Training to Advance Care Through Implementation Science in Cardiac And Lung Illnesses (TACTICAL) is a proposed career development program to dramatically accelerate the pace of implementation science research?and thereby effective delivery of care to patients, beginning with a focus on critically ill patients. TACTICAL proposes to immerse clinician-scientists in a rigorous training program that carefully integrates mentored implementation research practica with a formal curriculum. This will be done under the guidance of a cohesive 15-person multidisciplinary faculty and mentor group drawn from across the University of Michigan. Core faculty are drawn from the Schools of Medicine (Internal Medicine, Learning Health Sciences, Critical Care), Nursing, Business (Finance and Operations Management), Education, Public Policy, and Public Health as well as the Institute for Social Research and the Provost's Office. This postdoctoral training program will support 5 scholars for 3 years each. This will include a foundation in implementation science and health services research, including theory from psychology, sociology, economics, and operations management; research designs, including statistical analysis, qualitative methods, and randomized evaluations; measurement, including the conduct of surveys, mobile technologies, non-participant observation, focus groups, elicitation of patient perspectives, stakeholder engagement, secondary data, electronic medical records, administrative records, and detailed costing and finance; and comparative effectiveness research using multiple designs. This will be delivered through a structured series of individualized research practica resulting in published papers; formal coursework; and mentored independent research. This will culminate in an application for independent funding as an R01, R21, K08, or K23. Our vision of success is clear. As part of independent research careers focused on bringing evidence- based best practices to improve critically ill patients' lives, TACTICAL scholars will become independently- funded leaders who both drive change at their own institutions while also developing and evaluating better approaches for driving change nationally and internationally. In order to achieve this vision, we will draw on 5 basic tenets. First, implementation science demands deep interdisciplinary training. Second, a focus on the complex setting of the intensive care unit (ICU) and the complexity of implementation interventions required there will drive innovation in both ICU care and implementation science itself. Third, we will center their learning in mentored research with full and careful integration of didactics in service of advancing research. Fourth, our training plan builds on modern learning theory, emphasizing that learners master skills more quickly when didactics are tightly coupled to each scholar's own program of research. Fifth, we will build a structure, harnessing cohort and peer effects, that mandates and models productivity while nurturing creativity and tailoring.
Critically ill patients are very vulnerable. Too often the US health care system lets those patients and their families down by not providing them state-of-the-art care?even though we know what ought to be done. Training to Advance Care Through Implementation Science in Cardiac And Lung Illnesses (TACTICAL) is a proposal to develop scientists who can discover and implement better ways to make sure critically ill patients get the best care all the time..
