Making Contributions and Defining Success: An eDelphi Study of the Inaugural Cohort of CIHR Health System Impact Fellows, Host Supervisors, and Academic Supervisors

Abstract

Context: The Health System Impact (HSI) Fellowship, an innovative training program developed by the Canadian Institutes of Health Research' s Institute of Health Services and Policy Research, provides PhD-trained health researchers with an embedded, experiential learning opportunity within a health system organization. Methods/Design: An electronic Delphi (eDelphi) study was conducted to: (1) identify the criteria used to define success in the program and (2) elucidate the main contributions fellows made to their organizations. Through an iterative, two-round eDelphi process, perspectives were elicited from three stakeholder groups in the inaugural cohort of the HSI Fellowship: HSI fellows, host supervisors and academic supervisors. Discussion: A consensus was reached on many criteria of success for an embedded research fellowship and on several perceived contributions of the fellows to their host organization and academic institutions. This work begins to identify specific criteria for success in the fellowship that can be used to improve future iterations of the program. Résumé Contexte : Les bourses d' apprentissage en matière d'impact sur le système de santé (BAIS)-un programme de formation novateur mis au point par l'Institut des services et des politiques de santé des Instituts de recherche en santé du Canada-offrent aux chercheurs titulaires d' un Marc-André Blanchette et al.

Training for Health System Improvement: Emerging Lessons from Canadian and US Approaches to Embedded Fellowships

“…The efforts to establish these cohorts have proven valuable in both countries. In Canada, the structured opportunities, such as the National Cohort Retreat, have catalyzed collaborations among fellows to develop research studies (see, for example, the paper included in this special issue by Blanchette et al [2019]; Sim et al [2019]; Weijs et al [2019]), to submit multi-authored abstracts for panels at national conferences and to organize informal regional and thematic communities of practice.…”

“…So, to contribute to the currently limited evidence on impact-oriented HSPR training, it will be important to evaluate their impact at regular intervals, adjust their parameters for continued relevance to employment trends and health system needs and report on lessons learned. The papers in the present issue reflect initial efforts to learn from early experiences with the HSI Fellowship program, including whether and how fellows' enriched core competencies evolved over the course of the first year (see McMahon et al 2019a), what contributions fellows made to their host partner organizations (see Blanchette et al 2019) and the role and value of mentors in embedded research settings (see Bornstein et al 2019). Over time, as the Canadian and US programs expand and evolve, it will be important to investigate questions such as the following: Does hosting a fellow generate spillover effects for an organization' s internal culture of research and continuous learning?…”

“…Related to future direction #1 is the importance of developing consensus on the concept of embedded research impact -particularly from the perspective of the health system organizations that are embedding researchers. Recent efforts in Canada have focused on developing a framework for measuring the impact of HSPR on policy-and decision-making (CHSPRA, Impact Analysis Working Group 2018) and on understanding the contributions that HSI fellows have made within their host partner organizations (see Blanchette et al 2019). In the US, the AcademyHealth team has engaged its host sites to better understand what impact looks like and means from their perspective.…”

Training for Impact: PhD Modernization as a Key Resource for Learning Health Systems

“…The authors of the third paper, Blanchette and colleagues (2019) , are members of the inaugural cohort of HSI fellows who were curious about the contributions they and their colleagues had made to their health system partner organizations in their first year of the program. Reflecting the desired culture of an LHS, they designed a research project to satisfy their curiosity and inform improvements to the HSI Fellowship program.…”

Destination Impact! The Many Roads to Influencing Health System Change: A Response to Recent Commentaries

“…An eDelphi study done with HSI fellows, host supervisors and academic supervisors unanimously agreed that criteria for a successful fellowship includes developing fellows’ core competencies, better knowledge of health system and policy, academic and research productivity as well as a complete HSI Fellowship project. 10 Furthermore, both fellows and their supervisors saw improvement in all 10 HSI fellows’ core competencies by the 12-month mark. 11 In our original article, we recognized the importance of this by stating that HSI Fellowship enables both personal and professional transformation and our conceptualization of the process of creating fellowship-specific outputs stated “most important is the intersection or co-production of outputs that are created as the host organization and the HSI fellow (with support from their academic supervisor) operate within this mutual learning space with best available evidence and practices at that moment” (p. 327).…”