translational research

• Your Stories

Evidence Based Living

Bridging the gap between research and real life

• In The Media
• The Learning Center
• Cornell Cooperative Extension
• Youth Development
• Health and Wellness

What is translational research?

Cornell’s College of Human Ecology is pursuing a translational research model to better link social and behavioral science research to extension and outreach, creating a more seamless link between science and service. But the question arises: What is “translational research?”

Evidence-Based Living sat down with Wethington to talk about the growing field of translational research.

To start off, what exactly is translational research?

Many definitions have been given for translational research, but the definition I like best is that it is a systematic effort to convert basic research knowledge into practical applications to enhance human health and well being. 

Translational research was designed for the medical world.  It emerged in response to concern over the long time lag between scientific discoveries and changes in treatments, practices, and health policies that incorporate the new discoveries.

What is applied research, and how does it differ?

Translational research is broader than the traditional term “applied research.”  Applied research is any research that may possibly be useful for enhancing health or well-being. It does not necessarily have to have any effort connected with it to take the research to a practical level. 

For example, an applied research study might analyze longitudinal data that tracks participants’ health and social relationships.  The researchers would report their findings in an academic journal.

But in translational research, the same study would include some “action steps.”  The researchers would partner with a community and ask for ideas about how their findings might apply there.  Together, they would come up with an intervention plan that would also include scientific evaluation of its effectiveness. 

Why are social science researchers slower to adopt these models compared to the medical community?

I think the answer to this question is that researchers have followed where the money has been allocated. The opportunities for social and behavioral scientists have not been established as rapidly.

More recently, three major government institutions have been funding projects that emphasize public health outreach using translational research – the Centers for Disease Control, the National Institutes of Health and the National Institute on Aging.  All three have been establishing translational research centers across the country, primarily focused on underserved communities and health disparities.

Thus, social scientists are only now being encouraged to take part.  More recently economic stimulus funds dispersed the National Institute of Health funded a number of translational research projects headed by social scientists, including three funded at Cornell.  I predict that soon there will be social scientists engaged in translational research across the country, not just at funded centers.

What are the benefits of moving toward translational research?

For researchers, there is benefit to being affiliated with a center that provides seed funding for projects, methodological assistance, advice on developing proposals and experience in getting community input into research projects.

For universities, translational research centers provide a tactical advantage for attracting more funding.  Translational research centers also provide a way for universities to meet public service goals in their strategic plans.

For communities, translational research provides opportunities to make a difference in their own communities.  As part of one of the Cornell centers, we engaged public service agency directors in events where they could contribute to our research agenda.  With a stake in the research, communities feel that they are making a valued and important contribution.  We heard over and over from the community members that this was a real source of pride and accomplishment for them.

How can extension programs participate?

One way local extension programs can participate in translational research is to take part in community stakeholder groups that meet with researchers who are designing intervention and prevention research programs.  Typically, a wide variety of stakeholders need to be engaged.  County Cooperative Extension offices have many collaborative relationships in their counties and can work with researchers to make contacts.

Typically, local extension professionals do not have time to engage in research themselves.  Yet they have valuable experience that can be shared.  This makes Cooperative Extension an ideal contributor for implementing programs.

Nice reading! Thank you

A remarkable extraordinary read, ideally other huge schools can take an interest in something like this.

Quite the great read, hopefully other large schools are able to participate in something like this.

Speak Your Mind Cancel reply

A project at…, evidence-based blogs.

• Bandolier Evidence-Based Health Care
• British Psychological Society Research Digest
• Economics in Cooperative Extension
• EPB Exchange
• New Voices for Research
• Research Blogging
• Trust the Evidence

Subscribe by e-mail

Please, insert a valid email.

Thank you, your email will be added to the mailing list once you click on the link in the confirmation email.

Spam protection has stopped this request. Please contact site owner for help.

This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Return to top of page

Copyright © 2024 · Magazine Theme on Genesis Framework · WordPress · Log in

• Download PDF
• Share X Facebook Email LinkedIn
• Permissions

The Meaning of Translational Research and Why It Matters

Author Affiliation: Departments of Family Medicine and Epidemiology and Community Health, Virginia Commonwealth University, Richmond.

Translational research means different things to different people, but it seems important to almost everyone. The National Institutes of Health (NIH) has made translational research a priority, forming centers of translational research at its institutes and launching the Clinical and Translational Science Award (CTSA) program in 2006. With 24 CTSA-funded academic centers already established, other universities are transforming themselves to compete for upcoming CTSA grants. By 2012, the NIH expects to fund 60 such centers with a budget of $500 million per year. 1 Besides academic centers, foundations, industry, disease-related organizations, and individual hospitals and health systems have also established translational research programs and at least 2 journals ( Translational Medicine and the Journal of Translational Medicine ) are devoted to the topic. By some accounts, translational research has become a centerpiece of the European Commission's €6 billion budget for health-related research, and the United Kingdom has invested £450 million over 5 years to establish translational research centers. 2

Read More About

Woolf SH. The Meaning of Translational Research and Why It Matters. JAMA. 2008;299(2):211–213. doi:10.1001/jama.2007.26

Manage citations:

© 2024

Artificial Intelligence Resource Center

Cardiology in JAMA : Read the Latest

Browse and subscribe to JAMA Network podcasts!

Others Also Liked

Select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing
• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts

Study at Cambridge

About the university, research at cambridge.

• Undergraduate courses
• Events and open days
• Fees and finance
• Postgraduate courses
• How to apply
• Postgraduate events
• Fees and funding
• International students
• Continuing education
• Executive and professional education
• Courses in education
• How the University and Colleges work
• Term dates and calendars
• Visiting the University
• Annual reports
• Equality and diversity
• A global university
• Public engagement
• Give to Cambridge
• For Cambridge students
• For our researchers
• Business and enterprise
• Colleges & departments
• Email & phone search
• Museums & collections
• Office for Translational Research
• About the OTR overview
• Connections overview
• Industry partnerships
• AIMday overview
• AIMday Cell and Gene Therapy
• Connect: Health Tech
• SAS Institute
• Funding overview
• MRC Confidence in Concept overview
• CiC Expert Panel
• CiC Previous Awards
• CiC Case Studies
• Projects and Programmes overview
• Cambridge-Sunway Collaboration overview
• Sunway Programmes
• Sunway Committees
• RCP-Sunway-Cambridge seminars
• Collaboration Contacts
• Experimental Medicine Initiative overview
• EMI Programme Objectives
• EMI Training Events
• EMI Trainees overview
• Dr Akhilesh Jha
• EMI Case Studies
• EMI Contacts
• EMI How to Apply
• EMI Steering Committee
• Events overview
• Past Events

What is translational research?

• Connections
• Projects and Programmes

Translational research is 'the process of applying ideas, insights, and discoveries generated through basic scientific inquiry to the treatment or prevention of human disease'. The philosophy of 'bench to bedside' underpins the concept of translational medicine, ie. from basic research to patient care.

The translational pathway in medicine can be simplified via the model described within the Cooksey review (2006)*. Though it is not necessarily a linear and uni-directional path, two major gaps in translation were identified and articulated.  

translational_pathway_rework.png

In the context of the University, the OTR mainly addresses the first gap of '…translating ideas from basic and clinical research into the development of new products and approaches to treatment of disease and illness' rather than the second gap of '…implementing those new products and approaches into clinical practice'.

*A Review of UK Health Research Funding (the Cooksey Report) (2006)

© 2024 University of Cambridge

• Contact the University
• Accessibility
• Freedom of information
• Privacy policy and cookies
• Statement on Modern Slavery
• Terms and conditions
• University A-Z
• Undergraduate
• Postgraduate
• Research news
• About research at Cambridge
• Spotlight on...

Introduction: What Is Translational Research

• First Online: 01 January 2014

Cite this chapter

• Dennis V. Cokkinos MD, FESC 2  

1274 Accesses

1 Citations

There are many definitions of Research, Basic, Clinical and Translational Research. A very practical and short definition of Translational Research could be, the application of findings from Basic Research to patient, community and population care and to the advancement of the delivery of health services.

Usually three steps can be defined:

T1 (T for translation): is the transfer of new understanding of disease mechanisms gained in the laboratory into the development of new methods for diagnosis and therapy.

T2 is the translation of results from clinical studies into everyday clinical practice and health decision making.

T3 is the dissemination and implementation of research translation into practice/community/large populations.

Corresponding blocks or impediments are delineated to the successful employment of these steps. A newly introduced concept is the Valley of Death, separating research results from successful innovation-application.

To overcome these problems, the foundation and collaboration of centers able to conduct Translational Research, such as the National Institutes of Health and the National Clinical and Translational Science Award Consortium is important.

The teaching, training, and formation of translational researchers is difficult, varied and a matter of constant effort.

To overcome increasing costs the combination of “wet” –i.e. biological labs with “dry” or computational data is being increasingly employed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info
• Durable hardcover edition

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

Association for Clinical Research Training

Academic Health Centers

Biomedical Research Foundation Academy of Athens

Clinical and Translational Science Awards

General Clinical Research Centers

National Center for Advancing Translating Services

Translational Research Institute

National Institutes of Health

Translational Research

NSF. Definition of research. National Science Foundation 2007. http://www.Nsf.gov/statistics/randdef/business. cfm .

Oxford English Dictionary. www.oed.com .

Popper KR. Objective knowledge. 2nd ed. Oxford: Clarendon press; 1972. p. 191–205.

Google Scholar  

Illing J. Thinking about research: frameworkers, ethics and scholarships. Edinburgh: Association for the Study of Medical Education; 2007. p. 2–37.

Bush V. Science: the endless frontier; a report to the President by Vannevar Bush, Director of the Office of Scientific research and Development. Washington, DC: United states Government Printing Office; 1945. Accessed 13 Nov 2009. Section 3 (the importance of basic research), chapter 3 (science and the public welfare) http://nsf.gov/about/history/nsf50/vbush1945_content.jsp .

Hecker L, Birla RV. Intangible factors leading to success in research: strategy, innovation and leadership. J Cardiovasc Transl Res. 2008;1:85–92.

Article   PubMed   Google Scholar  

Glossary of themes for human subjects protection and inclusion issues based on the 1997 report of the NIH Director’s Panel on clinical research, entry: “clinical research”. http://grants.nih.gov/grants/peer/tree_glossary.pdf . Accessed 13 Nov 2009.

Schteingart DE. Introduction to principles of clinical and translational research. Athens: ESCI Core Course on Clinical Research; 2010.

Seely WE, Grinspoon S. Patient-oriented research: clinical pathophysiology and clinical therapeutics. In: Robertson D, Williams GH, editors. Clinical and translational science. 1st ed. London: Elsevier; 2009. p. 3–12.

Chapter   Google Scholar  

Califf RM, Zarin DA, Kramer JM, Sherman RE, Aberle LH, Tasneem A. Characteristics of clinical trials registered in ClinicalTrials.gov, 2007–2010. JAMA. 2012;307:1838–47.

Article   CAS   PubMed   Google Scholar  

Karp JE, McCaffrey RP. New avenues of translational research in leukemia and lymphoma: outgrowth of a Leukemia Society of America-National Cancer Institute workshop. J Natl Cancer Inst. 1994;86:1196–201.

Feldman AM, Koch WJ, Force TL. Developing strategies to link basic cardiovascular sciences with clinical drug development: another opportunity for translational sciences. Clin Pharmacol Ther. 2007;81:887–92.

Littman BH, Di Mario L, Plebani M, Marincola FM. What’s next in translational medicine? Clin Sci (Lond). 2007;112:217–27.

Article   Google Scholar  

Woolf SH. The meaning of translational research and why it matters. JAMA. 2008;290:211–3.

Dische S, Saunders M. Translational research–a new entity? Acta Oncol. 2001;40:995–9.

Coller BS. Translational research: forging a new cultural identity. Mt Sinai J Med. 2008;75:478–87.

Article   PubMed Central   PubMed   Google Scholar  

Coller BS. Translating from the rivers of Babylon to the coronary bloodstream. J Clin Invest. 2012;122:4293–9.

Article   CAS   PubMed Central   PubMed   Google Scholar  

Williams DR. Introduction to clinical research. In: Robertson D, Williams GH, editors. Clinical and translational science. 1st ed. London: Elsevier; 2009. p. xvii–xx.

