Perinatal Research Society’s Young Investigator Workshop Prepares the Next Generation of Investigators

Abstract

Sustaining impactful research within the field of perinatal biology requires training and retention of the next generations of physician-scientists and basic-scientists. Professional societies such as the Perinatal Research Society (PRS) have a unique role to play in training and retention of perinatal biologists. Here we report outcomes for an innovative Young Investigator Training Workshop created for the PRS. The PRS Workshop uses immersive, active-writing, and active-oral presentation design, with one-on-one feedback from NIH-funded faculty-mentors drawn from the PRS membership. Young Investigator data were collected by anonymous surveys of Young Investigators, NIH RePORTER, and individual Young Investigator follow-up. Ninety-seven Young Investigators attended the Workshops over the period 2013-2018. Young Investigators were physician- (73%) and PhD- (27%) scientists at the rank of clinical fellow/postdoctoral fellow (27%) or Instructor/Assistant Professor (73%). Participation by underrepresented minority (URM) Young Investigators was 14%. Young Investigators received NIH and non-NIH funding, with 80% of Young Investigators receiving new funding since the Workshop that they attended. NIH funding was received by 31% of Young Investigators in the form of K-series awards, R01 equivalents, and other NIH awards. In conclusion, our PRS Young Investigator Workshop serves as a model to facilitate training of emerging physician- and basic-scientists by scientific societies.

INTRODUCTION

Optimizing perinatal care depends, in part, on a strong foundation of research that spans basic science to the integration of clinical care. Sustaining impactful research within the field of perinatal biology requires training and retaining the next generations of physician-scientists and basic-scientists. However, attrition from the physician-scientist pool continues^1-3. Perinatal biology is particularly hard-hit with respect to attrition of physician-scientists^1,4-6. Basic-scientists are also increasingly being drawn away from biomedical research, a factor that is amplified for under-represented minority (URM) scientists^7-9.

Professional societies have a unique role to play in training and retaining perinatal biologists. Successful examples of professional societies that provide early-career investigator training and mentoring to perinatal biologists include the Society for Reproductive Investigation, Society for Pediatric Research, and the Perinatal Research Society (PRS). Here we report outcomes for a training initiative created for the PRS, with grant support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The initiative is the Young Investigator Training Workshop (hereafter Workshop), based on a model developed at the University of Utah¹⁰. The Workshop extends the mission of the PRS, with two goals delivered through interactive learning methods. First, young investigators compose sections of a clear grant proposal that tells a logical, cohesive story, and makes concise statements of scientific premise, significance, innovation, and impact on the field that are exciting and compelling. The second goal of the Workshop is young investigators learn clear oral communication skills. Active learning methods are one-on-one faculty-mentor feedback, practice talks, and Workshop-group discussions. Faculty-mentors are members of the PRS and are equally distributed among the Society’s three fields of focus (PRS tracks): obstetrics (OB), pediatrics (Peds), and basic science (Basic) in either obstetrics or pediatrics. The long-term goal is to engage the next generations of perinatal biology trainees who are committed to academic medicine.

The PRS Young Investigator Training Workshop

In 2011, the PRS added the Workshop as an innovative initiative to facilitate development of young investigators. The Workshop takes place before the Annual PRS main-meeting at the same venue. Each Workshop is attended by 15 to 20 young investigators and 6 to 8 faculty-mentors drawn from the PRS membership.

The Workshop emphasizes that young investigators consider the perspective of and expectations placed upon grant reviewers to effectively tell the applicant’s research project story to study section reviewers. In addition, oral communication skills are taught and practiced during the Workshop because 3 to 4 of the Young Investigators are selected, in advance, by the PRS President to present their research at the PRS main-meeting. Therefore, the latter Young Investigators practice their presentations at the Workshop for presentation clarity and scientific critique.

