UHN COMBIEL is a cross-disciplinary, multi-level, introductory research training program that utilizes an innovative educational model involving trainee-trainee interaction, guided by supervisors with content and methodological expertise. There is additional innovation in the creation of individualized experiences for trainees that ensure that all research elements, from study design and development of a research questions, operationalization into a research protocol, patient recruitment, data collection, quality control and data cleaning, data abstraction, data analysis and data interpretation are incorporated into each trainee’s educational plan. UHN COMBIEL uses a mixture of didactic lectures, interactive workshops, trainee presentations and works-in-progress meetings. Topics covered are more than just about research, and also include personal development and growth of trainees, frameworks for ethical thinking, quality improvement implementation, and networking skills. There is built-in opportunity to shadow UHN healthcare providers for career development. Since 2016, those already in the medical field also participate in practising or teaching clinical skills, depending on the level of the trainee. The program has been in existence for over a decade, run by Drs. Liu and Xu on a shoe-string budget, and coordinated by Cathi Brown. Over 200 trainees have passed through UHN COMBIEL, with over 30 trainee research awards, 100 publications, and 250 research presentations (poster, oral) across multiple disciplines. In 2020, the summer UHN COMBIEL program is utilizing an innovative approach (by necessity), focusing on clinical data abstraction projects and machine learning projects for medical undergraduates working remotely at home. UHN COMBIEL is continually adapting to foster a supportive learning environment that focuses holistically on the trainee learner. The ultimate goal is to develop independent thinkers who can deftly apply their critical thinking skills across multiple disciplines, and who have developed a strong enthusiasm for research in all of its forms.
Preparing Researchers of Tomorrow
In 2010, Clinician-Scientist, Prof. Geoffrey Liu (Medical Oncology, Epidemiology, Medical Biophysics, IMS, Pharmacology and Toxicology, Dalla Lana School of Public Health and University of Toronto) and Biostatistics Staff-Scientist, Prof. Wei Xu (Biostatistics, Dalla Lana School of Public Health) were among a number of scientists and clinicians who recognized a critical need of providing trainees interested in cancer research with cross-disciplinary research experiences across epidemiology, biostatistics, basic/translational sciences, and clinical medicine.
Further, to increase pre-medical, medical, and post-graduate trainees’ interest in clinico-translational oncology, there was recognition that these trainees needed to build basic research skills such as developing a research question, critical thinking to operationalize specific aims and hypotheses into research protocols and studies, and an understanding of rigorous scientific methods, regardless of whether this was cell line, animal model, human tissue, population or health sciences research. It did not matter whether individuals were undergraduate (sometimes even high school) trainees or visiting scientists, because the principles of designing and performing research studies remain identical. In addition, the trainees’ diverse backgrounds (clinical, epidemiological, biostatistics, basic/translational sciences, bioinformatics, health sciences research) offered a rich background to draw from during lectures, workshops, rounds, and in specific project discussions. UHN COMBIEL was created to address this training gap.
The educational innovation at UHN COMBIEL is the mixing of trainees with varying levels of training, diverse experiences and unique research backgrounds working together under the direction of multiple principal investigators from different backgrounds (clinicians, epidemiologists, biologists, biostatisticians, etc.) on the same project. Figure 1illustrates this innovative approach that has led to one publication being used in almost every Canadian lung cancer targeted drug submission to Health Canada and to the pan-Canadian Oncology Drug Review since 2018.
Thus, UHN COMBIEL was created by Drs. Liu and Xu, initially to provide a multi-level (from high school through visiting scientist level), cross-disciplinary research experience focused on:
Applied cancer research training involving populations, patients, and model systems
Interdisciplinary focused research that involves multiple disciplines to work together on comprehensive clinico-translational projects
Opportunities for trainees to work with other trainees in other disciplines on a project
Over time, other areas of research such as health outcomes, quality initiatives and laboratory-based research were also found to benefit from having their trainees develop broader research exposures.
UHN COMBIEL’s vision is to increase training capacity in cross-disciplinary cancer research at Princess Margaret Cancer Centre through the use of innovative and creative strategies, and foster a supportive environment while stimulating trainees to think critically and problem-solve.
As a formal training initiative, UHN COMBIELallows us:
To explicitly state our philosophy for training. This helps align and promote our research philosophy with formal training programs across the University, the province, nationally and internationally.
To develop milestones and benchmarks for measuring our training success and to improve cancer inter- and cross-disciplinary research training.
To seek leverage and independent funding to increase training capacity in inter- and cross-disciplinary cancer research.As a formal training initiative, UHN COMBIELallows us:
Increase training capacity in cross-disciplinary cancer research
A formal initiative allows us:
To explicitly state our philosophy for training students and fellows. This helps align and promote our research philosophy with formal training programs across the University, the province, nationally and internationally.
To develop milestones and benchmarks for measuring our training success and to improve cancer interdisciplinary research training.
To seek leverage and independent funding to increase training capacity in cross-disciplinary cancer research.