Williams GH, Robertson D. Clinical and translational science in infrastructure. In: Robertson D, Williams GH, editors. Clinical and translational science. 1st ed. London: Elsevier; 2009. p. 171–81.

Davis D, Evans M, Jadad A, Perrier L, Rath D, Ryan D, et al. The case for knowledge translation: shortening the journey from evidence to effect. BMJ. 2003;327(7405):33–5.

National Cancer Institute. Translational research working group definition of translational research. http://www.cancer.gov/trwg/TRWG-definition–ND-tr-continuum .

Sung NS, Crowley Jr WF, Genel M, Salber P, Sandy L, Sherwood LM, et al. Central challenges facing the national clinical research enterprise. JAMA. 2003;289:1278–87.

Lauer M, Scarlatos S. Translational research for cardiovascular diseases at the national heart lung and blood institute. Moving from bench to bedside and from bedside to community. Circulation. 2010;121:929–33.

Westfall JM, Mold J, Fagnan L. Practice-based research–“Blue Highways” on the NIH roadmap. JAMA. 2007;297:403–6.

Malliaras K, Kreke M, Marbán E. The stuttering progress of cell therapy for heart disease. Clin Pharmacol Ther. 2011;90:532–41.

Waldman SA, Terzic A. Clinical and translational science: from bench-bedside to global village. Clin Transl Sci. 2010;5:254–7.

Mc Garland Rubio D, Schoenbaum E, Lee S, Schteinggard DE, Marantz PR, Anderson KE, et al. Defining translational research: implications for training. Acad Med. 2010;85:470–5.

Koch WJ. Targeting the beta-adrenergic receptor kinase in heart failure. Lecture presented at the 1st international scientific conference on cardiovascular biotechnology: from cell to man. Biomedical Research Foundation of the Academy of Athens, 31 May 2013.

Kieburtz K, Olanow CW. Translational experimental therapeutics: the translation of laboratory-based discovery into disease-related therapy. Mt Sinai J Med. 2007;74:7–14.

Antoniades CH. Bridging the gap between basic science and clinical practice: the role of translational medicine. Lecture presented at the Biomedical Research Foundation Academy of Athens, 31 Oct 2012.

Murry CE, Jennings KA, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation. 1986;74:1124–36.

Chautard E, Thierry-Mieg N, Ricard-Blum S. Interaction networks: from protein functions to drug discovery. A review. Pathol Biol (Paris). 2009;57:324–33.

Article   CAS   Google Scholar  

Kerner JF, Hall KL. Research dissemination and diffusion. Res Soc Work Practice 2009;19:519–30.

Zucker DR. What is needed to promote translational research and how do we get it? J Investig Med. 2009;57:468–70.

PubMed   Google Scholar  

Bernard GR. Preparedness of the CTSA’s structural and scientific assets to support the mission of the National Center for Advancing Translational Sciences (NCATS). Clin Transl Sci. 2012;5:121–9.

Hartmann KE, Heitman E, Brown NJ. Training basic, clinical and translational investigators. In: Robertson D, Williams GH, editors. Clinical and translational science. 1st ed. London: Elsevier; 2009. p. 191–9.

Williams GH, Robertson D. The future of clinical research. In: Robertson D, Williams GH, editors. Clinical and translational science. 1st ed. London: Elsevier; 2009. p. 565–70.

Nadler LM, Roberts WC. Lee Marshall Nadler, MD: a conversation with the editor. Proc Baylor Univ Med Cent. 2007;20:381–9.

Verkoeijen PPJL, Tabbers HK. Good research requires productive theories and guidelines. Med Educ. 2013;47:858–65.

Pang T, Terry RF, The PLoS Medicine Editors WHO/PLoS Collection. No health without research: a call for papers. PLoS Med. 2011;8:4 e1001008.

White KL, Williams TF, Greenberg BG. The ecology of medical care. N Engl J Med. 1961;265:885–92.

Green LA, Fryer Jr GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001;344:2021–5.

Martin SS, Ou FS, Newby LK, Sutton V, Adams P, Felker GM, Wang TY. Patient- and trial-specific barriers to participation in cardiovascular randomized clinical trials. J Am Coll Cardiol. 2013;61:762–9.

Brutsaert DL. Heart failure: Quo Vadis. Lecture presented at cardiovascular biotechnology: from cell to man. Biomedical Research Foundation Academy of Athens, 31 May–1 June 2013.

Califf RM. Clinical trials. In: Robertson D, Williams GH, editors. Clinical and translational science. 1st ed. London: Elsevier; 2009. p. 13–37.

Welke KF, Ferguson Jr TB, Cooms LP, Dokholygan RS, Murray CJ, Sehrader MI, et al. Validity of the society of thoracic surgeons national adult cardiac surgery database. Ann Thorac Surg. 2004;77:1137–9.

Moss AJ, Francis CW, Rayan D. Collaborative clinical trials. N Engl J Med. 2011;364:789791.

Sipido KR, Casadei B, Holvoet P, Janssens S, Luttun A, Sampaolesi M. Bedside to bench: a look at experimental research with a clinical trial checklist. Cardiovasc Res. 2014;101:1–3.

Kaul S, Diamond GA. Trial and error. How to avoid commonly encountered limitations of published clinical trials. J Am Coll Cardiol. 2010;55:415–27.

Balas EA, Boren SA. In: Balas EA, editor. Yearbook of medical informatics: managing clinical knowledge for health care improvement. Stuttgart: Shattauer Verlagsgesellschaft mbH; 2000, p. 65–70.

Contopoulos-Ioannidis DG, Alexiou GA, Grouvias TC, Ioannidis JPA. Life circle of translational research for medical interventions. Science. 2008;321:1298–9.

Hudson J, Khazhragui HF. Into the valley of death; research to innovation. Drug Discov Today. 2012;18:610–3.

Butler D. Translational research; crossing the valley of death. Nature. 2008;453:840–2.

Roberts SF, Fischhoff MA, Sakowski SA, Feldman EL. Perspective: transforming science into medicine: how clinician-scientists can build bridges across research’s “valley of death”. Acad Med. 2012;87:266–70.

Coller BS, Califf RM. Traversing the valley of death: a guide to assessing prospects for translational success. Sci Transl Med. 2009;1:10cm9. doi: 10.1126/scitranslmed.3000265 .

Bodi V, Marrachelli VG, Husser O, Chorro FJ, Viña JR, Monleon D. Metabolomics in the diagnosis of acute myocardial ischemia. J Cardiovasc Trans Res. 2013;6:808–15.

Moses 3rd H, Dorsey ER, Matheson DH, Their SO. Financial anatomy of biomedical research. JAMA. 2005;294:1333–42.

Quinn T, Kohl P. Combining wet and dry research: experience with model development for cardiac mechano-electric structure-function studies. Cardiovasc Res. 2013;97:601–11.

The Royal Swedish Academy of Science. press release: pressmeddecande, 9 october 2013. Nobel prize in Chemistry. 2013.

Curry SH. Translational science: past, present, and future. Bio Tech. 2008;44:Pii–vii.

Braunwald E. Cardiovascular science: opportunities for translating research into improved care. J Clin Invest. 2013;123:6–10.

Stamler JS, Taber RL, Califf RM. Translation of academic discovery into societal benefit: proposal for a balanced approach–part 1. Am J Med. 2003;115:596–9.

Download references

Author information

Authors and affiliations.

Heart and Vessel Department, Biomedical Research Foundation, Academy of Athens, Athens, Greece

Dennis V. Cokkinos MD, FESC

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Dennis V. Cokkinos MD, FESC .

Editor information

Editors and affiliations.

Academy of Athens, Biomedical Research Foundation, Athens, Greece

Dennis V. Cokkinos

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cokkinos, D.V. (2015). Introduction: What Is Translational Research. In: Cokkinos, D. (eds) Introduction to Translational Cardiovascular Research. Springer, Cham. https://doi.org/10.1007/978-3-319-08798-6_1

Download citation

DOI : https://doi.org/10.1007/978-3-319-08798-6_1

Published : 22 September 2014

Publisher Name : Springer, Cham

Print ISBN : 978-3-319-08797-9

Online ISBN : 978-3-319-08798-6

eBook Packages : Medicine Medicine (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

• Research Overview
• Research Activities
• Research Resources
• Training & Education
• Collaborate With NCATS
• Funding Overview
• Open Funding Opportunities
• Small Business Programs
• Funding Policy & Operating Guidelines
• Grant Information
• Challenges and Prize Competitions
• Scientific Review
• Conference Grant Information
• Resources for You
• Resources for Researchers
• Resources for Trainees
• Resources for Rare Disease Patients and Advocates
• News & Events Overview
• Newsletters
• Scientific Publications
• NCATS Overview

About Translational Science

• Advisory Committees
• Careers at NCATS
• Director's Corner
• Divisions & Offices

We tackle ongoing challenges in research so that new treatments can reach people faster. We do this by advancing translational science.

Translational Science

Translation is the process of turning observations in the laboratory, clinic and community into interventions that improve the health of individuals and the public — from diagnostics and therapeutics to medical procedures and behavioral changes. 

Translational science is the field that generates scientific and operational innovations that overcome longstanding challenges along the translational research pipeline. These include scientific, operational, financial and administrative innovations that transform the way that research is done, making it faster, more efficient, and more impactful.    

Translational Science Spectrum

The translational science spectrum represents the stages of research involved in bringing more treatments to all people more quickly.

Translational Science Principles

The NCATS Translational Science Principles characterize effective translational science approaches. 

Translational Science Resources

We offer resources that describe translational science and its role in advancing research and health. 

Publications

Advancing Education and Training through Application of the Translational Science Principles

Faupel-Badger JM, Vogel AL, Austin CP, Rutter JL.  Advancing Translational Science Education  [published online ahead of print, 2022 Aug 31].  Clin Transl Sci.  2022;10.1111/cts.13390. doi:10.1111/cts.13390)

Translational Science Principles Enabling Team Science in NCATS’ Internal Research Program

Vogel AL, Knebel AR, Faupel-Badger JM, Portilla LM, Simeonov A.  A Systems Approach to Enable Effective Team Science from the Internal Research Program of the National Center for Advancing Translational Sciences .  Journal of Clinical and Translational Science.  Cambridge University Press; 2021;5(1):e163.

Teaching Translational Science Principles

Faupel-Badger JM, Vogel AL, Hussain SF, Austin CP, Hall MD, Ness E, Sanderson P, Terse PS, Xu X, Balakrishnan K, Patnaik S, Marugan JJ, Rudloff U, Ferrer M.  Teaching Principles of Translational Science to a Broad Scientific Audience Using a Case Study Approach: A Pilot Course from the National Center for Advancing Translational Sciences .  Journal of Clinical and Translational Science . Cambridge University Press; 2022:1–26.

Translational Science Education Events

View our upcoming and past meetings, workshops, webinars and other events. 

Last updated on April 19, 2024

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• My Account Login
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Open access
• Published: 04 June 2020

Everyday characterizations of translational research: researchers’ own use of terminology and models in medical research and practice

• Dixi Louise Strand   ORCID: orcid.org/0000-0003-0524-2466 1 , 2  

Palgrave Communications volume  6 , Article number:  110 ( 2020 ) Cite this article

8365 Accesses

2 Citations

2 Altmetric

Metrics details

• Medical humanities
• Science, technology and society

Biomedical literature and policy are highly concerned with encouraging and improving the clinical application and clinical benefit of new scientific knowledge. Debates, theorizing, and policy initiatives aiming to close the “bench-to-bedside gap” have led to the development of “Translational Research” (TR), an emerging set of research-related discourses and practices within biomedicine. Studies in social science and the humanities have explored and challenged the assumptions underpinning specific TR models and policy initiatives, as well as the socio-material transformations involved. However, only few studies have explored TR as a productive ongoing process of meaning-making taking place as part of the everyday practices of the actual researchers located at the very nexus of science and clinic. This article therefore asks the question of how the discourse and promise of translation is embedded and performed within the practices and perspective of the specific actors involved. The findings are based on material from ethnographic fieldwork among translational researchers situated in a Danish hospital research setting. The analysis draws on the analytical notion of performativity in order to approach statements and models of TR in the light of their performative dimension. This analytical approach thus helps to highlight how the characterizations of TR also contain prescriptions for how the world must change for these characterizations to become true. The analysis provides insights into four different characterizations of TR and reflects on the associated practices where performative success is achieved in practice. With the presentation of these four characterizations, this paper illustrates different uses of the term TR among the actual actors engaged in research-clinic activities and contributes insight into the complex processes of conceptual and material reorganization that form part of the emergence of TR in biomedicine.

