 31 (70.5) | 0.209 |
| 2nd author | 3 (10.0) | 2 (4.5) | |
| 3rd author | 1 (3.3) | 1 (2.3) | |
| 4th author | 1 (3.3) | 0 (0) | |
| 5th author | 2 (6.7) | 0 (0) | |
| Highest coauthor H-index in 2018, median (IQR) | 11 (4.25–19) | 16.5 (11–21.5) | 0.042 |
PGY1, postgraduate year 1; PGY2, postgraduate year 2
To assess the time from the PPA Bruce Parks Memorial Residency Showcase to publication, a stepwise Cox regression analyses was performed. The final model included residency type and first position after residency. Projects completed by PGY2 residents had a 75.3% probability of publishing faster compared with PGY1 residents (aHR: 3.05; 95% CI: 1.60–5.84). Additionally, the aHR for those who entered a faculty position was 1.96 (95% CI: 0.999–3.85) times faster to publication than those who entered clinical pharmacy positions, though this was not statistically different (p = 0.051).
A ZIP regression was performed to identify factors associated with subsequent publications. This model was selected because 239 (59.6%) residents did not have subsequent publications. Three variables were significant in the final models. Residents who published their research project were 2.33 times more likely to have a subsequent publication compared with those whose projects were unpublished (95% CI: 1.16–1.55). Additionally, residents who entered academia were 4.00 times more likely to have a subsequent publication compared with clinical pharmacists (95% CI: 1.54–11.1), and PGY2 residents were 2.27 times more likely to have a subsequent publication compared with PGY1 residents (95% CI: 1.35–3.85). Using the Poisson results, those who published their residency projects had 1.54 times more subsequent publications compared with those who did not publish (95% CI: 1.28–1.87). Residents who took an initial position in academia had 2.92 times more subsequent publications compared with those who accepted clinical pharmacy positions (95% CI: 2.44–3.48). Compared with PGY1 residents, there was no difference in the number of subsequent publications for PGY2 residents (OR: 0.84; 95% CI: 0.68–1.04).
Discussion
Previous studies have examined publication rates of pharmacy residency projects; however, this is the first study to evaluate publication rates of pediatric-focused residency research projects. Overall, 17.1% of residency projects presented at the PPA Bruce Parks Memorial Residency Showcase between 2006 and 2015 were published. The publication rate fluctuated throughout the years and ranged from 0% to 33%. In addition to this, we noted that 40.4% of these residents published at least 1 subsequent publication.
In our study, we observed a higher publication rate among pharmacy residents who presented at the PPA Bruce Parks Memorial Residency Showcase compared with other studies that reported pharmacy resident project publication rates of 4.2% to 11.4%.5–8 Olson et al8 evaluated the publication rates of abstracts presented at the Western States Conference in 1995, 2000, and 2005 by searching MEDLINE and EMBASE for every third abstract listed. The authors limited the time frame of the literature search to 5 years after presentation at the residency conference. A total of 825 abstracts were presented during the selected time frames, but only 270 (32.8%) were included in the literature search for publication. An overall publication rate of 6.3% was identified, and the authors noted that publication rates increased from 4.2% in 1995 to 8.2% in 2005. Stranges et al7 evaluated the publication rates of residency project abstracts presented at the Great Lakes Pharmacy Resident Conference. A literature search was conducted using Scopus, International Pharmacists Abstracts, and MEDLINE for all residency projects presented at the Great Lakes Pharmacy Residency Conference in 2003, 2005, and 2007. A total of 655 abstracts were presented during the selected conference years and 76 (11.6%) were published. The authors noted a decline in publications from 12.9% in 2003 to 9.9% in 2007.
The higher publication rate found in our study could be due to a variety of factors. First, approximately 30.9% to 38.1% of medications are considered off-label in children.12 Thus, there remains a considerable uncertainty and variation in dosing recommendations or pharmacokinetic differences in children. This presents a greater opportunity to publish descriptive or hypothesis generating research findings. Second, the 2 previous studies included a cross-sectional analysis of pharmacy abstracts presented at a regional pharmacy residency conference and included only projects from specific years versus an inclusive list of projects presented in consecutive years. An increase or decrease in the reported publication rate could have been noted in these studies with different population samples. Olson et al8 reported an incline in publication rates over time, whereas Stranges et al7 reported a decline. By reviewing consecutive years' conference abstracts, we noticed significant variation in publication rates; however, no trend was readily identifiable.