An innovative strength of the PRS Workshop is its immersive, active-writing, and active-oral presentation design. Active writing is by an iterative writing process during which each young investigator’s grant sections are critiqued one-on-one by a faculty-mentor, followed by revision and new one-on-one critique by a different faculty-mentor. This process is applied to the Specific Aims page, separate short paragraphs focused on significance, innovation, and study impact, as well as the Biosketch document, budget and budget justification pages, and compliance sections. Minimal didactic instruction is used to introduce the functions of these sections within an NIH grant application. In parallel, clear writing elements are applied to oral presentations that are practiced and critiqued to improve clarity targeted for a diverse audience. Teaching concepts include simple and straightforward slides, storyline, impact, and consideration of the audience’s standpoint. The goal of these iterative, active learning approaches is to promote clear writing and oral presentations that confuse the fewest readers/listeners and convey scientific premise and rigor, significance, innovation, and impact on the field.

Young Investigators are clinical fellows and postdoctoral fellows or junior faculty (faculty appointment <5 years). The PRS Secretary/Treasurer solicits nominations for young investigators across the nation. Selection is by PRS Council members and President. Young Investigators are selected based on three criteria: 1) career-appropriate strength of CV, 2) potential for career success, and 3) relevance of research to PRS/NICHD missions. Nominees from each PRS track are selected, with roughly equal representation among the three tracks. The Young Investigators’ home institutions provide travel costs to/from the venue, which serves as a litmus test for institutional recognition of the importance of supporting their most outstanding trainees and junior faculty.

Faculty-mentors drawn from the PRS membership are NIH-funded investigators who have track records as successful mentors. At least 50% of the Workshop’s faculty-mentors are also current or former members of NIH study sections or participate at other national scientific leadership levels. Faculty balance at each Workshop is consistent with PRS member composition goals; namely, minimum of 2 OB faculty, 2 Peds faculty, and 2 Basic Science faculty.

The importance of diversity within the pool of both young investigators and faculty-mentors is a high priority in selection of both groups for each annual Workshop. Workshop recruitment of women and URM young investigators and faculty-mentors involves outreach by PRS membership and PRS leadership. URM recruitment of young investigators and faculty-mentors is active, using two approaches: (1) institutional programs for efficiency and (2) PRS-specific innovations. Institutional efforts by the University of Utah Health Equity & Inclusion Office are followed by PRS and include institutional templates for fliers and mailings adapted for PRS use. PRS-specific efforts include encouraging PRS members who attend professional conferences or deliver papers at other academic settings to make personal contacts and/or “market” PRS to women and URM. PRS leadership solicits Historically Black Universities and Colleges, including medical schools, for young investigator nominations and invites institutional leaders of diversity and inclusion to attend the PRS meeting.

The PRS Young Investigator Workshop completed the first 5-year funding cycle of its R13 award in 2018. Here we report a quantitative evaluation of Workshop outcomes of Young Investigators from 2013-2018.

METHODS

Data presented are for Young Investigators of annual PRS Workshops held between 2013-2018 (inclusive). Young Investigator data were collected in 3 phases. The first phase involved young investigator completion of 2 anonymous surveys at the end of the Workshop; one survey addressed young investigator demographics; the other survey addressed young investigator institutional mentors. The second phase of Young Investigator data collection used NIH RePORTER (Version: 7.40.0), with the search completed in 2019 to assess NIH Research Project Grant awards for which the Young Investigator was Principal Investigator (PI) or multi-PI. The final phase of data collection, also collected in 2019, was by individual email between LJM and every young investigator. For this final data collection, Young Investigators were asked to verify data collected in phase 1 and 2, as well as answer additional questions that asked them to 1) confirm current PRS membership status, 2) confirm URM status (identification of race or ethnicity was not requested), 3) confirm current academic rank, 4) for those identified to have NIH funding, confirm current funding (mechanism, title, start date were included in the email), and indicate the number of unsuccessful submissions of the identified application(s), and 5) indicate all other non-NIH grant awards received since the Workshop, including the agency and award type as well as how many submissions preceded the funded submission.

