The Translational Science Conundrum for Junior Investigators

Abstract

Translational research is the integration of 2 broad categories of biomedical science—basic science and applied science. However, in dentistry, this effort has been concentrated among a few researchers and must expand to keep pace with other disciplines. This commentary discusses the ongoing challenges faced by translational researchers (particularly early-career investigators) as they conduct oral and dental research, disseminate work, and contribute to science in general. This commentary also provides some recommendations/initiatives that could potentially address or alleviate these challenges.

Knowledge Transfer Statement:

The challenges and recommendations outlined in this commentary will serve as steppingstones to process the concepts of translational science, facilitate training for future scientists, and serve as an approach for the early investigators in the field of translational science.

Translational research is the integration of 2 broad categories of biomedical science—basic science and applied science. The use of translational science within different fields is considered interdisciplinary. Prior studies pragmatically explored different models of translational science and applied basic research findings to practice and communities to improve health outcomes (Titler 2018). Moreover, there are research classification for translation of T0 to T4 (e.g., basic, clinical, practice, population, and policy-based research) in the translation science (Translational Science Spectrum 2015). Basic science focuses on laboratory examination and investigation of disease states in contrast to health, while applied sciences involve the clinical application of screening and diagnostic tests, preventive and therapeutic interventions, and humanities research. While translational science is often perceived as taking research from the “bench to bedside” (Goldblatt and Lee 2010), in practice, the integration of these aspects of biomedical science is bidirectional and “circular” with the long-term aim of promoting public health. For example, elucidating molecular information gained through laboratory techniques (including microarray, genome sequencing, and proteomics) requires a solid information loop between laboratories and clinics.

In dentistry, the recent focus has been on moving translational science forward. So far, efforts have concentrated on catching up with other disciplines. While there is a clear need for additional training programs for researchers and reviewers, existing cultural differences need to shift to address barriers. This loop or iterative process presents inherent barriers to understanding translational fundamentals and processes (Wagner 2017), as well as different research experiences and backgrounds. These barriers stem from differences in scientific disciplines or cultures, training, or practice for basic and clinical scientists; structured interdisciplinary training and sufficient protected time for research would be a logical step toward overcoming these barriers. Nevertheless, a new generation of early-career investigators continues to experience significant hurdles while conducting translational research. Ultimately, scientists from senior to early career need to facilitate the exchange of knowledge and experience, creating a new generation of translational researchers. This will add rigor and support the efforts to move forward translational research and cost-effective methods and designs.

This commentary discusses the ongoing challenges faced by early-career translational researchers when conducting oral and dental research, disseminating work, and contributing to science in general. This commentary also provides some recommendations/initiatives that potentially address or alleviate these challenges.

Biomedical sciences, including dental research, have progressively shifted to multidisciplinary studies. However, many fields lack the infrastructure to facilitate the transition from traditionally single-field trained scientists to translational scientists. Junior scientists in doctoral and postdoctoral training programs are advised that to achieve success in academia, scientific results must be clinically translatable. However, as young investigators are joining the ranks of the scientific community, they are met with a stark reality. Many reviewers of publications and grants, as well as tenure committees, do not understand the fundamentals of the scientific premise, methods, or even the unique challenges facing those working in translational research studies. Therefore, early-career investigators receive overly critical, sometimes inaccurate feedback, creating obstacles in their career progress and advancement. There is a need to address this process such that the desired rigor in translational science is enhanced, rather than hindered, based on the reviewer’s feedback.

There are 2 key reasons for this disconnect. First, junior scientists need to understand the specific challenges they will face upon entering translational fields of research and how to address this barrier to improve their translational projects in a fairly new field. Learning about and managing these issues should become a fundamental part of the translational scientist training programs. Specifically, training is needed on the types of challenges that might be encountered when submitting manuscripts, grants, and promotion/tenure packages so researchers can adequately address these issues proactively. The key is to seek and identify appropriate training early to anticipate barriers to the acceptance of scholarly publication, grants, and career goals as a translational researcher. Furthermore, for a significant mind-set shift to occur in dentistry, scientific and administrative review communications in translational research need to be improved.