Similar content being viewed by others

The translational lag narrative in policy discourse in the United States and the European Union: a comparative study

Wicked problems in a post-truth political economy: a dilemma for knowledge translation

The gains of reduction in translational processes: illness blogs and clinical-ethics cases, introduction.

Translational research has become subject to widespread debates in biomedical literature and politics, evoking high expectations, promises, and concerns. The term “translational research” was first used in a US national cancer program in the 90’s and has since appeared in research programs, research strategies, academic articles and journals, policy reports, and educational programs globally. The main interest underlying the concept in this normative policy oriented debate derives from a perceived series of gaps between life sciences, medical research, clinical practices, and effects in the form of, e.g., measurable health improvements. The rationale and promise of TR is to ensure and encourage that public investments in health science are turned into improved care practice and improved public health. The term TR is used interchangeably with other terms such as translational medicine, translational science, academic medicine, medical knowledge translation etc. TR is closely linked to research policy, funding incentives as well as organizational transformation in Europe, US, Australia, and more recently the Nordic countries, where Academic Health Science Centers (AHSCs) have been established in recent years to encourage translational interaction between research and clinic. As such, TR is important as a pervasive discourse in medical science and as a socio-economic reorganization of research practices. Existing studies have pointed to the multiple meanings of translational research in ongoing academic and policy debates—and to the way in which this concept is tied to a range of varying problems and possible solutions, not only in different medical fields but also in different national contexts (Crabu, 2018 ; Greenhalgh and Wieringa, 2011 ; Krüger et al., 2018 ; van der Laan and Boenink, 2015 ). Very few studies, however, focus empirically on how these expectations and characterizations of TR hold true in the context of actual researcher practices.

This article reports on an ethnographic case study of translational research networks in a Danish university hospital setting. The investigation focused empirically on the nature of these translational activities and on how translational research was “made to work” in a specific research-hospital setting. This article presents a particular sub-set of the data in order to explore how the translational researchers themselves understood and used the concept of translational research (TR). Focus is thus on how actors in a Danish research setting are entangled in wider discourses of TR and how they take part in performing TR discursively and materially. The analysis draws on key ideas from the work of Science and Technology Studies in order to understand TR as a set of performative statements and ideas that generate their own practices and thereby create the world they describe (Mackenzie et al., 2007 ; Mol, 2002 ). As such, the article contributes empirical insights into the researchers’ own descriptions and models regarding the concept, how the concept was performed in the setting studied, how researchers engaged with the concept, and what they made of it.

The article is structured as follows. First, I briefly present the literature on the concept of TR. The next section presents the methodological and theoretical backdrop for the research reported and the areas of investigation, translational research grounded in the fields of psychiatry and oncology. Hereafter, key statements and examples from the data are presented and analyzed. Lastly, the discussion reflects upon TR as a complex process of meaning production and material reorganization.

Translational research

In an important article from 2012, Van der Laan and Boenik “disentangle” the concept and rhetoric of TR and its different meanings, both historically and philosophically (van der Laan and Boenink, 2015 ). They focus on the extensive and exponential use of the concept in biomedical scientific literature during the years 1993–2010 and present different epistemic dimensions regarding the way the concept is interpreted and used. Krueger, Hendriks, and Gauch’s more recent literature survey of the term in biomedical and clinical research also finds a “kaleidoscope” of different dimensions, understandings, and applications related to the term (Krüger et al., 2018 ).

Despite the variances, one focal figure in this literature is the trope of “bench to bedside”. Here, TR is a science-clinic-public relationship conceptualized as a set of translational phases through which knowledge moves from basic biomedical research into diagnosis or treatment, subsequent development into evidence-based protocols, following deployment in clinical practice, and, ultimately, benefits for the individual and society through improvement of public health. The term implies a relocation and translation of knowledge across what are conceived of as somewhat separate domains. Yet, as noted in the existing literature studies, the way in which the specific gaps, models, and problematic barriers are constructed vary greatly. Likewise, the understanding of the very domains involved differs. Basic science, clinical research, clinical practice, the public, society, and politics are also defined and delineated in varying ways.

The social sciences and humanities have entered into and contributed to the biomedical debate on translational research, as recently reviewed by Crabu ( 2018 ). Work in these areas has challenged the transfer notion implicitly found in much of the literature on translational science—as well as the fundamental distinction between basic and applied science. Qualitative empirical studies also bring our attention to the very complex collaborations and recursive pathways of TR, where valuable breakthroughs in science and treatments can emerge by way of the clinical staff and their daily questions and puzzles, from patients or patient groups, commercial activity, or policy demands. The creation of new medical knowledge can thus have many “starting points” in addition to basic science, thus challenging the linearity implied in many discussions and policies on TR. In their study of laboratory and clinical practices related to Huntington Disease, Lewis, Hughes, and Atkinson, for example, point to TR as a complex of clusters and multiple processes of relocation and reconfiguration as objects, knowledge, practices, and resources are circulated between multiple sites (Lewis et al., 2014 ). Based on a study of health care innovation through extended translational networks in Canada, Lander and Atkinson-Grosjean ( 2011 ) likewise describe various hybrid domains of translational science that cut across presumed divides between basic science, clinic, as well as commercial and civic areas. Their study also illustrates how translational pathways flow through the interactions and relations among a complex collection of actors and organizations (Lander and Atkinson-Grosjean, 2011 ). This complexity is less visible in the normative depiction of TR as a unidimensional line from basic research to clinical practice and then to public health.

The study reported on in this paper converges with this line in the literature located in social science and the humanities, both openly exploring the complexities of TR and challenging the foundations and presuppositions of a normative TR agenda. The article focusses on the question of how actors involved in TR in a specific research-hospital setting engage with and use the concept. The exploration asks open questions as to which statements and models of TR circulate among these actors? What does TR mean in the context studied? How do these statements and models participate in shaping research and clinical practice? How does TR relate to other concepts and concerns? In exploring these questions, different understandings have emerged from the data, summarized here as four themes: TR as knowledge flow, TR as a political buzzword, TR as collaboration and exchange, and TR as competency and skills. Each of these understandings is depicted in turn in the analysis section. Based on this analysis, the paper contributes to existing social science and humanities explorations of TR and adds to existing work by illustrating the ways in which the concept of TR circulates in a particular setting and how the concept is adopted and used by actors in this setting as part of their everyday practice. The paper argues that these performative uses of the term are material and productive as they contribute to organizing work, as well as attaching value to specific kinds of work and specific skills.

The study reported here is based on ethnographic fieldwork in Danish hospitals carried out between January 2018 and March 2019. I conducted interviews and observations and collected a broad range of organizational and project documents. Observations included research team meetings, departmental meetings, public presentations of research, two academic conferences, patient testing and treatment, lab visits and informal conversations (~100 h). I took hand written notes during observation and subsequently wrote these out in text files—with concurrent memoing. Observations and informal conversations provided data on daily experiences and were linked to formal interviews that were conducted in parallel (n20). Interviews were conducted with various team members, primarily clinician-scientists (n11) but also research team members such as Ph.D. students (n4), biologists (n2), an engineer (n1), and lastly two department managers (n2). The interviews lasted 1–2 h, were recorded and transcribed with the respondents’ consent. All interviews were conducted at the hospitals and were semi-structured and included questions about the participants’ definitions, understandings, and models regarding the concept of TR. Data was stored, organized, and coded in the qualitative data analysis software NVivo using grounded theory and analytical tools from situational analysis (Clarke, 2005 ). The findings presented in this paper draw on a sub-set of the data regarding the way in which the translational researchers themselves understood and used the concept TR.

Ethical approval and consent were obtained in writing from the principle investigators of the research networks and from the informants. The project was also approved by the hospital management and reported to the regional ethics committee. Throughout the research project, I was simultaneously working as a consultant in a crosscutting research and innovation support unit at the hospitals. This involved weekly visits, meetings, workshops, and communication with staff and management at the hospital departments on issues related to research development and support in the region. This concurring consultancy work gave me a background understanding of the organization and the research infrastructure of the hospitals, but it is not included as a formalized part of the dataset due to research ethics of a dual role of employee and researcher.

Oncology and psychiatry

The setting for the research here is Region Zealand in Denmark and in particular two research networks based in the regional hospitals. These research networks connect different research projects or research protocols within a joint vision of changing and improving diagnosis and/or treatment within two very different medical areas, child and youth psychiatric diagnosis and cancer treatment. The two translational research networks were interdisciplinary, yet anchored in the two domains of oncology and psychiatry, referred to here as the electroporation and autism networks. The electroporation case was an international collaborative network working to develop and improve a new type of treatment for cancer, electroporation. This technique creates an electrostatic field in cancer cells in order to increase the permeability of the cell membrane, allowing chemicals, drugs or DNA to be introduced into the cell. When applied locally, this type of treatment has been found effective in killing the cancer cells of the tumor, and the treatment with this technique combined with administering calcium was found to release patterns into the immune system, possibly hindering a recurrence of the tumor and slowing further spreading of the cancer. A range of related projects sought to refine the technique in relation to specific cancer types and in relation to different types of chemicals, and to explore systemic immune responses of the treatment found clinically as an unexpected outcome of the treatment. This network played an important role in developing and implementing this particular type of cancer treatment internationally. The group was involved in developing European guidelines for clinical practices and in various political and practical implementation efforts to establish the treatment type as part of the standardized treatment program for specific cancer types in Denmark. The researchers were thus deeply engaged in research, but they were also focused on realizing its application in the clinic. Most of the researchers were also responsible for everyday clinical practices of examining patients and determining treatment strategies.

The second research network I studied conducted research on autism disorders in children and youth through a translational research design combining behavioral, psychological, and neurobiological approaches. The project was situated within a broader disciplinary debate regarding the Diagnostic and Statistical Manual (DSM) and concerning controversies as to the way in which to categorize symptoms of mental disorders. Autism in particular presents a contested diagnostic category, appearing clinically in a variety of forms and with varying professional understandings of its nature and appropriate treatments. The research network was concerned with this broader questioning of the very notion of autism as a singular disorder category and was critical of current diagnostic criteria and classification. Furthermore, the research network formed part of a shift in the clinic and the field more generally towards investigating mental disorders such as autism through laboratory practices and technologies like new IT-based cognitive function testing, electroencephalography (EEG), and magnetic resonance imaging (MRI). The researchers’ work was exploratory, seeking to find new ways of understanding autism as both symptoms and pathology, e.g., through a key psychiatric concept of cognitive flexibility that was investigated as part of the project.

Although several of the projects within both of these research networks included industrial partners, the lead researchers themselves stressed that their research was “investigator-initiated” and thus different in nature from clinical trials and medical research driven by industry. The lead researchers themselves framed their research, the research designs and approaches, as “translational”, e.g., in presentations and funding applications (“translational forskning” in Danish).

Analytical framework

Science Studies, Feminist Theory, and Cultural Studies have explored empirically and theoretically the way in which discourse, statements, and representations have productive consequences and effects upon reality (Foucault, 1990 ; Haraway, 1988 ; Latour, 1987 ; Mol, 2002 ). In their book on economics, Mackenzie et al. ( 2007 ) develop the term performativity to examine how economic theory takes part in shaping economic realities—how statements, models, concepts, and formulas over time shape the very worlds they describe. These authors illustrate how reality—socially and materially—over time becomes reshaped to fit with theoretical models and inherent presumptions. This analytical lens is highly relevant for understanding how the language of TR has been, and continually is, an agent for modifying the reality it describes. This analytical lens also leads us to study how actors involved in TR research take part in the actualization and “putting into motion” of TR through their use of TR concepts, models, and research designs. This is the focus in the following analysis where significant examples and excerpts related to the use of TR terminology are presented and discussed. According to Mol ( 2002 ), conversations and interviews are a way of listening to informants as if they were their own ethnographers, telling how their work of TR is understood and carried out. Interviews and conversations are thus analyzed as a way of learning about objects, events, and practices that are material and productive.