RESULTS

Ninety-seven Young Investigators attended the 2013-2018 Workshops. At the completion of each Workshop, the demographics survey was submitted by 97 (100%) of Young Investigators and their institutional mentor survey was submitted by 88 (90%) of mentors. Demographics of Young Investigators are presented in Table 1. Young Investigators were mostly female physician-scientists (71 (73%)) at the rank of Assistant Professor (41 (42%)). URM participation was 14 (14%), with similar numbers of female (8 (8%)) and male (6 (6%)) Young Investigators. At the time of data collection, 38 (39%) of Young Investigators had a faculty position or were promoted; six (6%) left academics. Recruitment of former Young Investigators to full PRS membership occurred for 25 (26%) individuals. Of the Young Investigators who completed the mentor survey, 85 (97%) identified a primary mentor. The majority of primary mentors were in the same department as the young investigator (55 (63%)) and were principal investigators on NIH grant awards (79 (90%)).

Table 1:

Young Investigator Demographics for 2013-2018 PRS Young Investigator Workshops

	Number (% of total)a
Female	71 (73%)
Male	26 (27%)
URM	14 (14%)
Degree
MD	65 (67%)
PhD	26 (27%)
MD-PhD	3 (3%)
DO	3 (3%)
PRS Track and Academic Rank
OB	29 (30%)
Assistant Professor	24 (25%)
Instructor	0 (0%)
Clinical Fellow	5 (5%)
Peds	34 (35%)
Assistant Professor	27 (28%)
Instructor	4 (4%)
Clinical Fellow	3 (3%)
Basic	34 (35%)
Assistant Professor	13 (13%)
Instructor	3 (3%)
Postdoctoral Fellow	18 (19%)

^atotal Young Investigators is 97

Of the 97 Young Investigators, 30 (31%) received NIH funding by the end of 2019. NIH funding varied across demographics. Of female Young Investigators, 24 (34%) received NIH funding since the Workshop that they attended. Of male Young Investigators, 6 (23%) received NIH funding since the Workshop that they attended. Of URM Young Investigators, 2 (14%) received NIH funding since the Workshop that they attended. Differences were also seen in award of NIH funding across PRS tracks. Of OB Young Investigators, 8 (28%), of Peds Young Investigators, 14 (41%), and of Basic Young Investigators, 8 (24%) received NIH funding since the Workshop that they attended.

Responses to the third phase of data collection were received from 65 (71%) of the 91 Young Investigators who had active email addresses at the time of this follow-up communication. Every Young Investigator who received NIH funding responded to the third phase communication. Among the respondents, 52 (80%) received new funding since the Workshop that they attended, with 40 (62%) of awards received within 1 year of Workshop attendance. Some Young Investigators had more than one grant award. Any type of funding received across demographics was similar for female Young Investigators (40 (80%)), male Young Investigators (12 (80%)), and URM Young Investigators (6 (86%)). Similarly, funding success since attending a Workshop was comparable across PRS tracks, with 16 (80%) OB Young Investigators, 22 (81%) Peds Young Investigators, and 14 (78%) Basic Young Investigators receiving funding.

Workshop Young Investigators who responded to the third follow-up communication received 82 awards. The distribution of awards to Young Investigators is shown in Table 2. Of the 37 NIH awards, 13 (35%) were K-type awards, 13 (35%) were R01-equivalent awards, 6 (16%) were R03 awards, and 4 (11%) were other NIH awards. Of the 37 funded NIH awards, 10 (27%) were funded on first submission, 15 (41%) on first resubmission, 8 (22%) on second resubmission, and 4 (11%) on third resubmission.