A majority of the resident research projects presented at the PPA Bruce Parks Memorial Residency Showcase were retrospective studies, which is expected given the 1-year time frame to conduct their projects. This is similar to previous studies that reported that approximately 60% to 80% of resident abstracts were retrospective projects.7,8 We classified abstracts based on study design, category (e.g., quality improvement, clinical) and patient population. Most projects were clinically focused and included NICU, PICU, or all pediatric populations. This is somewhat expected as these patient populations are broader, and many children's hospitals have 1 or more clinical pharmacists practicing in these areas. Previous studies have not described the patient populations or setting and focus of the research projects, so it is difficult to compare our findings with other studies. Approximately one-fifth of residency projects were noted to be similar to other projects based on the medication studied and patient population presented at the conference in the same year. This is important to note because many retrospective residency projects are limited by small sample size, which may impede publication. This finding emphasizes the opportunity for multisite collaboration between residency programs if a mechanism were in place to identify pursuit of similar projects.
Manuscripts for projects were presented at a median (IQR) of 21.4 months (16.2–30.5) after completion of the residency. We noted that time to publication was faster for PGY2 than PGY1 residents. This is consistent with previously reported time frames of 24 months.7,8 Nearly two-thirds of the published projects in this study were published in a pharmacy journal, which is a little lower than reported in previous studies with 76% to 83% of residency projects published in a pharmacy journal. It is difficult to determine why a greater percentage of publications in this study were published in medical journals versus previous studies. A journal impact factor was available for approximately half of the publications and was noted to be a mean of 2.2. To our knowledge, no previous studies evaluated journal impact factor for publications by pharmacy residents, so no comparisons can be made. The resident was listed as the primary author for a majority (86.5%) of the publications in this study, which is similar to the reported rate of 86.8% by Stranges et al.7 However, Olsen et al8 reported that the resident was listed as first author on only 59% of publications. It is impossible to determine how author order was determined for these publications, so little can be gleaned from these comparisons. However, based on the mean time to publication of the project, it is apparent that work continues on the writing and revision of the manuscript well after the resident completes the residency program. Therefore, if the resident is no longer directly involved in the project or if the manuscript requires significant revisions prior to journal submission, the resident may be moved down in the order of authors.
Overall, 40.4% of residents had subsequent publications after completing their residency. Residents who published their residency project were 2 times more likely to have a subsequent publication and had one-and-a-half times greater number of publications. This finding is similar to that reported by Stranges and Vouri13 who conducted a retrospective cohort study of published (n = 76) and unpublished (n = 76) projects presented at the Great Lakes Pharmacy Resident Conference. Overall, 55 residents (36.2%) had a subsequent publication within 5 years. Among these individuals, 50% published their residency projects, whereas 22.4% did not publish their projects (p < 0.001). The significant difference in subsequent publication rates based on publication status of the residency research project may be related to the rigor of the research program, mentor and coinvestigator research experience, or availability of biostatistician support. ASHP requires a resident to prepare a manuscript suitable for publication by completion of the residency program, but does not stipulate that it must be published.2,3 Therefore, many programs may choose to focus the primary research project on quality improvement initiatives that will benefit the institution directly while providing exposure to research, with no intention to publish.
The subsequent publication rate for this study was also evaluated based on years after residency completion to assess if there were differences based on number of years postresidency graduation. Statistical differences were noted in the first 2 years after residency and again in years 5 to 9. It is difficult to infer what this means based on this single study, but likely in the first 1 to 2 years after residency graduation the former resident was wrapping up other scholarly projects initiated during residency. No difference may be noted in years 3 to 4 because this is the time period where the former resident is now generating project ideas, starting projects, and beginning manuscripts as they develop their own scholarly work. Then a significant difference noted in years 5 to 9 after these scholarship initiatives could imply that these projects came to fruition and were subsequently published. The time frame of subsequent publications could also be affected by the initial position residents took following graduation. We noted that residents who took a positon in academia were 4 times more likely to have subsequent publications and had 3 times as many subsequent publications than residents who took a clinical position. This is not surprising given that publications are an expectation as a requirement for promotion for those in academia.
