By Nicole Fauteux
Bradley Henson, D.D.S., Ph.D., has been on the faculty at Western University of Health Sciences College of Dental Medicine (WU CDM) since the school was first formed in 2008. Today, he serves as the college’s Associate Dean for Research and Biomedical Sciences, and he remains as excited as ever by the prospect of growing research in a pioneering academic environment. He spoke with the CCI Liaison Ledger about the challenges of establishing a new research enterprise and the steps WU CDM is taking to gain a foothold in the dental research community.
Q: WU CDM is best known for its focus on preparing health professions students to practice interprofessionally. Where does research come in?
A: I think the focus on interprofessional education (IPE) in general has really helped with regards to research. We have to evaluate some of the curricular approaches that we’re taking, and research becomes part of that. We also recognize the need to take that research beyond student perspectives and those kinds of outcomes and begin to see if what we’re teaching will bear fruit in practice. We can look at student demonstrations of interprofessional principles both in clinic and in standardized patient exercises. We can look at student referral practices in our clinics. We see a rich cache of research opportunities in that.
One of the things that has made this process of building a research enterprise in a brand new dental school even possible is the fact that we’ve got a very open campus. It’s extremely collaborative, so we’re seeing not only educational research opportunities springing up from the interprofessional curricular component, but then we’re seeing the more informal, nuanced benefit of having a campus that really values exchange. We’ve got faculty collaborating with folks from the colleges of optometry, graduate biomedical sciences and osteopathic medicine, for example.
Q: WU CDM is building its research enterprise from the ground up. Where are you in this process?
A: We felt early on that we needed to identify some research values and really promote those values to build a research culture. This process needed to happen in tandem with investments both in infrastructure and in support and training.
We also had to nurture the view that creative ideas and research are valued here. We had to get students involved as early as possible. Student participation breathes life into any research program, and we were able to get a thriving and very active chapter of the American Association for Dental Research up and running fairly early in our development.
Part of building a culture of science also includes looking at your promotion and tenure policies and making sure that those policies are consistent with what you’re hoping to encourage. At our institution, we also hired a manager of labs to make sure we were coordinating everything and meeting all of our federal, state and regional obligations.
And then last, but not least, you’ve got to recruit people who do research, who value it. With a new dental school, these have to be people who are willing not only to mentor students and junior and nonresearch faculty, but also to dive into a much more collaborative environment. The evidence-based culture can’t stop at the research door; it has to be infused throughout the entire college and the curriculum.
One of our crowning achievements is that we have very few barriers between the clinical sciences on the one hand and the basic sciences and research on the other. We felt strongly that we needed to take advantage of any and every opportunity to build evidence-based principles into the curriculum, across all years. We’ve been working very, very hard to make sure students understand the impact of the biomedical sciences on their future careers.
Q: How have you engaged clinical faculty in research?
A: One of the things we did was to really encourage those nonresearch-focused faculty who expressed some interest in research to partner with more seasoned researchers, and thankfully we got a group of research faculty who welcomed them with open arms. In that process, we found strong clinical partners for projects that hadn’t been as clinically or translationally focused as we would have wanted—not just by providing patients for the projects, but by providing design ideas and taking part in the collection and presentation of data.
We also launched something I affectionately refer to as Dental Research 101. It consists of six sessions and gives clinicians some of the nuts and bolts for doing research. And we capitalized on university development and training offerings that already existed. These really came in handy to get our faculty who might not be seasoned researchers up and running.
Early on we also started to encourage faculty to apply for research funding. Of course, we kept it realistic. Building a brand new school and forming a research faculty that can go out and get NIH R01 [National Institutes of Health Research Project Grant] funding—you have to build toward that. So we got faculty thinking about preliminary data and some small foundation grants that are immensely helpful to an organization like ours. In the meantime, our faculty will be able to accumulate the preliminary data that they might need for a larger grant submission later on.
Q: Now that you’ve established an infrastructure, what’s next?
A: We’re right in the thick of making that transition now, and we’re starting to see emerging strengths in a number of areas. We’ve identified five research priorities for the school, based on the research people are doing now and areas that we can bolster:
– Molecular and metabolic diseases
– Diagnostic sciences and forensics
– Integrative neurobiology
– Health services research
– Educational research
We’re at the phase of identifying projects and making them happen. These projects are based on existing collaborations, and what’s consistent with our vision and mission and resources.