Table 2:

PRS Workshop 2013-2018 Young Investigator Grant Awards ^a

Agency	Number (% of Grant Awards)
NIH	37 (45%)
Foundation b	26 (32%)
Intramural c	16 (19%)
Other d	3 (4%)

^aIncludes all NIH and other awards

^bIncludes American Heart Association, March of Dimes, Society for Maternal Fetal Medicine

^cIncludes institutional K12 awards

^dIncludes industry and Health Resources and Services Administration Awards

During the 2013-2018 period, 22 faculty-mentors participated in at least one Workshop. Of these faculty-mentors, 9 (41%) were female, 2 (9%) were URM, 5 (24%) were OB track, 7 (33%) were Peds track, and 9 (43%) were Basic track. Research emphasis of the faculty-mentors was either obstetrics-based (13 (59%)) or pediatrics-based (9 (41%)).

Young Investigator impressions of the Workshop were assessed in surveys taken at the completion of each Workshop. Average participant responses (Likert scale of 1 to 5) are as follows: 1) Average rating of 2.6 for “Grant Writing Skills” before the Workshop, 2) Average rating of 4.6 for “Grant Writing Skills” after the Workshop, and 3) Overall workshop evaluation of 5.0. Examples of free-form comments include:

“Excellent workshop tailored to the junior investigator. Appreciate the session on creating publishable images. Appreciate all the feedback on specific aim page and imparted advice.”

“Cannot describe how incredible this time was. The progress I and all of us have made in big & small picture grant progress in 2 days is unbelievable.”

“This was an excellent experience. The main strength of the workshop is that it gives trainees the opportunity to interact one on one with the faculty.”

“This is by far the most excellent workshop that I have ever attended. Highly Recommended.”

“The format is excellent, very complete and through information from writing to speaking.”

No negative comments were submitted.

DISCUSSION

The information that we collected for PRS Young Investigator Workshops during the R13’s first five-year funding cycle demonstrates the success of our Workshop to facilitate grant award and academic advancement of young investigators. While we are aware that other societies offer training opportunities in perinatal research, the PRS uniquely leverages membership to provide immersive one-on-one interactions with young investigators. Over the study period, two-thirds of Young Investigators were physician-scientists who were at the start of their academic careers. Training initiatives, such as our Workshop, are valuable to physician-scientists early in their training because this is when attrition of physician-scientists often occurs^1,3,10-13.

Female and URM representation at the Workshop are a key priority of the Workshop and PRS. During the study period, 71% of Young Investigators were female and 14% of Young Investigators were URM, with approximately equal number of female and male URM Young Investigators. The high percentage of female Workshop Yong Investigators is consistent with greater numbers of female physicians in obstetrics and pediatrics. For example, in 2019, 59% of OB and 64% of Peds physicians were women¹⁴. A valuable extension of the Workshop is Young Investigators also participate in the PRS main-meeting, which immediately follows the Workshop. Main-meeting attendance provides additional opportunities for Young Investigators to network with PRS attendees. Demographics of main-meeting attendees during the study period were similar to demographics of Workshop Young Investigators and faculty-mentors, with females comprising 61% of attendees, and URM 7% of attendees.

NIH funding awards were not consistent across PRS tracks for Young Investigators. Young Investigators in the Basic track had the lowest award of NIH funding. Less NIH funding for Basic track Young Investigators may reflect the earlier career point for this group who attended the Workshop, the majority of whom were postdoctoral fellows. In contrast, the majority of Young Investigators in the OB and Peds tracks were Assistant Professors. When comparing the two clinical tracks, OB Young Investigators received less NIH funding than Peds Young Investigators. This outcome is consistent with national data indicating that OB investigators and OB Departments acquire less NIH funding than other clinical specialties^15,16. These results suggest the need to enhance efforts to recruit OB physician-scientists to PRS as members and as Workshop faculty-mentors. To this end, in 2017, PRS leadership created a subcommittee for OB recruitment at all membership levels. Strategies implemented by the committee include 1) allocation of funding to specifically defray the cost of attendance at the PRS meeting for OB physician-scientists; 2) a new partnership with the Society for Reproductive Investigation that displays a link to the PRS Young Investigator Grant Writing Workshop on their website; and 3) targeted emails, using publicly available email addresses of scholars and faculty for the Reproductive Scientist Development, Women's Reproductive Health Research, and Building Interdisciplinary Research Careers in Women's Health programs. These promotional and outreach efforts increased OB Workshop applications to the majority and led to increased recruitment of OB track members to PRS.

