Team Building: Critical Role of Interdisciplinary Research Teams in Translational Research C. Kent Osborne, M.D. Director, Lester and Sue Smith Breast Center Director, Dan L. Duncan Cancer Center

Translational Research Extending discoveries in the lab to improve care of the patient in the clinic Taking clinical observations back to the lab to study in depth Studying lab discoveries in human samples Lab Translation Clinic

Example Breast Cancer Program, Dan L. Duncan Cancer Center

Summary of Development of the Breast Cancer Program 1.Single basic scientist 2.Single clinical scientist 3.Collection of tumor tissue 4.Recruit biostatistician 5.Recruit additional basic and clinical scientists 6.Recruit pathologist 7.Start Breast Center to bring people from different disciplines together

Translational Research Team Research requires multidisciplinary expertise Clinicians - illuminate the clinical problem - discuss with basic scientists - review lab research progress - carry out lab research themselves - ultimately do clinical trial

Multidisciplinary Team Laboratory scientists - discuss clinical issues with physician - coordinate research in preclinical models - contact clinician after making discovery to discuss translation - multiple scientists with different types of expertise might be involved (cell biologist, molecular biologist, geneticist, biochemist, molecular epidemiologist)

Multidisciplinary Team con’t Pathologist - key to translational research - access to human tissues and fluids - must be part of the team, not just a provider - develop assays for clinical or lab specimens - histopath of tissues

Multidisciplinary Team con’t Biostatistician - plan and design lab and clinical experiments - analyze data, statistical significance - advise on design of translational experiments - coordinate management and storage of data

Multidisciplinary Team con’t Clinical trial support personnel - research nurses - study coordinators - data managers - quality assurance - regulatory staff: IRB, FDA, industry

How to Build the Team Find an institution with the resources and research environment conducive to multidisciplinary “team” research Recruit small but critical mass; get funding PPGs, SPORE, Center, other collaborative grants Build infrastructure: grants management, clinical trials support, regulatory and administrative staff Recruit missing ingredients

Important Features Organizational structure to facilitate working together across disciplines Frequent meetings to discuss results, address problems or plan future experiments Creation of Center or Institute often helps to cross traditional dept boundaries Strong leader who understands a little about a lot (some knowledge of all the disciplines) Mechanism of retrieving, storing and annotating clinical specimens

Potential Obstacles Scientific presentations, publications: “who gets the credit?” Academic standing and promotion: problem for service oriented team members Intellectual property issues Inter departmental interactions Who or what group gets the grant credit and money? Working with another institution

Conclusions Translational research is a relatively new discipline Best way to make progress in clinical medicine; increasingly favored by NIH Requires different disciplines to work together closely and communicate Goes against traditional academic medicine culture Requires team oriented people, not individualists

Conclusions con’t May necessitate new structures like Centers or Institutes Requires new appreciation by promotion committees, funding agencies, etc With the “right” group it can be fun and scientifically rewarding There is too much for one person to know thus requiring a multi expert team

Characteristics of a Leader Pays more attention to those being led than him/herself Humility with coworkers Don’t be dictatorial; listen to group; let others win Insecure person has no business being a leader Actions should set example Delegate and reward Build team or family atmosphere Vision, goals, strategy

Closing Advise There is no telling how far a person can go if he/she is willing to give someone else the credit.