The effect of coinvestigator research and scholarship experience was evaluated in those residents who published their residency project. In addition, the median coauthor H-index was higher for those who subsequently published (Table 5). Stranges and Vouri14 noted that having a coauthor with an H-index score ≥8 was associated with greater odds of publishing the project (OR: 2.9; 95% CI: 1.02–8.3). However, they did not evaluate if this affected whether or not the resident had subsequent publications. A previous systematic review evaluating the effect of mentorship in medical education noted that research mentorship influenced the career path, the pursuit of research opportunities, and research productivity.15 It is likely that if the resident has research mentors that publish regularly, they may have greater exposure to research and scholarship opportunities, providing the tools and confidence to navigate the process.
There are a few limitations to this study that must be considered. First, there was variation in the information provided for resident research presentations based on the conference year. Full abstracts were provided for some years, but limited information including only name of resident and project were available for other years. Therefore, some projects may have been misclassified based on patient population or category of the project. Second, we may have failed to capture these published projects, as well as those in which the author's name changed or if the resident was not included on the publication. However, attempts were made to utilize several methods for literature searches, as well as social media searches, including professional sites that include a listing of publications. Despite multiple social media searches, we were unable to find first position information or subsequent publication information for 7 residents (1.6%). In these situations, these were classified as no subsequent publication. Information for these residents may have changed the study findings, although chances are low due to the small overall percentage of unknowns. Third, it is difficult to capture all of the factors that could be associated with subsequent publication success. Attempts were made to capture known or highly suspected factors, but we were limited by what information was readily available using public website information. Fourth, not all PGY1 and PGY2 residents who conducted a pediatric research project presented at PPA. Due to financial limitations, not all programs may have allowed their residents to attend PPA. Therefore, it is possible, our findings may not be a complete representation of publication rates of all pediatric pharmacy residency projects but rather those just presented at the PPA Bruce Parks Memorial Residency Showcase. Last, this analysis included residents from 2015 with a final date of the analysis of publications in December 31, 2017. Over the last 5 years, there has been a 27% and 56% increase in all PGY1 and PGY2 residency positions.16 We recognize that if we chose to include data from more recent graduates that our findings may have changed. However, we still believe our findings are relevant to the PPA community and can be used by residency program directors and preceptors to strengthen the foundation of research and scholarship skills for residents who have interest in these aspects in their future careers.
Conclusions
The publication rate of 17.1% of resident pediatric projects at the PPA Bruce Parks Memorial Residency Showcase is higher than reported for other pharmacy residency conferences. A majority of these published projects were retrospective and had a clinical focus. Residents who published their residency project had 2 times greater odds of having a subsequent publication, and their quantity of publications were one-and-a-half times greater than those who did not. Future efforts should be taken to strengthen the foundation of research and scholarship skills to help facilitate independent success in publication for progression of their career and to help contribute the growing body of pediatric literature.
Acknowledgments
At the time of data collection, Drs Walling and O'Donnell were Doctor of Pharmacy students at the University of Oklahoma College of Pharmacy. This study was presented at the 2018 Pediatric Pharmacy Advocacy Group Annual Meeting in Salt Lake City, UT.
ABBREVIATIONS
- aHR
adjusted hazard ratio;
- ASHP
American Society of Health-System Pharmacists;
- CI
confidence interval;
- IQR
interquartile range;
- NICU
neonatal intensive care unit;
- OR
odds ratio;
- PGY1
postgraduate year 1;
- PGY2
postgraduate year 2;
- PICU
pediatric intensive care unit;
- PPA
Pediatric Pharmacy Association;
- REDCap
Research Electronic Data Capture;
- SD
standard deviation;
- ZIP
zero-inflated Poisson
Footnotes
Disclosure. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.
Ethical Approval and Informed Consent. The institution board/ethics reviewed this study and determined that it did not meet the criteria for human subjects research.
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