While the award of any funding to URM Young Investigators was similar to non-URM Young Investigators, the award of NIH funding to URM Young Investigators was lower than to non-URM Young Investigators. Nationally, the lower rates of NIH funding held by URM investigators is documented and occurs at the levels of career development awards as well as independent investigator awards^17-19. Better understanding of barriers to URM success in academics is required to begin to correct the course of inequity. Some of the barriers identified to date include lack of appropriate role models and academic mentors, limited networking opportunities, isolation, and lack of financial support^20-22. Corrective approaches being taken by PRS and the Workshop are, 1) attracting more URM members and trainees, 2) promoting mentor matches for URM young investigators, and 3) providing oversight to encourage URM trainees to pursue NIH funding. We also appreciate that URM nominees to attend the Workshop may have traveled a different life path and, thus, Workshop nominations for URM applicants should be reviewed through a different lens. These goals are facilitated in part by assuring rich diversity within the PRS membership and Workshop faculty-mentors.

Most Young Investigator nominations during the study period came from PRS membership. To broaden the reach of nominations beyond PRS membership, PRS leadership initiated additional recruitment strategies in 2018. In addition to the initiatives mentioned above to increase OB and URM recruitment, PRS members are encouraged to identify potential young investigators from forums unrelated to PRS. A flyer with a QR code linking back to the PRS Workshop application page is distributed and posted at national meetings, including the Society for Reproductive Investigation and the Pediatric Academic Societies.

Two limitations to our study are lack of a comparator group and lack of overall grant submission success rate. A suitable comparator group that did not attend the Workshop was not available. Also, we were unable to determine the overall success rate of grant submissions by PRS Workshop Young Investigators because we could not quantify unfunded submissions. We tried to gather this information; however, it was not provided. Nonetheless, overall success rate for PRS Workshop Young Investigators (45%) was similar to success rate for young investigators who participated in our University of Utah Workshop (40%), which is similar in format¹⁰. Distinctly for the University of Utah Workshop, all grant submission information (funded and unfunded) was available because the young investigators were required to submit all grant applications through the University’s Office of Sponsored Projects. Outcomes for the University of Utah Workshop also included success rates for K-series awards of 63% for female and 60% for male young investigators. These outcomes exceed the roughly 40% overall success rate for K-series awards reported by the NIH for 2013-2019²³. Another limitation is that, while the 90% of Young Investigators had mentors who were NIH funded, we do not know the funding level that the mentors had for their Young Investigators.

In conclusion, our PRS Young Investigator Workshop serves as a model to facilitate training of emerging physician- and basic-scientists by scientific societies. The Workshop also highlights the need and opportunities to maximize gender, racial, and ethnic diversity and equity at the trainee and faculty-mentor levels. The extreme competitiveness of the extramural funding environment magnifies the importance of training young investigators in the arts of writing successful grant proposals and effectively communicating their research and its impact on the field. Young investigators also need to understand that getting grants awarded is still possible, and that resilience and persistence are essential character traits for the successful pursuit of both K- and R-series NIH grant proposals and their equivalents²⁴. Perinatal biology has significant public health consequences, with the growing recognition that events during perinatal life are important determinants of disease in adult life. Our Workshop's impact is to facilitate the development of the next generations of investigators in perinatal medicine and biology through acquiring grant writing and communication skills. This impact, combined with participation in PRS, means that the Workshop is helping to ensure a future pool of nationally competitive physician-scientists and PhD-scientists to improve health and disease during the perinatal period, consistent with the mission of NICHD.