The analysis is organized according to four main understandings emerging from the data—TR as knowledge flow, TR as a political buzzword, TR as knowledge collaboration and exchange, and TR as competencies and skills. The quotes and excerpts are anonymized with regard to informant names and field of expertize and only attributed to the research network—named here as the autism and electroporation network, respectively. Throughout the analysis, the two networks also serve as analytical prisms for one another, juxtaposing their similarities and differences.

TR as knowledge flow from theory to practice

During the study, a dominant understanding of TR that appeared during observations, informal conversations, and interview questioning on the topic was TR as knowledge flow from theory to practice . This understanding aligns with the notion and modeling of TR that is pervasive in biomedical literature and the aforementioned bench to bedside trope. TR is conceived of as a set of transfers or flows of knowledge from basic biomedical research into clinical diagnosis and improved health for patients—and also concerns closing the gaps hindering this flow. This understanding was particularly prevalent in the electroporation network. A lead researcher involved in setting up laboratory studies, clinical trials, and implementation efforts in relation to the treatment technique electroporation explains her understanding of translational research to me in an interview:

It is about closing the gap between lab research and the patient’s everyday life. Moving knowledge from the laboratory over into clinical practice, as well as ensuring how we can take the biological tests that afterwards can go back to the researchers… moving from idea, to laboratory research, to clinical research and all the way into guidelines for new treatment. (Electroporation network)

This quote resonates with the dominant understanding of TR as knowledge that flows through a set of otherwise separate contexts and knowledge domains framed as laboratory, clinical practice (with associated guidelines), and the patient’s everyday life. She describes TR as the moving of laboratory research into clinical practice, and how TR also produces the biological data in the clinic to move back into the lab.

At a research event and presentation at the hospital, this researcher presents a timeline of her research on electroporation. She explains how she has been involved in the basic science in order to understand the cells and cell membranes and how they can be briefly destabilized by applying electrical pulses to the area. Based on these insights into cellular behavior, they developed new experimental electro-engineering tools for applying electricity directly to the skin and tumor and then for injecting drugs and chemicals into the area so these can enter into the tumor and cells creating a local and very effective new treatment form. These tools have subsequently been refined and developed and are part of standard treatment regimes for specific types of cancer, such as skin cancer. In addition, the technique and technology are being developed further for other types of cancers. For example, stomach and colon cancer, where the tumor is more difficult to access directly with electrodes. Here, the electrodes were undergoing further development in order for them to work with endoscopic devices.

In a timeline figure, a presentation slide sketches the steps of translation from basic science over into techniques tested on mice in order, for example, to refine how to administer the electricity and chemicals in an appropriate way and with the correct dosages. This led to further experimental treatments on patients, and later on, randomized trials with a larger number of patients proving both the safety and efficacy of this specific type of treatment. In 2013, the UK National Institute for Health and Care Excellence (NICE) guidelines state that sufficient evidence has been established for this particular treatment for cancer spreading in the skin. In conclusion, she notes that this process has been a relatively “rapid process of translation from the first discoveries to a treatment in widespread use.” She moves on to explain their more recent work on using calcium with this type of treatment to determine how this might have effects upon the immune system beyond the local effects of cancer cell death. The timeline and story of electroporation reiterates a temporal TR image of knowledge flow from theory to practice—and back again—over time.

When asked about definitions of the term translational, another researcher, part of the oncology research networks but involved in the study and treatment of other cancer types, similarly notes:

I think translational covers when we turn over basic science into practical science. I see it as research where we get out and onward from the lab. We have an aim that is out of the lab, and it is important for us to do something that potentially can get out and work in society. (Electroporation network)

This quote links up to an understanding of making science applicable and “something that can be used.” Other informants likewise recognized TR as the clinical application of theoretical or experimental knowledge—or “moving new knowledge closer to the clinic, so “it can be used and tested further.” One informant notes that TR in this way consists of a practical achievement that moves theory into clinical practice:

I define translational as the clinical application of theoretical or experimental knowledge. So translational science is that one translates, really a utilitarian term, that you translate something proven ex vivo or proven in a petri dish to something that has clinical consequences for patients.” (Electroporation network)

In the accounts recorded during the study, an understanding of TR as knowledge flow from theory to practice thus is in agreement with the dominant discourse in the literature and “promise of translation” envisioned in the future (Brown et al., 2000 ). The hope is that public investments in health science can and should be paid back in the form of improved care practice and improved public health. “Making a difference” was often mentioned as motivation for the career choice of working with translational hospital-based research, along with the value of participating in research that might be practically applicable to and an improvement of current clinical practice. This applicable-practice motivation was notable in both the electroporation and the autism network.

Following Mackenzie et al. ( 2007 ), the accounts and ideas also speak of actual practices where, in the electroporation network, knowledge artefacts, as well as biological material are relocated and exchanged. There are also accounts of how experimental research is connected to changing procedures for cancer treatment strategies and new standardized treatment programs.

TR as a political buzzword

Several of the informants in both research networks noted the buzzword character of the word, smiling or laughing at my question of their understanding in the interview thereby distancing themselves from the concept and instead locating the concept in a world of politics and funding bodies with interests different from their own. They reiterated statements resembling the objectives discussed above regarding knowledge flow and transfer, but then added that these ideas did not necessarily match the way TR projects actually played out according to their experience. A researcher from the autism network notes:

I know what it means, but that is not how I see it implemented. It is research that supposedly builds bridges between experimental research… over into clinical research, maybe back again. However, when I see translational programs implemented, it does not really get out to the patients, and it does not really get out into the clinic. (Autism network)

Several informants noted that the TR had a political buzzword quality and was about justifying funding for very specific types of research. Therefore, for some there was a discrepancy between the rhetoric of TR and the way it was realized in ongoing projects. Accounts such as the above imply a critical position—that the translational agenda is a way of living up to demands of funders or creating political enthusiasm for research—but that the actual move into clinic and patient benefits could be questioned.

One informant described TR as a specific kind of research funding to expand “the evidence base” rather than research enabling knowledge to flow between basic science and the clinic.

Really, a buzzword is about creating the funding to make the evidence. It is relatively inexpensive to fund the small, experimental studies but gets expensive when you want to test an intervention on a larger group. It is complicated to create the evidence to prove that this really should be part of the standard treatment plan. So it is a way of creating funding for this difficult phase, where promising research needs to create the evidence base for it to get used. (Electroporation network)

Here, TR is a way of creating political support for particular types of research funding—a way of filling an evidence gap that is necessary for something to be legitimate and justifiable as a diagnostic or treatment option in the clinic. Thus, in this understanding TR is understood as a rhetorical device serving particular interests and political agendas. This resonates with the political move to put significant resources into TR to increase the clinical relevance and application of research. Using research relies on the creation of very specific types of “robust” evidence such as randomized controlled trials—and these are a necessary intermediate stage for research findings to reach decision-makers and potentially have societal health impacts. So here, TR is about the political support for specific types of research, for creating particular research infrastructures that can enable credibility, validity, and paths of impacts for medical research.

Conversations and interviews where TR was referred to as a political buzzword can also be seen as part of the actors’ own reflections on a broader knowledge economy where colleagues, or they themselves, attempt to position themselves strategically in relation to political and funding agendas. They adhere to, draw on, but also smile at this—since what they see “play out” sometimes is a different scenario. The actors in both research networks involved were thus attentive to how one as a researcher strategically can link up to political agendas and adjust projects so they match the demands of policy and funding trends. Here, TR is pointed to as rhetorically powerful in justifying specific types of research resonating related analyses of how TR currently is mobilized in other national academic medical settings (Rushforth, 2016 ; Wilson-Kovacs and Hauskeller, 2012 ).

TR as interdisciplinary collaboration and exchange

A third understanding of TR that appeared in both networks was TR as a framing of interdisciplinary collaboration. Models and research designs of TR enabled and encouraged collaborations and exchanges across different medical specializations and across distinct departments and organizations. A researcher from the autism research network replies to the question of how she understands the term translational as follows:

I understand it broadly, that you try to connect knowledge and understanding from different levels—psychological, biological, social etc.—into a joint understanding of a phenomenon… The same phenomenon might really be the result of many different processes. (Autism network)

She moves on to explain how such processes can be captured at different levels and through different investigational methodologies deriving from different disciplines. Methods in her project included preclinical and clinical testing, neurobiological approaches, brain imaging, and at a later stage, if the funding becomes available, possibly also genetic testing. She explains that a translational approach is the next step in developing new knowledge on autism. Here, the promise of TR is to connect different knowledge forms to create radically new understandings.

The idea here is that the translational can dismantle diagnoses, as they are today. If we understand the translational levels, we will understand that the diagnostic system and the psychiatric system should be put together differently. (Autism network)

The research design of the autism project is therefore organized around a translational model that the lead researcher sketches for me on the whiteboard in her office, and later, after the interview, she sends me the model figure used in applications and when presenting the research (Fig. 1 ). Here, different translational levels are depicted along with the examinations, methods, and procedures applied to produce knowledge about these levels. The research project is designed around these translational levels through which the children included in the study move during a series of examinations marked in the figure as “assessments 1–5” under the column with procedures, ranging from standardized clinical screening tests and questionnaires, IT-based cognitive tests and paraclinical methods, including electroencephalography (EEG) and magnetic resonance imaging (MRI). These methods provide knowledge on different translational levels from the “psychosocial down to something increasingly biologically based”, she explains.

The translational model was shared by an informant in the autism research network and derives from their project description. The model depicts different translational levels along with the examinations, methods, and procedures applied to produce knowledge about these levels. The research project is designed around these translational levels and a series of examinations marked in the figure as “assessments 1–5” under the column with procedures, ranging from standardized clinical screening tests and questionnaires, IT-based cognitive testing, electroencephalography (EEG) to magnetic resonance imaging (MRI).

The model organizes the research project, the series of tests and examinations the patients and control subjects go through in which different kinds of technologies and expertize are involved. The tests take place in the childrens’ homes and in their school settings (using standardized questionnaires filled out by parents and teachers), in the psychiatric clinic (again using standardized screening and new cognitive tests developed as part of the project), in a neurobiology lab at the neurology department and at the department of medical imaging (where the MRI scanning technologies are located). The studies require personnel and expertize from these various disciplines in order to carry out the examinations and analyze the results. The autism research network thus spanned different departments and disciplinary specializations of child and youth psychiatry, psychology, psychophysiology, radiology, neurology, engineering, and screening software/IT development.

“It is like we take a cross-section and look at the same phenomenon at different levels”. (Autism network)

The translational research design brings together different methods and techniques for investigating many different parameters associated with autism. In this sense, the model of the translational research design can be seen as a workable boundary object (Star and Griesemer, 1989 ) enabling collaboration across a complex of scientific inquiry methods and knowledge forms into a joint workable research design. The model helps to make possible collaboration across specializations and departments and facilitates a joint study that combines approaches where autism is framed in different ways: as related to social, behavioral, and clinical symptoms, as a disease with a possible neurological basis, and as a disease with a possible brain structural basis. Through the translational research model, it becomes possible to relocate the phenomenon of autism into different disciplines and as such offers a tool towards collaboration. The language of TR in the autism network can thus be seen as a contact language enabling a joint interdisciplinary project to be planned and agreed upon (Galison, 1999 ).

In the same way, projects within the electroporation network were framed and depicted in translational models and research designs. This network also involved collaboration between a range of disciplines and areas of expertize, requiring collaboration between researchers based in oncology, surgery, dermatology, pathology, biochemistry, molecular biology, immunology, physics, engineering, IT, and palliation. A model (Fig. 2 ) was used in a research presentation to depict and present a subproject taking place within this translational network. The project was set up as a collaboration between the oncology and surgery department at the Danish hospital and included several other partners such as universities, industry, and e.g., a leading immunological research institute in France working to develop new methods to characterize the immune characteristics of cancer tumors, “the cellular landscape of the tumor”. Like the model from the autism network, it looks “across” and combines different types of examination and methodologies in a new way.

The translational model was shared by an informant in the electropration research network and derives from their project description. The model depicts the translational set-up for the study and different methods for examination that include and “sum up” patient outcomes, blood samples, and tumor biopsies across different stages of cancer—early cancer (Tidlig colon og rectum cancer), advanced cancer (Lokal avanceret rectum cancer), and cancer that has spread in the body (Metastatisk sygdom).