Q: Are there particular research opportunities that are perhaps more readily accessible to newer schools than to those with established research programs?
A: Health services research, educational research and IPE are three areas that are particularly well suited for a new school and for our institution. In developing WesternU’s predoctoral program, we’ve referred to a lot of material that’s come out of ADEA CCI [ADEA Commission on Change and Innovation in Dental Education]. We wanted to take some ideas, which have been discussed for a very long time, and begin to implement them, and now we’re at a point where it’s time to test those ideas. I can tell you anecdotally that our students do well on the dental boards and that we’re getting a lot of compliments when they get out in the world and treat patients, but we don’t have the evidence to support that, so now we’re in the process of writing up our research and getting it out there.
The College of Dental Medicine is well positioned to become a leader in the area of health services research due to the College’s robust community-based dental education mission and curriculum and as a result of significant health services grant support. This past year, we surpassed $10 million (2009–2015) in extramural funding awards that have supported new and innovative training models, as well as community-based service delivery models. That level of funding will provide us with a robust array of data for health services and educational research.
Q: What are the biggest challenges dental schools face in establishing and building research programs?
A: Research funding, shrinking budgets and faculty time—those apply to all schools. I think new schools also face a unique challenge that existing schools, even nonresearch-intensive programs, haven’t had to consider.
There have been a number of pieces written over the years about new dental schools not having a research focus, and there’s an implication that research isn’t important to some of those schools. All I can say is, that couldn’t be further from the truth, at least in our case. If anything, that can really put us in a catch-22 because when we try to be favorably reviewed for funding, the criticism is always there that as a brand new school without a research-intensive focus, our school may not be an ideal setting for research funding. However, without research funding and collaborative support from the greater dental research community, we cannot increase our research capacity and competitiveness for funding.
To date, we are proud of our development and research successes, and we feel that with time and a lot of effort and investment, we will be recognized as a dental school with a strong and vibrant research mission and culture.
Q: Previously you were on the faculty of the dental schools at the University of Michigan and the University of California, Los Angeles. Which lessons learned in those research-intensive environments have guided you in shaping WU CDM’s program?
A: It’s important to understand what it takes to conduct research at that level. It doesn’t get better than Michigan and UCLA in terms of the quality of research, so I have a very firm vision of what that quality looks like. It gives me a broad goal to aspire to in terms of developing policy and a vision for our own institution.
Q: How can schools that want to establish or beef up their research programs get started?
A: One of the key pieces is building the culture, not just expecting research to happen. You have to be very proactive. In a time when research dollars are drying up, collaboration and leveraging existing resources become absolutely crucial. At WesternU, we have developed shared laboratory space. Researchers have a designated area to put their things and to work, but—to encourage collaboration and sharing of common equipment and consumables—it’s in an open-bay setting.
This may be the research model going forward. You would be surprised at just how efficient this has been for us—the sharing of equipment and reagents even. We’re able to take very small budgets, a few thousand dollars at a time, and you’d be amazed at what we’re able to do with it just by this kind of cooperation. It’s been absolutely key to building this research enterprise.
Whether you’re a new school or not, you have to leverage the university’s existing resources. It’s not just a matter of funding. You need to be connecting with people who have the kinds of experience that you might not have. It’s about everybody feeling a common purpose to grow research and include students in this activity, and that includes reading papers, reading grant proposals. Having that kind of group dynamic—people weighing in and providing feedback for one another—has been crucial for us.
Q: What do you say to colleagues who don’t see the value of establishing a research enterprise in a school primarily dedicated to producing clinicians?
A: I would answer that question with a question: Do you want the absolute strongest clinicians out in the field, and do you want them to represent your institution in the best way possible?
Whether you’re from a new school or an old school, I think we’re all going to agree that research is central to any modern university. It not only enhances the human condition; it also inspires and informs other missions of teaching and service. If your interest is in training the strongest clinicians possible, then research, critical thinking and evidence-based practice have to be part of that.