Discussion

By leveraging the academic strengths of the University of Kentucky Center for Clinical and Translational Science (UK CCTS), the Indiana Clinical and Translational Sciences Institute, and the University of Cincinnati Center for Clinical and Translational Science and Training, the Visiting Scholar Program was successful in promoting the career development of KL2 scholars from all three institutions. Among 60 scholars who were eligible to participate, 20 (33.3%) applied for participation, and 18 (30%) were selected. Two applicants were not selected for program participation because the proposed networking opportunities were not strong. Program participants were representative of the broader population of eligible participants in terms of professional discipline, with female representation higher (78% vs. 65%) and underrepresented persons lower (11% vs. 18%; Table 5).

Based on evaluations completed immediately after program completion, all participants reported that both the opportunities to give an invited presentation and to participate in the Visiting Scholar Program were beneficial to career development, and a majority (11 of 12) reported that the program supported research development and was effective in expanding their collaborative networks (Table 3). More specifically, participants shared that the opportunity to engage in scholarly dialogue and critique with a new group of research experts helped them to refine and improve the rigor of their own work. Furthermore, the majority (11 of 12) of program graduates indicated they would recommend participation in the Visiting Scholar Program to other KL2 scholars.

For longer-term outcomes, a majority (10 of 11) of participants reported subsequent contact with investigators they met during their visit, including two collaborative grant submissions (one funded) and one collaborative manuscript submission 2- to 3-year post-program completion, as well as future plans for collaborative grant and manuscript submissions (Table 4). Given that only two scholars reported joint grant submissions and publications, we looked for potential reasons that might explain this level of outcome. One common factor identified was that these two scholars knew one or more investigators at the host institution prior to their visit. As a result, the Visiting Scholar Program served to strengthen those relationships and helped facilitate new connections beyond each scholars’ initial points of contact. For other scholars without a prior point of contact, the visit supported the formation of new connections and an additional program structures may be needed to encourage, support, and sustain new collaborations.

The overall impact of the program may be underreported, as 2- to 3-year intervals may not be adequate for collaborations to mature and translate into measurable outcomes such as joint grant submissions and publications. We recommend that outcomes be assessed at least annually (and perhaps at 6-month intervals) for at least 5 years following completion of the Visiting Scholar Program to fully capture the impact of the program on career development. We also recommend the addition of interviews to obtain more robust feedback and overcome the limitations of open-ended survey items [Reference Singla, Adebayo, Shields, Dorn and Thiboutot10]. While the long-term outcomes reported are modest, ongoing communication between scholars and faculty at the host institutions is ongoing for 10 of 11 visiting scholars, so it is possible that additional collaborative grants, manuscripts, and presentations will emerge over time.

Program improvements and modifications have occurred based on informal meetings with participating scholars and program directors. For example, based on informal feedback received from the first cohort of KL2 Visiting Scholars in 2018, we created a funding opportunity to promote and accelerate new research collaborations between visiting scholars and faculty at the host CTSA. To be eligible, the proposed multi-PI projects needed to involve collaboration between KL2 scholars who participated in the program and a faculty member at the host institution. Multi-PIs were required to have a full-time faculty appointment at their own CTSA institution, and scholars must have successfully completed their KL2 program at the time of pilot award funding. Funding was provided by the CTSAs of the collaborating multi-PIs, with funds spent at the CTSA that contributed funding (i.e., funds could not be transferred between institutions). Budget requests could not exceed $25,000 per CTSA ($50,000 total for direct costs only). Interested collaborators were asked to submit a joint letter of intent and biosketches for initial review. Upon invitation, the Multi-PIs were invited to submit a full proposal for a standard NIH-type study section review (see Supplemental Material, Appendix D: Funding Announcement for details).

The pilot grant was offered only one time and has been challenging to sustain. These challenges include partner institutions being on varying funding cycles, and the commitment of funds for the support of the pilot program was a concern at the end of a funding cycle when institutions were applying for continuation funding. Identifying additional sources of support for the pilot grant program could help to cover commitments during the times in which institutions are competing for renewed funding. The pilot grant program may be especially important in improving long-term outcomes for visiting scholar participants as it provides a more immediate mechanism to encourage and sustain newly developed cross-institutional parternships [Reference Robinson, Schwartz, DiMeglio, Ahluwalia and Gabrilove11].

The cost of the Visiting Scholar Program is an important consideration related to program expansion. The cost of this Visiting Scholar Program has been modest, in large part due to regional collaboration which limits travel cost. The host institution covers the cost of three meals – dinner on the night prior to the Visiting Scholar Program (typically including the visiting scholar and KL2 leadership at the host institution), and breakfast and lunch for the scholar. Some host institutions scheduled the scholar presentations to occur during the lunch hour and provided food for individuals attending the invited presentation. The scholars’ CTSA covered other travel costs (mileage, hotel expenses for one night) that were manageable, given the proximity between CTSA institutions (200 miles separate UK and IU, 85 miles separate UK and UC, and 130 miles separate IU and UC).

There are modest administrative costs associated with managing the program and developing itineraries for visiting scholars, which are subsumed within the CTSA and KL2 program budgets. Finally, there are costs to the scholars in time spent in preparing program applications and preparation for the invited presentation and program. The program is highly scalable, with costs of expanding the program associated primarily with increased travel costs to the scholars. Opportunities for hosting the Visiting Scholar Program using virtual tools are also possible, which would significantly reduce travel costs and could increase institutional efficiency by providing guidance on program support. We have provided appendix materials to reduce the cost of program development by other CTSA’s or national programs supported virtually.

Several opportunities for programmatic improvement are apparent. For instance, we currently rely heavily on scholar mentors and KL2 program leadership to prepare visiting scholars to perform effectively and professionally in their roles as visiting scholars. The opportunity to provide training for effective engagement in visiting scholar invitations to both optimize performance and career development through the training of all KL2 scholars is a future opportunity. For example, leveraging the communicating science program at the Indiana CTSI to assist visiting scholars with their presentations, offer constructive criticism, or provide cross-institutional workshops [Reference Rossing, Hoffmann-Longtin, Dudeck and McClure12]. Several scholars indicated that it would have been helpful to receive more input from the host institution in identifying potential faculty to meet during their visit. In this case, leveraging existing research development teams and advisory groups to help identify a more diverse group of senior scientists would help ensure young scholars form stronger, more diverse interdisciplinary collaborations [Reference Keller, Collier, Blakeslee, McCracken and Morris13].

The visiting scholars program is in the early stages of development and as a previously mentioned assessment of outcomes can be improved through an extended evaluation period and the addition of post-visit interviews. We anticipate that improvements to the program, including increased scholar support in the areas of communicating science and building networks, along with sustained availability of pilot grants will expand the number of visiting scholars who report sustained interdisciplinary collaborations and related outcomes.

In summary, the KL2 Visiting Scholar Program is a cost- and time-efficient program for enhancing KL2 scholar career development by leveraging the academic strengths of CTSAs to promote research development and expand professional collaborative networks. Resources developed to support the integrated UK CCTS, IN CTSI, and UC CCTST programs provided with this report should expedite the development of similar regional program development as well as national virtual visiting scholar opportunities.