One of the lead researchers explains the translational set-up for the study in which the patient is treated with calcium electroporation before the planned surgical removal of a cancer tumor. The treatment prior to surgery aims to stop the tumor growth and hinder spreading of the cancer. Blood samples and tumor biopsies are taken, and biological data is recorded before and after the surgery to assess the effect of the intervention. In the boxes on the left, the figure presents the different stages of cancer development to be examined—early cancer, advanced cancer, and cancer that has spread in the body (metastasized). The investigations then focus on three ways of “reading” the intervention. Firstly, what happens to the patients? Is it safe? How is the treatment experienced by the patient, e.g., pain? Are the side effects short term and long term? Does the tumor grow or spread (as seen and measured through imaging technologies)? Secondly, what happens as the result of this treatment at the molecular level in the tumor and in the blood, examined through tumor biopsy investigations and blood profiling testing before and after the treatment intervention? These different “readings” of the interventions’ effects are summed up (+). The researcher explains that this can be a new way of producing knowledge about the variation they find clinically, for example of how the same intervention works differently in two patients, by looking at the cellular level and the biological markers to explain and understand the variation and the immunological changes involved. Translation is a way of making the effects of an intervention visible and documentable, as a way of proving a link between treatment and specific effects. As such “translational” is a set of methods and tools that can be used to compare and evaluate treatments with the potentiality of providing a new and different kind of knowledge of what works, and sometimes how it works.

In the electroporation network, several researchers noted that the research is fragmented and separate (e.g., in relation to the different stages of cancers or in relation to different treatments before or after surgery). A researcher explains that not a lot of research focuses on all three phases, but that looking at the immune system as a whole rather than the tumor as an isolated entity to be treated or removed is often neglected. Looking at the effects of the treatment overall requires what he notes as a “helicopter view”. Another researcher in the project similarly refers to this work as grasping the “bigger picture”.

It is about designing the study so you see the bigger picture and get a 360-degree view… If you want to make a difference and do research that moves the way we think, then you have to include all the parts and include the whole spectrum. (Electroporation network)

Ideally, for example, results from patient-reported outcomes, molecular biological examinations of blood samples and immunological investigations of tumor material are linked up in the research project—as are different stages of cancer and phases of cancer treatment like pre, during, and post operation, thereby encompassing the “whole spectrum” by working across disciplines and joining differing techniques and niches of research. For both networks, bringing together these different investigational techniques and methods was where the research had the break-through potential to be a “game changer”, as one researcher puts it—in the sense of a new way of thinking about cancer or an entirely new approach to psychiatric diagnosis. This is where there is a promise and potential to change the foundations for existing classifications, diagnostics, and treatment strategies of illnesses. In both networks, TR is a productive and adaptable way of framing interdisciplinary research and multifaceted research problems. TR holds a promise of not only creating usefulness of research, but also of changing fundamental paradigms of both clinical research and practice.

TR as competencies and skills

A final and fourth understanding reappearing in the data material is TR as competencies and skills. When explaining their TR understandings and research activities it was often noted by the informants that such work required a set of specific competencies and skills. This concerned the ability to develop and use translational tools and methodologies in the research project and at the hospital. In the excerpt below, a lead researcher stresses the aspect of “ability to use”:

“To me, translation is the ability to have a tool to translate an effect of something, a clinical intervention, a clinical problem—to be able to translate that into an effect on the genetic, cellular, or molecular level. So translation to me is using that methodology, that method, to find an effect of something that happens clinically.” (Electroporation network)

As part of the electroporation study, Ph.D. students and young researchers went abroad and participated in research courses, seminars and visits—one in an electro-engineering institute in Slovenia to learn the electrophysics behind the technique, the other in an immunology laboratory in France to learn how to measure immune cells in the tumor with a novel prognostic technique. These kinds of exchanges were vital to developing the skills necessary to realize the TR objectives of the project. One of the Ph.D. students explains this as somewhat different from other kinds of clinical research at the department.

When you are a researcher at a hospital, you stand there with your patient, and then you send off your tests, I have heard jokes about this in the lab, you send off your tests into a black box, and we get a bunch of numbers back. I would like to go into that black box and see what happens, to understand how the tests are practically handled in the lab, because I think that the very numbers I get out of that black box, well I will to a greater degree understand them, if I have been there in the lab, where I see it and have it in my hands. (Electroporation network)

In this quote, the physician in research training points to her own movement between research located in a clinic and in a laboratory. Part of her research plan is to move into the laboratory and acquire the skills to understand laboratory-based analysis, results and possibilities. In order to gain these skills and competencies, and apply them to the clinical focus of her research, she notes how it is necessary to physically “move into the black box” and “have it in my hands”. As such, her training involves a shift from more “traditional” medical research into a new kind of translational research.

Another team member in the project has a background in human biology. She has been hired to support the translational research at the department and highlights that it is the exchanges between the different professional groups in the project that are so necessary and where we “really make the most of the knowledge we have”. She explains her mediating work and role and how her educational background in human biology has equipped her to be a clinical research biologist.

It is really about understanding a little bit of everybody else’s areas or field, so you can be precisely that link between chemists, physicists, and doctors. (Electroporation network)

In the electroporation network, a TR research agenda was thus closely linked with recruiting or educating the “TR agents” that could facilitate research activities and exchanges across disciplinary boundaries. A crucial supporting aim of the TR networks was thus to develop these skills in house—at the department and at the hospital, rendering the opportunities in the technologies and the lab more accessible.

Likewise, Ph.D. students in the autism network were trained thoroughly in the working of the neuro-lab by experts at the hospital and from abroad, setting up and using the physical equipment for carrying out EEG examinations, as well as the technologies and software involved in data analysis of the EEG results. As noted by one of the Ph.D. students, this was really a very different set of “much more technical skills” than those he was trained in as medical doctor in child and youth psychiatry. A key participant in the autism network was for example a trained psychologist and had experience from a previous job with MRI brain scanning techniques. His expertize in both child and youth psychiatry and imaging technologies made it possible to connect the psychiatric research interests with possibilities in the MRI devices for testing and analysis. He could speak the necessary highly specialized language related to diagnostic imaging, such as multi-slicing, pulse-sequences, and fiber tracking etc. He enabled the interactions and exchanges among the psychiatrists and the MRI engineer and imaging professor. Such ability to apply new methodologies across disciplines and to converse and move expertly across more than one discipline is thus a fourth way in which the discourse and promise of translation was embedded within the practices of both research networks.

This article has presented and explored different uses of the TR terminology in two specific settings of biomedical clinic-academic work practices. This type of inquiry is underexplored in the literature, and this empirical contribution thus adds to related efforts into studying how the actors in the field respond to political agendas of TR and changes in the biomedical research-clinic landscapes (Rushforth, 2016 ; Vignola-Gagne, 2014 ; Wilson-Kovacs and Hauskeller, 2012 ). The analysis has put forth a set of performative statements on TR along with the models of translation presented by these actors. Here we see how TR is embedded in the practices and perspectives of a set of particular actors involved in TR.

The first characterization of TR as knowledge flow can be viewed as an adaptation of the normative language of TR debates and policies. The goal and value of bench to bedside work enters into the actors’ own characterizations and meaning-making of their everyday work—as it also productively shapes and organizes these practices. Researchers involved in TR take on and seek to fulfill expectations and visions of the TR discourse and assumptions that circulate among funders, evaluators, management, and in health care prioritization and politics. TR also becomes part of the actors’ own sense-making and vision of how value can be created through their work for patients and for society. This brings our attention to how actors involved in carrying out TR take part in actualizing and putting into motion theories, models, and the very propositions of TR. This characterization places positive value upon specific kinds of work in the hospitals and among the hospital-based researchers. Translational research work that can ensure that research results are used, integrated into practice, and can produce benefits for patients and society is thus also characterized and performed as desirable and good.

The second characterization points to the critical position of TR as associated with a political agenda and something that can be used strategically to secure funding. TR offers an opportunity for researchers to position themselves advantageously in relation to TR policy and funding—thus potentially gaining a privileged professional status as key leaders of change, as noted in related studies (Vignola-Gagne, 2014 ; Wainwright and Williams, 2009 ; Wilson-Kovacs and Hauskeller, 2012 ). The researchers themselves take part in critically reflecting upon political agendas, funding flows and the consequences for their work, their career, and their field of expertize. They thus participate in questioning the very promises and hopes of the TR dominant discourse and the transformations they experience.

In the third characterization presented here, TR as collaboration and exchange, TR becomes a way of seeing and analyzing the subject matter across disciplinary divides. As such, the translational research design combines several different investigational methodologies from different and otherwise somewhat distinct disciplines. In the terms of Latour, these techniques mediate the object studied in different ways, rendering it visible for science in particular ways (Latour, 1987 ), and these different mediations are brought together in the promise of “seeing the bigger picture”—and “changing the game” in radical ways. TR discourse and promises become an organizing factor for research and research activities in the hospital studied. TR serves to facilitate epistemological boundary spanning (Evans and Scarbrough, 2014 ) and is a productive way of framing interdisciplinary research and multifaceted research problems that cannot be solved with traditional research frameworks. In this understanding TR perhaps opens for alternative ways of creating medical knowledge and evidence other than—or in combination with—the gold standard of randomized controlled trials (Timmermans and Berg, 2003 ; Wieringa et al., 2017 ).

Lastly, TR is closely linked to the building and expanding of interdisciplinary and transactional skills in the hospital setting studied. This is discussed under the fourth characterization, TR as competencies and skills. This theme highlights the integration of new knowledge forms into the hospital research setting, as well as the very practical, material, and embodied abilities of TR such as handling the equipment, delivering the electric pulses to the tumor areas as in electroporation, and learning to administer the details of the EEG equipment and devices. New skills must be learned and entered into clinical practice and experimentation. Likewise, medically trained employees move into the lab and learn to work with the biopsies, blood samples, and cells “in their hands”. Scientific investigation of cancers and autism is shifted out of the clinic into the laboratories of for example neurobiology and brain imaging—and the techniques and skills from these disciplines are relocated into clinical and medical practice and achieve new value here.

With the presentation of these four understandings, this article illustrates different uses of the term TR among actors engaged in research-clinic activities in two settings, that of clinical oncology and that of clinical psychiatry. The analysis presented in this article does, of course, not cover all the ways in which actors involved in TR use the term. Rather it illustrates some specific, situated uses—uses that reappeared and were focal in the data material produced in this study. The analysis provides new insights into TR as a”force of example” (Flyvbjerg, 2006 ). Rather than providing a total overview or mapping generalized patterns, the analysis explores specific context-dependent appearances of TR. The study brings out differences and connections for further juxtaposition to other studies in different specializations in different national contexts. It is important to note that the characterizations were not mutually exclusive, but overlapping and entangled in the setting studied. The understandings were mobilized, in turn, to bring out different aspects and values of the hospital-based research work in specific situations. All characterizations circulated in both networks—thus seemingly co-existing within these networks, as well as sometimes in the course of a single interview.

Notable are however also some of the differences in the two research networks. The networks were not analyzed as comparative cases (several cases of the same), but selected due to differences and analyzed in juxtaposition to bring out differences. In the electroporation network, the dominant understanding of TR as knowledge flow was more prevalent than in the autism network. In the electroporation network TR as knowlegde flow appeared as the primary understanding of the term and also as an important guiding rationale of conducting hospital-based translational research. This might be linked to the ways in which the field of cancer research historically has been tied to the political and funding agenda of TR. Historical studies have analyzed how the rise of translational research and a translational agenda, particularly in the US, is closely linked to cancer research and to the promise of cancer cures based on research into new drugs and treatment therapies (Fujimura, 1996 ; Keating and Cambrosio, 2012 ; Löwy, 1996 ). All early publications 1992–1997 using the term are also related to cancer research, in particular research on biomarkers in relation to cancer prevention and the establishment of tissue banks and cancer research centers in this period (van der Laan and Boenink, 2015 ). Historically, TR in this version seems more closely linked to the electroporation network than to that of psychiatry—where the understanding of TR as collaboration and exchange was foregrounded more often. These differences bring our attention to the ways in which TR is situated differently in different disciplines and underscores the contextual nature of the concept.