The second reason is that single-discipline trained scientists are often responsible for reviewing translational research publications and grants. As experts in their respective fields, these scientists are expected to apply their knowledge set regarding methodology (including sample collection), data analysis, interpretation, and discussion sections to determine the feasibility or appropriateness of studies that are broad/cross-cutting disciplines. Thus, this is a real concern as they are often evaluating research that is outside of the scope of their training or expertise. This is a key systemic issue that is difficult to redress.

To address the first reason, universities have instituted a bottom-up approach, creating more translational science training programs for early-career scientists. However, using only a bottom-up approach will take a generation before enough senior investigators are appropriately trained to effectively evaluate translational science. This approach often overlooks established scientists and principal investigators without translational science training and whose understanding of the idea of translational research is more abstract than practical. The current model is based on the premise that senior scientists will receive additional training through seminars, professional meetings, and teaching. However, if we hope to make translational science more effective, more formal infrastructure and incentives are required. Many disciplines require formal continuing education for their professionals; thus, one suggestion is to add continuing dental education training in translational science for reviews of grants and manuscripts involving translational research in dentistry. For example, the National Center for Advancing Translational Sciences offers publicly accessible programs, training, and educational resources through their website. Another suggestion is to develop collaborative groups and networking opportunities for basic and clinical science investigators and trainees with similar research interests. By adding or improving this top-down approach, institutions and professional societies that create, offer, and incentivize specific translational science training programs for mid-career and senior investigators are more likely to rapidly advance the field of translational science.

There is also increased need for scientific investigators to collaborate in preclinical and clinical research teams, but it comes with notable difficulties. First, it takes significantly more time and resources to design and implement clinical and translational studies when compared to basic science experiments. Of note, it requires considerably more resources and staff to collect a reasonable number of clinical samples to be appropriately powered for meaningful translation. Further, presenting or disseminating work in peer-reviewed journals is often hindered by limited experience with clinical or interventional studies among reviewers (Pogue 2019). The time between submission and rejection further delays the translation of work and into clinical and dental practice.

To mitigate some of these challenges, we have two recommendations. First, upscaling institutional training at all levels (funding agencies, chancellors, administrators, business managers, faculty, and students). Online modules could offer some training in conducting research with a mix of clinical components and basic science. Too often, training for basic scientists and clinicians remains siloed, leading to divergent cultures and a loss of opportunity for cross-disciplinary collaboration. Second, institution of a more comprehensive reviewer selection process for peer reviews. For example, create a talent database that allows selection of multiple subdisciplines for choosing the most suitable reviewers for a research topic(s). This database would also be key to the development of collaborative groups in which investigators having similar or diverse research background and different levels of experiences could connect and network.

In defining translational research in the context of oral and dental research for young investigators, these challenges significantly affect career progression. In academia, the current criterion for promotion relies heavily on individual research output such as high-impact publications and grant funding. Early-career investigators involved in translation typically have shorter publication records since translational projects generally take longer to complete. Furthermore, such investigators are likely to be part of a relatively large interdisciplinary team, and their role in publications and on grants may not appear dominant. There is a growing need for institutions to update or revise the tenure and promotions criteria used to evaluate and recognize the contributions of investigators who conduct translational research. Many institutions are working toward this, for example, by using reviewers with diverse expertise and understanding of translational research and moving away from “traditional” assessment criteria. Such steps will encourage basic scientists and clinician scientists interested in pursuing translational research in academia.

Conclusions

We hope this commentary will spark a conversation on how to move translational science forward in dental research. The bottom line is that translational research is costly and time-consuming; therefore, good clinical and translational research needs to flush out the design and methods to avoid comprising the strength of the study outcomes. As the evidence gathered through translational research propels policies toward better clinical practice and addressing the factors contributing to health disparities, the time for translational science in dental research has come.

Author Contributions

S.J. Calderon, contributed to conception and design, data acquisition, analysis, and interpretation, drafted and critically revised the manuscript; S.S. Momeni, M.O. Coker, contributed to data conception and design, drafted and critically revised the manuscript. All authors gave final approval and agreed to be accountable for all aspects of the work.