Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
Uncovering the Confidence Gap in Veterinary Clinical Research
Discover the hidden confidence gap in veterinary clinical research as we chat with Dr. Sarah Moore. Sarah takes us behind the scenes of a groundbreaking study co-authored with Dr. Allison O'Kell that surveyed veterinary faculty using the Clinical Research Appraisal Inventory (CRAI-12). Despite the enthusiasm and participation in clinical research, many respondents revealed they lacked the formal training necessary to excel. This episode discusses the potential for enhanced training programs that could revolutionize veterinary education and bolster veterinarians' roles in comparative medicine and disease modeling.
Sarah also opens up about her personal journey in clinical research, emphasizing the value of on-the-job training and experiential learning in fostering her passion. She addresses the need to dismantle the barriers and phobias that many veterinarians face regarding research, making it more accessible and exciting. Tune in to understand how veterinarians can drive improved patient care and encourage pet owners to participate in clinical trials, pushing the profession toward a brighter, research-driven future.
JAVMA article: https://doi.org/10.2460/javma.24.03.0212
INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ?
JAVMA ® : https://avma.org/JAVMAAuthors
AJVR ® : https://avma.org/AJVRAuthors
FOLLOW US:
JAVMA ® :
Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook
Instagram: JAVMA (@avma_javma) • Instagram photos and videos
Twitter: JAVMA (@AVMAJAVMA) / Twitter
AJVR ® :
Facebook: American Journal of Veterinary Research - AJVR | Facebook
Instagram: AJVR (@ajvroa) • Instagram photos and videos
Twitter: AJVR (@AJVROA) / Twitter
JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals
You're listening to Veterinary Vertex, a podcast of the AVMA Journals. In this episode, we chat about clinical research, self-efficacy and academic veterinary clinicians in the United States with our guest, sarah Moore.
Speaker 2:Welcome to Veterinary Vertex. I'm Editor-in-Chief Lisa Fortier, and I'm joined by Associate Editor Sarah Wright. Today, we have Sarah Moore joining us. Sarah, thank you so much for being here with us today.
Speaker 3:Oh, thank you guys. So much for the invitation.
Speaker 1:All right, let's dive right in to learn more about your article. So, sarah, your JAVMA article discusses clinical research self-efficacy in academic veterinary clinicians in the United States. Please share with our listeners the background on this study.
Speaker 3:So this is a study that surveyed academic veterinary medical faculty across North American vet schools, really with the goal of helping us to gain a better understanding of what aspects of clinical research they felt comfortable with and, maybe more importantly, which areas they felt less comfortable.
Speaker 3:For this study, we used a modification of a self-efficacy instrument that's called the Clinical Research Appraisal Inventory, or the CRAI-12.
Speaker 3:And that instrument had been previously validated for use in physicians and it just needed a couple of small tweaks or modifications to reflect the differences in regulatory framework between human and veterinary clinical studies.
Speaker 3:The goal of that tool really is to evaluate a parameter that we call self-efficacy, which basically is just a measure of how confident do you feel about performing a task or a set of tasks.
Speaker 3:And one thing that I do think is really important to call out right from the start is that self-efficacy is not a direct measure of competency, so in theory, you could feel really confident about doing something and actually be terrible at it. I'm sure we can all think of that sort of one-off example of someone in our lives that has fit that description at some point, but there are plenty of studies that show that there is a good relationship between self-efficacy and willingness to do a particular task, and the tasks that you're being asked to complete as part of your job every day, and how you report yourself your satisfaction with your job and what you report as your level of burnout. So, as veterinary clinicians who do lots of clinical research as part of our jobs, my co-author, dr Allison O'Kelley, and myself decided that hey, this might be something really important to look at in veterinary clinicians as a whole.
Speaker 1:Yeah, it's a fascinating topic and really appreciate you sharing this. Javma, Thank you. So what are some of the important take-home messages from this Javma article?
Speaker 3:So probably one of the most important things that I took away from the study was that, while the vast majority and in our study it was almost 90% of veterinary faculty that responded said that they had participated in a clinical research project over the last five years, and again that same proportion also indicated having a general interest in clinical research. Also, the majority of them indicated that they had not completed any formal research training, and so what that tells me is that we have a really motivated and highly enthusiastic workforce in the veterinary community that really is uniquely positioned to make a huge impact in comparative medicine, and that we also have lots of opportunity to support those individuals with training opportunities that will better equip them to navigate clinical research. I don't personally find that particularly surprising, but I do think there is a lot of power in documenting that so that we can think about how we as a profession move the needle forward on that in the future.