This article has presented selected findings from an ethnographic study of the everyday practices of TR in a specific setting. The discourse of TR, including the policy initiatives and organizational transformations linked to the TR discourse, can be seen as a paradigmatic shift in medical science. Yet little is known about how such a paradigm shift plays out in concrete settings, what it means to the actors involved, how it changes what constitutes meaningful and valuable research—as well as meaningful and valuable everyday work practices. This article proposes that actors take part in performing the emergence of TR and possible paradigm shifts by foregrounding and valuing specific versions of TR along with specific practices, specific skills. This entails that other practices and skills perhaps are backgrounded and become less visible and less valued. That which the less visible and less-valued practices are composed of (e.g., perspectives of patients or other working groups at the hospitals) constitutes a pressing question for further work beyond the scope of this paper. One of the important points highlighted here is the different ways in which TR discourses, promises, and expectations form an active part of the researchers’ sense-making and practices. The analysis presented in this article also allows us to reflect on how these actors take part in fulfilling a societal obligation, encouraging and improving the clinical application and clinical benefit of new scientific knowledge. They share the concerns found in the TR debates and policy regarding the closing of a “bench-to-bedside gap”, but also rework these orientations in relation to their specific projects and practices. Applying the notion of performativity, statements and models of TR have been approached in the light of their agency and their performative dimension. This analytical approach thus helps to understand how TR characterizations—and statements—also contain a prescription for how the world must change for them to become true. Mackenzie et.al. suggest that performative success is when there is created both a new language and theory, as well as new reality ( 2007 ). This article provides insights into four co-existing characterizations where such performative success was achieved in the setting studied. The analysis also points to a disciplinary difference through the juxtaposition of two different research networks. New languages, theories and realities were successfully in the making in these networks along with changing implications for the way in which research knowledge is produced and applied, as well as cultural shifts in what constitutes good and valuable research. In conclusion, this performative lens is proposed as a potential step forward toward developing a social science and humanities understanding of TR, how usefulness of research is characterized and realized through practice while keeping in sight the complexity and materiality of such processes.

Data availability

The dataset generated and analyzed during the current study is not publicly available due to the sensitive nature of the content and the use/consent agreed with informants. Selected anonymized extracts and summaries are available from the corresponding author on reasonable request and signing of a MOU to ensure the ethical use of data.

Brown N, Rappert B, Webster A (2000) Contested futures: a sociology of prospective techno-science. Ashgate, Farnham

Google Scholar  

Clarke AE (2005) Situational analysis: grounded theory after the postmodern turn. Sage Publications, California

Book   Google Scholar  

Crabu S (2018) Rethinking biomedicine in the age of translational research: organisational, professional, and epistemic encounters. Sociology Compass. https://doi.org/10.1111/soc4.12623

Article   Google Scholar  

Evans S, Scarbrough, H (2014) Supporting knowledge translation through collaborative translational research initiatives: “bridging” versus “blurring” boundary-spanning approaches in the UK CLAHRC initiative. Soc Sci Med. https://doi.org/10.1016/j.socscimed.2014.01.025

Flyvbjerg B (2006) Five misunderstandings about case-study research. Qual Inq. https://doi.org/10.1177/1077800405284363

Foucault M (1990) The history of sexuality. Volume 1, An introduction. Vintage, New York

Fujimura JH (1996) Crafting science. a sociohistory of the quest for the genetics of cancer. Harvard University Press, Cambridge

Galison P (1999) Trading Zone-coordinating action and belief. In: Biagolo M (ed) The Science Studies Reader. Abingdon-on-Thames, Routledge, pp. 137–160

Greenhalgh T, Wieringa S (2011) Is it time to drop the ‘knowledge translation’ metaphor? A critical literature review. J R Soc Med. https://doi.org/10.1258/jrsm.2011.110285

Haraway D (1988) Situated knowledges: the science question in feminism and the privilege of partial perspective. Fem Stud. https://doi.org/10.2307/3178066

Keating P, Cambrosio A (2012) Cancer on trial: oncology as a new style of practice. University of Chicago Press, Chicago

Krüger AK, Hendriks B, Gauch S (2018) The multiple meanings of translational research. negotiating medical science. https://doi.org/10.31235/OSF.IO/W6XJN

Lander B, Atkinson-Grosjean, J (2011) Translational science and the hidden research system in universities and academic hospitals: a case study. Soc Sci Med. https://doi.org/10.1016/j.socscimed.2010.11.019

Latour B (1987) Science in action: how to follow scientists and engineers through society. Harvard University Press, Cambridge

Lewis J, Hughes J, Atkinson P (2014) Relocation, realignment and standardisation: circuits of translation in Huntington’s disease. Soc Theor Health. https://doi.org/10.1057/sth.2014.13

Löwy I (1996) Between bench and bedside: science, healing, and interleukin-2 in a cancer ward. Harvard University Press, Cambridge

Mackenzie D, Muniesa F, Siu L (2007) Do economists make markets. Do economists make markets? On the Performativity of Economics. Princeton University Press, New Jersey. https://doi.org/10.1086/597458

Mol A (2002) The body multiple: ontology in medical practice. Duke University Press, Durham

Rushforth A (2016) What’s in a slogan? Translational science and the rhetorical work of cancer researchers in a UK university. Nord J Sci Technol Stud. https://doi.org/10.5324/njsts.v4i1.2170

Star SL, Griesemer JR (1989) Institutional ecology, ‘translations’ and boundary objects: amateurs and professionals in Berkeley’s Museum of Vertebrate Zoology, 1907–39. Soc Stud Sci. https://doi.org/10.1177/030631289019003001

Timmermans S, Berg M (2003) The gold standard: the challenge of evidence-based medicine and standardization in health care. Temple University Press, Philadephia

van der Laan AL, Boenink M (2015). Beyond bench and bedside: disentangling the concept of translational research. Health Care Analysis: HCA: J Health Philos Policy. https://doi.org/10.1007/s10728-012-0236-x

Vignola-Gagne E (2014) Argumentative practices in science, technology and innovation policy: the case of clinician-scientists and translational research. Sci Pub Policy. https://doi.org/10.1093/scipol/sct039

Wainwright S, Williams C (2009) Stem cells, translational research and the sociology of science. In: Atkinson P, Glasner P, Lock M. Handbook of genetics and society: mapping the new genomic era. Routledge, Abingdon-on-Thames, pp. 41–58

Wieringa S, Engebretsen E, Heggen K, Greenhalgh T (2017) Has evidence-based medicine ever been modern? A Latour-inspired understanding of a changing EBM. J Eval Clin Practice. https://doi.org/10.1111/jep.12752

Wilson-Kovacs DM, Hauskeller C (2012) The clinician-scientist: professional dynamics in clinical stem cell research. Sociol Health Illn. https://doi.org/10.1111/j.1467-9566.2011.01389.x

Download references

Acknowledgements

This study was funded by Data and Development Support, Region Zealand, and hosted by Department of People and Technology, Roskilde University. The study was carried out with support and supervision from Jesper Grarup, Peter Kjær, and the two research groups Health Promotion Research and Dialogical Communication at Roskilde University. Special thanks are also extended to the participants in the study.

Author information

Authors and affiliations.

Data and Development Support, Region Zealand, Soroe, Denmark

Dixi Louise Strand

Department of People and Technology, Roskilde University, Roskilde, Denmark

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Dixi Louise Strand .

Ethics declarations

Competing interests.

The author declares no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Cite this article.

Strand, D.L. Everyday characterizations of translational research: researchers’ own use of terminology and models in medical research and practice. Palgrave Commun 6 , 110 (2020). https://doi.org/10.1057/s41599-020-0489-1

Download citation

Received : 04 December 2019

Accepted : 22 April 2020

Published : 04 June 2020

DOI : https://doi.org/10.1057/s41599-020-0489-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Translation Research

Translation research explores how scientific work moves into practice and benefits society. Although this new field of research has not received much attention in occupational safety and health, it can have a valuable impact on workers everywhere. Today’s workplaces need research findings and products that can improve the quality of life, health, and work. Through translation research, NIOSH studies the process, drivers, and barriers for turning knowledge into practical applications that create these improvements for the safety and health of workers.

Translation researchers apply scientific investigative approaches to study how the outputs of basic and applied research can be effectively translated into practice and have an impact. This includes studying how knowledge and interventions are spread, accepted, applied, and institutionalized.

Activities in translation research range across the basic-to-applied continuum, and studies referred to as intervention research and translation research often overlap. NIOSH delineates the two in this way: intervention research involves improving an intervention or designing a new one, whereas translation research involves studying processes for putting research outputs into practice or use. These processes can include activities such as efficacy research (testing interventions in a realistic setting) and effectiveness research (testing interventions in a wide range of settings). Translation research also includes limited proof-of-concept testing and large-scale studies of research outputs and their impact.

Translation research has four stages (Table 1):

• Stage 1, development translation research , studies how a discovery made in a laboratory, field or pilot study or findings of risks, can move into a potential health and safety application to be tested.
•  Stage 2, testing translation research , assesses the value of a new finding, invention, process, training program, or intervention. It looks for larger-scale workplace safety and health practices aimed at a specific work sector or across two or more work sectors.
• Stage 3, institutionalization translation research , studies how evidence-based technology and recommendations become well-accepted workplace safety and health practices that are communicated and used on a large scale.
• Stage 4, evaluation translation research , explores the “real world” health benefits and effects of moving these discoveries and interventions into large-scale practice. This phase examines impact over time through ongoing surveillance and evaluation.

Table 1. Examples of Translation Research for Different Types of Hazards

* Stage 0 is the basic or applied research finding that becomes the focus for study in Stages 1–4 of the translation research framework.  It is not part of that framework.

The translation research process should be a never-ending loop of research and translation, allowing for ongoing integration of effective approaches. This focus on improving the implementation of science shows NIOSH’s value as the nation’s primary occupational safety and health research institute. Translation research findings add great value to occupational safety and health research by helping us understand how science can better achieve practical benefits and what factors stand in the way of scientific work leading to useful outcomes. Translation research reveals how discoveries and guidance improve the lives of workers.

The phrases translation research , translational research , and translational science have been used to describe the systematic effort to convert basic research outputs into practical applications to enhance human health and well-being. Generally, these uses of the phrase translational research refer to harnessing knowledge from basic medical science and bringing it into clinical practice (so-called bench-to-bedside models). In contrast, NIOSH defines the phrase translation research to refer to the study of the process of moving “research-to-practice-to-impact” and the methods, barriers and facilitators, context, and issues encountered in this process. However, in the scientific literature, the two descriptors of research—translation versus translational—overlap.

Source: Schulte et al. [2017]

In 2016 NIOSH developed a framework for a wide-ranging plan for translation research. The plan will help NIOSH study how to move research findings into practice as quickly as possible, to improve worker safety.

NIOSH created its Translation Research Program to nurture, promote, and coordinate translation research and to more effectively transform science into useful actions and products. Translation research explores the processes by which research findings are successfully implemented in the workplace.

Compared with other workplace safety and health efforts, translation research is a new field without a large base of scientific papers. The program builds on previous NIOSH health communication work and research into effective interventions. It also includes research on social and behavioral science topics and on how scientific innovations spread and become practical benefits to society.

The research-to-practice process starts with research and ends with useful innovations. The Translation Research Program’s efforts focus on the research-to-practice continuum to learn how to make any given step better and how to improve its impact. The goal is to develop relevant, widely applied knowledge that creates a safer and healthier work environment.

This work faces challenges, however:

• Identifying translation research priorities, to focus limited resources yet achieve maximum impact
• Focusing on how decision-makers get and use workplace safety and health information, as well as barriers that prevent such information from reaching those who need it
• Finding which approaches work best in making safety and health research products that will have the most effective benefits.

NIOSH continues to gather translation research, promote goals for internal research competitions, and develop the skills of staff. Its work outside the institute may include offering dedicated funding opportunities and developing and promoting training for translation research.

