Renewal: Gastrointestinal Surgery Outcomes Research Fellowship

 描述（申请人提供）：在他们的一生中，美国人平均将经历近九次外科手术，许多与消化道疾病或肥胖相关的疾病有关。尽管是一些最常见的干预措施，但这些程序中的大多数都没有经过严格的科学评估。对于几乎所有这些程序，关于手术流行病学，临床有效性，实现最佳结果的最佳实践，人群水平的结果，患者报告的观点和成本考虑的基本问题尚未得到解决。随着医疗保健服务的改革，以及我们努力建立一个学习型医疗保健系统，解决这些问题至关重要。缺乏严格的外科临床研究的一个原因是缺乏正式的卫生服务和对外科医生的比较有效性研究培训。为了满足这一需求，我们建议继续和扩大华盛顿大学的国家研究服务奖（NRSA）奖学金在临床，卫生服务，比较有效性和以病人为中心的结果研究外科医生。该奖学金涉及先进研究方法的教学培训和实践经验，重点是与胃肠道系统，肥胖和肥胖相关疾病相关的干预措施。培训集中在6个领域（使用观察数据的研究，以患者为中心的结果和偏好评估，医疗保健中的卫生经济学和行为经济学，政策和实施科学研究，临床/转化研究和研究运营管理），旨在培养外科医生学者，他们将成为成功的科学家，并帮助建立和推进学习型医疗保健系统的目标。该奖学金的教学部分包括通过华盛顿大学公共卫生和社区医学学院获得公共卫生硕士（MPH）或理学硕士（MS）学位的课程，以及卫生服务和药学系博士候选人培训计划的额外课程和证书培训。所有受训人员完成一套项目和研究，代表广泛的研究方法和方法。学员的经验是由一个结构化的导师计划与经验丰富的调查人员谁有一个职业生涯的承诺，以培训和职业生涯的成功，在高层次的研究和整合证据到实践中的变化培育。T32研究员还参与了独特的社区、地区和国家学习医疗保健系统计划，包括华盛顿州的比较有效性研究翻译网络（CERTAIN）3、外科护理和结局评估计划（SCOAP）4以及旨在优化住院前患者的计划，名为Strong for Surgery（stronghforsurgery.org）。学员参加NRSA奖学金两年，然后再接受5-7年的博士后临床培训，担任高级腹腔镜、前肠、肝胆、结直肠或减肥手术领域的普通或专业外科医生，然后再获得学术职位。目前的NRSA奖学金计划每年支持一名新学员，由于计划的成功，导师能力和学员需求，我们要求每年扩大到两名新学员。

 DESCRIPTION (provided by applicant): Over the course of their lives the average American will undergo nearly nine surgical procedures, many related to diseases of the digestive track or conditions associated with obesity. Despite being some of the most commonly performed interventions, most of these procedures have not been subjected to rigorous scientific evaluation. For almost all of these procedures, fundamental questions regarding surgical epidemiology, clinical effectiveness, best practices to accomplish best outcomes, population-level results, patient-reported perspectives, and cost considerations have yet to be addressed. As healthcare delivery is reformed and as we strive towards building a learning healthcare system, addressing these questions is critical. One reason for the shortfall in rigorous clinical research in surgery is a paucity of formal, health services and comparative effectiveness research training for surgeons. To address this need, we propose the continuation and expansion of the University of Washington's National Research Service Award (NRSA) fellowship in clinical, health services, comparative effectiveness and patient-centered outcomes research for surgeons. This fellowship involves didactic training and practical experience in advanced research methodology focused on interventions related to the gastrointestinal system, obesity, and obesity-associated conditions. The training is focused in 6 areas (research using observational data, patient-centered outcome and preference assessment, health economics and behavioral economics in healthcare, policy and implementation science research, clinical / translational research, and research operations management) and is intended to develop surgeon- scholars who will be successful scientists and help build and advance the goals of a learning healthcare system. The didactic component of this fellowship includes coursework that results in a Masters of Public Health (MPH) or Masters in Science (MS) degree through the University of Washington School of Public Health and Community Medicine, with additional coursework and certificate training in the PhD candidate-training program of the Departments of Health Services and Pharmacy. All trainees complete a set of projects and studies representing a wide spectrum of research methods and approaches. The trainee's experience is fostered by a structured mentorship program with seasoned investigators who have a career commitment to training and career success in high-level research and integrating evidence into practice change. The T32 Fellows also participate in unique community, regional and national learning healthcare system programs including Washington State's Comparative Effectiveness Research Translation Network (CERTAIN),3 the Surgical Care and Outcomes Assessment Program (SCOAP)4 and a program aimed at optimizing patients before hospitalization called Strong for Surgery (strongforsurgery.org). Trainees participate in the NRSA fellowship for two years and then serve an additional 5-7 years of additional postdoctoral clinical training as general or specialty surgeons in the fields of advanced laparoscopy, foregut, hepatobiliary, colorectal, or bariatric surgery before obtaining academic faculty positions. The current NRSA fellowship program supports one new trainee per year, and because of program success, mentor capacity and trainee demand we are requesting an expansion to two new trainees per year.