Speaker 2:Yeah, I think that's really important, sarah, you know the CTSC and COHA and some others have really tried to bring these how to do clinical research to academics. This is also important, as you said, for the large practices and private practices. The sponsoring companies, the drug companies, the dog food companies really really need people to do this clinical research to test the clinical efficacy of some of these products that they're trying to get to market. But the barrier is just too great. Sometimes it might be administrative barrier and it might also be I don't know how to do this. So, thank you, for I think it's really really important, as you said, to document this so department chairs and deans and hospital administrators, chief medical officers, can really take a look and be like huh, how could we address this in our group? Yeah, absolutely.
Speaker 2:What sparked your interest in clinical research? Self-efficacy.
Speaker 3:Yeah, it's a good question and I think that first, it's important for me to say that I am in no way a subject matter expert in self-efficacy theory, so the design for the study really was born out of consultation with individuals in the human health care field, both physicians and maybe, more importantly, a couple of really amazing nurses who are?
Speaker 3:experts in this area, where there has been much work that has been done to document some of these things.
Speaker 3:But this study was really born out of a longer-term plan to look towards designing a research training curriculum that could help meet veterinarians where they are with respect to research skills, as well as help map out a plan for what types of training opportunities would help get them where they need to be.
Speaker 3:Plan for what types of training opportunities would help get them where they need to be. It also kind of came out of the observation for myself that there really isn't a playbook for training in clinical research for veterinarians and that so much of it is learned on the job over the course of a career. So the idea is that if we can document what areas people feel less comfortable with, we can design programs and support services that would help them navigate those challenges and make them more interested and excited about research opportunities as they come along. I know you both feel the same as I do on this point, but I'm not sure it gets specifically called out enough that veterinarians are such an important part of clinical and translational research and the pipeline that goes along with that, particularly as it pertains to disease modeling and understanding of comparative medicine, and so anything we can do to help veterinarians feel more empowered to join or remain in the research workforce is hugely important from my perspective.
Speaker 2:I also like your comment about job satisfaction, well-being and less burnout.
Speaker 3:if you're super excited to go and contribute in novel ways, yeah, I think for a lot of people you know, the opportunity to contribute in research just becomes that like exciting thing that can make you want to get up in the morning and keep doing what you're doing. So I agree it's really important thing that can make you want to get up in the morning and keep doing what you're doing.
Speaker 2:So I agree it's really important. You mentioned earlier a interesting finding. That was confidence doesn't always reflect competence, which I think all of us had a couple of folks from middle school or whenever it was. It was ding, ding, ding like the pop up in your mind. But what are some of the most surprising findings from this article?
Speaker 3:So yeah, again some of the most surprising findings from this article. So again, maybe not the most surprising finding, but I think something that I hadn't really considered previously was that we, as veterinarians, are actually pretty uncomfortable with qualitative research methods. Like I said, that's maybe not the most surprising thing when we're thinking about a group of professionals that are trained in a STEM field.
Speaker 3:But the reality is that there are a lot of questions that are important to the field of veterinary medicine that could be best answered with qualitative methods. You know, for example, research questions around veterinary professional curricula and how that's delivered, around causes and prevention of medical errors, around factors that drive pet owner adherence to treatment plans for their pet. So this really is an entire area of research methods that we as veterinarians are generally unfamiliar with and, as a result, generally uncomfortable with and don't tend to employ, and we really could advance the field in some pretty impactful ways through a better understanding of these types of study design. So maybe just a call out as an opportunity for, you know, future research training opportunities.
Speaker 2:I think that's a great point. I think that became more common in COVID when people couldn't get to the bench to get that quantitative data. And we see more and more on clinical efficacy wastage in clinics, like you know, pre-plastic syringes and sort of things like that that are really interesting.
Speaker 3:Yeah, absolutely. And you think about carbon footprint of clinical trials and things that are sort of the decentralized trials through the next wave of sort of research methods, and I do think there's likely to be a qualitative component to that that we need to get a little more comfortable with.
Speaker 2:Yeah, thank you. What are the next steps for clinical research self-efficacy.
Speaker 3:So one of the important next steps, I think, is just actioning some of the needs that we were able to outline in our results, and, honestly, there's some pretty low hanging fruit there. So, for example, biosepical support, which is the thing that respondents in our survey indicated the lowest confidence of any of the skills that we listed in our inventory. Obviously, as veterinarians with a few exceptions we're not going to have the confidence of a trained biostatistician when it comes to more complex analyses, so this is really where partnerships come into play. Finding those ways to develop and maintain accessibility to biostat support, I believe, is probably one of the single most impactful ways that we can support veterinarians in research, and then those of us that do research every day know that this relationship with a biostatistician, particularly up front during that design phase of the study, always results in more reliable and impactful results, and so it really is a win for everybody when that piece of the equation goes well.
Speaker 3:Other kind of attainable areas that we identified were with respect to writing a competitive grant application and understanding the proposal review and award process. Both of these were things that were scored pretty low by our respondents relating to their comfort level, and so you know thinking about ways to, you know, help to increase people's confidence with those. I think any of us that have ever served on a study section reviewing grants can attest to how helpful it is to have that inside view of the funding decision making process and how much better it makes you personally as a grant writer the next time you go to put together a proposal. Integrated into that process with that level of insight, or at least getting them more exposure to basic principles that go along with that, I think can really help set people up for success when it comes to research funding.
Speaker 3:And then I think, lastly, the other thing that you know, I think, in terms of next steps, is that this study really focused on veterinary faculty. Of next steps is that this study really focused on veterinary faculty, but it would be great to collect similar information on veterinary trainees so that we can think about how we bridge these training gaps early on, before our future clinicians even realize that they're there. So I actually think that will be hugely important as a next step in growing the next generation of veterinary clinician scientists. Oh, and actually I realized I said lastly, but one more thing, so this really the last one, that's what I'll say, is that focusing on our veterinary nursing care team, I also think is a big opportunity and a significant need from my perspective. So, again, those of us that do a lot of clinical research know that often the real drivers of those projects are our veterinary technicians. So helping them grow in comfort with their contribution to the research team also is likely to be hugely impactful.
Speaker 2:I think, two things I'd like to emphasize for anybody who's listening. There's nothing more important than your veterinary technician team, you know rewarding them so they don't have the same burnout, rewarding them so they have a sense of well-being, and rewarding them financially, which a lot of especially academics are pretty poor at doing, but they're an absolutely vital part of our team.
Speaker 3:Yeah, I could not agree more and I think it offers, it opens up an area of career advancement as well, as we think about. You know ways for veterinary technicians to specialize or sort of define themselves in their next stage of their career. I think research can be an important opportunity for them as well.
Speaker 2:And, as you know, sarah, we have two journals JABMA, which your article is in, and then AJVR, which is our research journal. And regardless of the journal, from an editorial standpoint, the number one, two and three reasons that a manuscript gets rejected, or a major and a major and a minor and a major revision are statistics. So I couldn't agree with you more to get somebody involved upfront. You know, as you also said, many people don't have training so they do what their mentor did and there's been an over-reliance on p-values in veterinary medicine for a very long time. So getting a biostatistician involved from the very beginning will really help your work all the way through to the end.
Speaker 3:Yeah, absolutely.
Speaker 2:AI is everywhere. Sarah, do you see a role for AI in clinical research?
Speaker 3:self-efficacy, it's such an interesting question and we definitely did not address knowledge around AI as part of this particular project. But it is such a new area area and there are so many important ethical and data quality considerations around AI, particularly when it's being used in the clinical setting and particularly when it's being used for making decisions around care delivery.
Speaker 3:So I completely agree that it will be an important part of research training moving forward. It's just hard for me to believe that it won't be infused into almost every area of research in the future, and so we as professionals are going to need to know how to be forward thinking in integrating some training around data bias and ethical considerations in this area, not to mention helping our clinicians think about how we foster those relationships with data scientists that can help us to start to answer some really important questions that AI can be a powerful tool in tackling.
Speaker 3:So I absolutely see a role for AI in this area of research in the future. I think it's going to be a really important tool to integrate into the training process.
Speaker 1:Yeah, it's everywhere. You just Google something now and like even the top results for your search results is just an AI generated summary of the results. It absolutely is. Yeah, and for those of you just joining us, we're discussing clinical research, self-efficacy and academic veterinary clinicians in the United States with our guest, sarah Moore. Sarah, how did your training prepare you to write this article?
Speaker 3:how did your training prepare you to write this article? You know, I think a lot of my training in this area has come as part of being on the job and being part of clinical research teams in my various roles. So much of that training has been experiential and that is important and also sometimes it's not the most efficient way to learn things.
Speaker 3:I think we all know sort of school of hard knocks and all of that. But I think that has really demonstrated for me how much opportunity there is for helping people feel more comfortable with clinical research, and I personally love seeing people get excited about clinical research, but it's hard to be excited about something when there are major aspects of it that make you uncomfortable. And so my hope is that this project, and hopefully future projects that come from it, can help really break down some of those barriers, those, I guess, research phobias.
Speaker 3:I guess we'll call them, so to speak so that more people are excited and interested in getting involved.
Speaker 1:Now, this next set of questions is going to be very important for our listeners. Now, this next set of questions is going to be very important for our listeners. What is one?
Speaker 3:piece of information that veterinarians should know about clinical research, self-efficacy and academic veterinary clinicians. Yeah, so this is actually something that a member of my team at work recently mentioned in the context of this data and it really hit home for me and it's something I hadn't thought of about this before. But I think we all tend to feel like everybody else out there just inherently knows what they're doing and that we are the only person who has questions about how to do things or has uncertainty about the best way to approach a research problem.
Speaker 3:So maybe one of the most important bits of information to come from this actually is some documentation that everybody has portions of their clinical research skill set where they are more comfortable and then conversely, also where they're less comfortable, and that we're all somewhere along that learning curve towards being confident, but that we all have areas that we can improve.
Speaker 1:So, on the other side of the relationship, what's one thing the public should consider around clinical research?
Speaker 3:self-efficacy with the patient care aspects of clinical research, and they were very comfortable in identifying and acknowledging the important clinical questions that needed to be answered to help improve the way we deliver veterinary health care, which really underscores what we, I think, as veterinarians, all kind of inherently know, which is that those of us that are working in veterinary clinical trials are doing it because we want to see patients receive better care and to have access to new and better treatments. So all of our findings in this study around low self-efficacy really centered more on skills that were unrelated to patient care. So nothing about this study should dissuade the public from wanting to enroll their pet in a clinical trial. This study should dissuade the public from wanting to enroll their pet in a clinical trial. If anything, I hope it actually encourages people, because our results demonstrate how very many veterinarians are invested in advancing the veterinary healthcare field, and obviously we can't do that unless we're in partnership with pet owners as well.
Speaker 2:Yeah, thank you for sharing this really important and unique topic with us at Jabma Sarah, and we look forward to those low-hanging fruit manuscripts coming our way too.
Speaker 3:Yeah, absolutely. I hope our team can contribute to some of those and I hope other folks as well want to pick up that torch and run with it.
Speaker 2:As we wind down, we like to ask kind of a fun question. So for Sarah, what is the oldest or the most interesting item on your desk or in your desk drawer?
Speaker 3:So this is a great question. I actually had to think about this a little bit. So this actually and I'll show it because I know there might be some video that goes along with this but this is actually a picture that I've had in my office for a long time now, and it's a picture of a patient that I originally saw on a consultation during my residency program, which is longer ago now than I'm going to comment on here. But his owner sent me this picture that shows him celebrating his 15th birthday, and there's actually a lot of story to tell here, most of which we don't have time for, but I met this dog and his owner once when he was only two or three years old, and I had a pretty at least from my perspective straightforward consultation with this owner about managing his seizures, and then I never saw him again until like 10 plus years later, in a move that was halfway across the country, and through a series of events, I actually met him and his mom again.
Speaker 3:His mom was kind enough to reach out and to share with me some details about her circumstances from way back when I first met them. That had caused our consultation to be much more meaningful to her than it was to me in the moment and I had had no idea about any of that the time we met and honestly, I was really surprised about the impact when she shared it with me. It was a very straightforward appointment from my perspective and I don't think that impact was really any reflection on me as a clinician, necessarily, but rather was just a really good reminder to me of how frequently the small things we do as veterinarians, or small things that we say that we just take for granted as part of doing our job in our profession, can have such a positive and lasting impact, even when you don't realize that they did. So I have kept that picture for a long time now as a reminder of that, because it really can be something easy to forget sometimes and I just appreciate being reminded.
Speaker 1:Beautifully said. Do you mind holding that picture up again so we can see it?
Speaker 3:Yeah.
Speaker 1:Oh, very nice. Thank you, that's great, and just thank you so much again, sarah, for being here today and for sharing your manuscript to you again with Javma.
Speaker 3:Well, thank you guys so much for the invitation. It was great to have the opportunity to talk to you.
Speaker 1:And to our listeners. You can read Sarah's article and print Javma or using your favorite search engine. I'm Sarah Wright with Lisa Fortier. We want to thank each of you for joining us on this episode of the Veterinary Vertex podcast. We love sharing cutting edge veterinary research with you and we want to hear from you. Be sure to leave us a rating and review on Apple Podcasts or whatever platform you listen to.