Publications which have guided the development of the NIOSH Translation Research Program include the following:

• Schulte PA; Cunningham TR; Nickels L; Felknor S; Guerin R; Blosser F; Chang C-C; Check P; Eggerth D; Flynn M; Forrester C; Hard D; Hudson H; Lincoln J; McKernan LT; Pratap P; Stephenson CM; Van Bogaert D; Menger-Ogle L [2017].  Translation research in occupational safety and health: a proposed framework . Am J Ind Med 2017 Dec; 60(12):1011-1022.
• Dugan, A.G. & Punnett, L. Dissemination and Implementation Research for Occupational Safety and Health. Occup Health Sci (2017) 1: 29.
• Tinc PJ, Gadomski A, Sorensen JA, Weinehall L, Jenkins P, Lindvall K.  Adapting the T0-T4 implementation science model to occupational health and safety in agriculture, forestry, and fishing: A scoping review.  Am J Ind Med. 2018;61:51–62.
• Khoury MJ, Gwinn M, Ioannidis JPA [2010]. The emergence of translational epidemiology: from scientific discovery to population health impact. American Journal Epidemiology 172: 517-524.
• Lucas DL, Kincl LD, Bovbjerg VE and Lincoln JM [2014]. Application of a translational research model to assess the progress of occupational safety research in the international commercial fishing industry. Safety Science 64:71-81.
• Ogilvie D, Craig P, Griffin S, Macintyre S and Wareham NJ [2009]. A translational framework for public health research. BMC Public Health 9(1):116.
• NIOSH Translation Research Roadmap and Implementation presentation to the Board of Scientific Counselors Meeting, March 2016
• Hager LD. BLS occupational hearing loss report for 2007.  CAOHC Update.  2009; 21: 7-9.
• Berger EH, Franks JR, Behar A, et al. Development of a new standard laboratory protocol for estimating field attenuation of hearing protection devices. Part III. The validity of using subject-fit data.  J Acoust Soc Am.  1998; 103: 665-672.
• Murphy WJ, Davis RR, Byrne DC, Franks JR. Advanced hearing protector study. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, NIOSH EPHB Report No. 312-11a; 2007.  https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2008113769.xhtml
• Stephenson CM, Stephenson MR. Hearing loss prevention for carpenters. Part 1-using health communication and health promotion models to develop training that works.  Noise Health. 2011; 13: 113-121.
• Davies H, Marion S, Teschke K. The impact of hearing conservation programs on incidence of noise-induced hearing loss in Canadian workers.  Am J Ind Med. 2008; 51: 923-931.
• Masterson EA, Deddens JA, Themann CL, Bertke S, Calvert GM. Trends in worker hearing loss by industry sector, 1981-2010.  Am J Ind Med.  2015; 58: 392-401.
• Wagner GR. The inexcusable persistence of silicosis.  Am J Public Health.  2005; 85: 1346-1347.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1615617/
• Cecala AB, O’Brien AD. Here comes the Helmet-CAM: A recent advance in technology can improve how mine operators investigate and assess respirable dust.  Rock Prod.  2014; 117: 26-30.
• Haas EJ, Willmer D., Cecala AB. Formative research to reduce mine worker respirable silica dust exposure: A feasibility study to integrate technology into behavioral interventions.  Pilot Feasibility Study.  2016; 2: 6.
• Reed WR, Kwitowski AJ, Helfrich WJ, Cecala AB, Joy GJ. Guidelines for performing a helmet-CAM respirable dust survey and conducting subsequent analysis with the Enhanced Video Analysis of Dust Exposures (EVADE) software. Pittsburgh, PA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS, (NIOSH) Publication No. 2014-133; 2014.  https://www.cdc.gov/niosh/mining/UserFiles/works/pdfs/2014-133.pdf
• Bourbonnais R, Comeau M, Vézina M. Job strain and evolution of mental health among nurses.  J Occup Health Psychol.  1999; 4: 92-107.
• Bourbonnais R, Brisson C, Vinet A, Vézina M, Lower A. Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital.  Occup Environ Med.  2006; 63: 326-334.
• Jimmieson NL, Hobman EV, Tucker MK, Bordia P. Change in psychosocial work factors predicts follow-up employee strain: An examination of Australian employees.  J Occup Environ Med.  2016; 58: 1002-1013.
• Ruotsalainen JH, Verbeek JH, Mariné A, Serra C. Preventing occupational stress in healthcare workers.  Cochrane Database Syst Rev.  2015; 4: D002892.
• Dollard M, Skinner N, Tuckey MR, Bailey T. National surveillance of psychosocial risk factors in the workplace: An international overview.  Work Stress.  2997; 21: 1-29.
• NIOSH. Commercial fishing vessel shipper dies after being pulled into a deck winch-Alaska. Anchorage, AK: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Fatality Assessment and Control Evaluation (FACE) Program, State FACE Reports-Alaska: Report No. FACE AK-95-23; 1995.  https://www.cdc.gov/niosh/face/stateface/ak/95ak023.html
• Lincoln JM, Lucas DL, McKibbin RW, Woodward CC, Bevan JE. Reducing commercial fishing deck hazards with engineering solutions for winch design.  J Safety Res.  2008; 39: 231-235.
• Lincoln JM, Woodward CC, King GW, Case SL, Lucas DL, Teske TD. Preventing fatal winch entanglements in the US southern shrimp fleet: A research to practice approach.  J Safety Res.  2017; 60: 119-123.
• Levin JL, Gilmore K, Wickman A, et al. Workplace safety interventions for commercial fishermen of the gulf.  J Agromedicine.  2016; 21: 178-189.
• Teske TD, Victoroff T. Increasing adoption of safety technologies in commercial fishing. Study in progress. Anchorage, AK: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH); 2017.
• CDC. Fatal and nonfatal injuries involving fishing vessel winches- Southern shrimp fleet, United States, 2000-2011. MMWR.  2013; 62: 157-160.  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6209a1.htm

Exit Notification / Disclaimer Policy

• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
• You will be subject to the destination website's privacy policy when you follow the link.
• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• HHS Author Manuscripts

Defining Translational Research: Implications for Training

Doris mcgartland rubio.

Associate Professor and Director of the Data Center, Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA

Ellie E. Schoenbaum

Professor of Epidemiology & Population Health, Director Education and Career Development Core, Institute for Clinical and Translational Research, Institute for Clinical and Translational Research, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY

Linda S. Lee

Associate Director for the Clinical Research Training Program, Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, NC

David E. Schteingart

Professor, Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes; Co-Director, Education, Mentoring and Career Development Core, Michigan Institute for Clinical and Health Research; University of Michigan, Ann Arbor

Paul R. Marantz

Associate Dean for Clinical Research Education and Professor, Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY

Karl E. Anderson

Professor, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX

Lauren Dewey Platt

Executive Director, Scholars in Clinical Science Program, Harvard Catalyst/The Harvard Clinical and Translational Science Center, Harvard Medical School, Tosteson Medical Education Center, Boston, MA

Adriana Baez

Professor, Departments of Pharmacology and Otolaryngology-Head and Neck Surgery, University of Puerto Rico School of Medicine, San Juan, Puerto Rico

Karin Esposito

Assistant Professor of Clinical Psychiatry, Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL

Because translational research is not clearly defined, developers of translational research programs are struggling to articulate specific program objectives, delineate the knowledge and skills (competencies) that trainees are expected to develop, create an appropriate curriculum, and track outcomes to assess whether program objectives and competency requirements are being met. Members of the Evaluation Committee of the Association for Clinical Research Training (ACRT) reviewed current definitions of translational research and proposed an operational definition to use in the educational framework. In this article, the authors posit that translational research fosters the multidirectional and multidisciplinary integration of basic research, patient-oriented research, and population-based research, with the long-term aim of improving the health of the public. The authors argue that the approach to designing and evaluating the success of translational training programs must therefore be flexible enough to accommodate the needs of individual institutions and individual trainees within the institutions but that it must also be rigorous enough to document that the program is meeting its short-, intermediate-, and long-term objectives and that its trainees are meeting preestablished competency requirements. A logic model is proposed for the evaluation of translational research programs.

The National Institutes of Health (NIH) has traditionally supported the training of basic and clinical scientists in a variety of disciplines. More recently, it has supported the training of scientists in translational research through the K30 and Clinical and Translational Science Award (CTSA) programs. 1 Because both basic research and clinical research are clearly defined, developers of programs to train individuals in these types of research have been able to articulate program objectives, delineate the knowledge and skills (i.e., competencies) that trainees are expected to develop, create an appropriate curriculum, and track outcomes to assess whether program objectives and competency requirements are being met. In contrast, because translational research is not clearly defined, developers of translational research programs are struggling with some of these processes.

As members of the Evaluation Committee of the Association for Clinical Research Training (ACRT), we began to address this problem by reviewing the definitions of different types of research. We then developed working definitions of translational research and associated terms. Here, we present our working definitions, discuss their implications for educational training programs, and offer a framework to guide institutions in developing processes of program evaluation.

Definitions of Basic Research and Basic Science

According to the American Cancer Society, basic science involves laboratory studies that provide the foundation for clinical research. 2 As one cancer center indicates, basic science entails gathering knowledge that is essential for applying discoveries to patient care. 3 However, in 1945, when the director of the US Office of Scientific Development and Research proposed the establishment of the National Science Foundation (NSF), he made the following distinction between basic research and applied research:

Basic research is performed without thought of practical ends. It results in general knowledge and an understanding of nature and its laws. This general knowledge provides the means of answering a large number of important practical problems, though it may not give a complete specific answer to any one of them. The function of applied research is to provide such complete answers. 4

The NSF definition thus identifies the main objective of basic research as the acquisition of knowledge without the obligation to apply it to practical ends.

Basic research training is pervasive in medical schools. With PhD programs offered in disciplines such as the biomedical sciences, computational biology, and neuroscience, the basic science field has been well established. Competencies within the basic sciences have been clearly defined, allowing for effective development and evaluation of educational programs. About 60% of the NIH budget is allocated for basic research, and most of the basic research funds go to PhD scientists. 5

Definitions of Clinical Research

In 1997, the NIH Director’s Panel on Clinical Research issued the following 3-part definition of clinical research:

• Patient-oriented research. Research conducted with human subjects (or on material of human origin such as tissues, specimens and cognitive phenomena) for which an investigator (or colleague) directly interacts with human subjects. Excluded from this definition are in vitro studies that utilize human tissues that cannot be linked to a living individual. Patient-oriented research includes: (a) mechanisms of human disease, (b) therapeutic interventions, (c) clinical trials, or (d) development of new technologies.
• Epidemiologic and behavioral studies.
• Outcomes research and health services research. 6

In 1998, the NIH introduced the Clinical Research Curriculum Award to “improve the quality of training in clinical research.” 7 Over 50 training programs were funded through this award, and many of these programs grant degrees in clinical research.

The NIH’s definition of clinical research has been widely accepted by institutions and programs and provides a common basis for the NIH-funded clinical research training programs. The definition has facilitated cross-program efforts to identify core competencies, best practices, and meaningful outcomes that are relevant across the broad spectrum of training in clinical research. This in turn has allowed program evaluators to develop useful assessment metrics to document the success of training programs.

Today, about 30% of the NIH budget is spent on clinical research. 5 However, some believe that this figure includes studies of animal models, in which case the actual support for clinical research would be much less. 5

Definitions of Translational Research

The definition of translational research is less clear than the definitions of basic and clinical research.

Although a Medline search indicates that the term translational research appeared as early as 1993, there were relatively few references to this term in the medical literature during the 1990s, and most references were to research about cancer. At the time, the literature on cancer tended to use the term translational research to refer to work spanning different types of research (e.g., immunology studies spanning basic and clinical research) or work spanning disciplines within a particular type of research (e.g., bench research involving molecular genetics and immunology). Today, the literature includes a plethora of attempts in various fields to define the term. 8

In a recent announcement about applying for a CTSA, the NIH offered the following definition:

Translational research includes two areas of translation. One is the process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans. The second area of translation concerns research aimed at enhancing the adoption of best practices in the community. Cost-effectiveness of prevention and treatment strategies is also an important part of translational science. 9

According to this definition, translational research is part of a unidirectional continuum in which research findings are moved from the researcher’s bench to the patient’s bedside and community. In the continuum, the first stage of translational research (T1) transfers knowledge from basic research to clinical research, while the second stage (T2) transfers findings from clinical studies or clinical trials to practice settings and communities, where the findings improve health.

In a commentary published in 2008, Steven Woolf pointed out that “translational research means different things to different people” 10 (p211) and argued that the different types of translational research are too narrowly defined. In particular, he argued that if T2 research is going to result in the knowledge needed to improve health and the quality of life, then T1 research must include sciences related to populations (e.g., epidemiology, psychology, economics, and behavioral sciences). 10

When the Institute of Medicine (IOM) convened the Clinical Research Roundtable, the roundtable group developed a model for translational research that was highly aligned with the NIH definition. 11

Like the NIH and the IOM, the Translational Research Working Group of the National Cancer Institute (NCI) included both basic and clinical research in the T1 segment of the continuum: “Translational research transforms scientific discoveries arising from laboratory, clinical, or population studies into clinical applications to reduce cancer incidence, morbidity, and mortality.” 12 But given that basic research and clinical research involve inherently different knowledge sets and methodologies, including both of them in the same segment of the continuum (i.e., in T1) obscures the fact that multidisciplinary translational research can also occur at the interface of basic and clinical science.

A Framework to Design and Evaluate Translational Research Programs

As members of the ACRT Evaluation Committee, our goal was to develop a framework to assess translational research programs. We quickly realized, however, that disagreements over what is and is not included in the definition of translational research would make it difficult for us to define competency requirements and determine whether these requirements were being met. We therefore began discussing the definitions outlined above. We also consulted articles published on the topic of translational research 8 , 10 , 11 , 13 , 14 and data provided on the Web sites of the first 12 CTSA recipients. 15

Working definitions

We developed the following working definition of translational research:

Translational research fosters the multidirectional integration of basic research, patient-oriented research, and population-based research, with the long-term aim of improving the health of the public. T1 research expedites the movement between basic research and patient-oriented research that leads to new or improved scientific understanding or standards of care. T2 research facilitates the movement between patient-oriented research and population-based research that leads to better patient outcomes, the implementation of best practices, and improved health status in communities. T3 research promotes interaction between laboratory-based research and population-based research to stimulate a robust scientific understanding of human health and disease.

We believe that when T1 is conceptualized as the process of moving from bench to bedside, it represents a movement toward the goal of improved health. It may evoke the image of a patient receiving medical care or the image of a healthy individual benefiting from improvements in health care or public health. Alternatively, it may suggest that patient-oriented research (research at the bedside) is a key step toward improvement in the treatment or prevention of disease.

The model that we propose (see Figure 1 ) captures the dynamic interplay inherent in the concept of translational research. The model’s circular structure suggests that research is a continuing cycle, and its bidirectional arrows emphasize that new knowledge and hypotheses are generated at each step. Some basic research and population-based research is translational, but neither type of research is by definition translational. In contrast, patient-oriented research fundamentally addresses issues that have the potential to translate to clinical practice and therefore affect health. For these reasons, the model includes only part of basic research and population-based research within the circular structure but includes all of patient-oriented research within this structure.

Model for translational research, as proposed by the Evaluation Committee of the Association for Clinical Research Training.

The concept of basic research, as defined earlier, is generally well understood. The concepts of patient-oriented research and population-based research fall within the broader rubric of clinical research as defined by the NIH. We use the term patient-oriented research to refer to studies that include groups of patients or healthy individuals and are designed to understand the mechanisms of disease and health, to determine the effects of a treatment, or to provide a decision analysis of the care trajectories of patients. 16 Clinical trials are an example of patient-oriented research that has the potential to directly affect clinical practice. We use the term population-based research to refer to studies involving epidemiology, social and behavioral sciences, public health, quality evaluation, and cost-effectiveness.

In our model, the T1, T2, and T3 arrows represent bridges from one type of research to another. Examples of T1 research are drug development, pharmacogenomics, and some studies of disease mechanisms and research into new areas such as genetics, genomics, and proteomics. Examples of T2 are clinical epidemiology, health services (outcomes) research, and the newly developing methodology of community-based participatory research. Examples of T3 are emerging disciplines such as molecular and genetic epidemiology. T3 research highlights, for instance, how research in populations informs hypotheses that can be tested in basic science laboratories and how biomarkers in animal models can translate into population-based screening tools.

Implications for the design of training programs

The interaction of several disciplines is required to translate knowledge from one type of research to another (e.g., to move a basic science discovery to the bedside). Collaboration among disciplines through multidisciplinary teams facilitates the emergence of novel concepts and approaches to addressing important health issues. The emergence and development of new ideas are goals of translational research, and there are many possible models of training that can provide the academic path to these goals.

Training in translational research will vary depending on the background of trainees and the areas of research they plan to pursue. Given the diversity of educational backgrounds and research interests, it will be necessary to design a customized curriculum for almost every trainee. To ensure an understanding of complementary disciplines and to enhance communication and collaboration, trainees who have focused on basic laboratory research will need to become immersed in clinical sciences and clinical practice, while trainees with a clinical focus will need to gain exposure to basic science research. Both types of individuals will also benefit from training in population-based sciences, as is encouraged, for example, by the Burroughs Wellcome Fund, which sponsors the Institutional Program Unifying Population and Laboratory Based Sciences. 17

The details of a clinical immersion experience will depend on the area of research interest. For example, trainees interested in neuroscience may wish to accompany clinicians in a psychiatry or neurology clinic, and trainees working on bone tissue regeneration may participate in the activities of a clinical orthopedic surgery program. Trainees seeking laboratory immersion could take courses in techniques of molecular biology or genetics and work at the bench for a concentrated period of 3–4 months. Trainees who have a background in the social sciences or economics and are interested in health services research may need to join a team of investigators working in their area of interest.

All trainees could benefit from fundamental instruction concerning study design, data collection, statistical analysis, ethics and research integrity, protection of human subjects, the search for funding sources, the writing of institutional review board protocols and grant applications, the pursuit of patents and technology transfer, and government requirements for new drugs and devices. Because of the nature of translational research, it is also imperative for training programs to ensure that trainees develop the competencies needed to thrive in a multidisciplinary collaborative team. These competencies include communication and negotiation skills as well as ethical and humanitarian attitudes.

The most effective approach would be to design an individualized curriculum for each trainee, guided by a customized, learner-centered advisory committee that includes mentors with various and complementary backgrounds in clinical practice and basic and clinical research. One of the mentors would assume the role of primary mentor to ensure coordination of efforts and the success of the mentoring process.

Mentoring is a demanding but highly rewarding enterprise whose success depends on the widely varying skills, needs, and attitudes of different individuals. 18 Mentors who are able to monitor the incorporation and understanding of translational research essentials will be crucial to the positive outcomes of training programs. However, trainees will also need to have critical thinking skills and practical knowledge about how to work collaboratively and manage teams. Although most medical schools now realize the importance of teaching their students how to think critically, 19 the truth is, as Jerome Groopman points out, that the older generation of students were not taught to think as clinicians. 20 Although recent emphasis has shifted to training medical students and residents how to follow preset algorithms and decision trees, these approaches are challenging when clinicians need to think outside their domains. 20 Since clinical and translational research in this century necessitates out-of-the-box thinking, training programs must teach young researchers how to excel as critical thinkers.

Historically, medicine has taken a hands-off approach to teaching management and leadership, the notion being that learning how to manage and lead is simply intuitive. “Something about management looks so easy that we...never doubt that we could succeed where others repeatedly fail,” says Thomas Teal, former senior editor of the Harvard Business Review . 21 (pp3–4) Because managing is less a series of technical tasks and more a set of human interactions, managers and team leaders require what Daniel Goleman and his colleagues call “emotional intelligence” 22 and other skills that are not usually taught in research training programs. When we think of innovation and creative problem solving, we often look to engineers and designers to learn about these processes. 23 Similarly, when we think of management, we often look to the corporate sector. A useful approach to creating a supportive environment that fosters critical thinking and leadership and management skills must include the explicit training of fellows and junior faculty in these areas.

An effective training program in translational research must use traditional curricular elements in new ways to ensure understanding across disciplines. In addition, it must create and use new curricular elements and approaches to ensure that its trainees are able to do the following: critically examine the research process; think “out of the box” to develop ways to impact health care by transferring knowledge from and to the bench, bedside, and community; engage in multidisciplinary collaboration; understand successful approaches to community engagement; and develop appropriate techniques to manage multidisciplinary research teams in the future. Using multidisciplinary skills, the translational researcher will be able to think and perform in an integrated interdisciplinary manner and become a new type of investigator.

Meeting these goals is a challenge because research training programs are not traditionally content-based. We need to consider the creation of a community of learners and leaders by fostering the use of problem-based learning 24 , 25 as a gateway to collaborative leadership. Adopting these techniques will require a change in culture in medical schools, but the time is right to begin the process of this cultural shift if we wish to take a leap forward in enhancing the practice of moving from bench to bedside to community and back in translational research.

An approach to evaluation

With the necessity of customizing training in translational research, the approach to evaluation must be flexible. One of the most flexible approaches is to design a logic model that offers a graphic display of the relationships between program elements, objectives, and desired outcomes in the short term, intermediate term, and long term. The accompanying logic model ( List 1 ) provides an example of a framework for a training program in translational research. The logic model approach has the advantage of being adaptable as definitions of research and research goals evolve. Specific elements in the model can change, along with indicators and data sources, without completely disrupting the overall logical flow of objectives.

Logic Model for Training in Translational Research

In the logic model for a translational research program, the domains to be evaluated could include (1) whether the tools employed to achieve preestablished objectives, including general and scientific area specific competencies in translational sciences, are adequate; (2) whether the trainees acquire the cognitive and practical skills they need to effectively conduct translational research; (3) whether the trainees are successful in developing and pursuing a translational research career; and (4) whether the program as a whole promotes and enhances translational research. The outcomes of each of these domains could include (1) evidence that courses, seminars, workshops, and laboratory experiences offered in the program lead to fulfillment of preestablished competency requirements; (2) evidence of improvement over time in the trainees’ knowledge and skills regarding translational research topics and endeavors, as assessed via testing and via evaluations provided by scientific advisory committees; (3) evidence of successful career development, as measured by the ability to publish articles in peer-reviewed journals, to obtain research grants and academic appointments, and to gain leadership positions in multidisciplinary teams; and (4) evidence of the increased impact of the program at the institutional level and the national level, as judged by whether more translational research is funded and conducted at these levels.

We believe that translational research moves in a bidirectional manner from one type of research to another—from basic research to patient-oriented research, to population-based research, and back—and involves collaboration among scientists from multiple disciplines. The design of an effective training program in translational research is a challenge because the program must offer each of its trainees the opportunity to master a combination of skills that are not taught together in traditional training programs. The approach to evaluating the success of translational training programs must be flexible enough to accommodate the needs of individual institutions and individual trainees within the institutions, but it must also be rigorous enough to document that the program is meeting its short-, intermediate-, and long-term objectives and that its trainees are meeting preestablished competency requirements. A logic model framework with appropriate domains may be well suited to these evaluation efforts.

Acknowledgments

The authors wish to acknowledge the members of the Evaluation Committee of the Association for Clinical Research Training, especially Sunday Clark, ScD (University of Pittsburgh), Yvonne Belanger, MS (Duke University), David Goff MD, PhD (Wake Forest University), and Jan Hogle, PhD (University of Wisconsin).

Funding/Support: This research was supported by National Institutes of Health grants awarded to the University of Pittsburgh (UL1 RR024153), Duke University School of Medicine (UL1 RR024128), Albert Einstein College of Medicine (UL1 RR025750), Harvard Medical School (K30 RR022292), and University of Wisconsin (UL1 RR025011).

Other disclosures: None

Ethical approval: Not applicable

Contributor Information

Doris McGartland Rubio, Associate Professor and Director of the Data Center, Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA.

Ellie E. Schoenbaum, Professor of Epidemiology & Population Health, Director Education and Career Development Core, Institute for Clinical and Translational Research, Institute for Clinical and Translational Research, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.

Linda S. Lee, Associate Director for the Clinical Research Training Program, Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, NC.

David E. Schteingart, Professor, Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes; Co-Director, Education, Mentoring and Career Development Core, Michigan Institute for Clinical and Health Research; University of Michigan, Ann Arbor.

Paul R. Marantz, Associate Dean for Clinical Research Education and Professor, Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.

Karl E. Anderson, Professor, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX.

Lauren Dewey Platt, Executive Director, Scholars in Clinical Science Program, Harvard Catalyst/The Harvard Clinical and Translational Science Center, Harvard Medical School, Tosteson Medical Education Center, Boston, MA.

Adriana Baez, Professor, Departments of Pharmacology and Otolaryngology-Head and Neck Surgery, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.

Karin Esposito, Assistant Professor of Clinical Psychiatry, Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL.