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>> WELCOME, EVERYONE TO THE 100th MEETING OF THE ADVISORY COUNCIL WE’RE REALLY EXCITED ABOUT THIS AS SORT OF IN SOME WAYS ANNIVERSARY OR AT LEAST A NOTABLE MEETING THAT WE HAVE HERE IN TERMS OF NUMBERS I WILL JUMP IN TO THE DIRECTOR’S OVERVIEW IN JUST A SECOND BUT I WANTED TO SAY A FEW WORDS OF INTRODUCTION QUICKLY BECAUSE AS YOU NOTICED SINCE THE LAST TIME YOU ALL WERE HERE AND AS WE DISCUSSED ON CALLS SUBSEQUENTLY, THERE’S BEEN A FEW CHANGES IN THE LEADERSHIP AND SO I JUST WANT TO SAY BEFORE WE JUMP IN A FEW WORDS ABOUT THAT SO I GUESS I WOULD SAY DESPITE THE — WE REALLY VALUED ANN’S LEADERSHIP AND WERE SAD TO SEE HER GO BUT FOR GOOD REASONS FOR FAMILY REASONS THAT SAID I’M HONORED TO BE HERE AND SERVE IN THIS TEMPORARY ACTING ROLE FOR THE NURSING INSTITUTE RECOGNIZE THERE’S BEEN A LITTLE BIT OF CHANGE OVER THE LAST FEW MONTHS IN PARTICULAR AND THE LAST YEAR AND WE KNOW THAT CAN BE CHALLENGING BUT OUR STAFF HERE AT THE NURSING INSTITUTE PRESENTED AN OCCASION AND I WANT TO EMPHASIZE ALL THE EXCHANGES HOWEVER, CHALLENGES UNDERSCORE THE NIH LEADERSHIP AND DR COLLINS ARE IN STRONG SUPPORT AND INTERESTED IN THE INSTITUTE AND THE SUCCESS GOING FORWARD MY GOAL IN THE NEXT FEW MONTHS IS AND REMAINS TO CONSIDER THE SCIENTIFIC DIRECTION OF THE INSTITUTE AND KEEP IT ON THE SAME COURSE IT’S BEEN ON OF COURSE BEING OPEN TO AND EMBRACING AND LEVERAGING SCIENTIFIC OPPORTUNITIES WHEN THEY PRESENT THEMSELVES BECAUSE WE DON’T WANT TO MISS SOMETHING JUST BECAUSE WE’RE IN A TRANSITIONAL TIME AND ALSO TO SORT OF ADDRESS SOME OF OUR CHALLENGES WITH THE MANAGEMENT OF THE INSTITUTE THINGS THAT EVERY ORGANIZATION FACES JUST IN TERMS OF UPDATING AND BE ABLE TO LEVERAGE SOME OF MY CONNECTIONS ACROSS NIH AND OFFICE OF THE DIRECTOR AND IN SCIENTIFIC ADMINISTRATION WITH ALL THAT CHANGE I’M OPTIMISTIC BECAUSE I THINK IT CREATES AN OPPORTUNITY, A POTENTIAL FOR GREAT OPPORTUNITY I’M REALLY EXCITE ABOUT THE OPPORTUNITIES THAT ABOUND FOR NINR IN THE FUTURE I’M ENJOYED NOT THAT IT’S THE ENDING BUT IT’S THE OPPOSITE I ENJOYED WORKING WITH THE STAFF AND STARTING TO GET TO KNOW ALL OF YOU ALL AND WILL CONTINUE TO DO SO OVER THE NEXT FEW MONTHS WITH THAT SAID I’M GOING JUMP IN TO SOME LOGISTICS OF THE DAY BEFORE WE JUMP TO THE OVERVIEW FIRST, THE THEME FOR TODAY WE HAVE A THEME FOR THE COUNCIL IT’S ALL ABOUT TRAINING WE’VE INVITED A FEW SPECIAL GUESTS HERE TODAY SO WE HAVE DR CHOPMAN HERE TO GIVE US ANN UPDATE AND DATA THEY HAVE ON TRAINING AND WE HAVE A PANEL AND PRESENTATIONS FROM TRAINEES FROM THEIR VARIOUS LEVELS IN THEIR CAREER TO TALK ABOUT THEIR PERSONAL EXPERIENCE AS TRAINEE AND THEN WE’LL HAVE A PRESENTATION FROM OUR STAFF HERE WHO HELP DO ANALYSES AND PROVIDE INFORMATION ON WHAT NINR IS DOING AND HAS DONE AND CONSIDERING FOR THE FUTURE WITH ALL THIS WOULD LOVE YOUR FEEDBACK THAT’S WHY YOU’RE HERE AND THEN WE HAVE A CONCEPT AFTER LUNCH WE’LL PRESENT TO YOU SO CLOSED SESSION WILL BEGIN AT 9:00 A.M. AND DR. SOLMAN WILL BE ABLE TO MAKE IT AND I JUST WANT TO TAKE A MOMENT TO WELCOME OUR NEW COUNCIL MEMBERS A FAMILIAR FACE WHO WAS HERE AD

HOC LAST TIME BUT DR. ONOKEM PROFESSOR AT EMORY AT THE WOOD ROUGH — WOODRUFF SCHOOL OF NURSING AND IS A THEORIST IN CROSS-CULTURAL WOMEN’S HEALTH AND HER MOST OUTSTANDING CONTRIBUTION TO NURSING SO FAR HAS BEEN RESEARCH PROGRAM THAT ADOPTS COMPUTER TECHNOLOGY TO ELIMINATE GENOMIC DISPARITIES SHE HAS TAKEN THE LEAD AND HER EMERGING STUDIES IS THE FIRST OF ITS FIND TO USE TECHNOLOGY TO BUILD NURSING KNOWLEDGE I WON’T GO THROUGH HER MANY MANY AWARDS AND ACCOLADES WE’RE EXCITED ABOUT HER PARTICIPATION ON THE COUNCIL AND FORWARD TO MORE IN THE FUTURE AND THRILLED TO BE HERE WITH YOU TODAY I’LL MENTION THIS A LITTLE BIT LATER IN THE SLIDE SET BUT I WANT TO SAYBURY JUMP IN — SAY BEFORE I JUMP IN, A FAMILIAR FACE DR. JESSICA GILL WHO HAS BEEN IN OUR INTRAMURAL PROGRAM AND DISTINGUISHED SCIENTIST AND ACTING IN THE DEPUTY DIRECTOR ROLE AT THE INSTITUTE AND DR KATHLEEN ANDERSON WHO IS SERVING AS THE ACTING DIRECTOR OF THE DIVISION OF EXTRAMURAL SCIENCE PROGRAMS AND THE ACTING EXECUTIVE SECRETARY OF THE COUNCIL TODAY SO JUST FOR SOME BACKGROUND ON HER, SHE IS RESPONSIBLE FOR LEADING, MANAGING AND COORDINATING ALL OF OUR SCIENTIFIC PROGRAMS AT THE INSTITUTE AND EVERYTHING THAT FITS WITH GRANTS MANAGEMENT REVIEW, ETCETERA SHE ON WHAT IS CALLED A DETAIL TO NINR IT’S ESSENTIALLY NIMH NATIONAL INSTITUTE OF MENTAL HEALTH HAS LOANED HER TO US AND HAS BEEN VERY GENEROUS AND WE’RE EXCITED TO HAVE HER HERE JUST A WORD ABOUT HER BACKGROUND HER POSITION IS THE DEPUTY DIRECTOR OF THE DIVISION OF TRANSLATIONAL RESEARCH AND SUPPORTS PROGRAMS OF RESEARCH AND TRAINING THAT TRANSLATE KNOWLEDGE FROM BASIC SCIENCE TO DISCOVER PHYSIOLOGY AND TRA JEKTSRY OF MENTAL HEALTH — TRAJECTORY OF MENTAL HEALTH DISORDERS AND IS AN EXPERIENCED ADMINISTRATOR AND WE’RE GRATEFUL TO HAVE HER HERE SHE JOINED NINR IN EARLY DECEMBER BURY WANT TO TAKE A MOMENT TO THANK THOSE WHO SERVED IN THE ROLE I THINK WE FINALLY GOT HER DOWN TO ONLY DOING ONE JOB AND HOPING SHE CAN HELP MORE WITH ACTIVITIES AND PROJECT WE HAVE GOING ON IN THE OFFICE OF THE DIRECTOR THANK YOU FOR HER CONTINUED ROLE TO CONTINUE WORKING WITH ME AND WITH THAT I’LL TURN IT OVER TO KATHY TO GO OVER PROCEDURES >> WANT TO THANK HER AS WELL >> I JUST HAVE RIGHT NOW A FEW REMINDERS FO REMINDERS FOR YOU FIRST THE MEETING IS BEING RECORD I WANT TO REMIND YOU TO USE YOUR MICROPHONES MAKE SURE YOU TURN THEM ON WHEN YOU SPEAK AND THEN TURN THEM OFF PORTIONS ARE BEING UPLOADED TO THE SITE

I’M ASKED TO REMIND YOU THAT COUNCIL MEMBERS BE NOT ENGAGED IN LOBBYING WHILE RECEIVING INSTRUCTIONS AND I’LL TALK ABOUT CONFLICT OF INTEREST AND CONFIDENTIALITY TOMORROW AT THE BEGINNING OF CLOSED SESSION I WANT YOU TO REVIEW THE CONFIDENTIALITY STATEMENT OF THE MATERIALS THAT WERE UPLOADED FOR YOU I HOPE YOU HAD AN OPPORTUNITY TO REVIEW THE MEETING MINUTES FROM THE OCTOBER COUNCIL UNLESS ANYBODY HAS ANYTHING THEY WANT TO DISCUSS I’LL IS FOR A MOTION TO I NEED A MOTION CAN I GET A SECOND MOTION? ANYONE OPPOSED? MOTION CARRIES >> I’LL GO OVER THE EXCITING UPDATES OCCURRED AT HHS & NIH AND DISCUSS UPDATES FROM NINR AND TALK ABOUT SOME OF THE SCIENTIFIC ADVANCES THAT HAVE ADVANCED OVER THE LAST FEW MONTHS THERE’S BEEN A CHANGE DR. STEVEN HAHN WAS SWORN IN AS THE COMMISSIONER OF THE U.S. FOOD AND DRUG ADMINISTRATIONS THE FDA HE’S PREVIOUSLY BEEN THE CHIEF MEDICAL EXECUTIVE AND HE IS A RADIATION ONCOLOGIST BY TRAINING HE WAS SWORN IN I BELIEVE SOME TIME IN NOVEMBER AND HAS BEEN GETTING HIS FEET WET WITH EVERYTHING AT THE FDA WHAT THAT HAS MEANT FOR NIH MORE BROADLY IS DR. NED SHARPLESS WHO WAS APPOINTED AS THE DIRECTOR OF THE NATIONAL CANCER INSTITUTE HAD MOVED OVER AND ACTING COMMISSIONER OF THE FDA AFTER DR. SCOTT GOTTLIEB LEFT AND HE HAD BEEN IN THAT ROLE SIX OR SEVEN MONTHS AND NOW TO NIH’S GOOD FORTUNATE HE’S BACK SERVING AS DIRECTOR OF THE INSTITUTE AND WE SELECTED AN ASSOCIATE DIRECTOR FOR DATA SCIENCE SO THIS IS AN AREA OBVIOUSLY THAT IS MASSIVELY IMPORTANT TO EVERY FIELD OF RESEARCH RIGHT NOW BECAUSE THE VOLUME OF DATA WE ARE GENERATING KEEPS GROWING EXPONENTIALLY SUSAN WAS SELECTED AND SHE’S ALSO THE DIRECTOR OF THE OFFICE OF DATA SCIENCE STRATEGY WHICH IS LOCATED WITHIN THE NIH OFFICE OF THE DIRECTOR BEFORE AND SHE WAS A DIVISION DIRECTOR AT THE NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES AND HAD SPENT TIME IN THE DEPARTMENT OF ENERGY EXCITED SUSAN HAS OFFICIALLY STEPPED INTO THE ROLE WE SELECTED AN OFFICER FOR THE “ALL OF US” PROGRAM THERE’S A LARGE SIGNATURE PROGRAM WE HAVE WITHIN THE OFFICE OF THE DIRECTOR THAT’S BUILDING A COHORT OF A MILLION OR MORE PEOPLE WITH VERY DIVERSE BACKGROUNDS TO LOOK AT THE INTERSECTION OF GENETICS AND ENVIRONMENT AND THEY COME FROM MY STOMPING GROUNDS AT VANDERBILT MEDICAL CENTER AS A PROFESSOR OF MEDICINE AND WE’RE EXCITE ABOUT JOSH’S ARRIVAL SHORTLY AND ONE NOTE, ASIA DISHMAN WHO HAS BEEN SERVING AS THE CEO OF ALL THE PROGRAMS CINCINNATI THE INSTHECHGS “ALL OF US” PROGRAM AND IS CHIEF

INNOVATION OFFICER WE STILL GET TO KEEP ERIC AROUND AND VALUE HIS INPUT AND EXPERTISE AND AMONG NIH THROUGH CHAINS OF REACTION DR. MARTHA SOMMERMAN THE DIRECTOR OF THE NATIONAL INSTITUTE OF DENTAL AND CRANIAL FACIAL DISORDERS RESEARCH HAS RETIRED AND IT’S A FAMILIAR ROLE AS HE SERVED AS THE DIRECTOR OF THE INSTITUTE FOR 10 YEARS BEFORE BECOMING DEPUTY DIRECTOR AT NIH SO HENCE IT’S BEEN AN INTERESTING RIDE OVER THE LAST COUPLE MONTHS AND SOMETHING WE HADN’T ANTICIPATED HAPPENING AND SHE STILL HAS HER LAB AT NIH AND STILL AN ACTIVE SCIENTIST AND THEY LAUNCHED THE NEW COLLABORATION AND THIS IS LOOKING CLEARLY AT HIV AND SICKLE CELL DISEASE LOOKING AT GENE-BASED STRATEGIES TO BE IMPLEMENTED TO DEVELOP AFFORDABLE CARE FOR SICKLE CELL AND HIV AND SOMETHING ELSE THAT HAS BEEN BREWING ACROSS NIH AND IN THE BROADER SCIENTIFIC COMMUNITY AND SOCIETY AS A WHOLE IS THE ISSUE OF ANTI-HARASSMENT AND SO SPECIFICALLY NIH CONVENED OR DR. COLLINS CONVENED A WORKING GROUP OF HIS ADVISORY COMMITTEE TO THE DIRECTOR OR ACD TO PUT TOGETHER CHANGES ON CULTURE AND HARASSMENT THEY REPORTED OUT THEIR RECOMMENDATION WHICH DR. COLLINS ACCEPTED AND FOCUSSED ON A VARIETY OF DIFFERENT THINGS INCLUDING HAVING NIH DEVELOP A MEANS OF DIRECTOR REPORTING AND HOW WE TREAT RESEARCH CONDUCT AND THERE’S A HOST OF RECOMMENDATIONS IF YOU’RE INTERESTED CHECK OUT THE REPORT ON THE ACD WEBSITE THERE WAS AN AI WORKING GROUP THAT RELEASED ITS FINAL REPORT ON RECOMMENDATIONS THAT ADDRESSED THE NEED FOR INVESTMENT ON DATA, ETHICS AND PEOPLE TRAINING PEOPLE WHO ARE MULTILINGUAL RECRUITING PEOPLE WHO CAN SPEAK THE LANGUAGES AND MACHINE LEARNING AND FRIENDLY DATA SET AND PUBLISHING AND CONTRIBUTING THEN AND CONSENT AND DATA ACCESS STANDARDS AND ETHICAL PRINCIPLES, CURRICULA AND MAKING SURE WE HAVE THE POOL OF RESEARCHERS CLOSER TO HOME AT THE NINR, WE’LL GO THROUGH SOME OF THE

STAFFING CHANGES THAT HAVE OCCURRED AND WHAT MIGHT BE MOST INTEREST TO YOU ALL IS AN UPDATE ON THE NINR DIRECTOR SEARCH AS A REMINDER, IF WE DIDN’T HAMMER HOME THE DEADLINE THE APPLICATION’S CLOSED NOVEMBER 18 SO LATE LAST YEAR THERE’S BEEN INITIAL REVIEW OF THE APPLICANT QUALIFICATIONS THAT’S GONE ON AND THEY’RE CURRENTLY CONDUCTING INTERVIEWS I’M HOPEFUL BEFORE THE NEXT MEETING OF COUNCIL WE’LL HAVE AN ANNOUNCEMENT BEFORE OUR SELECTION SO STAY TUNED FOR THAT ONE IN THE INTERIM, I’M DELIGHTED TO BE SERVING AS THE NINR ACTING DIRECTOR AND HAVE BEEN SINCE JANUARY 1 ALL OF EXACTLY TWO WEEKS AND AT THE SAME TIME ASKED JESSICA AND GAEL — GAIL TO SERVE AS THE ACTING DEPUTY DIRECTOR OF THE INSTITUTE WE’RE DELVING IN HEADFIRST AND TRYING TO GET OUR HANDS AROUND THE ISSUES RELATED TO THE INSTITUTE AND MANY OTHER THINGS WE AS I SAID BEFORE IS WE BROUGHT ON AN ACTING DIRECTOR OF THE INTRAMURAL SCIENCE PROGRAM AND KATHY HAS BEEN SERVING IN THIS ROLE SINCE EARLY DECEMBER AND WE’RE GRATEFUL FOR TAKING ON THIS ROLE AND BRINGING A WEALTH OF EXPERIENCE TO THE INSTITUTE WE’RE ALSO ANNOUNCE AND WELCOMING DR. TERRY ARMSTRONG TO SERVE AS OUR ACTING SCIENTIFIC DIRECTOR OF OUR DIVISION OF INTRAMURAL RESEARCH EFFECTIVE FEBRUARY 3 SHE’S COMING TO NINR ON DETAIL FROM THE NATIONAL CANCER INSTITUTE HER ROLL OVER THERE IS DEPUTY CHIEF OF THE NEURAL ONCOLOGY BRANCH AND THAT’S WITHIN THE STANFORD CANCER RESEARCH SHE’S A TRAINED CLINICIAN AND SCIENTIST AND HER RESEARCH IS INTERVENTIONS THAT REDUCE SYMPTOMS ON BRAIN TUMOR PATIENTS THESE INTERACTING WITH OUR INTRAMURAL PROGRAM IN COLLABORATING WITH THE SCIENCE CENTER WE’RE GRATEFUL TO TERRY FOR AGREEING TO COME OVER AND SPEND TIME WITH NINR AND I THINK SHE HAS GREAT EXPERIENCE AND EXPERTISE TO CONTINUE TO STRENGTHEN OUR PROGRAM WE’VE ALSO AS OF NEXT MONDAY MR. AARON CONDON IS OUR EXECUTIVE OFFICER I’M SURE THEY’RE THRILLED TO GET ADDITIONAL SUPPORT AND HELP HE HAS A BROAD CHANGE OF EXPERIENCE IN PROGRAMMATIC MATTERS HELPING US WITH OUR ADMINISTRATIVE FUNCTIONS HE STARTED AT NINR LAST IN DECEMBER OF 2018 HE’S BEEN HERE A LITTLE WHILE HE’S FAMILIAR WITH THE INSTITUTE AND SPENT TIME AT THE NATIONAL CANCER INSTITUTE SO WE’RE EXCITED TO WELCOME ALL THE NEW PEOPLE TO NINR BUT WE ALSO WANT TO ACKNOWLEDGE SOME STAFF THAT HAVE DONE SOME AMAZING THINGS SO DR. MICHELLE AND DIANA HAVE BEEN RECOGNIZED FOR THEIR CONTRIBUTION TO THE HEAL INITIATIVE AT THE NINDS DIRECTOR’S AWARD CEREMONY THEY’RE GONE ABOVE AND BEYOND THEIR NORMAL ROLES TO HELP REPRESENT NINR IN THIS LARGE

IITIATIVE WE HAVE AT NIN AND THE HEAL INITIATIVE IS THE HELPING TO END ADDICTION LONG TERM CONGRATULATES FOR THE HONOR AND FOR HIM IT’S A GOOD TRANSITION BUT WE’VE HAD A FEW RETIREMENTS AND DEPARTURES IN THE LAST SEVERAL MONTHS SINCE WE LAST MET OUR CHIEF OF THE SCIENCE IMPLEMENTATION BRANCH HAS RETIRED AT THE END OF DECEMBER AND HE HAS BEEN AT NINR SINCE 2010 SO WE CONGRATULATE HIM ON HIS RETIREMENT AND AUGI WAS A PROGRAM DIRECTOR WHO OVERSAW OUR PROGRAM IT’S NOT ALL BAD NEWS WE MANAGED TO CONVINCE THEM TO STICK AROUND A LITTLE WHILE OR STAY AWAY HE RETIRED DECEMBER 31st AND CAME BACK JANUARY 6 PART-TIME WITH US AS WE WORK THROUGH HIRING AND BACKFILLING HIS POSITION HE’S AROUND FOR ANOTHER FEW MONTHS AT LEAST THEN DR. GABINI WHO SERVED AS THE CHIEF OF THE OFFICE OF EXTRAMURAL PROGRAMS HE GOT A NEW JOB IN NOVEMBER AND IS NOW THE EXECUTIVE DIRECTOR OF RESEARCH AT MASSACHUSETTS GENERAL HOSPITAL INSTITUTE OF HEALTH PROFESSIONALS HE IS NOW A LITTLE BIT CLOSER TO HIS FAMILY AND HE LEFT BUT IT’S A GOOD MOVE FOR HIM WE WANT TO THANK THEM FOR ALL THEIR TRBT CONTRIBUTION TO — THANK THEM FOR THEIR CONTRIBUTIONS TO NINR SO SOME ACTIVITIES GOING ON BESIDES OUR STAFF CHANGES WE HAD A COUPLE DIRECTORS LECTURES THE FIRST ONE WAS ASSOCIATED WITH THIS AND THERE WAS A PRESENTATION ON THE SYMPTOMS OF HEART DISEASE AND WOMEN DR. PATRICIA STONE PRESENTED HER RESEARCH ON QUALITY OF CARE FOR OLDER ADULTS THOSE LECTURES CAN BE VIEWED IF ANYONE WAS UNABLE TO VIEW THEM AND ALSO ON OUR YOUTUBE CHANNEL JUST A FEW OTHER NOTES ABOUT SOME THINGS THAT NINR HAS BEEN PARTICIPATING IN YOU MAY BE FAMILIAR WITH THE SOUTH HEALTH INITIATIVE THERE’S SOMETHING ABOUT MY VOICE THAT SETS OFF SIRI ALL THE TIME CLEARLY IT’S INTERESTED IN OUR SOUND HEALTH INITIATIVE THIS PROGRAM IS A PARTNERSHIP NIH HAS WITH THE NATIONAL KENNEDY CENTER AND NATIONAL ENDOWMENT THEIR ARTS ONGOING SINCE 2017 IT’S EXPLORING THE RELATIONSHIP BETWEEN THE BRAIN AND MOVING AS PART OF THE INITIATIVE THERE’S ACTIVE MUSIC ENGAGEMENT INTERVENTION FOR YOUNG CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA AND PARENTS IT EXPLORES MUSIC WE’RE THERE COULD BE INTERESTING DATA TO COME FROM THAT ALONG WITH OTHER HEAL INITIATIVES WE MENTIONED PREVIOUSLY, I WANT TO EMPHASIZE

NINR IS INVOLVED WITH THIS EFFORT AGAIN WE HAVE BEEN DELIGHTED WE WERE AWARDED TO EXPAND ON SOME OF OUR SUPPORTIVE STUDIES WE HAVE ONGOING THE FIRST ONE THAT WE’LL MENTION IS ONE LOOKING AT THE IMPACT OF MUSIC THERAPY AND CANCER SURVIVORS AND PAIN IT’S TO LOOK AT THE IMPACT OF INTERACTIVE MUSIC THERAPY ON PAIN IN CANCER SURVIVORS WHO ARE OPIOID USERS ANOTHER ONE IS LOOKING AT PAIN INTENSITY AND THESE ARE ALL REALLY IMPORTANT STUDIES THAT WE’RE GLAD WE CAN EXPAND ON AND CAPITALIZE ON THE RESEARCH EFFORTS WE HAVE ONGOING AT NINR AND DR. JESSICA GILL IS BACK AGAIN PART OF A CONSORTIUM LOOKING AT BRAIN INJURIES AND MILITARY PERSONNEL IT’S A $50 MILLION EFFORT LOOKING AT TRAUMATIC BRAIN INJURIES ON SERVICE MEMBERS IT’S CALL THE LONG TERM IMPACT OF MILITARY RELEVANT BRAIN INJURY CONSORTIUM IT LAUNCHED IN OCTOBER OF LAST YEAR AND IS PARTNERING WITH THE UNIVERSITY OF THE HEALTH SCIENCES ACROSS THE STREET AND WALTER REED MEDICAL CENTER AND WITHIN THE EXTRAMURAL COMMUNITY WE WANTED TO PROMOTE SOMETHING OUR GRANTEES HAN BEEN INVOLVED WITH IN EARLY DECEMBER DR. SARAH STANTON DIRT OF THE HOPKINS CENTER TO PROMOTE RESILIENCE AND FAMILIES LIVING WITH CHRONIC CONDITIONS AN NINR CENTER OF EXCELLENCE AND SPOKE ON THE TOPIC OF COMBATTING CONDITIONS THE PANEL DISCUSSED IMPROVING CONDITIONS FOR PATIENTS WITH CHRONIC CONDITIONS INTERESTED TO SEE THE WORK AND DIFFERENT WAYS OUR GRANTEES ARE RECRUITING THEIR EFFORTS AND KNOWLEDGE AND A FEW WE WANT TO HIGHLIGHT TO YOU ALL BECAUSE THEY’RE EXCITING TO US THE FIRST WHICH IS A TOPIC I THINK IS DEFINITELY OF INTEREST TO THE DEPARTMENT AND TO THE NIN LEADERSHIP MORE BROADLY AND VERY IMPORTANT TO NINR IS ONE THAT DR. SUSAN CARMICHAEL AND HER COLLEAGUES HAVE CONDUCTED RESEARCH ON THEY PUBLISHED LAST YEAR ON A STUDY THAT LOOKED AT SEVERE MATERNAL AND STILL BIRTHS AND LIVE BIRTH DELIVERIES AND FOUND SOME WOMEN HAVE FOUR FOLD HIGHER WHICH IS SOMETHING THATFOLD HIGHER WHICH IS SOMETHING THAT IS CONCERNING IT WAS AN INTERESTING STUDY INTERESTING RESULTS FROM THAT HOPEFULLY WE CAN START TACKLING A WAY TO ADDRESS THE MORBIDITIES NOT TO MENTION MORTALITY WE WANT TO MENTION AN NINR FUNDED STUDY ON HIV/AIDS THAT LOOKS AT ANTIRETROVIRALS AND MEN AND BLACK MEN WHO HAVE SEX WITH MEN WHO SELF-REPORTED HOMELESSNESS ARE MORE LIKELY TO HAVE BEEN TESTED FOR HIV THAN THEY’RE HOUSED COUNTER PARTS SOMEWHAT UNSURPRISINGLY THEY HAD MORE DIFFICULTY ADHERING TO THEIR INDIVIDUAL THERAPY IT PROVIDES INFORMATION HOW CAMPAIGNS AND OTHER EFFORTS CAN BE DESIGNED TO PREVENT HIV

SPREAD WITHIN HIGH-RISK POPULATIONS THIS IS OF GREAT IMPORTANCE TO THE INSTITUTE FOR END OF LIFE PALLIATIVE CARE TWO STUDIES THAT CAME OUT LAST YEAR LOOKING AT DISPARITIES IN HOSPICE UTILIZATION FOR CANCER PATIENTS LIVING IN THE DEEP SOUTH AND FOUND HOSPITALIZATION DIFFERED BY PATIENTS AND HOSPITAL CHARACTERISTICS THOSE THAT WERE IT ILLUMINATED SOME WAYS TO IMPROVE HOSPITAL UTILIZATION IN OLDER PARENTS AND PATIENTS AND SO THEN THEY FOUND SOME RACIAL DIFFERENCES IN HEALTH CARE TRANSITIONS AND HOSPICE USE AT AND THE OF LIFE AND THEY FOUND SOME VARIATIONS BETWEEN REASONS BETWEEN END OF LIFE AND PALLIATIVE CARE TRANSITIONS AND PATTERNS THEY FOUND AFRICAN AMERICAN PATIENTS ANCHORED THE HIGHEST NUMBER OF TRANSITIONS AND HISPAN HISPAN HISPANIC AND ASIAN LIKELY TO DIE IN A HOSPITAL SAYING THEY USE THE AT THE END OF LIFE IT WILL HELP US IMPROVE HOW WE ADDRESS QUALITY END OF LIFE CARE FOR DIFFERENT POPULATIONS SO I WANT TO HIGHLIGHT SOME OF OUR NIN FUNDING OPPORTUNITIES OUT ON THE STREET AS WE SAY SO I’M NOT GOING TO GO THROUGH ALL THESE HERE BUT I ENCOURAGE TO YOU TAKE OUT THE LINK ON OUR WEBSITE THAT HAS OUR FUNDING OPPORTUNITIES LISTED FOR THOSE AND NINR ALSO FREQUENTLY PARTNERS WITH I.C.s ACROSS NIN AND WE HAVE SUPPORTED RESEARCH ENDEFER ACROSS OUR TRADITIONAL BOUNDARIES A FEW SCAEXAMPLES AND CHECK OUT MORE INFORMATION ON THOSE EFFORTS SO MORE WE HAVE THE SUMMER GENETICS INSTITUTE CELEBRATING ITS 20TH ANNIVERSARY WHICH WE’RE EXCITED ABOUT SO THE APPLICATION DEADLINE IS MARCH 1 ANYONE INTERESTED MARK YOUR CALENDARS THE SESSION ITSELF IS HAPPENING JUNE 1 TO JUNE 26 ON THE NIH CAMPUS AS A REMINDER IT’S A TUITION-FREE ONE MONTH LONG RESEARCH AND TO DATE WE’VE HAD 430 SGI GRADUATES WE’RE EXCITING ABOUT THIS ANNIVERSARY SYMPOSIUM WE HAVE AS WELL THE METHODOLOGIES BOOT CAMP IS GOING TO BE HELD AUGUST 3-6 ON THE NIH CAMPUS THE BOOT CAMP IS HELD EACH SUMMER AND FEATURES LECTURES NATIONALLY AND INTERNATIONALLY RECOGNIZED SCIENTISTS FROM NIH AND UNIVERSITIES ACROSS THE COUNTRY SOME OTHER STATISTICS IS WE’VE HAD AS OF 20189 WE’VE HAD 950 STUDENTS, FACULTY AND CLINICIANS ATTEND THE METHODOLOGY BOOT CAMPS AND REGISTRATION OPENS APRIL 1 PLEASE PASS THIS INFORMATION ON TO ANYONE INTERESTED IN ATTENDING WE ALSO HAVE ROTATIONS BEING OFFERED IN THE SYMPTOMS SCIENCE CENTER WE’RE PROMOTING THESE THROUGH NIN AND THE SYMPTOMS SCIENCE CENTER CLINICAL TO HELP PROMOTE AND ACHIEVE THE ESTABLISHED

OBJECTIVES AND ROTATION PARTICIPANTS WILL HAVE A DUEL TRACK THING THOSE INTERESTED IN LEARNING IN PATIENT-REPORTED OUTCOMES OR PHENOTYPING SYMPTOMS CAN ROTATE THROUGH THE CLINIC AND THOSE WANTING TO LEARN SPECIFIC ASSAYS TO MEASURE EXPRESSION OR OTHER METHODS CAN ROTATE THROUGH THE LABORATORIES WE’RE EXCITED TO OFFER THIS NEW TRAINING OPPORTUNITY THE NIH ASSISTANCE TRAINING CENTER THE GOALS ARE TO TRAIN TAILORED TO USER NEEDS USING A MODULAR CURRICULUM AND COMMON DATA ELEMENTS AND TO LEARN ABOUT INTEGRATING CLINICAL RESEARCH WITH THE LAB THROUGH THESE COLLABORATIONS AND EXPANDING MENTORSHIP ASSESSMENT OF SYSTEMS CAN BE STANDARDIZED AS WE TRY TO LEAD THE EFFORT OF SYSTEM SCIENCE EXPERTS AT NINR LAST BUT NOT LEAST WE HAVE A FEW COUNCIL MEMBERS ROTATING OFF THE COUNCIL AFTER THIS MEETING TODAY AND I JUST WANT TO ACKNOWLEDGE THOSE FOLKS LISTED HERE AND THANK THEM FOR THEIR SERVICE ON THE ADVISORY COUNCIL DR KATHERINE BOWLES AND DR. KELLY AND DR. PANKLAR WE THANK YOU FOR YOUR SERVICE ON THIS ADVISORY COUNCIL NOW WE ALSO ACKNOWLEDGE YOU MAY HAVE STAYED LONGER THAN ANTICIPATED BUT WE’RE GRATEFUL FOR THAT AND LOOKING FORWARD TO THE ARRIVAL OF OUR NEW COUNCIL MEMBERS THANK YOU ALL FOR YOUR SERVICE ON THIS COUNCIL [APPLAUSE] I REALLY APPRECIATE YOUR SERVICE TO THE INSTITUTE AND THEN ONE QUICK REMINDER, FOR THE LATEST ON ANYTHING RELATED TO NINR PLEASE CHECK OUT OUR WEBSITE YOU CAN SUBSCRIBE TO OUR DELIVERY SERVICE THAT’S FOR INFORMATION RIGHT TO YOUR IN BOX DON’T HAVE TO GO TO THE WEBSITE WE ENCOURAGE YOU TO DO SO AND WE HAVE BEEN FORTUNATE AT NINR AND NIH TO RECEIVE A FUNDING INCREASE FOR FY19 WE APPRECIATE CONGRESS’S EFFORTS TO CONTINUE TO INCREASE AND WE CONTINUE TO LEVERAGE THE BEST NURSING RESEARCH I’LL TURN IT OVER TO DR. GRASON AND KEVIN WILSON FOR OUR LEGISLATIVE AND BUDGET ACTIVITIES >> GOOD MORNING EVERYONE I’M KEVIN WILSON THE BUDGET OFFICER AT NINR FIRST I’LL GIVE YOU A QUICK OVERVIEW OF THE FEDERAL BUDGET PROCESS AND THEN MOVE INTO FACTS AND FIGURES AND THINGS LIKE THAT AROUND SUMMERTIME WE START PREPARING THE BUDGET AND SUBMISSION FOR THE 2020 BUDGET THAT PROCESS BEGAN IN SUMMER 2018 THE DEADLINE TO TURN INTO OMB WAS EARLY FALL WE EITHER GET INCREASES OR DECREASES AND COMMENTS AND THINGS WE HAVE TO RESPOND TO WHEN THEY RETURN THE BUDGET TO US IS AROUND THANKSGIVING WE HAVE AN OPPORTUNITY AT THAT POINT TO APPEAL AND ASK FOR MORE MONEY FOR CERTAIN PROGRAMS OR ADDRESS THE CONCERNS OMD HAD THAT APPEAL PROCESS WHEN COMPLETED OMB SOMETIMES GOES

ALONG WITH OUR REQUEST AND SOMETIMES THEY DON’T DEPENDS ON EACH YEAR ONCE THAT HAPPENS THEY ROLE THE AGENCIES TOGETHER IN ONE BUDGET AND THE PRESIDENT SMITS THEM TO CONGRESS — SUBMITS THEM TO CONGRESS THAT USUALLY HAPPENS AROUND FEBRUARY, SPECIFICALLY THE STATE OF UNION AND THEN THEY VOTE ON A BUDGET RESOLUTION AND AT THAT POINT THE SUBCOMMITTEES WILL DEFEND THEIR BUDGETS AND THEY ASK QUESTIONS ABOUT THE BUDGET TO RECOMMEND HOW TO PUT THE BILLS TOGETHER THEY CAN EITHER ACCEPT THE PRESIDENT’S BUDGET AS IT IS AS LONG AS IT REMAINS WITHIN THE CONFINES OF THE BUDGET OR CAN RECOMMEND THEIR OWN BUDGET OR MODIFY THE PRESIDENT’S BUDGET ONCE THEY VOTE ON THOSE RESPECTIVE BILLS THEY’LL GO TO THE HOUSE FLOOR OR SENATE FLOOR FOR APE OVERALL VOTE IN CONGRESS AND ONCE THOSE PASS WE HAVE THE BUDGET BILL FROM EACH SIDE AND THE SENATE RESOLVES DIFFERENCES THEY WORK OUT DETAILS AND COME UP WITH A FINAL BUDGET BILL AND IT’S SENT BACK TO EACH CHAMBER WHERE THEY VOTE ON IT ONCE THAT’S APPROVED THE BILL’S SENT TO THE PRESIDENT AND HE EITHER SIGNS IT INTO LAW AND THEN WE GET AN APPROPRIATION IT LEADS TO THE NITTY-GRITTY OF OUR SLIDE TODAY THIS IS A THREE-YEAR BUDGET SLIDE THOSE THE FY18 OMNIBUS A PACKAGE OF APPROPRIATIONS LUMP INTO ONE BILL FY19 WE RECEIVED A 5.2% INCREASE AND THE MINI BUS IS A FEW APPROPRIATION BUSINE BILLS LUMP INTO ONE BILL WE ALSO RECEIVED WHAT WAS SIGNED A FEW WEEKS AGO BY THE PRESIDENT INTO LAW FOR ANOTHER 3.8% THE NIN INCREASES ARE HIGHER BECAUSE THEY INCLUDE MONEY FOR THE CURES INITIATIVES AND HEAL INITIATIVES THE PRESIDENT INITIALLY RECOMMENDED A 14% DECREASE ACROSS NINR AND 2% DECREASE OVERALL MOST THE SPECIAL INITIATIVES THE HOUSE AND SENATE RECOMMENDED 5% AND 6% INCREASES AND WE STILL RECEIVED A 3.8% INCREASE CONGRESS SIGNED INTO LAW RECENTLY THIS SLIDE DEPICTS OUR FUNDING LEVELS IN THE LAST 30 YEARS THE BLUE LINE REPRESENTS ACTUAL FUNDI FUNDING AND THE RED LINE SHOWS WHAT THE DOLLARS LOOK LIKE MEASURED IN FY19 DOLLARS THIS SLIDE REFLECTS THE SPENDING THE LAST SLIDE I’LL SHOW YOU WHAT HAPPENED IN FY19 TWO OF THIS THIRDS WENT TO TWO-THIRDS WENT TO RPGs

OUR INTRAMURAL PROGRAMS A LITTLE OVER 8% TRAINING FOR RSAs IS 4.5% ABOUT SECOND HIGHEST AT NIH THAT WILL BE DISCUSSED LATER ONLY SECOND TO NIGMS THE OTHER IS CAREER GRANTS AND CENTERS RECEIVED ABOUT 3.5% AS WELL ON THE R&D PORTION IS MOSTLY TAPS INCLUDING PROGRAM EVALUATION RMS IS RESEARCH MANAGEMENT SUPPORT AND ADMINISTRATIVE SERVICES AND SALARIES FOR EXTRAMURAL AND ADMINISTRATIVE STAT STAFF WITH THAT I’LL PASS IT OFF TO JOHN SO THANKS, KEVIN THIS WILL BE VERY BRIEF I WANTED TO HIGHLIGHT A COUPLE ITEMS FOR YOU >> AS YOU PROBABLY KNOW THERE’S A LOT OF BUILD INTRODUCED SOME RELATED TO NIH AND MOST THE BILLS DON’T GO ANYWHERE BUT THIS ONE DID SO I THOUGHT I’D MENTION IT TODAY THE PALLIATIVE CARE AND HOSPICE EDUCATION TRAINING ACT THIS PASS THE HOUSE OF REPRESENTATIVES OCTOBER 28 IT THEN MOVED IT ON THE SENATE OF NOTED — NOTE THE BILL HAD CO-SPONSORS ON A BIPARTISAN BASIS IN THE HOUSE WHICH IS ENCOURAGING AND HAS A GOOD NUMBER OF CO-SPONSORS IN THE SENATE AS WELL MUCH OF THE BILL IS FOCUSSED ON ESTABLISHING PROGRAMS TO INCREASE PALLIATIVE CARE AND HOSPICE EDUCATION TRAINING TO INCREASE THE NUMBER OF FACULTY IN THAT AREA SPECIFICALLY OF INTEREST TO NINR ARE PROVISIONS IN THE BILL THAT CALL FOR AN NIH STRATEGY TO INTENSIFY RESEARCH ON PALLIATIVE CARE AND HOSPICE AND REQUIRES NIH TO REPORT ON THEIR ACTIVITIES AND PALLIATIVE CARE EVERY THREE YEARS OR SO AS PART OF A LARGER NIH REPORT NOW WE WAIT AND SEE WHAT HAPPENS IN THE SENATE THEY CAN PASS IT AND CHANGE IT OR DO NOTHING TIME WILL TELL WE WERE FORTUNATE TO HOST TWO TOURS RELATED TO CONGRESS IN OUR INTRAMURAL PROGRAM THE FIRST WAS IN JUNE AND THIS IS STAFF FROM THE MENTAL HEALTH CAUCUS AND CAME AROUND TO LABS AT NIH INCLUDING DR. GILL’S LAB THIS SAY — IS A TERRIBLE PICTURE BUT BEHIND THE WATER MACHINE IS DR. CASHIN AND THEN A MONTH LATER WE HELD A TOUR WITH MEMBERS OF CONGRESS THIS WAS THE HOUSE NEW DEMOCRAT COALITION AND MEMBERS AND THEIR STAFF CAME AROUND TO VISIT NIH AND HERE THEY ARE TALKING TO DR GILL ABOUT HER WORK IN THE MIDDLE MIDDLE OF JULY THAT WAS A GREAT TOUR THEY ASKED A LOT OF FANTASTIC QUESTIONS AND THEY WERE IMPRESSED AND SEEMED INTERESTED AS IT A GREAT OPPORTUNITY TO HIGHLIGHT ALL THE EXCITING WORK GOING ON IN THE INTRAMURAL PROGRAM HOPEFULLY THERE’LL BE MORE IN THE FUTURE AND I WANT TO THANK DR. GILL AND HER STAFF FOR BEING WILLING AND FLEXIBLE ENOUGH TO DO THE TOURS THIS ONE WE HAD A THREE OR FOUR-DAY TOUR AND IT WENT OFF WITHOUT A HITCH AND A GOOD TIME WAS HAD BY ALL

>> THESE ARE THE FIRST TOURS WHERE WE’VE HAD CONSIDERATION STAFF AND MEMBERS AND IT’S A GREAT WAY TO SHOW FOLKS ON THE HILL AND BUILD RELATIONSHIPS IT’S GREAT WE’VE HAD THE OPPORTUNITY TO DO SO TWICE LAST YEAR BEFORE WE MOVE ON, ARE THERE ANY QUESTIONS WE’LL MAKE IT AN OPEN QUESTION >> CONGRESS HAS THE POWER OF THE PURSE BASICALLY IT’S COMMON PRACTICE FOR A PRESIDENT TO PUT FORWARD A BUDGET TO MATCH THEIR POLICIES IF THEY CAN SOME PRESIDENTS REQUEST BIG INCREASES SOME PRESIDENTS PRESIDENT BUSH FOR EXAMPLE BECAUSE OF THE CLIMATE GAVE SLIGHT INCREASES PRESIDENT OBAMA PRETTY MUCH HELD THE SAME MEASURE, MAYBE SOME SLIGHT INCREASES AND THEN WE HAD A SEQUESTER YEAR WITH A BIG DECREASE THIS PRESIDENT HAS RECOMMENDED SPENDING REDUCTIONS ACROSS THE GOVERNMENT BUT AS THEY SIGN IN LAW THE PRESIDENT HAS TO PUT HIS MARK OUT IN >> THERE’S A SAYING THAT WHAT THE PRESIDENT PROPOSES AND CONGRESS DISPOSES WE’VE BEEN GRATEFUL TO HAVE WHAT WE’VE HAD > SO AT ONE POINT THE NINR BUDGET WAS ABOUT 6% NOW IT’S 4.5% I DON’T KNOW WHAT THAT MEANS IN DOLLARS SO CAN WE HAVE SOME MAYBE A LITTLE EXPLANATION OF WHERE WE GOT FROM 6% TO 4.5% AND DOES IT MATTER SIT MORE MONEY? HOW DOES IT TRANSLATE OUT IN THE REAL WORLD FOR THOSE HELPING INDIVIDUALS GET TRAINING HOW ABOUT WE HOLD THAT THOUGHT UNTIL LATER BECAUSE WE’LL HAVE A WHOLE PRESENTATION >> THEY’LL DISCUSS THE NUANCES WITHIN THAT BREAKDOWN WE CAN DISCUSS THAT LATER THIS AFTERNOON KEEP THAT QUESTION AND LET’S SIRRAL BACK TO IT — CIRCLE BACK TO IT IF THERE’S NOTHING ELSE I’M DELIGHTED TO INTERDICE — INTRODUCE OUR NEXT SPAESHL DR TRAUTMAN FROM THE COLLEGES OF NURSING AND HAS BEEN SINCE JUNE OF 2014 SHE’S FORMALLY THE EXECUTIVE DIRECTOR OF THE CENTER FOR HEALTH POLICY AND HEALTH CARE TRANSFORMATION AT JOHNS HOPKINS HOSPITAL AND HAS HELD A VARIETY OF DIFFERENT CLINICAL AND ADMINISTRATIVE LEADERSHIPS INCLUDING THE UNIVERSITY OF PITTSBURGH MEDICAL CENTER AND JOHNS HOPKINS AND SERVED AS THE VICE PRESIDENT OF PATIENT CARE SERVICES AND TRAINING FOR EMERGENCY MEDICINE AT JOHNS HOPKINS AND HAS MANY ACCOLADES WE’VE TALKED ABOUT HER TIME SHE WAS A 2007, 2008 HEALTH POLICY FELLOW AND WORKED WITH

NANCY PELOSI ON THE HOUSE OF REPRESENTATIVES SHE’S HAD A WEALTH AND VARIED EXPERIENCE AND WE ARE GRATEFUL SHE’S GOING TO TALK TO US ABOUT WHAT THEY’VE DONE >> I’M TRYING TO GO GREEN SO I HAVE A LITTLE BIT OF PAPER BURY BEGIN, I WANT TO THANK TARA AND THE STAFF AND COUNCIL HERE YOUR EFFORTS, YOUR WORK TO ASSURE WE HAVE OPPORTUNITIES FOR NURSE SCIENTIST TO CONTRIBUTE IS CRITICALLY IMPORTANT I’M GRATEFUL FOR THE OPPORTUNITY TO SPEAK WITH YOU BRIEFLY TODAY I’LL SHARE A LITTLE BIT OF DATA AND WORK WE’RE DOING WITH OTHERS AND HOPEFULLY IT WILL HELP INFORM YOUR DISCUSSION WE’LL HAVE TIME FOR DISCUSSION AFTER I CONCLUDE THESE BRIEF POUR — POWER POINTS BUT YOU CAN ASK QUESTIONS ALONG THE WAY AND IT’S ONGOING CONVERSATION SO IMPORTANT TO US AND I THANK YOU NOR OPPORTUNITY TO BE HERE THE AMERICAN ASSOCIATION OF COLLEGES AND NURSING IS THE VOICE FOR ACADEMIC NURSING WE REPRESENT 825 SCHOOLS OF NURSING ACROSS THE COUNTRY THAT REPRESENTATION INCLUDES OVER 500,000 STUDENTS AND OVER 40,000 FACULTY ABOUT 19,000 TO 20,000 FACULTY ARE FULL TIME CLEARLY OPPORTUNITIES FOR NURSE SCIENTIST TO MAKE A DIFFERENCE NOT JUST FOR THE PROFESSION SOLD SOME OF OUR OTHER HEALTH PROFESSIONS ARE SEEING A DECLINE WE’RE NOT EXPERIENCED THAT IN NURPGS OVERALL WE — NURSING OVERALL WE SEE POSITIVE GROWTH AND AS YOU CAN SEE THERE’S GROWTH AND INTEREST IN THE NURSING PROGRAMS AN IMPORTANT POINT TO MAKE ON THIS SLIDE IS WE ADVISORY CONCERNS BECAUSE SBREN SEEING A DECLINE IN INTEREST IN Ph.D PROGRAMS AND WANT TO BETTER UNDERSTAND WHY THAT’S HAPPENING IT’S TOO SOON TO CELEBRATE BUT IT’S A TINY BIT OF GOOD NEWS IN THAT WE ARE HELPFUL MANY EFFORTS WILL REVERSE THE DECLINE IN TREND WE’LL COME BACK TO THAT CAN SEE OVERALL IN THE UNITED STATES WE NOW HAVE 135 Ph.D PROGRAMS, FOUR WITH DOCTOR OF NURSING SCIENCE, FOUR OR EDD AND ONE Ph.D./M.D WE JUST FINALIZED A VARE WITH RESPONSES COMING BACK IN AND LOOKING AT THE DATA WE’LL HAVE UPDATED INFORMATION WE NOW THERE ARE NOW FOUR COMBINED Ph.D. M.D. PROGRAMS AND IT GIVES INFORMATION ON ENROLLMENTS AND WHAT IS TROUBLING IS THAT WE ARE STILL TURNING AWAY QUALIFIED APPLICANTS WE’RE FIND THAT SIMILAR TO WHY WE’RE TURNING AWAY CANDIDATES IS SIMILAR TO Ph.D. THAT IS WE HAVE A SHORTAGE OF FACULTY SOME ARE BEGINNING TO QUESTION THEIR VAL VALUE AND RETURN ON INVESTMENT IN ACADEMIA AND WE MUST DO MORE BECAUSE THERE’S MANY OPPORTUNITIES IN ACADEME ANDAWI ACADEMIA AND WE’RE WORKING WITH MEMBERSHIP TO REDUCE THAT WE’RE SHOWING THE GROWTH IN THE RESEARCH NURSING PROGRAMS AND THAT’S IMPORTANT TO SEE THAT I WANT TO TALK WITH THE STUDENT POPULATION THE GOOD NEWS IS WE ARE SEEING AN INCREASE IN UNDER REPRESENTED GROUPS HOWEVER, WE’VE SEEN A SLIGHT DECLINE IN THE NUMBER OF WHITE Ph.D. STUDENTS AND WANT TO SEE AN INCREASE IN ALL STUDENTS AND SEEING AN IMPROVEMENT IN OUR RECRUITMENT OF MALES AND AS YOU CAN SEE BY THIS GRAPH IT’S STILL

STAYING FAIRLY CONSTANT NOT JUST THOSE INTERESTED IN Ph.D PROGRAMS WE KNOW WE MUST DO MORE TO INCREASE OPPORTUNITIES FOR DIVERSITY WITHIN OUR STUDENT POPULATION AND WE’RE HAVING GREAT SUCCESSES IN MANY PROGRAMS THIS SLIDE SHOWS THE ENROLLMENT AND GRADUATIONS OUR GRADUATIONS ARE ALSO STEADY WITH A SLIGHT INCREASE THEN THIS ONE SHOWS SUSTAINING Ph.D. ENROLLMENT THE POINT OF CONCERN WE DID SEE THE DECLINE AND IT WAS NEARLY A 10% DECLINE AS A SAID IT’S TOO SOON TO CELEBRATE THAT LESS THAN 1% INCREASE BUT WE’RE FOCUSSED AND WANT TO DO AS MUCH AS WE CAN TO UNDERSTAND IT AND ADDRESS AND PUT IN PLACE ACTIONS TO HELP US MINIMIZE SO THE CHALLENGE THE SCHOOLS OR STUDENTS FACE MANY MAY BE AWARE THERE WAS WORK DONE BY THE NATIONAL ACADEMY OF MEDICINE A CONSENSUS WAS CUB PUBLISHED AND MANY FINDINGS ARE SIMILAR TO WHAT WE ARE HEARING FROM OUR COMMUNITIES THAT WHAT IS HAPPENING IS IN SOME RESPECTS A CHANGE IN THE INFORMATION OF POTENTIAL STUDENTS FOR WHAT THE VALUE OF PURSUING Ph.D. EDUCATION COULD BE FOR THEM THERE’S A GULF BETWEEN THE NUMBER OF QUALIFIED SCIENTISTS AND THE OPPORTUNITIES PEOPLE THINK ARE POSSIBLE MANY SERVING IN THIS STUDY AND THROUGH OUR MEMBER SCHOOLS AND STUDENTS, MANY BELIEVE THERE’S A LIMITED OPPORTUNITY FOR THEM ONCE THEY COMPLETE A PROGRAM INDEED THAT’S NOT TRUE BUT WE NEED TO DO MORE WITH RESPECT TO MARKETING AND HELPING PEOPLE UNDERSTAND WHERE THE DIFFERENT OPPORTUNITIES ARE SOME THINK IF THEY PURSUE A Ph.D. WHILE SOME MAY HAVE INTERESTS IN BEING A SCIENTIST THINK THAT’S ALL IT ENTAILS AND BEING A SCIENTIST COULD BE RICH AND REWARDING THERE ARE OTHER OPPORTUNITIES THERE’S ALSO WITH RESPECT TO RESEARCH ON INVESTMENT AN I AM FROM A GENERATION WHERE IT TOOK SEVEN YEARS FOR MY Ph.D. PROGRAM AND A WAS FINE WITH THAT I WOULD SAY MOST I TALKED TO TODAY, THAT’S NOT ACCEPTABLE THERE IS AN INTEREST IN BEING ABLE TO REALIZE A RETURN ON INVESTMENT WE’VE CREATED NEW AND DIFFERENT WAYS TO STRUCTURE OR CURRICULUM SO GRADUATES CAN GRADUATE SOONER AND MAYBE A CONTRIBUTION EARLIER IN MY CAREER I WENT SLOWLY ON MY JOURNEY BECAUSE OF ALL OF MY WORK COMMITMENTS AND PERSONAL COMMITMENT THERE ARE LESS INDIVIDUAL ARE INTERESTED IN THAT TYPE OF A PATHWAY THERE’S ALSO AGAIN WE NEED TO DO A BETTER JOB PROVIDING CAREER INFORMATION IF YOU HAVE AN OPPORTUNITY TO GO TO THE WEBSITE I ENCOURAGE TO YOU DO SO WHAT WE’VE DONE THERE, WE NOW HAVE A QUICK LINK FOCUSSED ON Ph.D. EDUCATION AS PART YOU CAN LISTEN TO VIDEOS OF OTHER SCIENTISTS AND HEAR ABOUT THE CONTRIBUTIONS THEY ARE MAKING WE HEARD FOR SOME WHO ARE UNAWARE OF WHAT ALL THE POSSIBILITIES WERE THIS IS ONE WAY THAT’S HELP INDIVIDUALING GAIN A BETTER UNDERSTANDING OF WHAT IS POSSIBLE YOU CAN SEE SOME DATA SLIDES AVAILABLE AS WELL THE PROLONGED POST-DOC AND TRAINING AND SALARIES AND I KNOW YOU’LL HEAR FROM SCIENTISTS AND SOME FROM THE PROGRAM LATER AND WE HEARD OVER AND OVER AGAIN THE VALUE OF STRONG MENTORSHIPS AFTER I DEFENDED MY DISSERTATION AND WE WAS EXCITED AND WE WERE GOING TO MEET AT A RESTAURANT TO HAVE A CELEBRATION AND I FORGOT MY CONTACT INFORMATION AND AT THE TIME YOU COULD DIAL 4-1-1 AND I DIAL IT AND I ASK THE

NUMBER OF THE PERSON AND THE OPERATOR HELP ME THE OPERATOR SAID TO ME, I JUST HAVE TO SAY, WHAT’S GOING ORGANIZATION YOU — ON, YOU SOUND SO EXCITED I SAID I JUST DEFENDED MY DISSERTATION TO GET MY Ph.D. AND MY SISTER’S DRIVING THE CAR AND SHE SAID I CAN’T BELIEVE YOU SAID THAT TO A STRANGER AND THE POINT IS THERE’S EXCITEMENT ABOUT BEING ABLE TO ACHIEVE THE EDUCATIONAL SUCCESS THE ATTAINMENT OF THE DEGREE WHAT I REALIZED WAS NOT SO MUCH FOR ME PERSONALLY AND I THINK I CELEBRATED FOR A YEAR BUT IT’S BEEN MY EXPERIENCE PERHAPS WITH ALL OF OUR EDUCATION AND CERTAINLY WITH MY Ph.D EDUCATION THERE’S ABSOLUTELY NO WAY I COULD HAVE GONE ON THAT JOURNEY ALONE NOT ONLY SUPPORT FROM FAMILY AND FRIENDS AND EDUCATIONAL COLLEAGUES AND FACULTY BUT MY COLLEAGUES AT HOPKINS I LEARNED AS MUCH ABOUT MYSELF AS RESEARCH DURING THE PROCESS I LIKE TO SHARE AND WE ALL HAVE OUR PERSONAL STORIES BUT I LIKE TO SHARE I WAS HAPPY TO TELL ANYONE ABOUT ACHIEVING THAT GREAT MILESTONE AND I WOULD LIKE US TO BE ABLE TO CELEBRATE MORE FOR ALL OF OUR COLLEAGUES WHO ARE BECAUSE IT’S NOT JUST ABOUT WHAT WE ACHIEVED BUT WE WILL NOT REALIZE BETTER HEALTH CARE IN THIS NATION IF WE DON’T CONTINUE TO MAXIMIZE OPPORTUNITIES FOR ALL AND IMPORTANTLY NURSE SCIENTISTS TO PARTICIPATE I HAVE A PICTURE HERE IT’S NOT A ONE SIZE FITS ALL IT WOULD BE EASY TO SAY IF WE DID ONE, TWO AND THREE IT WOULD REASSURE PIPELINES AND WE NEED TO HAVE RECOMMENDATIONS FOR RESEARCH INSTITUTIONS LIKE CAN AND SHOULD WE THINK ABOUT DOING DIFFERENTLY FOR CURRICULUMS AND OTHER OPPORTUNITIES AND RECOMMENDATIONS FOR PRINCE VAL INVESTIGATORS AND RECOMMENDATIONS TO NIH AND TO POLICY MAKERS WE CONVENED IN AUGUST 2018 AND PRODUCED A FINAL REPORT WE PRODUCED AND IT’S AVAILABLE ON THE WEBSITE THERE WERE FOUR BROAD CATEGORIES OF RECOMMENDATIONS OF WHAT WE BELIEVE LEADS TO THE FURTHER ACTIVITY INACTION THAT’S CONTINUING THE CONVERSATION THAT SMALL UP TICK AND WE NEED TO SEE A STRONGER LEVEL OF INTEREST AND HELPING PEOPLE UNDERSTAND WHAT THE OPPORTUNITIES ARE, IDENTIFYING DATA GAPS THERE ARE PLACES WHERE WE DON’T HAVE GOOD INFORMATION THAT TELLS US WHAT’S CREATING SOME CHALLENGES AND WE NEED TO CONTINUE TO THINK ABOUT WHO THE COMMUNITY STAKEHOLDERS ARE THAT ARE LARGER THAN THOSE OF US WHO ALREADY HAVE BEEN PARTICIPATING IN THE CONVERSATIONS TAKE RECOMMENDATIONS FOR STUDENTS WE NEED TO IDENTIFY THOSE NURSE A PROCLIVITY TO RESEARCH AND CREATE STRONG PEER CONNECTIONS AND REAL MENTORING EXPERIENCE WE NEED TO HIGHLIGHT THE IMPACT OF NURSING SCIENCE I WORKED WITH SARAH AT HOPKINS AT THE SPEAKER’S OFFICE BACK IN 2007-2008 SARAH CAME AT THE TIME WITH HER RESEARCH THAT WAS MAKE A SIGNIFICANT DIFFERENCE BUT ON A SMALL SCALE FOR SENIOR ELDERLY MRERNZ THAT LED TO AN OPPORTUNITY AND SOME WERE FROM GOVERNMENT SOURCES AND NOW HAS LED TO SUPPORT OF A PROGRAM WE HOPE TO SEE TO GET MORE TRACTION WHERE WE’RE ABLE TO TAKE AND UTILIZE SERVICES OF HANDYMEN IN THE HOME OF SENIOR CITIZENS AND REDUCE THE RISK OF FALLS AND PROMOTED A HEALTHIER AND EVEN SAVING MONEY AND A HEALTHIER INDIVIDUAL AN FOR INSTITUTIONS WE HAVE TO HELP DEFINE THE SCIENCE IN THE

FUTURE AND THINK OF DEVELOPING CONSORTIUM BETWEEN ACADEMIC INSTITUTIONS TO SUPPORT SCIENCE AND MANY STUDENTS ARE NOT JUST WITHIN THE ACADEMIC INSTITUTIONS BUT WHAT ARE WE DOING WITH OUR PRACTICE LEADERS AND PARTNERS MANY HAVE TALKED ABOUT THE IMPORTANCE OF HAVING A NURSE SCIENTIST ON THEIR STAFF HAS BROUGHT TO THEIR WORK AND THE CARE OF THEIR PATIENTS AND COMMUNITIES AND WITH TO THE DATA GAPS I DO NOT BELIEVE WE YET FULLY UNDERSTAND ALL THE NUANCES OF THE CHALLENGES THAT WE FACE AND AACN IS CURRENTLY CONDUCTING A SURVEY WE NEED TO MAKE SURE THERE’S OPPORTUNITIES TO GO DEEPER AROUND CHALLENGES WE FACE WHEN WE LOOK TO THINK ABOUT THE BREADTH AND DEPTH OF RESOURCES WE’RE PLEASED TO SEE THE PRESIDENT’S BUDGET AND ULTIMATELY WHAT WAS PASSED THE SUPPORT FROM CONGRESS HAS SHOWN AN INCREASE AND THAT QUESTION WAS ASKED AND WHAT ASKED AN INCREASE RELATIVE TO WHAT WE NEED WITH RESPECT TO PROGRAMMING AND ARE WE ALIGNING THE RESOURCES THAT WE HAVE AND THE DIFFICULTY LIES NOT SO MUCH IN GENERATING NEW IDEAS BUT IN ESCAPE FROM THE OLD ONES AS AN ECONOMIST AS I THINK ABOUT THAT, I THINK WE ARE DOING MORE TO ATTEMPT TO ESCAPE FROM THE OLD PROGRAMS AND CURRICULUMS AND BEING MORE TIME EFFICIENT FOR RESOURCES FOR STUDENT AND TIME WE NEED TO ASK WHERE ELSE CAN WE CHANGE TO BE MORE ATTRACTIVE TO THE STUDENT POPULATION COMING IN THERE’S ACTIVITIES ON ACN AND A FEW OF WHAT ARE ON HE HORIZON EVERY JANUARY THE AMERICAN ASSOCIATION OF COLLEGES HOSTS AND WE HAVE ONE OF THE HIGHEST NUMBERS OF ATTENDEES COMING THIS YEAR WE FLIPPED BETWEEN NAPLES AND CALIFORNIA SO GOOD WEATHER AND EXTREMELY RICH DISCUSSION AND PRESENTATION THERE’S IN ADDITION TO TALKING ABOUT THE CHALLENGES, WE RECOGNIZE THE NEED TO DO MORE AND HIGHLIGHT OPPORTUNITIES OTHERS HAVE FOUND WITHIN THEIR OWN ENVIRONMENT AND TALKING ABOUT WHAT TOMORROW’S LEADERS ARE EXPECTING BOTH THOSE CONDUCTING RESEARCH AS WELL AS BENEFITS IN THAT RESEARCH AND DEEP DIVE CONVERSATIONS THIS IS NOT AS SIMPLE AS A ONE SIZE FITS ALL WE’LL ALSO HAVE A FOCUS GROUP WE ALSO DEVELOPED A Ph.D PIPELINE COMMUNITY CALLED ACN CONNECT THERE’S A LOT OF CONVERSATION OCCURRING THERE CAN SEE 32 FACULTY HAVE JOINED THE DISCUSSION GROUP AND THEY’RE JUST GETTING STARTED ONLINE COMMUNITIES CAN BE A VALUABLE SOURCE MANY REMEMBER REMEMBER WHEN I STARTED IN COLLEGE AND YOU SEE THE ANALOGY OF PUSHING THE ROCK UP THE HILL AND WHEN YOU GET TO THE TOP YOU SLIDE DOWN AGAIN WE HAVE A LOT OF PUSHING YET TO DO WE’RE MAKE GREAT STRIDES IN HAVING AN OPEN CONVERSATION IN WHAT THE CHALLENGES ARE AND I BELIEVE ALL OF US NEED TO DO MORE TO SUPPORT OPPORTUNITIES FOR THOSE WHO HAVE POTENTIAL TO MAKE A CONTRIBUTION IN SCIENCE THEN I’M A BIG FAN OF ABRAHAM LINCOLN AND HE SAID THE BEST WAY TO PREDICT THE FUTURE IS TO CREATE IT I HOPE WE CREATE A FUTURE WHERE WE VALUE THE IMPORTANCE OF DISCOVERY FOR ALL NURSES BUT MOST IMPORTANTLY WE SUPPORT AS WELL A COMMUNITY OF NURSE SCIENTISTS MAKING A DIFFERENCE TO SUPPORT HEALTH CARE AND HOW WE LEARN IMPROVE THE WAY WE THINK ABOUT HOW WE PREPARE QUALIFIED RESEARCHERS FOR TODAY AND TOMORROW SO THAT CONCLUDES MY BRIEF REMARKS PARDON A FEW STUMBLES

I’M NOT SURE WHY I DID HAVE COFFEE THIS MORNING NOW IF THERE’S QUESTIONS, COMMENTS, DISAGREEMENTS OR ANYTHING YOU’D LIKE TO SHARE ABOUT WHAT YOU ALL ARE DOING OR WHAT YOU THINK IS IMPORTANT >> I’M SURE YOU’RE AWARE NATIVE-AMERICAN Ph.D. ARE UNDER 25 ABYSMAL WHEN WE’RE ALMOST 7 MILLION IN POPULATION WE’RE LOOKING AT WHAT ARE ATTRACTIONS AND DETERRENTS AND ONE DETERRENT IS [OFF MIC] >> USING PIPELINE? THAT’S THE FIRST I HEARD THAT MANY DON’T WANT TO BE ASSOCIATED WITH PROGRAMS >> THIS IS A RECOMMENDATION? WORDS MATTER SIGNIFICANTLY WHEN WE ARE TRYING TO ADVANCE POLICY OR EXPLAIN A PROBLEM >> WE STARTED USING PATH BASED >> THAT WAS THE FIRST I HEARD THAT AND I APPRECIATE YOU SARING IT BECAUSE WE SHOULD NOT BE DIRECTING ADDITIONAL BARRIERS IF WE CAN KNOWINGLY PREVENT THAT >> I WAS GOING MENTION WE HAVE BEEN USING ACROSS NIH GROWING IN FREQUENCY AND I DON’T KNOW IF IT’S BETTER OR NOT BUT WE LIKE TO SAY IT’S NOT A PIPELINE OR A STRAIGHT PATH AND AS PEOPLE GO FURTHER AND FURTHER IN THE PROCESS AND PATHWAY IT’S MORE ACTUALLY LIKE A FUNNEL SHAPE THAN ANYTHING ELSE IT’S A WAY TO THINK ABOUT IT >> IT’S A PIPELINE, PER SE THANK YOU >> DO YOU HAVE THE MP GRADUATES VERSUS OTHERS AND THEY’RE OUR FACULTY MEMBERS AND WE BEGIN TO THINK ABOUT HIRING THEM I THINK THERE MAY BE SOME IMPLICATIONS >> YOU RAISE A VERY GOOD POINT THAT’S AN AREA WHERE WE NEED BETTER DATA UNDERSTANDING THE OUTCOMES, IF YOU WILL, AND WHERE CAREER TRAJECTORIES TAKE THEM FOR Ph.D THAT IS A PART OF WHAT WE WANTED TO DO TO ENRICH THERE’S SOME DATA WE NEED TO HAVE RICHER DATA ABOUT >> THE AGE PEOPLE ENTER INTO THESE PROGRAMS ARE HIGHER AND THAT HAS A RIPPLE EFFECTS AND WHAT YOUR EXPERIENCE HAS BEEN AS DISCUSSED AND IMPLEMENTED IN TERMS OF TRYING TO ENCOURAGE PEOPLE TO JOIN THE PROGRAMS EARLIER >> THANK YOU YES, THAT’S TRUE WE’RE SEEING OLDER POPULATION ENTERING AND THEN DESPITE HOW WONDERFUL WE ALL MAY BE THEN THERE’S A TIME FOR US TO MAKE A CONTRIBUTION IN PART SOME OF THAT HAS BEEN MY OWN EXPERIENCE WAS THE CAREER PATH IN WORK AND THEN GETTING EXPERIENCE AND THEN I’LL GET MY

EMPLOYER WHICH I’M GRATEFUL MY EMPLOYER SUPPORTED MY Ph.D EDUCATION BUT IT WAS A MUCH MORE LINEAR APPROACH AND PURPOSEFUL I THINK THAT’S FOR SOME OF US AND THE DATA WOULD SUPPORT THAT I ALSO THINK THE IDEA OF THE LOVE OF DISCOVERY IT’S NOT ACROSS THE PROFESSION AND WE WERE HAD FUNDING TO CREATE OPPORTUNITIES TO HAVE AN EXPEDITED PATHWAY >> THERE’S BEEN SPECIAL PROGRAMS AND THERE’S A REDUCTION IN TIME AND CONTROVERSY AMONG COLLEAGUES BECAUSE THEY’LL HAVE THE MENTALITY WE NEED TO PRACTICE SO MANY YEARS AND THEN COME BACK WE NEED TO ENCOURAGE NOW THAT WE HAVE ACCELERATED PROGRAMS WITH ONE DEGREE AND WANT A SECOND DEGREE THEY HAVE A SKILL SET THAT DO WELL AND SOME HAVE BEEN SUCCESSFUL AND PART OF THE GOAL IS WE CREATE PROGRAMS LIKE THAT >> SOME WHO EXPRESS CONCERN THEN AND EVEN NOW FELT STRONGLY AND GROUP ABOUT THE IMPORTANCE OF E HAVING YEARS OF CLINICAL EXPERIENCE AND WITHOUT THAT THOUGHT ONE DIDN’T HAVE THE CONTEXT THAT WOULD BE IMPORTANT TO THEN APPLY AS THEY GO THROUGH THE Ph.D. PROGRAMS WE HAVE SHOWN THAT CONCERN DOESN’T EXIST IN REALITY TO THE EXTENT PEOPLE THINK IT HAS BUT IT’S IMPORTANT TO UNDERSTAND THE PROVISION — PROFESSION AND THAT’S ESCAPING FROM THE OLD AND LITERALLY WHEN I GRADUATED I NEEDED TO BE A NURSE A COUPLE YEARS AND I COULDN’T GET SUPPORT FROM MY EMPLOYER FOR MY TUITION ASSISTANCE UNTIL I WORKED FOR A PORTION OF TIME AND PART WAS A BUSINESS DECISION BUT WE’RE CHANGING IT AND SEEING CHANGES AND DIFFERENT KINDS OF SUPPORT AND WE HAVE TO DO MORE EARLY ON TO IMPROVE AND HELP PEOPLE SEE HOW THE OPPORTUNITY COULD BE OF INTEREST TO THAT >> I WONDERED HOW UP TO DATE OUR DATA ARE IN THE LAST SIX TO EIGHT YEARS BOTH AT MY INSTITUTION AND ONCE I’M GOING AROUND THE COUNTRY, IT’S BEEN A RAPID SHIFT OF YOUNG B.S.N. TO Ph.D. IN OUR PLACE ALMOST ALL ARE THAT NOW MAYBE THAT’S BECAUSE WE GO AFTER THEM I WONDER IF WE’RE RESPONDING TO THE SHIFT AND WE’RE NOT HOLDING ON TO AN OLD IDEA WHEN I DO GO ACROSS THE COUNTRY, WE KEEP SAYING WE WANT MORE Ph.D. PROGRAMS, I GUESS, BUT THERE’S CONCERN ABOUT THE QUALITY AND SOME PROGRAMS DO ADMIT OLD EVER STUDENTS WE HAVE TO BE CAREFUL SAYING DO WE WANT MORE Ph.D.’S TO BE FACULTY IN SCHOOLS OF NURSING ACROSS THE COUNTRY OR ARE WE THINKING ABOUT NURSE SCIENTISTS AND START BREAKING OUR DATA DOWN TO LOOK AT THE PEOPLE WHO ARE SETTING OUT TO BE NURSE SCIENTISTS WHO ARE CAREERS AND WITH WHAT ARE THEIR CAREER TRAJECTORIES WITH THE SHIFT SOMETIMES WE’RE STILL THINKING MORE PROGRAMS ARE BETTER I’M NOT SURE THAT’S TRUE WHEN I LOOK AT WHAT THE SUCCESS OF THE PEOPLE THERE ARE AND WHAT THEY’RE DOING THEY’RE PRODUCING FACULTY AND

THAT’S A DIFFERENT NEED THAN JUST OUR NURSE SCIENTISTS >> WE NEED TO BE ABLE TO HAVE OF COURSE Ph.D. PREPARED FACULTY AND NEED THOSE AND SHOULD HONOR THE PATHWAY TO BECOME A SCIENTIST AND PERHAPS NOT BE IN THE ACADEMIC COMMUNITY THEY’RE NOT MUTUALLY EXCLUSIVELY AND WHEN THE INSTITUTE OF MEDICINE CONCLUDED THEIR STUDY THEY IDENTIFIED THE MAJORITY ARE WORKING IN ACADEMIA YET THAT ISN’T WELL KNOWN WE ALSO DON’T HAVE RICH DATA WE HAVE TO UNDERSTAND AND TO YOUR POINT ABOUT AGE, WE LOOK AT AVERAGE BUT I’LL LOOK AT THE BREAKDOWN I BELIEVE OUR ANECDOTAL EXPERIENCES AND I BELIEVE THE DATA BEGINS TO SHOW THE INCREASE IN THE YOUNGER AGE ENTERING AND WE NEED TO LOOK AT BOTH OF THOSE GOOD POINT >> A POINT OF CLARIFICATION IT’S THE FIRST TIME I HEARD MORE Ph.D.s ARE WORKING IN PLACES OTHER THAN ACADEMIA I DON’T KNOW WHERE I’VE BEEN I DIDN’T REALIZE THAT THAT’S JUST Ph.D.s OR NURSE SCIENTISTS? >> THE REPORT I’LL RECOMMEND IS FROM THE INSTITUTE OF MEDICINE IN 2018 THAT WAS LOOKING AT BIOMEDICAL SERVICES RESEARCHERS AND CONSENSUS STUDY AND THAT WAS ONE OF THE POINTS RAISED IN THAT REPORT THAT’S NOT ACN DATA BESIDES QUESTIONING THE POINT, DID YOU WANT TO SAY MORE? OKAY >> YOU MAFD AN IMPORTANT POINT — YOU RAISED AN IMPORTANT POINT THE LONG TIME IT TAKES TO GET FUNDING PARTICULARLY RO1s AND IT’S TRUE ACROSS OTHERS AND WE MIGHT UNDERSTAND BUT INSTITUTIONS OFTEN DON’T AND IT SEEMS SO MANY SOLUTIONS HAVEN’T WORKED THE 9900 GRANTS ARE COMING AND PRIORITIZING EARLY CAREER AWARDS HASN’T DONE IT I SPEND SO MUCH TIME AS A SENIOR PERSON HELPING PEOPLE SURVIVE, FIVE, SEVEN, NINE YEARS TO GET AN ACADEMIC RO1 GRANT AND HELPING PEOPLE BE RESILIENT AND THICK-SKINNED AN NOT GIVE UP THIS REMAINS A BIG PROBLEM AND EXPECTATION HAVEN’T CHANGE WE FEEL FAILURE WILL HELP DISCOURAGE SOONER AND MAY BE A DETERRENT >> I WOULD AGREE >> AND TO BUILD ON THAT AND IT’S NOT AN EASY QUESTION BECAUSE YOU INDICATED SEVERAL INITIATIVES HAVE ADDRESSED THE PROBLEM AND WHAT DO YOU THINK NINR COULD DO TO TRY TO HELP MOVE THE NEEDLE ON THIS? >> IDENTIFY THE PROBLEMS AND SOLUTIONS I THINK THE THINGS THAT ARE DONE ARE GOOD TO DO AND THE OTHER ANGLE IS INSTITUTIONS THEY NEED TO BE AWARE AND THAT’S PART OF THE PROBLEM TOO PEOPLE HAVE DONE WELL AND GAINED FUNDING AND I THINK IT’S NOT JUST AN NIH ISSUE BUT THERE’S INSTITUTIONS THAT NEED TO BE AWARE THAT THE WORLD IS DIFFERENT AND

>> ONE OF THE CONCERNS I’M SEEING LATELY IS MORE THAN TWO, YOUNG INVESTIGATORS WITH EXCELLENT TRAINING WITH Ph.D.s SEEM ALL SET AND READY TO GO AND GIVE A SLIVER OF TIME TO RESEARCH WHICH IS DISCONCERTING THEY DON’T KNOW HOW TO INTEGRATE IT INTO RESEARCH THIS IS PEOPLE WHO NEED YEARS AFTER >> DO YOU THINK THEY’RE EXTERNAL OR INTERNAL PRESSURE >> IT’S A CHOICE >> AND I WANTED TO TALK ABOUT Ph.D. PROGRAMS ENROLLMENT AND INSTITUTIONAL FUNDING TO SUPPORT THE STUDENTS I KNOW PUBLIC INSTITUTIONS, THAT’S A MAJOR CHALLENGE UNLESS YOU CAN INSTITUTE SOME TYPE OF STRATEGY TO HELP STUDENTS GO THROUGH SO WHEN YOU TRY TO ATTRACT YOUR POTENTIAL Ph.D. STUDENTS THEY’RE LOOKING FOR THE FUNDING BECAUSE THEY’VE SACRIFICED SO MUCH FOR THEIR BASIC EDUCATION >> THAT’S WHERE WE COULD DO MORE WE KNOW FUNDING MATTERS FOR OTHERS INTERESTED IN PROGRAMS AND WHEN THE FINANCIAL RESOURCES ARE THERE IS ONE LESS CHALLENGE OR BARRIER WHAT WE CAN DO IS LOOK MORE AT THAT IN A DEEPER WAY DID ANYONE ELSE HAVE A COMMENT? I PUT UP THE ONE SLIDE WHERE WE DID A FOCUS GROUP SURVEY AND LOOKED AT THE CHALLENGES IDENTIFIED THROUGH THE IOM WORK WHERE THE CHALLENGES WERE THE LENGS — THE LENGTH OF A POST-DOC WERE SOME CHALLENGES AND PROMOTING RECRUITMENT TO TALK ABOUT ADDRESSING THESE AND SUPPORTING THE MENTORING IT’S CRITICALLY IMPORTANT TO HELP NAVIGATE NOT JUST THE RESILIENCE IN THE PROGRAM BUT ALSO THE RESOURCES THAT MAY BE AVAILABLE >> I’D LIKE TO GO BACK TO WHAT THEY WERE SAYING AND THAT HAS BEEN ON THE P32 WITHOUT THE MECHANISMS WE HAVE MANY PEOPLE THAT WANT TO DO A Ph.D. BUT IF YOU DON’T HAVE FUNDING, IT’S A HUGE CONSTRAINT >> IT HURTS OUR UNDERREPRESENTED MINORITY STUDENTS IF WE WANT TO CONTRIBUTE TO THE DIVERSITY OF OUR Ph.D. GRADUATES AND NURSING WE HAVE TO LOOK AT THAT SERIOUSLY >> I AGREE WE NEED TO LOOK AT ALL FUNDING SOURCES WE’RE SELE SEEING SOME OF THE FOUNDATIONS THAT USED TO BE ABLE TO SUPPORT THIS OR NOT AND THAT’S ONE OF MANY SOURCES FOR FUNDING I AGREE HAVING A BETTER INFORMATION OF WHAT IS OCCURRING WITH RESPECT TO FINANCIAL RESOURCES IS IMPORTANT BUT NOT DRAMATICALLY ANYWHERE I’M AWARE OF >> ONE THING YOU DIDN’T SAY BEFORE AND I’D LIKE TO EXPAND UPON, WE TALKED ABOUT THE LEVEL OF DISCOVERY I KNOW SOME OF US COULD DO BETTER I KNOW AT TIMES WHEN I’VE HAD MY MENTEES WITH ME, THEY GOT STRESS AND HEAVY WORK LOAD AND WE HEAR THINGS LIKE I DON’T WANT A CAREER WHERE I HAVE TO WORK SO MUCH WE WORK SO MUCH BECAUSE WE LOVE WHAT WE DO >> I SUPPORT THAT AND WHILE I CAN’T QUANTIFY IT I THINK WE’RE SOMETIMES NOT THE ROLE MODELS WE

COULD BE TO SEE HOW MEANINGFUL THE EDUCATION IS TO A REWARDING AND SATISFYING CAREER >> I WANT TO HIGHLIGHT THE AREAS OF VULNERABILITY FROM A FUNDING PERSPECTIVE CONTINUE INTO FACULTY AREAS AND WHEN CERTAINLY MEDICINE OFTEN IN NURSING ESPECIALLY, PEOPLE WHO GO INTO Ph.D.s EARLY IN LIFE ARE BUILDING FAMILIES AND THE REAL TENSION BETWEEN WORKING OVER FULL TIME AND HAVING CHILDREN AT YOUNG AGES IS EYE HUGE AREA WHERE PEOPLE SIMPLY STOP SO FUNDING FOR SURE FOR EARLY CAREER PROFESSIONALS, K AWARDS, THOSE SORTS OF WRITING AWARDS AND I DON’T WANT TO SPEAK OUT OF HAND BUT I WONDER WHAT THE TENSION IS BETWEEN THE VULNERABLE FACULTY AND MEDICINE WHERE YOU GET NOT SUCKED IN, IT’S A GREAT THING TO DO TO TAKE CARE OF PATIENTS BUT WHEN YOU CAN’T PROTECT YOUR OWN SALARY, YOU HAVE LESS AND LESS TIME >> GOOD POINT >> THERE’S A DIFFERENT TAKE ON THIS WE ALL KNOW THE FUNDING IS CRITICAL BUT I ALSO THINK THE REVIEWERS LOOKING INTO THE PROGRAMS ARE NOT DOING A GOOD JOB OFTEN THEY’RE COMING UP WITH COMMENTS WHICH ARE UNNECESSARY AND ALSO SHOWING THEIR CLUELESS MAYBE YOU SHOULD ALSO LOOK TO EDUCATION OF REVIEWERS BEING INVITED MAYBE ASKING WHAT IS A GOOD CONSTRUCTIONI CONSTRUCTIONIVE — CONSTRUCTIVE CRITICISM AND WHAT IS A GOOD CRITICISM WITH ENTHUSIASM >> THIS MAY BE A CHANGE OF TOPIC SO IF THERE’S STILL MORE CONVERSATION I’M HAPPY TO WAIT A MINUTE BUT A TOPIC IMPORTANT TO NINR THAT IS >> ONE OF THE THINGS THAT IS CLEAR IS PACE OF PRODUCTIVITY IS OFTEN OBSESSED AND THERE ARE NO OPPORTUNITIES I WOULD SAY IT’S NOT AT ALL — I THINK YOU WOULD VERY MUCH HESITATE IN EITHER AS A MENTOR WRITING A LETTER OR AS THE APPLICANT TO COMMENT ON OTHER FACTORS AFFECTING YOUR PRODUCTIVITY AS AN INVESTIGATOR I THINK THAT’S A CULTURAL ISSUE AND THERE’S AN OPPORTUNITY FOR THE NIH AND NINR TO ALLOW FOR AND HAVE INPUT RELATED TO WHAT’S GOING ON OUTSIDE OF YOUR CAREER TO BE ABLE TO ASSESS THAT PACE AND NOT NECESSARILY PENALIZE SOMEONE WHO HASN’T BEEN AS PRODUCT IT PRODUCTIVE AS THEIR PEER THOUGH THEY’RE TALENTED AND NOT HAVE A MECHANISM >> YOU DON’T THINK IT WILL CAPTURED IN SOME OF THE CHANGES MADE TO THE BIOSKETCH? >> I’M NOT 100% SURE >> ON THE BIOSKETCHES FOR F31s AND THE INSTRUCTIONS SPEAK TO SO THE ABILITY TO BE EXPLAINED YOU HAVE TO DO THAT CAREFULLY AND SOME IS ANXIETY ON THE PART OF THE APPLICANT ON MAYBE NOT

HAVING 20 PUBLICATIONS WHEN THEY GRADUATE FROM THEIR Ph.D PROGRAMS WHICH IS WHAT MOST DON’T HAVE THERE’S ANG SIDE ON WHAT YOU’LL NEED AND IT’S LARGELY MENTORING TO HELP INDIVIDUALS TELL THEIR STORY IN A WAY THAT’S ACCURATE AND IT’S REVIEWERS UNDERSTANDING PEOPLE COME FROM DIFFERENT PLACES AND DO DIFFERENT THINGS EVERYBODY DOESN’T LOOK THE SAME AND REEGD THE STORY THAT’S IN FRONT OF YOU AND NOT THINKING ABOUT THE STORY YOU READ TWO APPLICATIONS PREVIOUSLY >> I KNOW THERE’S BEEN DATA THAT SHOWS MOST STUDENTS WHO CLAIM TO SEE ACADEMIC CAREERS FEEL CONFIDENT IN CARRYING OUT THE ACADEMICS AND ONE AREA THEY FELT LESS CONFIDENT ABOUT IS REVIEWING AND WRITING GRANT PROPOSALS BUILDING ON WHAT YOU SAID, RITA AND I THINK THIS IS OBVIOUSLY A SPACE NINR COULD DO BETTER IN GETTING INFORMATION AND ENCOURAGE RESOURCES YOU HAVE AT NIH AND WITHIN OUR INSTITUTE TO HELP BUILD EXPERIENCE AND EXPOSURE TO THE PROCESSES >> WE’RE NOT A NEW IDEA BUT I SEE INCREASING DISCUSSION ABOUT AN INTEREST IN ADMISSION TO OUR Ph.D. PROGRAMS FROM INDIVIDUALS WHO ARE NOT NURSES AND THERE ARE SCIENTISTS AROUND THIS TABLE NOT NURSES AND CONTRIUTE TO NURSING SCIENCE I THINK ONE OF THE CHALLENGES WE HAVE IN TALKING ABOUT PATHWAYS TO CONDUCT NURSING SCIENCE IS HOW WHILE HELP THEM DEVELOP THE SKILLS THEY NEED TO CONTRIBUTE TO NURSING SCIENCE I THINK IT’S SOMETHING THEY SHOULD BE CONCERNED ABOUT AND SOME AREN’T NURSES EITHER BUT THEY’RE STILL CONTRIBUTING TO HOW THE SCIENCE OF NURSING IS DEVELOPING WE’RE WORKING ON HOW WE DO THAT WITHIN THE CONTEXT OF OUR CURN EDUCATIONAL PROGRAMS AND WILL THEY GET FUNDING THERE’S QUESTIONS ABOUT THAT AND I’M NOT SURE ACN HAS FORMALLY ADDRESSED THIS BUT WE DISCUSSED THIS AT THE Ph.D. CONFERENCE BUT NOT IN SYSTEMATIC WAYS >> THERE’S ONGOING DISCUSSION THERE ISN’T A POSITION PER SE I WOULD IS A FROM MY OWN PERSONAL EXPERIENCE AND THERE IS STRONG SUPPORT FOR OTHERS TO UNDERSTAND AND CONTRIBUTE AND IN THE NURSING COMMUNITY THERE’S WANING INTEREST IN BEING SCIENTISTS MOST THE CONVERSATION HAS FOCUSSED ON WHAT TO DO TO STIMULATE INTEREST WITHIN THE PROVISION AND WE’RE MAKING ADVANCES AND PEOPLE UNDERSTAND THE SCIENCE OF NURSING THEY’RE ALL GOOD POINTS THERE’S A LOVE OF DISCOVERY IN THIS ROOM AND WE’RE COMMITTED TO WORK WITH YOU AND THE LARGER COMMUNITIES THIS IS THE RESPONSIBILITY OF ALL OF OURS AND I DO BELIEVE THE FUTURE’S BRIGHT I THINK WE NEED TO BE EVEN MORE PURPOSEFUL ABOUT OUR ACTIONS IF WE DON’T WANT TO BE IN THIS

GROUP AND ANY OTHER PARTING QUESTION OR COMMENTS? I’LL TAKE YOUR FEEDBACK BACK TO OUR BOARD AND WE’LL HAVE DEEPER CONVERSATIONS IN THE DOCTORAL CONFERENCE IS THIS GOING TO BE ONGOING WORK NUN OF US THINK WE’LL SOLVE IT TOMORROW I THINK WE CAN CONTINUE TO TAKE BIG STEPS AND I’D LIKE TO BE ABLE TO SAY WHEN WE LOOK AT THE NEXT SET OF DATA, ONE WE HAVE INFORMATION ON WHAT WAS RAISED TODAY AND WE’RE SEEING A STRONGER INCREASE IN THOSE WHO ARE IN THE PROFESSION AND PURSUING THIS NOT ONLY FOR THE INTEREST OF OTHERS I THANK YOU VERY MUCH FOR GOOD CONVERSATION AND I HOPE HAVE YOU A GOOD AND RICH REST OF YOUR MEETING THANK YOU >> THAT WAS A THOUGHTFUL AND ROBUST CONVERSATION AND WE LOOK FORWARD TO THE REST OF THE CONVERSATION MORE THIS AFTERNOON SO THINK WE SHOULD GO AHEAD AND BREAK EARLY FOR LUNCH BUT BEFORE WE DO, JUST A COUPLE HOUSEKEEPING THINGS TYPICALLY WE ANNOUNCE GUESTS WE HAVE IN THE ROOM AND THERE’S ONE FROM ACN SOME ARE IN THE OVERFLEW FLOW ROOM AND WE HAVE — OVERFLOW ROOM AND WE HAVE VALERIE ADELSON AND CHRISTINE TOCHI FROM DUKE UNIVERSITY WE APPRECIATE ALL YOU ATTENDEES FROM OUTSIDE NINR AND NIH FOR TRAVELLING HERE TO ATTEND THIS MEETING I THINK WE CAN BREAK EARLY FOR LUNCH WHEN WE RETURN WE’LL HEAR FROM THREE EARLY-STAGE CAREER SCIENTISTS ABOUT THEIR EXPERIENCE TRAJECTORY AND HEAR ABOUT THE BARRIERS AND FACILITATORS THEY’VE EXPERIENCED LONG THEIR PATHWAY AND DR SHIRLEY MOORE HAS AGREED TO MODERATE THE PANEL Q&A FOLLOWING THEIR PRESENTATIONS SHIRLEY HAS EXPENSIVE EXPERIENCES WITH MENTOR AND INTEREST AND PASSION IN TRAINING JUNIOR INVESTIGATORS WE LOOK FORWARD TO THAT CONVERSATION AND DISCUSSION IN THE MEANTIME, ENJOY YOUR LUNCH CAFETERIA IS UPSTAIRS ON THE FIRST FLOOR BECAUSE WE’RE GETTING DONE A FEW MINUTES EARLY WHAT IF WE’RE BACK AT 12:30 TO SPEED THINGS ALONG AND GET MORE CONVERSATION IS THAT OKAY? NO? I SEE SOME YESES AND SOME NOS LONGER LUNCH? ALL RIGHT YOU TWISTED MY ARM LET’S BE BACK AT 12:45 ON THE DOT AND WE’LL GET STARTED THANK YOU ALL WE’RE GOING TO GET INTO OUR DISCUSSION WITH SOME TRAINEES WE’VE INVITED HERE TODAY FIRST UP IS MS. JACKELYN BOYDEN AT THE UNIVERSITY OF PENNSYLVANIA SCHOOL OF NURSING AND RECEIVED AN RSA INDIVIDUAL PRE-DOCTORAL FELLOWSHIP IN 2018 FOR HER DISSERTATION IN HOME-BASED PALLIATIVE CARE OUTCOMES AND SERVING AS A STUDENT MEMBER OF THE NURSING ASSOCIATION ON RESEARCH ADVISORY COUNCIL AND WORKED AS A NURSE-EDUCATED RESEARCHER AT A VARIETY OF PLACES IN THE D.C AREA SO WE WELCOME MS. BOYDEN TO COME GIVE A LITTLE BIT OF AN OVERVIEW OF HER CAREER PATH AND FIND SOME INFORMATION ABOUT WHAT HER EXPERIENCE HAS BEEN ONE IMPORTANT THING TO NOTE BECAUSE THIS IS COMING VERY SOON IT WILL BE HERE BEFORE SHE KNOWS IT SHE’S PLANNING TO GRADUATE IN MAY 2020 THAT’S EXCITING GOOD AFTERNOON THANK YOU FOR THE INTRODUCTION FORS THE OPPORTUNITY TO BE HERE TO SPEAK WITH YOU I HAVE NO CALENDARS AND WANT TO

ACKNOWLEDGE MY TWO FUNDING SOURCES AT THE NINR AND UNIVERSITY OF PENNSYLVANIA SCHOOL OF NURSING WHAT I HOPE TO ACCOMPLISH IS PROVIDE A BRIEF SNAPSHOT OF MY TURN FROM BSN NURSING STUDENTS TO A Ph.D. GRADUATE AND DURING THIS TIME I WAS HOPING TO SHARE THREE LESSONS I HAVE LEARNED I FEEL HAVE BEEN CRITICAL FOR FACILITATING THIS JOURNEY I’LL START HERE WITH MY JOURNEY I RECEIVED MY BSN FROM THE UNIVERSITY OF MICHIGAN AND STARTED AS A PEDIATRIC INTENSIVE CARE NURSE IN THE CHILDREN’S HOME PHILADELPHIA AND RECEIVED A MASTERS IN NURSING FROM PUBLIC HEALTH IN CHICAGO AND WORKED IN LONG-TERM CARE AND POS TIS — HOSPICE AS A NURSE EDUCATOR IN THE D.C. AREA AND AN ALONG THIS JOURNEY WHILE I FEEL I HAVE MANY LESSONS I SHARE THREE HERE I FEEL ARE CRITICAL ALONG THE WAY LESSONS ARE THIS LESSON ONE IS TO FIGURE OUT WHAT DRIVES YOU LESSON TWO IS TO BUILD LIFE COURSE AND LESSON THREE IS TO SEEK AND BE READY FOR OPPORTUNITIES LESSON ONE TRYING TO FIGURE OUT WHAT DRIVES YOU I THINK I WAS FORTUNATE EARLY ON TO FIND OUT WHAT I WAS INTERESTED IN CLINICALLY AND PASSI PASSIONATE ABOUT PEDIATRICS, I’LL START THERE I THINK I LEARNED PRETTY EARLY ON IN MY UNDERGRADUATE PROGRAM IN MICHIGAN I VERY MUCH ENJOYED WORKING WITH CHILDREN BUT IT WASN’T UNTIL I STARTED WORKING AT A BEDSIDE NURSE IN ICU I FOUND IT WAS A PASSION OF MINE AND KNEW AS MUCH AS AS I LOVED HELPING CHILDREN AT THE HOSPITAL UNFORTUNATELY FOR SOME FAMILIES IT WOULD NOT [INAUDIBLE] FOR THEM AND I WANTED TO HELP THESE FAMILIES AND EXPERIENCES RECEIVE THE BEST CARE AND BECAME A DRIVER IN ANY NEXT STEPS IN ANY JOURNEY AND I WAS FORTUNATE TO HAVE EARLY EXPERIENCES FOR EXAMPLE AT MICHIGAN AT MICHIGAN I WAS ONE OF SIX STUDENTS THAT HAD A CHANCE TO COMPLETE A ROTATION IN HOSPICE DURING ANY UNDERGRADUATE PROGRAM SO IT PARKED MY INTEREST AND WORKED IN PALLIATIVE AND END OF LIFE CARE IT WASN’T UNTIL I WAS WORKING AS A NURSE EDUCATOR I HAD THE OPPORTUNITY TO WORK WITH PROVIDERS AND NURSES AND SOCIAL WORKERS WITHIN AN ORGANIZATION IN A COMMUNITY SETTING I LEARNED DURING THIS TIME NAH WORKING WITH CHILDREN AT THE END OF THEIR LIFE IS A DEEP DISCOMFORT AND PREVENTED SOME CHILDREN AND FAMILIES FROM RECEIVING THE HIGHEST LEVEL OF CARE WE COULD SEE IN THE HOME SETTING ADDRESSING THIS BECAME THE NEXT DRIVER IN ANY JOURNEY AND FINALLY HOME AND COMMUNITIES CARE PARTICULARLY MASTERS OF PUBLIC HEALTH PROGRAM IT DROVE HOME FOR ME THE LESSON THAT NO INDIVIDUAL TRULY LIVED IN A SILO AND THE HEALTH AND WELL BEING OF EVERY PERSON IS DEEPLY AND INTIMATELY CONNECTED TO THE HOME AND COMMUNITY SETTING SO I HAD DONE A SIGNIFICANT PORTION OF MY RESEARCH I KNOW WE HAD DISCUSSIONS ON THIS EARLY IN THE MORNING BUT IN MY SITUATION THESE AREAS OF INTEREST HAD INFORMED MY RESEARCH IN TABULATING MY CAREER GOING FORWARD LESSON TWO, BUILD YOUR TEAM OF MENTORS AND I’D LIKE TO SHARE WITH YOU WHAT DRIVES ME AND WHAT KEEPS ME UP AT NIGHT BESIDES MY CHILDREN, OF COURSE WITHOUT THE SUPPORT, GUIDANCE AND CHEER LEADING OF MANY MENTORS ALONG MY JOURNEY I COULD TRULY NOT BE WHERE I AM TODAY

WITHOUT THEM WHILE I HAVE WORKED WITH MANY MENTORS IN THE INTEREST OF TIME I WANT TO INTRODUCE A FEW OF THEM THAT PLAY AN IMPORTANT ROLE AND WILL IN THE NEXT SEVERAL YEA YEARS HELPED MY CAREER THESE WERE MY MENTORS DURING MY MASTER’S PROGRAM AND INTRODUCED ME TO THE WORLD OF PALLIATIVE CARE RESEARCH DR. STEPHEN CONNOR ALSO IN THE TOP ROW WAS A MENTOR IN HOSPICE AND HELPED TO SUPPORT MY DECISION TO GO BACK FOR MY Ph.D AT THE TIME AND THE FOUR INDIVIDUALS ON THE FINAL ROW ARE THE FOUR PEOPLE WHO ARE PART OF MY DISSERTATION COMMITTEE AND THEY HAVE BEEN INSTRUMENTAL IN SUPPORTING ME FROM BEFORE I GAINED MY Ph.D. TO WHERE I AM TODAY IN COMPLETE MIG RESEARCH PROJECT AND PLANNING THE NEXT STEPS ALONG MY CAREER FINALLY, LAST BUT NOT LEAST THIS PERSON IS THE MOST RECENT ADDITION TO MY TEAM OF MENTORS I’M VERY GRATEFUL FOR HIS KNOWLEDGE AND GUIDANCE AND HIS OVERALL VERY SUPPORTIVE TRANSITION IN THE PAST YEARS OF MY CAREER AND AGAIN WITHOUT THE SUPPORT AND GUIDANCE OF THESE MENTORS IN MY LIFE I WOULDN’T BE WHERE I AM TODAY WITHOUT THEM LESSON THREE, SEEK AND BE READY FOR OPPORTUNITIE AGAIN, I’VE BEEN FORTUNATE AND HAD MANY OPPORTUNITIES ALONG MY CAREER AND WANT TO SHARE TWO TODAY AND I’LL START WAY PICTURE ON THE TOP LEFT THAT WAS A PICTURE I TOOK MY FIRST DAY OF MY Ph.D. PROGRAM AND I WAS ALSO WITH MY FIRST DAUGHTER SHE WAS BORN THAT VERY WEEKEND NOT GREAT TIMING I’M GRATEFUL TO BE TRAINING AT PENN FOR MANY DIFFERENT REASONS AND I THINK THE FIRST REASON IS THAT I’VE HAD THE OPPORTUNITY TO TAKE COURSES AND LEARN FROM MANY DIFFERENT PROFESSORS FROM MANY DIFFERENT SCHOOLS NOT JUST AT THE SCHOOL OF NURSING BUT SCHOOL OF MEDICINE AND EDUCATION AND BUSINESS SCHOOL AND I THINK HAVING AN OPPORTUNITY TO LEARN FROM SO MANY DIFFERENT PERSPECTIVES HAS HELP ME ENHANCE MY OWN PERSPECTIVE AND BROADEN MY RESEARCH BEING AT PEN I ALSO HAD THE OPPORTUNITY TO WORK WITH PROVIDERS AT CHILDREN’S HOSPITAL NEXT DOOR AND I WORKED FROM THE VERY BEGINNING WHERE I BEGAN ATTENDING THEIR WEEKLY CLINICAL TEAM MEETINGS I THINK IT WAS AN OPPORTUNITY FOR ME TO STAY CLINICALLY GROUNDED IN THE PROGRAM ALSO, THIS TEAM OF PROVIDERS HAS SUPPORTED ME IN MY RESEARCH PROJECT FROM THE BEGINNING DAYS OF MY DESIGN OF THE PROJECT SO WHERE I AM TODAY I’M VERY GRATEFUL TO THEM AND FINALLY, BEING AT PENN I MENTIONED I HAD MY DAUGHTER THE FIRST WEEK OF CLASS AND BEING A RATHER NAIVE FIRST-TIME MOM I HAD NO IDEA HOW HARD IT WOULD BE TO HAVE A BABY IN THE FIRST PLACE LET ALONE TWO BABIES AND BE IN A Ph.D. PROGRAM AND I THINK THE UNIVERSITY HAS BEEN VERY SUPPORTIVE OF ME IN HELPING ME FIND THAT BALANCE IN MY PERSONAL AND PROFESSIONAL LIFE AND I TOOK A SEMESTER OFF AND SPENT TA TIME LEARNING HOW — THAT TIME LEARNING HOW TO BE A MOM IN THE FIRST PLACE AND LIFE INTO MY CAREER.T PART OF MY OF COURSE THIS IS STILL A WORK IN PROGRESS BUT I’D LIKE TO THANK THE UNIVERSITY FOR HAVING SUPPORT MED AND FOR MANY REASONS AND I’M ABLE TO FOCUS MY TIME AND ENERGY ON MY RESEARCH TRAINING WHICH VERY IMPORTANT AND THE FELLOW-HAS PROVIDED

FUNDING FOR WORK IN MY FIELD AND PROVIDING DOLLARS TO CARRY OVER RESEARCH PROJECT OF COURSE I’M VERY GRATEFUL AND SO THE LAST THING HERE IS I THINK NO MATTER WHERE YOU ARE TO LOOK FOR THE OPPORTUNITIES THAT WILL FACILITATE YOUR CAREER AND BE READY FOR THEM EVEN WHEN YOU MAY NOT FEEL READY AND I MENTIONED MY DISSERTATION AND I’D BE HAPPY TO TALK ABOUT IT LATER AND TO EVALUATE CARE AND EXPERIENCES WITH HOME-BASED PALLIATIVE CARE FOR FAMILIES AS YOU CAN SEE IT’S A CULMINATION OF ALL MY PASSIONS FROM PEDIATRICS TO PALLIATIVE AND HOME-BASD CARE I’M FINISHING UP DATA COLLECTION HOPEFULLY IN THE NEXT COUPLE WEEKS I’LL BEGIN A FORMAL ANALYSIS AND WRITE-UP SHORTLY AFTER THAT THE NEXT STEPS IS I’M PLANNING A DISSERTATION IN APRIL AND GRADUATE IN MAY I WILL THEN BEGIN A POST-DOC FELLOWSHIP IN CHOCK AND I APPLIED IN DECEMBER AND BEYOND THAT I OBTAIN A NURSE FACULTY POSITION JUST TO SUMMARIZE MY CLINICAL INTERESTS FROM MY INCREDIBLE TEAM OF MENTORS THAT HAVE FACILITATED MY JOURNEY AND I CONTINUE TO WORK TOWARDS ANY CAREER GOAL WHICH IS TO IMPROVE PALLIATIVE AND HOSPICE CARE PROVIDED TO ALL CHILDREN AND FAMILIES AND PARTICULARLY THOSE WHO SPEND THE LAST SEASON OF LIFE AT HOME WITH THIS, THANK YOU TO THE NINR FOR THE OPPORTUNITY TO BE HERE AND SUPPORTING MY RESEARCH AND DR. MILLER AND FOR THE INVITATION TO BE HERE AND AGAIN I WANT TO THANK MY COLLEAGUES THANK YOU SO MUCH >> JUST A REMINDER WE’LL SAVE QUESTION FOR THE PANEL DISCUSSION NEXT UP WE HAVE DR. MARK LOCKWOOD AND DR. LOCKWOOD’S PASSION FOR CLINICAL RESEARCH BEGAN SOON AFTER STARTING HIS NURSING CAREER IN ST. LOUIS, SORRY, WASH-U OVER HIS MORE THAN TWO DECADE NURSING CAREER HIS ACQUIRED SKILES IN PURCHASE PROTOCOLS INCLUDING NOVEL MEDICATIONS AN MEDICATION ADHERENCE AND HEALTH INEQUITIES AMONG KIDNEY TRANSPLANT RECIPIENTS IN 2012 HE WAS ACCEPTED DO THE SCHOOL OF NURSING AND HIS DISSERTATION WORK INCLUDED THREE IMPORTANT STUDIES EXAMINING FACILITATING AND BARRIERS TO THE PRE-KIDNEY TRANSPLANT EVALUATION HE HAS COMPLETE THE NINR SUMMER GENETICS INSTITUTE FELLOWSHIP AND IN 2019 HE WAS AWARDED A KA23 MENTOR, PATIENT-ORIENTED CAREER RESEARCH DEVELOPMENT AWARD FROM NINR ENTITLED STUDIES IN GUT MICROBIOTA AND SYMPTOMS AND PRE AND POST KIDNEY TRANSPLANT PATIENTS WITH THAT I’LL TURN IT OVER >> THANK YOU, EVERYONE I APPRECIATE THE OPPORTUNITY TO BE HERE TO TALK ABOUT MY JOURNEY TO BE A NURSE SCIENTIST AS YOU CAN TELL FROM THE TITLE THE NURSE SCIENTISTS AND MENTORS PLAYED AN IMPORTANT ROLE IN MY PROGRESS I WANT TO TALK ABOUT THE TIME LINE OF MY NURSING CAREER AND TALK ABOUT FACILITATORS AND BARRIERS AND WAYS TO ENGAGE EARLY CAREER NURSES IN NURSING SCIENCE I KNOW THIS IS AN INCREDIBLY BUS SLIDE BUT I WANT TO POINT OUT THREE THINGS ON HERE FIRST THING IS MY NURSING CAREER UNFOLDED IN THREE PHASES THE FIRST PHASE WAS MY EARLY TRAINING AND TIME AS A CRITICAL CARE NURSE MY SECOND PHASE AND LONGEST PHASE WAS MY TIME AS A CLINICAL RESEARCH NURSE AND CURRENT PHASE NOW IS AS A NURSE SCHOLAR AND NURSE SCIENTIST I ALSO WANT TO POINT OUT IN 2009 MY TRAJECTORY CHANGED WHEN I ENTERED THE MSN PROGRAM AT

LOYOLA UNIVERSITY IN NEW ORLEANS FINALLY, I WANT TO POINT OUT AS YOU CAN SEE FROM THE TIME LINE THERE WAS A 12-YEAR DELAY IN RECEIVING MY EDUCATION IN RECEIVING MY BACHELOR’S DEGREE AND WE’LL TALK ABOUT THE FACILITATORS AND BARRIERS AS I WENT THROUGH IB PHASE ONE I WORKED IN THE THORACIC CAREER AND THERE WAS AN INTENSIVE CLINICAL TRAINING PROGRAM THERE I HAD A LOT OF NURSE FACILITATORS BUT NOT MENTORS AND IT WAS MY FIRST EXPOSURE TO RESEARCH THOUGH WAIT MINIMAL ROLE I — THOUGH IT WAS A MINIMAL ROLE I PLAYED I WASN’T THINK ABOUT NURSING AS SCIENCE AT THIS POINT I WAS THINKING OF NURSES AS CLINICIANS AT THIS POINT AND PROBABLY BECAUSE I DIDN’T HAVE ACCESS TO MASTERS OF NURSES AT THIS POINTS AFTER A FEW YEARS I MADE THE TRANSITION TO MY ROLE AS A CLINICAL RESEARCHER AT WASHINGTON UNIVERSITY IN ST. LOUIS I BEGAN TO HAVE RESEARCH MENTORS AS PART OF MY CAREER TRAJECTORY I BEGAN WORKING EXCLUSIVELY WITH KIDNEY TRANSPLANT PATIENTS AND GAINED EXPERTISE AS A RESEARCHER AND BECOME CERTIFIED BY THE FIRST PROFESSIONAL ORGANIZATION I BELONGED TO THOUGH I WASN’T ACTIVE JUST A MEMBER BECAUSE OF SE CERTIFICATION AND I DOESN’T HAVE ACCESS TO MENTORS AND I THINK AT THIS POINT IN MY CAREER I WAS LACKING CONFIDENCE AND DIDN’T HAVE THE ROLE MODELS TO GUIDE ME AND CONSIDERED PURSUING MY MASTERS DEGREE BUT FINANCIAL CONSTRAINTS MADE IT NOT POSSIBLE AT THAT POINT IN 2009 THIS WAS A MAJOR PIVOTAL TIME IN MY TRAJECTORY THIS IS WHEN I WAS WORKING AT THE UNIVERSITY OF CHICAGO AND STARTED AN ONLINE PROGRAM AT LOYOLA UNIVERSITY AND A COLLEAGUE DECIDED TO GO THROUGH THE PROGRAM AND ASKED IF I’D GO THROUGH IT WITH HER AND I SAID WHY NOT BECAUSE THERE WAS 100% TUITION REIMBURSEMENT AND I THOUGHT I’D GIVE MYSELF A RAISE THIS IS GREAT IT TURNED OUT TO BE MORE BECAUSE I GOT MY FIRST EXPOSURE TO NURSE SCIENTISTS WHOSE WORK WAS CHANGING HEALTH CARE WHICH WAS EXCITED AND JOINED THE TRANSPLANT NURSES SOCIETY AT THE TIME AND GAVE ME EXPOSURE TO A MULTITUDE OF NURSE SCIENTISTS VERY ACCOMPLISHED WORKING WITH ORGAN TRANSPLANT PATIENTS AT THIS POINT I ACTIVELY SOUGHT OUT MENTORS AND LEADERSHIP ROLES AT THE UNIVERSITY OF CHICAGO I WAS THE CO-CHAIR OF THE PRACTICE AND RESEARCH COUNCIL AND THROUGH THE SEEKING OF MENTORS EVENTUALLY CAME ACROSS WHO BECAME MY DISSERTATION CHAIR CHRISTOPHER LEE WHO WAS A WONDERFUL MENTOR AND EXCELLENT NURSE SCIENTIST SO FROM THAT 12-YEAR PERIOD I DIDN’T HAVE ACCESS TO NURSE SCIENTISTS AND NOW I’M IN THE PROGRAM AND NOW DRAWING NURSE SCIENTISTS AN MENTORS FROM THREE DIFFERENTD MENTORS FROM THREE DIFFERENT AREAS FROM MY EDUCATION AND PROFESSIONAL SOCIETY AND MY WORK AT THE UNIVERSITY OF CHICAGO AT THE END OF 2016 I ACCEPTED A POSITION AT THE UNIVERSITY ILLINOIS OF CHICAGO AND HAD THE ORGANIZATION VFD — INVEST IN ME THROUGH GRANT AWARDS AND I CONTINUED ADDING TO MY LIST OF MENTORS FANTASTIC NURSE SCIENTISTS AT UIC AND SCIENTISTS AND OTHER PHYSICIANS UIC ALSO OFFERED RESOURCES TO BUILD ANY CONFIDENCE GRANT-WRITING WORK SHOPS AND IT HELP IMPROVE MY CONFIDENCE AND MY SKILL NOW, AT THE TIME I GRADUATED I DIDN’T HAVE THE FINANCIAL RESOURCES TO PURSUE I POST-DOC I THE COLLECT OF NURSING — COLLEGE OF NURSING ALLOWED ME TO APPLY FOR THE SUMMER GENETICS INSTITUTE OF 2017 AND I’M A GRADUATE OF THE CLASS OF 2017 AND THIS WAS CRITICAL BECAUSE I WAS LOOKING TO CHANGE MY PROGRAM

OMICS WAS BECOME HOT AREA AND I WANTED TO BE PART OF THE OMICS REVOLUTION OCCURRING AND THE SUMMER GENETICS INSTITUTE ALLOWED ME TO EXPAND MY INFORMATION OF GENOMICS SO I COULD GO BACK TO MY INSTITUTION AND COLLEAGUES AND COLLABORATORS WHO ACTUALLY HAD BECOME PART OF MY TEAM TODAY AND HELPED ME WRITE MY K23 APPLICATION AND LED TO ADDITIONAL TRAINING RELATED TO THE MICROBIOME I WAS FORTUNATE AT THE END OF 2019 AND HERE’S MY EXCELLENT TEAM THE FOCUS OF THE STUDY WE’RE LOOKING AT CHANGES IN ORGAN GUT MICROBIOTA AND THE SEVERITY OF PATIENT-REPORTED SYMPTOMS AFTER TRANSPLANT EVEN AFTER PATIENTS HAVE THE TRANSPLANT A LOT OF PATIENTS STILL HAVE SYMPTOMS AND I BECAME INTERESTED IN GUT BUY — BIOME AND WE TAKE SAMPLES BEFORE THE TRANSPLANT AND LOOK AT GENOMICS SEQUENCING TO LOOK AT THE GENE CONTENT AND SEE HOW IT’S ASSOCIATED WITH DIFFERENT OUTCOMES INCLUDING SYMPTOM PHENOTYPES SO WHAT ARE SOME THINGS WE CAN DO TO HELP ENCOURAGE EARLY CAREER NURSES TO PURSUE A CAREER IN NURSING SCIENCE? REDUCING FINANCIAL DISINCENTIVES IS CRITICAL THAT TUITION REIMBURSEMENT CHANGED THE TRAJECTORY OF MY CAREER AND WAS VERY IMPORTANT INCREASE NURSE’S EXPOSURE TO NURSE SCIENTISTS AND I’M ALWAYS AMAZED HOW FEW KNOW WHAT A NURSE SCIENTIST IS FIRST REDUCING FINANCIAL DISINCENTIVES THIS IS FROM A STUDY OF NURSES THAT COMPLETED THEIR ASSOCIATES DEGREE AND ASKED WHAT WERE BARRIERS TO PURSUING A MASTER’S DEGREE AND FINANCIAL DISINCENTIVES WERE NUMBER ONE TUITION REIMBURSEMENTS ARE VERY IMPORTANT IF I HAD NOT HAD THAT AVAILABLE TO ME I PROBABLY WOULDN’T HAVE PURSUED MY MASTER’S DEGREE OR BE STANDING HERE BUT WORK IN INDUSTRY LOAN FORGIVENESS IS IMPORTANT TOO IF STUDENTS HAVE TO TAKE ON A LOAN OR STUDENT LOAN OR AN EXPECTATION THERE’S LOAN FORGIVENESS AT THE END THAT MAY BE A WAY TO INCENTIVIZE NURSES AGAIN, THIS IS TAKEN FROM THE NIH LOAN REPAYMENT PROGRAM WEBSITE YOU CAN SEE THE NINR DIDN’T PARTICIPATE IN THE PROGRAM FOR A WHILE BUT THEY’RE STARTING TO AGAIN THIS IS IMPORTANT THIS IS A WAY TO INCENTIVIZE NURSES TO TAKE ON THE BURDEN AND THERE’S AN EXPECTATION THEY MAY HAVE A LOAN FORGIVENESS BY THE TIME THEY’RE DONE AGAIN, IT’S IMPORTANT WE’RE MENTORING THE EARLY CAREER NURSES TOO EARLY IN MY CAREER I DIDN’T HAVE ACCESS TO LOAN ACCESS WE NEED TO INCREASE EXPOSURE TO EARLY CAREER NURSES WE CAN DO THIS THROUGH DOUBLE MENTORING PROGRAMS AND MORE IMPORTANTLY WE NEED TO LEVERAGE THE CONTINUUM THROUGH PROFESSIONAL NURSING MODELS THERE’S SOME THAT HAVE BEEN PROPOSED AND IT’S FOCUSSED ON Ph.D. PREPARED FACULTY AND WORKING WITH DMP STUDENTS IT NEEDS TO EXPAND BEYOND THE HALLS OF ACADEMIA AND GET INTO THE CLINICAL SETTING BECAUSE THAT’S WHERE WE’LL BE RECRUITING OUR BEST AND BRIGHTEST AND IT’S IMPORTANT TO DEVELOP STRATEGIES FOR M.S. BASED PRACTICE AND Q.I AS PART OF THE NURSING CULTURE THIS SHOULDN’T BE A SIDE PROJECT IT NEEDS TO BE INCORPORATED INTO THE JOBS EXPECTATIONS WE NEED TO RAISE THE PROFILE OF CAREER SCIENTISTS LEVERAGE SOCIAL MEDIA PROGRAMS AND DO WE NEED A REPRESENTATIVE FOR NURSING SCIENCE? WE ALL KNOW THE SCIENCE WE DO IS

VERY EXCITING AND IT IMPACTS THE COMMUNITY AND WE SHOULD LET PEOPLE KNOW SO SOME OF THE THINGS AND LOOKING AT Q.I. AND THE MASTER’S PROGRAM GAVE ME THE SPARK TO ASK MY OWN QUESTIONS AND THAT WAS TRANSFORMATIONAL FOR ME AND JOINING PROFESSIONAL ORGANIZATIONS AND ACCESSING MENTORS AND BEGINNING TO ACTIVELY SEEK OUT MENTORS AND MY WILLINGNESS TO ADAPT AS OPPORTUNITIES APROSE SO THE MAIN KEY POINTS IS I THINK EARLY CAREER NURSES WE NEED TO FIND A WAY THEM TO UNDERSTAND THE SCIENCE WE DO A LOT OF TIMES THINGS STAY IN THIS ROOM AMONG THE SCHOLARS AND WE NEED TO FIND A WAY TO CON ICT BETTER THROUGH OUR — CONNECT EARLY THROUGH OUR EARLY CAREER NURSES THANK YOU >> NEXT UP WE HAVE DR. MINISSIAN A CLINICAL LIPID SPECIALIST AND CARDIOLOGY CENTER AT THE SCHMITT HEART INSTITUTE AT CEDAR-SINAI AROUND PART OF THE POSTPARTUM REGISTRATION AND REPOSITORY TO IDENTIFY AND RISK STRATIFY AND TREAT WOMEN WITH ADVERSE PREGNANCY OUTCOMES IN HER EARLY NIH FUNDED STUDY IS ASSOCIATED WITH FOSTERING OF MATERNALCARDIO MARKERS AND RECEIVED MANY AWARDS AND SHE WAS MOST RECENTLY AWARDED A K99S, ROO FOR SPONTANEOUS DELIVERY AND ECLAMPSIA AND HAS BEEN INVOLVED IN LOTS OF GROUPS AND HAS RECEIVED THE FIRST NURSE TO RECEIVE THE OUTSTANDING ADVOCATE OF THE YEAR AWARD BY THE AMERICAN COLLEGE OF CARDIOLOGY AND THE COLLEGE TO REDUCE ETHNIC DISPARITIES IN CARDIOVASCULAR OUTCOMES THANK YOU FOR COMING >> THANK YOU SO MUCH SUCH AN ABSOLUTE PLEASURE TO BE HERE TODAY AND THIS PICTURE OF DR. BANKS AND I STANDING NEXT TO YOUR SIGN, I WAS IN THIS LOVELY YOUNG LADY’S CHAIR AS A GUEST NOT AS A PRESENTER THAT’S A WONDERFUL HONOR I WAS SUCH IN AWE AND IT’S A PLEASURE TO BE HERE THANK YOU SO MUCH FOR THE INVITATION FOR ALL OF US WITH KIDS IN THE ROOM, SEE A NEED, FILL A NEED THAT’S WHAT WAS DRIVING MY CAREER GOAL I WAS AN ACUTE CARE NURSE PRACTITIONER AND STUDENT AT UCLA I HAD GRADUATED FROM THIS COMBINED PROGRAM IN 2005 AND STEPPED INTO MY VERY FIRST ROLE AS AN ACUTE CARE NURSE PRACTITIONER CHARGED WITH STARTING A WOMAN’S HEART PROGRA IN LOS ANGELES AT CEDAR-SINAI SO 15 YEARS LATER WITH A $37 MILLION ENDOWMENT FROM BARBRA STREISAND WE’RE THE BARBARA STRI STREISAND WOMEN’S HEART CENTER AND HAVING THE OPPORTUNITY TO BE WITH MANY DIFFERENT MENTORS BEING IN THE CLINICAL AND SEEING GAPS IN CARE I STARTED IN HEART FAILURE I’M AN OLD ICU NURSE FROM OVER 20 YEARS AGO AND I GOT SICK FAST OF WATCHING PEOPLE DIE TOO YOUNG IN OUR ICUs HAVING A WAY TO GO INTO PREVENTION AND I GOT A BOARD CERTIFICATION AS A LIPID SPECIALIST BECAUSE ALL THESE WOMEN WITH STATIN MYALGIAS AND I SPEAK ON THE TOPIC ALL THE TIME BECAUSE IT CONTINUES TO BE A PROBLEM HAS BEEN MY MANTRA, I FEEL, IN LIFE UP TO THIS POINT

WE HAD 20 DIFFERENT STUDIES ONGOING IN EVERY SINGLE MOMENT AND I STARTED COORDINATING STUDIES FOR OUR MEDICAL DIRECTOR AND STARTED TO TOY WITH IDEAS AND GOT MY FIRST $5,000 GRANT FROM THE LIPID ASSOCIATION WHICH I WAS SO PRIVILEGED THEY GAVE ME MONEY TO DO SOMETHING THAT I LOVED THAT I THOUGHT WELL, HEY, I’M GOING TO DIVE INTO RESEARCH, A Ph.D. WHY WOULD I NEED TO GO BACK TO SCHOOL I HAVE A CHEMISTRY UNDERGRAD AND BACHELOR’S OF SCIENCE AND NURSING BECAUSE UCLA DIDN’T ACCEPT BACHELOR’S IN CHEMISTRY THOUGH I HAD AN R.N. AND HAVE AN ASSOCIATE’S DEGREE IN NURSING NOT SURE IF I MENTIONED THAT YOU START TO THINK ABOUT ALL THESE EXTRA YEARS OF SCHOOL SO DR. KAREN HAD HU — HUSK IMPACT MED SIG — IMPACTED ME IN A MUTHE — HUGE WAY IN 2010 I WAS IN THEIR SCIENTIFIC SESSIONS IN THEIR YOUNG FACULTY INVESTOR — INVESTIGATOR DAY WHERE THEY TAILOR THE CARE FOR YOUNG Ph.D STUDENTS I WAS ABSORBING THIS INFORMATION I WAS SO ENCOMPASSED BY WHAT I WAS LEARNING AND THINKING I DON’T KNOW FLUFF TO KNOW I DON’T KNOW ENOUGH AND I ASKED MER TO TALK WITH ME AND SHE WAS GRACIOUS WITH HER TIME AND SAID IF YOU WANT TO MAINTAIN INTELLECTUAL PROPERTIES ON YOUR IDEAS A Ph.D. SIS A MUST AND I WROTE MY APPLICATION AT THE MEETING AND HAD IT SUBMITTED BY DECEMBER 1 AND I GOT IT IN A WHIRLWIND BUT IT TOOK ME TWO TO THREE YEARS TO REALLY THINK ABOUT HOW ON EARTH I WAS GOING TO BEING ABLE TO FUND MYSELF AND COVER MY TIME IN CLINICAL BECAUSE I WAS GOING TO GO BACK AND GET A Ph.D I WANTED TO HAVE ENOUGH TIME WITH IT WITH THAT BEING SAID DESPITE ALL THIS WONDERFUL INFORMATION I FEEL YOU NEED TO HAVE AN AHA MOMENT WITH YOUR TOPIC AS YOU HEARD OTHER PRESENTERS TODAY ALL HAVE THIS IDEA THAT COMES TO THEM AND IT NEEDS TO SPARK INTEREST THIS IS DR. JANET EDWARDS AND SHE’S AT CEDAR-SINAI AND A MISSED DINNER WITH HER IN PRESENTING MY BECAUSE COINCIDENTALLY THE TIMINGS WERE THE SAME SHOW SHE WAS A PRESENTER AND PREGNANCY SERVES AS THE FIRST TEST AND INCREASED MORTALITY IN YOUNG WOMEN WITHIN WEEKS AFTER THEY DELIVER UP TO DAY SIX IT’S SIGNIFICANT AND SO I WAS SITTING BETWEEN THE DIRECTOR OF THE WOMEN’S HEART CENTER AND THOUGHT THIS IS MY TOPIC THIS IS WHAT I’M GOING TO GO AFTER IT’S PERFECT IT’S NOT TOO BROAD IT’S NOT TO NARROW AND OVER THE BRANCH OF LOVING EVERYTHING CARDIOVASCULAR PREVENTION THIS IS THE PHASE I TARGET MY CURRENT IDEAS IN RESEARCH INTERVENING TO AVOID A DISEASE ALTOGETHER WHEN I WAS STARTING TO GET READY FOR THE Ph.D. PROGRAM I REALLY WISHED THEY WOULD HAVE HAD A WORKSHOP PRIOR TO STARTING IT BECAUSE THEY DON’T REALLY SHARE WITH YOU YOUR QUESTION FLUSHED OUT ON THE FIRST DAY YOU GET THERE LU LUCKILY FOR THE I HAD A TOPIC AND I CAME FROM A VERY DEVELOPED

RESEARCH INSTITUTE BUT IF YOU DON’T HAVE THAT, I HAD 12 COLLEAGUES AND I WATCHED THEM FLUSTER WITH IT BECAUSE THEY’RE TRYING TO FINAGLE WITH A TOPIC AND SOME COULD THE FRUSTRATED AND COULDN’T SWITCH TOPICS WHICH WAS KIND OF SUICIDAL WATCHING IT BECAUSE YOU HAVE TO SUBMIT YOUR WRITTEN WORK AND IF YOU DIDN’T SUBMIT ALL THE COURSE WORK ON YOUR TOPIC YOU WERE UP ALL NIGHT RE-WRITING THINGS YOU HAD DONE IN ASSIGNMENTS PRIOR I HAD A FAIR AMOUNT OF PUBLICATION STEPPING INTO THE PROGRAM WHICH WAS HELPFUL BUT AS WE ALL KNOW IF YOU WANT TO BE COMPETITIVE FOR THE PRE-DOCTORAL AWARDS HAVING PUBLICATIONS REALLY IS A FEATHER IN YOUR CAP THE THREE YEARS IT TOOK FOR KNOW FIGURE OUT HOW I’D PAY FOR ELEMENTARY SCHOOL WHICH WAS $20,000 A YEAR COMPARED TO MY $5,000 A YEAR, LUCKILY MY HUSBAND SAYS, WELL, I DON’T KNOW AS THE YEAR GOES BY AND THE pAPPLICATION’S IN BOTH MY BOSS AND HUSBAND WHO HEAVILY RELY ON ME FOR MANY DIFFERENT THINGS ARE LIKE, I DON’T KNOW, DO YOU REALLY NEED THE Ph.D MY HUSBAND’S LIKE WE CAN’T AFFORD IT TOO MANY PEOPLE, SCHOOL, I DON’T KNOW IT WAS A HUGE SACRIFICE MY HUSBAND IS A SAINT FIT — IF IT WASN’T FOR HIM I WOULDN’T HAVE BEEN SO SUCCESSFUL WE WERE ABLE TO FINAGLE IT OUT AND I WAS A DEAN SCHOLAR AWARDEE SO THAT MADE IT FINANCIALLY REALISTIC FOR ME WHEN WE START THINKING ABOUT OPT OPTIMIZING THE WORK AND IF THERE WAS A WORKSHOP OF THE NITTY-GRITTY Ph.D.s THAT WOULD HAVE BEEN GREAT THIS IS MY FIRST PAPER I WROTE IN MY PROGRAM WAS MY LITERATURE REVIEW I TURN INTO A MINI META-ANALYSIS AND GET IT IN THESE ARE WONDERFUL PUTTING THEM IN OUR BACK POCKET AND GRANT OFFICERS OUR RELATIONSHIP WITH NINR, IF IT WASN’T FOR DR. BANKS AND DR HUSK I PROBABLY WOULDN’T HAVE THE CLOSE RELATIONSHIP HERE NOW, SEVEN, EIGHT YEARS WORK CLOSELY TOGETHER AND HAVING AND HAVING AN OPPORTUNITY AND I’VE HAD A WITH WITH A — WEALTH OF INFORMATION AND THAT WAS A WIN FOR ME AND ALLOWING THAT SAME OPPORTUNITY FOR OTHERS WOULD BE HELPFUL INCREASING STIPENDS FOR STUDENTS TO TRAVEL SPECIALTY MEETING WHERE NINR OFFICERS ATTEND AND IF YOU’RE GOING TO THE D.C. AREA, PLEASE GO MEET WITH YOUR MENTOR AND YOU NEVER KNOW WHO YOU’RE GOING TO MEET I HAPPENED TO MEET THE AUTHOR OF MY BOOK ON NURSING THEORY AND I WISH I HAD IT WITH ME TO SIGN IT AND FINDING BALANCE IT’S SO INCREDIBLY IMPORTANT AT CEDAR’S WE HAVE A WORK-LIFE BALANCE PROGRAM IT’S IMPORTANT FOR US AS STUDENTS WE USUALLY WEAR MULTIPLE DIFFERENT HATS FOR ME THE HARDER I WORK, THE HARDER I PLAY AND SO THIS WAS A PICTURE OF ME I GOT TO BE THE RESERVE NATIONAL CHAMPION WITH MY HOURS — HORSE A COUPLE MONTHSBU BEFORE I PRESENTED MY DISSERTATION AND WE FINISHED TOP AND LIFE OUTSIDE OF SCIENCE I FEEL KEEPS MY FRESH AND KEEPS MY MIND CREATIVE AND CONTINUOUSLY THINKING OUTSIDE OF THE BOX AND THANK YOU VERY MUCH FOR THIS OPPORTUNITY

CAN YOU JOIN THE TABLE? THEN YOU WOULDN’T HAVE TO MOVE >> THERE’S NOTHING LIKE STORIES TO BRING TO LIFE REAL WORLD EXPERIENCES AND I APPRECIATE HEARING YOUR STORIES AND FILLED WITH FACTS ALONG THE WAY JUST THE WAY YOU DIT WAS GREAT FOR US THE PURPOSE OF THIS PANEL IS TO SEEK THE OPINIONS OF OUR STRAININGIES AND ENGAGING WITH THE GOAL OF IMPROVING NURSE SCIENTIST TRAINING YOU GUYS HAVE THE LIVED EXPERIENCE ROUB OF WE’RE INTERESTED IN THE TRAINING PROGRAMS AND ATTRACT PEOPLE TO THEM AND THAT’S THE CENTER OF THE QUESTIONS I HAVE THE PROCESS WE’LL USE IS THAT I’LL ASK QUESTIONS HERE I THE END OF EACH QUESTION WE’LL OPEN IT FOR MER COMMENTS AND DISCUSSIONS — MORE COMMENTS AND DISCUSSIONS ON THE GROUP AND HOPE IT’S INTERACTIVE AND ENLIGHTENING US HERE MY FIRST QUESTION THEY DIDN’T COME PREPARED WITH BUT DAWNED ON ME WHILE YOU GUYS WERE TALKING THERE’S DISCUSSION TODAY IN THE NURSING DOCTORAL COMMUNITY ABOUT DMP VERSUS OTHER TRAINING AND I IT WAS STRUCK BY THE AMOUNT OF CLINICAL EXPERIENCE YOU EACH HAD AND HAD A CHOICE TO MAKE, ALL OF YOU, IN YOUR PHASES WHETHER TO GO FOR THE DNP OR Ph.D I’M INTERESTED IN ABOUT YOUR THOUGHTS ABOUT THAT AND WHY YOU MADE YOUR FINAL DECISION >> I HAD CONSIDERED THE PROGRAM BUT THEN I THOUGHT I’D HAVE TO GO BACK AND GET MORE EXPERIENCE IN THE ICU AND WAS AT A POINT I COULDN’T DO THAT AND MANAGING CLINICAL TRIALS AS A RESEARCH NURSE WAS FOCUSES ON RESEARCH I HAD ED BOTH PROGRAMS THE DNP WAS UP AND COMING ON THE WEST COAST ALSO IT WASN’T A DECISION I SERIOUSLY CONSIDERED BECAUSE I HAD A LOVE FOR RESEARCH AND I HAVE CREATED MY CLINICAL AS MY LAB I HAVE A REGISTRY AND BIOREPOSITORY EVERY TIME I TOUCH A PATIENT I’M COLLECTING DATA I GAME WITH A UNIQUE OPPORTUNITY FOR THE CHAIR FOR THE NATIONAL NURSES OF CARDIOLOGY FOR ABOUT EIGHT YEARS AND WITH THAT CAME A LOT OF LEADERSHIP EXPERIENCE AND I FELD THE DNP PROVIDED LEADERSHIP THAT EXTRA LEADERSHIP COMPONENT AND MORE OF AN OPERATIONAL DIRECTION AND WHEN I CAME TO THAT FORK IN THE ROAD RESEARCH WAS PULLING ME IN THAT DIRECTION >> I THINK FOR ME I ALSO DIDN’T THINK MUCH ABOUT THE DNP MAYBE GOING BACK TO MY EARLY EXPOSU EXPOSURES TO MENTORS IN LIFE I HAD EXPOSURE TO FACULTY AS A GRADUATE STUDENTS AND WAS IN AN HONORS PROGRAM IN MICHIGAN AND WAS ABLE TO WORK CLOSELY WITH NURSE FACULTY AND SO I THINK

THAT EARLY EXPOSURE TO NURSING RESEARCH HELP SPARK AN INTEREST AND LEARN WHAT NURSING RESEARCH IS EARLY ON AND LOOK AT THE DNP WHEN I WAS LOOKING AT MY DOCTORAL EDUCATION >> I’M A NURSE PRACTITIONER ANY COMMENTS FROM THE GROUP WE’RE IN POSITIONING OF COUNSELLING PEOPLE ONE WAY OR ANOTHER [INAUDIBLE] IF THERE’S ONE THING IN YOUR CAREER DEVELOPMENT AND — >> HE STOLE MY SECOND QUESTION WHICH WAS MENTORS WERE IMPORTANT BUT DIDN’T HEAR WHAT THEY DID SPECIFICALLY ABLE AND TRAINING PERIOD AND WHAT THEY DID MAY BE DIFFERENT BUT I WANT TO SPARK THAT >> I WAS IN AN AREA WHERE I WAS THE ONLY NURSE AROUND I WOULD ALWAYS SEE IT AS SOMETHING NEGATIVE BUT SAW IT AS EXPOSURE AS WHAT A NURSE SHOULD PRACTICE AS AND ALWAYS PRACTICED TO THE HIGHEST AUTONOMY OF MY LICENSE AND OPTIMIZED WHAT IT WAS GOOD AT AND PROGRAM BUILDING AND THE AMERICAN HEART AND COLLEGE OF CARDIOLOGY I HAD JUST GOTTEN OUT OF NURSING SCHOOL AND DID THAT AND HAD ME SIGN UP FOR PCNA AND THE HOSPITAL PAID FOR ALL THOSE DUES WHICH WAS VERY IMPORTANT AND SHE WAS A BOARD OF TRUSTEE OF THE ACC AT THE TIME AND SHE SIGNED ME UP FOR ALL KINDS OF VOLUNTEER OPPORTUNITIES AND GAVE THE OPPORTUNITY TO TRAVEL AND GAVE ME TRAVEL MONEY AND BEFORE YOU KNEW IT WAS CHAIR FOR NURSES AND THEN I WAS THE NATIONAL CHAIR AND IT WAS A WONDERFUL OPPORTUNITY I THINK THAT’S KIND OF WHAT GOT ME HEADED IN THE RIGHT DIRECTION >> FOR ME I CAN BREAK IT DOWN TO MY DECISION AND THERE WERE SEVERAL MENTORS IN MY LIFE TO SUPPORT THE DECISION TO GO BACK FOR MY Ph.D. AND WHERE I WAS WORKING AT A NURSE EDUCATOR AND HE HELPED ME TALK THROUGH THAT DECISION AND WAS IT THE RIGHT TIME FOR ME IN MY CAREER OR THE RIGHT TIME TO GO BACK IS IT GOING TO BE BENEFICIAL FOR ME TO GO BACK AT THIS TIME THE OTHER POINT WAS WHERE TO GO FOR A Ph.D I WENT THROUGH SEVERAL PROGRAMS AND SPOKE WITH MENTORS IN MY LIFE AND TRYING TO FIGURE OUT WHERE WOULD BE THE BEST FIT FOR ME TO GO AND THERE WERE MORE DECISIONS THERE THAN JUST THE PROGRAM AND THERE WERE OTHER LIFE DECISIONS THAT WENT INTO THAT DECISION MAKING PROCESS BUT I HAD A CONFERENCE WITH AND HELP ME TALK THROUGH THE STRENGTHS AND WEAKNESSES IN PROGRAMS WOULD BE FOR SELECTING A PROGRAM I THINK THAT DECISION-MAKING

PROCESS MANAGED TO HELP SUPPORT ME IN HELPING ME I THINK I KNEW WHAT I WANTED TO DO IN TERMS OF Ph.D. BUT HELP ME SUPPORT THOSE DECISIONS AND HELP ME TALK THROUGH THOSE DECISIONS >> THESE WERE PLANNED DISCUSSIONS WHERE YOU SAID I’M THINKING ABOUT GOING BACK I’M INTERESTING TO FIGURE OUT HOW FORMAL VERSUS INFORMAL >> FOR ME THEY WERE PRETTY FORMAL THERE WERE MENTORS IN MY LIFE I WORKED WITH AND I CAN THINK OF TWO IN PARTICULAR WHERE WE TALKED THROUGH THE DECISION AND >> I HAVE HAD MENTORS GREAT AT PROVIDING PROFESSIONAL ADVICE AND MENTORS EXCELLENT AT PROVIDING ADVICE ABOUT LIFE AND ACADEMIA AND HE’S ALSO A GREAT GUY SO WE HAD A SERIES AND THIS IS FOR A LOT OF MENTORS TOO AND YOU COULD HAVE IN FORMAL CONVERSATIONS OVER THE PHONE OR HAVE MORE FORMAL MEETINGS WITH CONFERENCES WHEN YOU’RE TRYING TO THINK THROUGH THE IMPORTANT LIFE-SAVING DISCUSSIONS HAVING REGULAR MEETINGS WITH THE CORE MENTOR GROUP IS IMPERATIVE TIME GETS AWAY FROM ALL OF US TOO EASILY >> MY MENTORS AT UCLA KNEW ME 20 YEARS AND THEY YOU MY CHILDREN AND MY HUSBAND AND FOR ME TO BE SUCCESSFUL WHEN WOULD THE TIME BE TO STEP IN WHERE IT WOULDN’T BE TOO MUCH OF A SHOCK FOR MY FAMILY DYNAMICS LET ALONE FINANCIAL DISCUSSIONS SO I MET WITH THEM EVEN NOT BEING IN THE PROGRAM I MET WITH THEM RELIGIOUSLY QUARTERLY FOR THE THREE YEARS I WAS PREPARING TO STEP INTO THE PROGRAM AT CEDAR-SINAI WITH OUR TEAM AND HAD A ONE-ON-ONE WITH OUR MEDICAL DIRECTOR WEEKLY I STILL DO AND MOST RESEARCH IDEAS I’M FLUSHING OUT ALL KINDS OF THINGS THAT SEEMS TO KEEP THE BALL ROLLING ONE OF THE THINGS THAT HAVE COME UNIN ISSUE IN — IN ISSUE IS WRITING TRAINING GRANTS IS TIMING IN IN TERMS OF YOUR OTHER STATUS FOR INSTANCE, DID YOU WRITE FOR YOUR F31 WHILE IN YOUR Ph.D PROGRAM OR BEFORE YOU STARTED IT? IN OTHER WORDS, WHAT PROVIDED YOU THE TIMING GUIDANCE AT THAT TIME TO ACTUALLY PRODUCE THE APPLICATION? YOU HAVE TO BE IN A CERTAIN THING JUST INTERESTED IN WHY YOU DECIDED ON THAT AND THE TIMING OF WRITING THE APPLICATION >> I THINK I KNEW I WANTED TO APPLY TO THE PROGRAM BUT I THINK THE TIME I DECIDED TO APPLY WAS TO SEE DO I HAVE ENOUGH PROJECTS DEVELOPED AT THIS POINT AND PUT IT IN MY COURSE WORK AND WHEN IT WAS WRITING MY PROPOSAL THAT’S

WHERE WE HAD OUR PROPOSAL AND IT MADE SENSE TO WRITE THE APPLICATION ALONGSIDE THE PROPOSAL FOR ME I DECIDED TO SUBMIT THE APPLICATION >> DID YOU WORRY IT WOULD EXTEND YOUR Ph.D. STUDY TIME IF YOU GOT IT? AND I THINK MAYBE FOR MY SITUATION WHERE I WAS LUCKY TO HAVE A SPOUSE AND WE COULD GET BY ON HIS INCOME AND FOR ME ADDING A POTENTIAL YEAR OR SO ON TO MY PROGRAM WOULD HAVE HAD A FINANCIAL BURDEN ON MY FAMILY AND FOR SOME PEOPLE I KNOW IT’S SOMETHING THEY’D CONSIDER AND AND I THINK FOR ME I KNEW EARLY ON I WANTED TO DO IT AND THEN FIND THE TIME TO SUBMIT IT >> MARGOT WHEN YOU WERE WRITING FOR NUR KOO AWARD WHAT WAS THE TIMING OF THAT? >> MY K99R IDEA CAME YEARSBURY SUBMITTED IT I HAD IT AS AN AIMS PAGE AND IN MY BACK POCKET WHILE I WAS FLUSHING OUT THE F31 ONE OF THE BEST THINGS THAT UCLA HAS IS AN NCRA CLASS IN THE FIRST CLASS IN THE SPRING WITH THE DEAN SCHOLAR FELLOWSHIP I HAD A FULL WRITE FOR TWO YEARS THAT HELP ME BYPASS THE T.A AND WILL FUND THE SECOND TWO YEARS OF IT I HADN’T HAD A DISCUSSION WRITING ALL THE GRANTS WOULD EXTEND TIME TO MY DOCTORAL TRAINING AND MORE LIKE A FREIGHT TRAIN I WANT TO BE DONE AND I WANT TO DO IT RIGHT AND MOVE ALONG I DIDN’T WANT TO BE IN SCHOOL SEVEN YEARS I GOT CLOSE TO FOUR AND A HALF AND FINISHING IN AND THEY ALWAYS SAY DOCTORAL STUDENTS WILL CRACK AND I SAID I AM NOT GOING TO CRACK >> WHEN DID YOU WRITE IT? >> I WROTE IT THE YEAR AFTER I GRADUATED AND WAS TRYING TO SUBMIT IT I SUBMITTED IT IN OCTOBER OF 2019 AN HAD IT READY THE YEAR BEFORE I GOT MY THREE PUBLICATIONS OUT AND PUTTING THE K99 TOGETHER >> YOU WERE WORKING IN PRACTICE >> I WAS I WAS FUNDED ONE DAY A WEEK OF FREEDOM FROM DR. LINDA BOLTON WHO GAVE ME A .20 TO BE ABLE TO WRITE I WAS A WRITING MACHINE I WENT TO THE PASADENA LIBRARY WHERE NO ONE COULD FIND ME AND WOULD TAKE A LUNCH AND SIT FOR EIGHT HOURS AND WAS VERY PRODUCTIVE THANKS TO HER I WAS ABLE TO ACCOMPLISH AS MUCH AS I HAVE BECAUSE I ON CALL FOUR DAYS A WEEK >> YOUR INVESTMENT PAID OFF >> I HOPE SO >> IT DIDN’T HAVE A LOT OF SUPPORT I WAS FORTUNATE BECAUSE MY JOB WAS FLEXIBLE ENOUGH TO ALLOW ME TO GET HOURS TO COMPENSATE

FINISHED THE Ph.D. AND THEN WROTE THE K23 OR BEFORE? >> I STARTED WRITING K23 AS SOON AS I GRADUATED I’M IN MY THIRD YEAR >> WHAT HAS BEEN THE MOST CHALLENGING PART? >> IT’S VERY CHALLENGING IT WAS A WHIRLWIND OF A COUPLE MONTHS WE DECIDED TO SUBMIT IT AND I HAD A DISSERTATION STUDY AND MANY OTHER LIFE THINGS AND WRITING THE APPLICATION I THINK A COUPLE THINGS HAD HELP ME IN THE PROCESS THE ONE THING I WOULD SAY IS MY EFFORT 2 PROPOSAL WAS THE NEXT STEP IN MY DISSERTATION PROJECT AND I DID FIELD TESTING LOOKING AT THE CLINICAL INSTRUMENT I THINK IT’S IN LINE APPLICABLE WITH MY CURRENT DISSERTATION OF WORK AND IT’S BEEN EASIER TO WRITE FROM THAT STANDPOINT AS AN EXTENSION OF WHAT I’M DOING NOW THE OTHER THING THAT WAS HELPFUL IF THE PROCESS — IN THE PROFESSIONAL AND I FOUND THE PROCESS SUBMITTING TO CHOC WAS VERY HELPFUL BECAUSE I WAS ABLE TO WORK ALONG THE PROCESS OF GETTING MY APPLICATION IN >> I HAVE ANOTHER FOLLOW-UP MENTOR QUESTION WHICH IS WE HEAR OFTEN AT LEAST THOSE IN ACADEMIA WHO HAVE STUDENTS WHEN THEY WRITE THEIR F AWARDS OR POST-DOCS THEY HAVE TROUBLE FNDING CLINICAL MENTORS AND I’M INTERESTED IN THE CLINICAL INTERESTS MAYBE HAVE YOU A CLINICAL INTEREST >> WHAT I WOULD SAY TO THAT IS NO IT WAS NOT A BARRIER FOR ME BUT I ALWAYS WONDERED, IT’S ALWAYS BEEN VERY INTERESTING TO ME WHY THERE HAS NEVER BEEN A PRECEPTORSHIP, IF YOU WILL, TO PAIR STUDENTS WHO ARE LEARNING HOW TO DO CLINICAL RESEARCH AND NOT PAIRING THEM WITH A PRECEPTOR WHO DOES CLINICAL RESEARCH I HAVE THAT SYNERGISTICALLY AND YOU CAN’T IMAGINE YOU WOULD TRAIN A NURSE PRACTITIONER OR R.N. OR NOT HAVE THEM GO THROUGH PRECEPTING AND TO ME IT’S IMPERATIVE AND I HAVE NOT ACCEPTED JOBS THAT HAVE BEEN PROPOSED TO ME RECENTLY BECAUSE I WANT TO KEEP MY HANDS ON PATIENTS NOT 90% OF THE TIME BUT JUST ENOUGH I FEEL LIKE I AM STILL BEING STILL LATED AND RELEVANT >> I WAS EMBEDDED IN THE CLINICAL TRAINING IN UNIVERSITY OF CHICAGO AND ACCEPTED A

POSITION AT UNIVERSITY OF ILLINOIS AND I DIDN’T KNOW ANYBODY THERE THE GOAL IS BEING PERSISTENT AND REACH OUT TO PEOPLE AND IN MY EXPERIENCE PEOPLE ARE VERY GENEROUS WITH THEIR TIME IF YOU CAN MAKE THE CASE AND SHOW HOW THERE COULD BE SOME SYNERGY WHEN WHAT YOU’RE DOING AND THEY’RE DOING I THINK WE’RE OPEN AND RECEPTIVE TO THAT I HAVE DONE A LOT OF COLD CALLING AND E-MAILING AND BEING PERSISTENT IN MAKING CONNECTION SOME TAKE LONGER THAN OTHERS I THINK OVERALL IN GENERAL THEY’RE RECEPTIVE >> DID YOU SEE IT WAYS MATTER OF FINDING THEM AND — WAS A MATTER OF CONNECTING OR RESEARCHERS IN THE CLINICAL AREA ARE SCARCE? >> IN MY AREA THEY WERE THERE SO I DIDN’T HAVE A PROBLEM I DON’T KNOW I HAD FORMAL CLINICAL MENTORS BUT I CAN TALK TO WORKING WITH A PALLIATIVE CARE TEAM AT CHOC AND THEY PROVIDED SOME OF THAT CLINICAL MENTORSHIP NOT RESEARCH MENTORSHIP BUT AGAIN I THINK I’VE GONE TO THE TEAM OVER THE PAST FEW YEARS AND THEY’VE BEEN VERY SUPPORTIVE AND HELP ME WITH MY RESEARCH PROJECT WHICH HAS BEEN IMPORTANT IN THE DESIGN OF IT AND CARING FOR THE PROJECT WHERE I AM NOW WITH IDENTIFYING PARENTS AND RECRUITMENT THEY HELP PROVIDE THE CLINICAL PERSPECTIVE TO THE PROJECT I MAY NOT HAVE CURRENTLY I THINK FOR ME WORKING WITH A TEAM HAS BEEN IMPORTANT TO MY RESEARCH >> I HAVE OTHER QUESTIONS BUT I THOUGHT WE’D OPEN IT UP TO THE GROUP FOR QUESTIONS AND TO GO IN ANY DIRECTION SPLAY QUESTIONS ABOUT THE LAST 15 MINUTES WE’LL KEEP OPEN >> THANK YOU I WANT TO DIVERGE INTO AN AREA OF INTEREST TO ME AND OTHERS AND SHARE ABOUT THE JOURNEY AND THE PROCESS IN THE Ph.D. PROGRAM THAT YOU EXPERIENCED WHERE YOU WERE MENTORS OR EXPOSED TO PREFER TO AS THE GENE POPULATION AND HOW DISPARITIES SHOULD BE IN RESEARCH AND HOW DID IT INFLUENCE YOUR AREAS OF STUDY AND ONE LAST PIECE IS WHO SERVED AS MENTORS IN THOSE AREAS? >> YES, YES, YES UCLA THE SCHOOL OF NURSING PRIDES THEMSELVES ON RESEARCH AND VULNERABLE POPULATIONS I HAD ALMOST EVERY PROFESSOR I CAN THINK OF HAD POPULATIONS IN LATINO WOMEN’S HEALTH, NATIVE-AMERICAN HEALTH WE I DID AN NIH FOUNDATION GRANT STUDYING ETHNIC ETHNIC WOMEN WHO WORK IN INNER CITY AREAS AND RECEIVED MENTORSHIP TO GO OUT TO THESE WOMEN AND COMMUNITIES WHERE THEY WERE AND STUDIED HOMELESS POPULATIONS AND USED DIFFERENT MODELS WHERE PEOPLE LIVED IN THE HOMELESS COMMUNITY AND EMPLOYED THEM TO HELP HER RESEARCH AND LATINA WOMEN STUDIES AND THAT WAS GOOD AND IT HELPED WITH A GRANT WRITING AND OPENING MY EYE TO SPECIAL POPULATIONS THAT ARE OTHERWISE IGNORED

I HOPE WE CAN HELP IMPROVE THAT >> I WORKED ON KIDNEY TRANSPLANTS AND I HAD ACCESS TO A LOT OF GREAT MENTORS THERE BUT THEY WERE MOSTLY PHYSICIAN AND PUBLIC HEALTH MENTORS AND THAT WAS A GREAT EXPERIENCE WHEN I TRANSITIOED TO UIC MY PROGRAM TRANSITIONED ON THE NEEDS OF KNOWLEDGE I REALLY HAVE A GOAL TO INCORPORATE THAT IN MY PROGRAM AT SOME POINT >> >> THEY LOOKED AT HEALTH DISPARITY AND EQUITY AND IT’S NOT A FOCUS OF MY RESEARCH RIGHT NOW BUT IN THE FUTURE I HOPE WE CAN LOOK MORE AT THAT PARTICULAR POPULATION PARTICULARLY IN THE PALLIATIVE CARE SPACE >> I’D BE REMISS IF I DIDN’T MENTION AN INCREDIBLE SCIENTIST WHO HAS DONE INCREDIBLE WORK SHE IS NOT MY PRIMARY MENTOR BUT I CONSIDER HER MY PRIMARY MENTOR SHE’S BEEN AMAZING AND HELPED ME WITH MY GRANT WRITING AND HAS DONE INCREDIBLE WORK WHEN I DO INCORPORATE THAT BACK >> OTHER WORK IN MINORITY COMMITTEE ISSUES AND STUDYING IN GRANTS THERE’S OUR LOCAL CANCER CENTER RECEIVED LARGE NIH MONIES AND THEY HAVE A POPULATION HEALTH THAT REACHES OUT THEY DO A LOT OF WORK ON RUNG COURSES ON RECRUITING MINORITIES INTO RESEARCH AND THEN HAVING APPROPRIATE TOOLS AND METHODOLOGIES WE CAN LOOK TO OUR PRACTICE SITES DOING A LOT OF RESEARCH WHERE THEY’RE TAKING THIS SERIOUSLY AND PRACTICE SITES >> THE CTSIs AND INSTITUTIONS HAVE COMMUNITY ENGAGEMENT GROUPS WHICH IS TRAINING WHERE THEY HAVE PROGRAMS AND HELP WITH RECRUITMENT THAT’S IN DIVERSE POPULATIONS >> IT SPEAKS TO THE LARGER CHALLENGE IN NURSING IN PARTICULAR WITH FACULTY IT’S CHALLENGING WHEN YOU’RE CREE CEUTING IN YOUR PROGRAM — YOU’RE RECRUITING IN YOUR PROGRAM TO HAVE EXPERIENCE AND WE TALK ABOUT THE INTRAPROFESSIONAL MODEL WHERE WE HAVE THE NURSES AT THE POINT OF CARE ALL THE WAY TO THE HALLS OF ACADEMIA AND RECRUIT THE BEST AND BRIGHTEST NURSES WHO MAYBE WOULDN’T HAVE THOUGHT OF A Ph.D AND I WORKED AT THE UNIVERSITY OF CHICAGO AND STARTED TO DEVELOP A MODEL THAT RECRUITED ALL THE WAY TO THE BEDSIDE AND THE TRUMP ADMINISTRATION LOOKED AT THAT AND IT WAS IMPORTANT FOR RECRUITING YOUNGER NURSES AND GETTING THEM ENGAGED AND EXPOSURE TO NURSE SCIENTISTS TO SEE WHAT WE DO AND HAVE THEM ENGAGED IN PROJECTS I THINK THAT’S REALLY IMPORTANT THERE WERE 12 YEARS WHERE I DIDN’T HAVE ACCESS OR EXPOSURE TO NURSE SCIENTISTS FOR 12 YEARS 12 YEARS OF MY CAREER THAT’S HALF MY CAREER HAD I HAD ACCESS WOULD THAT HAVE EXPEDITED MY JOURNEY

IT WOULDN’T HAVE HURT I’M SURE OF THAT >> I’M WONDERING IF THERE WERE ANY TIMES YOU FELT VULNERABLE AS SCIENTISTS AND MAY HAVE FOR YOU HAVEN’T EXPERIENCED WHERE YOU’RE IN A GROUP OF PEERS OR SIMILAR SITUATIONS IS THAT SOMETHING YOU’VE NOTICED AND HAS THERE BEEN INTERVENTIONS HELPFUL TO YOURSELF OR OTHERS? >> I THINK THERE ARE DIFFERENT BARRIERS THAT STAND IN THE WAY BETWEEN DIFFERENT STUDENTS I REMEMBER BEING AN UCLA STUDENT AND A STUNT — STUDENT I KNEW IN MEDICAL SCHOOL HAD TO DROP OUT BECAUSE SOMEBODY DIED AND HAD TO GO BACK TO WORK AND WASN’T ABLE TO AFFORD MEDICAL SCHOOL AND LOOK HOW HARD IT IS TO GET INTO UCLA SO HARD IF YOU WERE GOOD ENOUGH TO GET INTO MEDICAL SCHOOL, YOU DON’T HAVE TO WORRY ABOUT THE TUITION I UNDERSTAND WE DON’T HAVE ACCESS TO THAT TYPE OF SUPPORT BUT I THINK YOU’RE HEARING AND ECHOING THAT THIS SAY JOURNEY OF OURS AND THE PERIODS IN TIME WHERE ESPECIALLY AS A NURSE PRACTITIONER YOU MAKE A GOOD INCOME AND THEN HAVE TO CUT BACK I HAD TO THINK STRONGLY I HAD BEEN AN M.P. FOR EIGHT YEARS EXCEEDING EXPECTATIONS TO BACK OFF TO TWO DAYS A WEEK WHICH IS WHAT I DID TO FULLY DEDICATE THE TIME I FELT I NEEDED TO BE ABLE TO TRULY LEARN THAT, WAS A SIGNIFICANT HARDSHIP ON MY FAMILY MY HUSBAND’S IN HIS OWN BUSINESS FIVE YEARS BEFORE I WORKED FOR FUN LIFE DOESN’T ALWAYS WORK LIKE THAT I THINK SOME OF THE CHALLENGES GO AROUND THE MONIES AS FOR BEING DISCOURAGED, I THINK EVERYONE CAN FEEL DISCOURAGED AT TIMES AND BEING A NURSE IN AN ACADEMIC SETTING WHERE I’M NOT JUST IN A SCHOOL OF NURSING WHERE WE ALL LOOK QUITE DIFFERENT CAN BE QUITE INTIMIDATING BEING A WOMAN SCIENTIST IN PARTICULAR HAS ITS OWN DIFFICULTIES AND I SIT ON DIFFERENT LEADERSHIP GROUPS TO HELP ADDRESS THE ISSUES WE STILL FACE THE FACT THAT I’M A NURSE AND A WOMAN, I FEEL CAN BE SOMETIMES A DOUBLE CHALLENGE BECAUSE UME HAVE PEOPLE PULL THAT CARD ON OCCASION OR TRY AND IF YOU’RE NOT CONFIDENT IN WHAT YOU DO AND HAVE GREAT SUPPORT IT CAN BE INTIMIDATING IN AN ACADEMIC SETTING >> I’M NOT SURE I HAVE FELT VULNERABLE FROM A SCIENTIFIC PERSPECTIVE BUT TALKING ABOUT CHALLENGES IN A PROGRAM BALANCING WORK AND FAMILY FOR ME IT’S SOMETHING I’VE STRUGGLED WITH IN MY PROGRAM I HAD TWO BABIES NOW IN MY PROGRAM AND HAS BEEN A VERY BIG CHALLENGE WITH WORKING FULL TIME IN THE Ph.D. PROGRAM BOTH MY KIDS WERE IN SCHOOL PART-TIME THREE DAYS A WEEK SO I’M TRYING TO FIT IN A FULL COURSE LOAD AND Ph.D. WORK DURING NAP TIME AND WHEN KIDS ARE EN BED — IN BED AND THERE’S TIMES I’VE CONSIDERED IS THIS WHAT I WANT AND WHEN I SUBMITTED WAS A FEW MONTHS AFTER MY SECOND DAUGHTER WAS BORN AND WE WROTE A GRANT WHILE IT’S BEEN CHALLENGING FOR ME OF COURSE MY FAMILY AND FRIENDS HAVE BASKETBALL A SUPPORT FOR ME AND MENTIONED THE UNIVERSITY AND MY PROFESSORS HAVE BEEN VERY SUPPORTIVE OF

HELPING ME FIND THE BALANCE I THINK IT’S HELPED ME GET THROUGH THE PROGRAM >> I THOUGHT I WAS CHALLENGING IN ACADEMIA AND I FEEL LIKE IT’S DISCOURAGED LIKE YOU’RE SUPPOSED TO KEEP THAT TO YOURSELF IT’S FRUSTRATING ALMOST ANY TIME YOU HAVE A SUCCESS IT’S FOLLOWED BY REJECTION OR MAJOR FAILURE IT’S IMPORTANT TO HAVE A WIDE ARRAY OF MENTORS THERE’S MENTORS I GO TO REVIEW MY GRANTS AND THOSE I HAVE A CUP OF COFFEE TO SAY AM I DOING THE RIGHT THING OR GO TO INDUSTRY AND MAKE MORE MONEY BUT WOULD I BE SATISFIED MENTORS ARE SO IMPORTANT IT’S A FRUSTRATING GIG AS WE ALL KNOW I THINK I’M LEARNING AND TOLD BY MY MENTORS AND PLEADING WITH THEM AND TRUSTING WITH THEM THERE’S SETBACKS AND I’M STARTING TO SEE THAT NOW >> HARKENING BACK TO THE EARLIER DISCUSSION THE OPPORTUNITY TO DO THIS FINANCIALLY WE’RE MISSING OUT ON FOLKS WHO CAN’T AFFORD TO DO THIS I ADMIRE ALL HAVE YOU DONE AND I THINK OF PEOPLE NOT DOING IT BECAUSE THEY CAN’T IMAGINE THIS FINANCIALLY >> I HAVE FRIENDS WITH SIMILAR BACKGROUNDS I HAD AND CHOSE THE DNP ROUTE BECAUSE OF TWO YEARS AND SIMPLY BECAUSE OF LOGISTICS SIMILAR TO ALL THE LOGISTICS I’VE DESCRIBED I HAD TO TRY AND WORK OUT AND TO DO THAT OVER FOUR TO FIVE YEARS IS A LONG TIME PEOPLE DIE, PEOPLE GET MARRIED IT’S A LONG TIME I THINK THAT’S A STRONG CONSIDERATION THE SHEER TIMING OF IT >> HOW CAN NINR HELP FOSTER OUR PROFESSIONAL DEVELOPMENT WE’RE GOING THROUGH RESTRUCTURING IN MY OWN INSTITUTION I THINK WHEN I WAS LISTENING TO THE SYMPTOM SCIENCE EXPERT PROPOSAL YOU HAVE HERE AT — WITH THE PROGRAM IS A WONDERFUL IDEA AND WOULD BE FANTASTIC FOR PEOPLE TO BE ABLE TO TAKE ADVANTAGE OF BUT IT’S OFTEN TIMES GETTING OUT THE WORD UNLESS YOU’RE AT A SCHOOL OF NURSING AND YOU HAVE YOUR HAND DIRECTLY ON A GRANT OFFICER OR YOU HAVE ESTABLISHED A RELATIONSHIP WITH ONE WHILE YOU WERE IN TRAINING, THEY’RE NOT OFTEN TIMES I THINK EVEN QUITE AWARE OF IT I WAS SO EXCITED TO HEAR ABOUT IT BECAUSE NOW YOU SUBMIT APPLICATIONS AND THAT TYPE OF THING AND THEN WHAT DO YOU DO FOR PEOPLE WHO MAYBE CAN’T PHYSICALLY GET HERE MAYBE CONSIDER TRANSLATING THAT PROGRAM IN A BUY — BI-COASTAL OR SIMILAR PROGRAMS AND I’LL HAVE A DISCUSSION WITH OUR CNO BECAUSE FOR INSTITUTIONS THAT HAVE THE CAPABILITY OF HAVING CENTERS OF EXCELLENCE IT WOULD MAYBE BE A NICE PAIRING SO PEOPLE DON’T NEED TO TRAVEL ACROSS THE COUNTRY AND THEN YOU HAVE TO TRY AND FIND SOMEBODY WHO’S GOING TO COVER YOU FOR A MONTH OR SO, SIX WEEKS WHERE IF IT WAS LOCAL, THAT WOULD BREAK DOWN A LOT OF THE FINANCIAL BARRIERS

>> WE HAVE ONE LAST QUESTION IN ORDER TO FINISH ON TIME >> THANK YOU FOR YOUR PRESENTATION >> THERE’S BEEN OPPORTUNITIES WORKING PART-TIME AND YOU HAVE OTHER MEANS OF SUPPORT HAD THESE NOT EXISTED [INAUDIBLE] >> I WOULD HAVE USED A DIFFERENT FINANCIAL MECHANISM IF I WASN’T GOING TO GET THAT DEAN SCHOLAR FELLOWSHIP, LUCKILY CEDAR SI CEDAR SINAI HAS A TUITION PROGRAM WHEN HAVE YOU A LONG PROGRAM, A Ph.D. PROGRAM IT’S A ONE-ON-ONE DISCUSSION WITH THE CNO WHO DECIDES IF THEY’RE GOING TO OFFER YOU TUITION REIMBURSEMENT AND SUPPLEMENTATION IN FACT I HAD BENEFIT FROM THAT EVEN WHEN MY F31 WAS SCORED IT WAS A GOOD SCORE BUT FUNDS WERE TIGHTER THAT YEAR AND JUST MISSED THE LINE I GOT BRIDGE FUNDING FROM CEDAR WHICH WAS GREAT THEY GAVE ME AN EXTRA $5,000 TO BUY A COMPUTER AND HAVE A LITTLE BIT OF MONEY EXTRA TO USE AT MY DECISION AND THAT MADE A DIFFERENCE AND THE TIE SPEND FROM THE F31 WAS HELPFUL IN CREATING A BALANCE FOR ME FINANCIALLY >> I THINK IT WOULD HAVE MADE THE DECISION HARDER TO GO BACK IF I HAD TO PAY MY OWN WAY I STILL HAVE LOANS FROM MY MASTER’S PROGRAM SO ADDING ADDITIONAL LOANS WOULD BE A BARRIER FOR ME AND THE FACTBURY WAS FUNDED I WORKED AS A TEACHING ASSISTANT AND PENN SUPPORTED IN THAT WAY BECAUSE I WAS TEACHING IT’S FOCUSSED MY REASONABLE AND ALLOWED KNOW TEACH THAT WAS A BIG DECISION FOR MY FAMILY IF I HAD TO PAY I DON’T KNOW IF I COULD HAVE GOTTEN BACK THAT THE POINT IN MY CAREER >> I WOULD LIKE TO THANK THE PANELISTS FOR YOUR SHARING FREELY GIVING US INSIDE INTO YOUR DAILY LIVES AS WHAT YOU EXPERIENCE AS TRAINEES THANK YOU VERY MUCH >> I HOPE WE CAN CONTINUE THE DISCUSSION AFTER THE NEXT SET OF PRESENTATIONS SO WE’RE GOING END WITH AGE OVERVIEW AND DISCUSSION OF THE NINR TRAINING PORTFOLIO LED BY DR. DAVID BANKS AND DR.ON GRASON DAVID’S GOING START HE’S THE RESEARCH TRAINING OFFICER AT NINR WHO YOU ALL KNOW AND LOVE AND RECEIVED THE INDIVIDUAL AND INSTITUTIONAL FELLOWSHIPS AND OUR MENTOR CAREER AWARDS HE HOLDS MANY DEGREES BACHELORS OF SCIENCE AND NURSING, BACHELORS OF ECONOMIC AND SOCIAL WORK AND Ph.D. IN HUMAN DEVELOPMENT HIS PRESENTATION’S GOING TO BE FOLLOWED BY A PRESENTATION FROM DR. JOHN GRASON YOU HEARD FROM THIS MORNING HE’S THE CHIEF OF THE OFFICE OF SCIENCE POLICY AND LEGISLATION IN THE DIVISION OF PUBLIC POLICY LIAISON >> THANK YOU PEACE AND BLESSINGS TO EACH AND EVERY ONE OF YOU THANK YOU FOR TAKING TIME TO JOIN US THIS AFTERNOON ROUND OF APLUS FOR — APPLAUSE FOR THEM TO TAKE TIME FROM THEIR SCHEDULE TO BE WITH US IT’S BEAUTIFUL I’LL MOVE INTO THE PRESENTATION AND WE’LL TALK ABOUT KEY ISSUES AND IT’S ALWAYS BEEN INVOLVED IN TRAINING AND CAREER DEVELOPMENT AWARDS AS WELL AS SUPPORTING WITH LOAN REPAYMENT AND DIFFERS PROGRAMS AT NIH

NINR PROVIDES SUPPORT WHERE A NURSE IS IN THEIR CAREER TRAJECTORY AND HAVE SUPPORT MECHANISMS AND HAVE WAYS FOR INDIVIDUALS REGARDLESS OF THEIR CAREER STAGE TO GET SCIENTIFIC RESEARCH TRAINING THEY NED TO BE SUCCESSFUL TO THE RESEARCH ENTERPRISE AND WE’RE EXCITED ABOUT THAT BECAUSE WE PRIDE OURSELVES ON OUR ABILITY TO ENSURE FOLKS GET THE EXPOSURES THEY NEED WE’RE WORKING TOGETHER AND IT’S AVAILABLE FOR OUR COMMUNITIES AND PEOPLE TO GAIN MORE WITH THE RESEARCH THEY WANT TO DO SPEAKING OF GETTING ON CAMPUS AN EXCITING PROGRAM IS FOR INDIVIDUALS IN DOCTORAL PROGRAMS TO FINISH THEIR ACADEMIC WORK AND WORK ON DISSERTATIONS HOW FABULOUS WOULD THAT HAVE BEEN WHILE WE WERE IN SCHOOL I’D LIKE TO ASK JOHN TO STEP FORWARD AND TALK ABOUT THE DATA WE’LL LOOK AT OUR CAREER DEVELOPMENT APPLICATIONS AWARDS AND TOUCH A LITTLE BIT ON OUTCOMES I SHOULD NOTE THAT AS WE GO FORWARD PAY ATTENTION TO THE YEAR, RANGE ON SOME OF THE SLIDES SOMETIMES IT WILL GO BACK AND FORTH HASN’T AND IT DEPENDS ON WHERE WE’RE GETTING THE DATA FROM AS KEVIN TOUCHED ON THIS MORNING FOR FIZZ — FISCAL 19 IT PLACES NINR SECOND IN NIN THE AVERAGE IS 2.3% BACK IN ’98 IT WAS 7.5% AND GONE TO 4. 5% NOW AND WE TOUCHED ON THAT LATER IF WE THROW THE CAREER DEVELOPMENT AWARDS IN THERE THAT WAS BACK TO TRAINING AND DEVELOPMENT AND WE’VE BEEN AROUND 3% TO 2.5% IF WE LOOK AT T32 AWARDS AND THE GREEN LINE ARE THE TO THE NUMBER OF APPOINTMENTS THERE ARE THE AWARDS LAST YEAR WE HAD 19 AND THE NUMBER SPUK WAITED CONSISTENTLY WITH THE NUMBER OF AWARDS THIS IS THE DATA FOR NIH LAST YEAR NIH RECEIVED ABOUT 4500 APPLICATIONS FOR F31s AND THE SUCCESS RATE WAS AROUND 25% THE NUMBER OF APPLICATIONS THE DARK BLUE BARS NIH HAS RECEIVED TRENDED UPWARDS OVER TIME SMO HAD — THERE’S DARK BLUE BARS THROUGH 2000s INCREASING IT FLUCTUATES DEPENDING ON THE

YEAR AND IF WE LOOK AT NIN THE NUMBERS ARE RELATIVELY SMALL AND THERE WERE A NUMBER OF APPLICATIONS WITHIN THE YEARS AND THE SUCCESS RATE HAS ALWAYS BEEN RELATIVELY HIGH FOR THESE AROUND 40%, GIVE OR TAKE 10% WE THOUGHT IT’D BE WORTH LOOKING AT WHERE THE AWARDS ARE GOING AND THIS PLOT HERE, EACH OF THOSE BARS IS ONE INSTITUTION IT PLOTS THE NUMBER OF BOTH Fs AND T POSITIONS AT THE INSTITUTION SINCE 2000 TO THE LEFT OF THAT RED LINE ARE ADMINISTRATIONS AND 80% OVER THE 20 YEARS WERE AT THE TOP 20 INSTITUTIONS THESE ARE THE F AWARDS WE RECEIVE A BI-COASTAL TREND THIS IS OVER THE LAST 18 YEARS WHERE THE SIZE OF THE DOT INDICATES THE FUNDING AND THE T32 AWARDS SO THEN WE ALSO LOOKED AT THE TOPICS OUR TRAINEES ARE LOOKING AT IN ORDER TO DO THIS WE WORKED WITH THE NIH OFFICE OF PORTFOLIO ANALYSIS AND THEY HAVE INTERESTING TOOLS TO LOOK AT GRANT PORTFOLIOS I’M GOING TO PRESENT A LITTLE BIT OF THE DATA THEY’VE GIVEN US I’M SURE THERE’LL BE MORE TO COME IN THE FUTURE I WANTED TO FOCUS ON THE TRAINING SO THIS SLIDE HERE IS VERY SIMPLE AND ENTIRELY SELF-EXPLANATORY WHAT THIS IS LOOKING AT IS FROM FISCAL ’15 TO ’19 THERE WERE ABOUT 400,000 APPLICATIONS RECEIVED BY NIH THAT’S OVER ALL MECHANISMS INCLUDING RPGs, AWARDS OVER THE FIVE YEARS I’M GUESSING THEY USED THE SOFTWARE I’M NOT GOING TO BEGIN EXPLAINING BUT IT’S ABLE TO CLUSTER THE APPLICATIONS INTO TOPIC AREAS AND THE LINES INDICATE THE DIFFERENCE BETWEEN THE TOPICS AND THE DIAMETER SHOWS HOW MANY APPLICATIONS WERE ED ON THAT PARTICULAR TOPIC THE HEAT MAP ELEMENT OF IT, THE REDDER THE DOT THE MORE AWARDS THAT WERE GIVEN IN THOSE AREAS THE HEAT MAP ELEMENT JUST SHOWS THE TRAINING BOARDS AND SHOWS WHERE NIH IS FUNDING ITS TRAINING AWARDS MORE INTERESTING TO US IS IF WE LOOK AT THE MAP AND TRAINING AND NONE ARE PARTICULARLY SURPRISING THIS RED DOT IS PALIALITYIVE CARE AND EXERCISE AND WEIGHT MANAGEMENT AND OTHER TOPICS HERE AND THERE BUT NOTHING REALLY I DON’T THINK ANY OF US WOULDN’T EXPECT WHEN IT COMES OUR TRAINING PROGRAMS WHICH I SUPPOSE IS GOOD BECAUSE IT MEANS OUR TRAINEES ARE DOING RESEARCH IN THE AREAS AND THIS SHOWS THE

TOP 10 TOPICS FUND NIH AND NINR ACCORDING TO THE ANALYSIS AND PALLIATIVE CARE WAS AT THE TOP OF THE LIST AND MOST OTHER TOPICS ARE WHAT YOU’D EXPECT FOR US BUT THE KEY QUESTION GOING FORWARD WHEN YOU LOOK AT THESE IS THERE ANYTHING ON THE LIST THAT’S MISSING THAT WE’RE NOT SUPPORTING? TIS IS A SAMPLE OF THE DATA WE’LL LOOK AT GOING FORWARD AS WE LOOK AT OUR TRAINING PORTFOLIO I SAID I’D TOUCH BRIEFLY ON THE OUTCOMES AS BEST AS WE CAN TELL OF OUR TRAINING PROGRAMMIS WHICH IS ALWAYS A QUESTION HOW DO YOU DEFINE SUCCESS OF THESE PROGRAMS VERY BRIEFLY WE DID A QUICK ANALYSIS THAT SHOWED ONE THIRD OF PEOPLE WE TRAINED BETWEEN ’98 AND 2018 SUBSEQUENTLY APPLIED FOR AN RPG IT TURNS OUT THAT NUMBER IS RELATIVELY HIGH COMPARED TO THE NIH WHICH WAS GREAT TO SEE IN FACT THE NIH AVERAGE WAS ACROSS ALL THE INSTITUTES WAS ROUGHLY 16% OR SO SO THAT’S GOOD I’LL LET YOU STEW ON THAT A LITTLE BIT WHERE IT’S MORE CONCERNING AND OF THOSE WHO APPLIED FOR AN RPG, 40% AWARDED FUNDING WHICH IS PRETTY GOOD THAT’S LOW COMPARED TO OTHERS AT THE NIH THAT’S INTERESTING NOT SURE HOW TO EXPLAIN THAT WE’LL HAVE TO TAKE MIEFR LOOK AT THAT GOING FOR — MORE OF A LOOK AT THAT GOING FORWARD I WANTED TO GIVE YOU A BRIEF OVERVIEW OF THE TYPES OF THINGS WE’RE LOOKING AT HERE I’LL TURN IT BACK OVER TO DAVID FOR MORE DISCUSSION >> THANK YOU, JOHN I APPRECIATE THAT SO WHEN WE THINK ABOUT NINR, WE WANT TO SHOW WE’VE TAKEN LEADERSHIP AND CONTINUALLY LOOKING TO FIND INNOVATIVE STRATEGIES THAT WILL HELP INCREASE THE NUMBER OF NURSE SCIENTISTS CAPABLE OF MAKING IMPORTANT CONTRIBUTIONS TO OUR RESEARCH ENTERPRISE THE FIRST LIMITED COMPETITION FOR NURSE SCIENTIST SCHOLARS WAS DESIGNED BY US, BY NINR TO INCREASE THE LIKELIHOOD OF SUCCESS WITH AN INITIAL RO1 APPLICATION FOR NURSES WHO DEVELOP A CAREER DEVELOPMENT AWARD NURSES WHO HAD A K BUT NOT YET EARNED AN RO1 WERE ELIGIBLE IT WAS A LIMITED COMPETITION WE PUT IT ON THE STREET AND THERE’S TWO MORE ROUNDS TO GO TELL EVERYBODY AND THERE’S THE MOSAIC WE JOINED IT AND ARE READY NIH HAS SOCIAL SCIENCES ON IT WE PARTS IT IN THOSE OPPORTUNITIES AS THEY COME UP THE INITIAL MEETING OF OUR T32 PROGRAM DIRECTORS WAS HELD LAST YEAR THE MEETING CONCLUDE THE T32 MECHANISM IS IMPORTANT IN TERMS OF DEVELOPING RESEARCH TRAINING AMONG NURSE SCIENTISTS THEY WROTE AN ARTICLE ACCEPTED FOR PUBLICATION IN NURSING OUTLOOK AROUND INDIVIDUALIZED DEVELOPMENT PROGRAMS WHICH IS A CORE ELEMENT OF WHAT MAKES THE T32 SUCCESSFUL TO TAKE ADVANTAGE OF THE MS. OF SCALE AN PARTNER WITH THE CENTERS OF INFECTIOUS DISEASES TO MOVE INTO R SERIES AND MOST AGREED OR STRONGLY AGREED IT WAS A FANTASTIC WORKSHOP AND COULD BE HELPFUL

AND WE’LL HAVE MORE OF A DISCUSSION PERIOD >> WE DEVOTE SERVICE TO TRAINING WE NOTICED SOME TRENDS JOHN MENTIONED WE STARTED TO HAVE CONVERSATIONS ABOUT FACTORS THAT MAY BE CONTRIBUTING TO THE DATA JUST WANT TO GET YOUR TAKE ON THE DATA WE’VE SHOWN TODAY AND THERE’S DISCUSSION QUESTIONS UP HERE THAT COULD HELP START THE CONVERSATION I KNOW WE DON’T DO A LOT OF THIS BUT HOPEFULLY HAVE YOU QUESTIONS THE BIGGEST ONE THAT HAS COME UP THAT WAS RELEVANT FROM EARLIER TODAY WAS WE HAD THIS DECLINING NUMBER OF F32s AND Fs IN GENERAL THE QUESTION IS AS WE’VE DISCUSSED A LITTLE BIT TODAY IS THERE A TIMING COMPONENT CONTRIBUTING TO THAT? I’M WONDERING IF YOU CAN TALK ABOUT THAT >> IT’S A TOPIC NEAR AND DEAR TO MY HEART HAVING SERVED AS A CHAIR >> AS THE GROUP THAT REVIEWS THE APPLICATION >> AND I TEACH A GRANT-WRITING CLASS AND I HOPE THEY’RE LISTENING BECAUSE I TOLD THEM TO TODAY WE’LL SEE WHEN I GET BACK I THINK SOME OF WHAT’S BEEN GOING ON IS ONE THERE’S BEEN A COUPLE INITIATIVES IN FOUNDATIONS AND THEN THERE’S THE ISSUE IN THE DECLINE IN ADMISSION TO OUR Ph.D. PROGRAMS SO IF WE DON’T HAVE STUDENTS THEY CAN’T APPLY WE’RE SEEING AN UPTICK IN OUR APPLICATIONS TO OUR Ph.D PROGRAMS AT OUR PLACE AND I KNOW SOME OF OUR COLLEAGUES IN THE MIDWEST THERE’S AN UP TICK IN APPLICATIONS LAST YEAR AND THIS YEAR THAT’S GOOD NEWS WE’LL GET YOU BACK INTO THE PATH TO THE F31 I THINK OUR T32 PROGRAMS WHICH IS SMALL AND STUDENTS WHO HOLD FELLOWSHIPS ON T32s GETTING THEM TO RIGHT F APPLICATIONS — WRITE F APPLICATIONS IS ONE MECHANISM WE CAN FOLLOW THROUGH BUT IT HAS TO DO WITH THE FACT WE’VE HAD LIMITED STUDENTS AND MAYBE INDIVIDUALS DIDN’T KNOW THESE WERE OPPORTUNITIES FOR THEM AND THERE ARE FUNDING THINGS AND GETTING POTENTIAL Ph.D. STUDENTS WRITING AND A SECOND SOME OF THOR AND GRANT-WRITING CLASS I LOVE THE IDEA OF ONE OF OUR PANELISTS OF HAVING THEM CONSOLIDATE BUT I MIGHT COMING UP THIS YEAR IT’S A PROCESS I DO THINK IT’S PART OF THE WHOLE PICTURE OF THE DECLINE IN OUR Ph.D. ENROLLMENT THAT’S PART OF THIS IN MOST OF OUR Ph.D. PROGRAMS THERE’S A SIGNIFICANT NUMBER OF INTERNATIONAL STUDENTS WHO ARE NOT ELIGIBLE FOR THESE THEY DON’T ARRIVE EARLY THEY’RE LUCKY TO ARRIVE FIRST TO LAST GIVEN THE PAPERWORK TODAY YOU DON’T LIKE TO HAVE TWO

GROUPS YOU CAN TEACH FEDERAL GRANT WRITING TO EVERYBODY THESE ARE THE REAL WORLD PROBLEMS WE HAVE WE HAVE A NUMBER OF STUDENTS INTERNATIONAL WITH FULL PAY UP FRONT AND HELPS SUBSIDIZE THE Ph.D. PROGRAM I’M THINK THE REALITY IS WHO’S IN THE PROGRAM AND HOW WE DEVELOP THESE SUBSETS PEOPLE WHO APPLY FOR FEDERAL AND ONES WHO DON’T >> I WAS WONDERING DOVETAILING ON THE F STORY AND INTERNATIONAL STORY SO THE F99, KOO MECHANISM IS AVAILABLE TO INTERNATIONAL STUDENTS AND I KNOW NINR IS SORT OF CONNECTS TO THOSE OPPORTUNITIES BUT HAVEN’T BEEN THE PRIMARY INSTITUTION TO PUT THAT OUT THERE IS THAT AN OPTION? >> THERE’S A NEWER PROGRAM >> THE FIRST YEAR WE DIDN’T GET APPLICATIONS OR SIGN ON AGAIN >> IT MAY BE RECONSIDERING WHETHER WE SIGN ON TO THAT >> WAS THAT FOR A PARTICULAR GROUP OF FOLKS? WAS THAT THE NINDS? >> THE NCI >>,000 ARE POPULATION SPECIFIC S&P >> CORRECT >> THEY ALLOW ONE NURSE FROM ONE INSTITUTE THEY NEED TO COMPETE >> IF NINR WERE TO HAVE THEIR OWN F99 MECHANISM I COULD SEE WHERE THERE’D BE MORE TRAFFIC >> ONE OF THE THINGS I’VE SEEN OVER THE YEARS IS CONFUSION AND THINK MORE PEOPLE COULD BE APPLYING >> I WANT TO ECHO THE WORD CONSTRICTIONS IT FORCES THEM TO GO TO CLRNG PRACTICE EVERY WEEKEND — CLINICAL PRACTICE EVERY WEEKEND TO MAKE BIG BUCKS THERE SO THEY’RE NOT MENTORING AND WORKING ON THE GRANT AND WORKING WITH IT INSTEAD THEY GO TO THE OTHER PART OF IT THE 10-HOUR MAXIMUM THING THEY CAN GET IF THEY GO OUTSIDE ACADEMIA THERE’S NO MINIMUM >> THE OTHER IS GETTING INFORMATION TO FOLKS SO THEY UNDERSTAND ABOUT THESE AWARDS ABLE — AVAILABLE AND HAVE RESOURCES TO WRITE AND SEVERAL MENTIONED PROGRAMS WITHIN THEIR INSTITUTIONS TO HELP WITH GRANT WRITING AND WONDERING WHAT MORE YOU THINK NINR COULD BE DOING TO PROMOTE AWARENESS OF SOME OF THE PROGRAMS THAT ARE OFFERED >> KEEP GOING TO THE NURSING REGIONAL SOCIETIES MOST ARE VERY STUDENT FRIENDLY AND HAVE INCENTIVE TO GET STUDENTS THERE WE TRY TO GET THEM LINKED UP WITH PROGRAM PEOPLE I WOULD SAY KEEP THAT UP AND AMERICAN HEART, THERE WAS A STORY THERE

>> MANY ORGANIZATIONS THE PRESENTATION WAS HIGHLY REL RELEVANT AND EVERYBODY ENJOYED IT USUALLY WE HAVE REGIONALS AND WE HAVE OFFICERS AND THERE’S FUNDING OPPORTUNITIES AND WAYS TO BE LINKED >> AT THE WESTERN INSTITUTE THEY HAVE A SPECIFIC CALLED RESEARCH AND INFORMATION EXCHANGE JUST FOR STUDENTS AND MAYBE EVEN IF THERE WAS AN OPPORTUNITY >> I THINK IT’S INTIMIDATING WE SIT THERE AND I BELIEVE THEY’RE REPRESENTING INTRAMURAL AND THE PROGRAM OFFICERS SEEM PRETTY BUSY I THINK ASSOCIATE DEAN FOR RESEARCH CAN COORDINATE THOSE SO SOME COMMUNICATION IS GREAT >> WE HAVE A COMMUNICATION STAFF MEMBER WHO GIVES MESSAGES OUT AND HAS A TABLE AND IT’S ALWAYS POPULAR FOR 10 MINUTES PEOPLE CAN SIGN UP AND IF NO ONE SIGNS UP YOU CAN STOP THERE AND THERE’S POSTER SESSIONS AND IT’S BEEN EFFECTIVE >> I DON’T KNOW IF YOU THOUGHT ABOUT DOING WEBINARS AND THE PRACTICAL SORTS OF THINGS YOU’D HAVE TO BROADCAST THAT WIDELY AND STUDENTS WHO WERE OUT AT OTHER INSTITUTIONS SO THOSE PEOPLE ON THE RIGHT-HAND SIDE HAVE A PERCENTAGE OF THE TRAINING AWARDS >> THE NOT 20 >> HOW DO YOU GET TO THOSE INDIVIDUALS YOU HAVE TO HAVE MENTORS AND SPONGSERS TO HELP WITH THEIR RESEARCH BUT THERE’S A LOT OF SPOKES ON THAT END MAYBE WE DON’T REACH BECAUSE THEY’RE PERHAPS NOT AT THE RESEARCH CONFERENCES OR WHATEVER WILL WORK BUT THOSE ARE THE PRACTICAL MESSAGES AROUND THE TRAINING PLAN ITSELF AND WHAT ARE REASONABLE GOALS YES, SPONSORS HELP WITH THAT BUT YOU KNOW WHAT SCORES WELL AND THAT IS GREAT INFORMATION FOR T32s AND FINDING OUT BEST PRACTICES FOR DIRECTORS IN RECRUITING I BELIEVE THE SUCCESS OF THE T32 IS RECRUITING TALENT INTO THE SLOTS I’M INTERESTED IN MINORITIES AND NOT BECAUSE OF THEIR LOCATION IN THE COUNTRY WHERE THEY HAPPEN TO HAVE A LOT OF MINORITIES AN EXAMPLE I WILL GIVE IN CLEVELAND I FORMED RELATIONSHIPS WITH HISPANICS SERVING UNDER GRAD SCHOOLS AND WENT ON RCRUITP RECRUITPED — RECRUIT AND GAVE A SPEECH AND ASKED THE DEAN FOR

THE BEST AND BRIGHTEST AND THEY MOVED TO START A CAREER THEN LATER I THINK THIS GROUP SAID I CAN’T BELIEVE YOU WOULD USE YOUR T32 MONEY TO GO DOWN AND RECRUIT THEM I SAID I GET A CERTAIN AMOUNT OF MONEY FOR THE PROGRAM I THOUGHT WAS USABLE FOR THAT EXPENSE FOR RECRUITMENT AND STRENGTHEN THE PROGRAM AND APPLY TO THE PROGRAM WHEN THEY GET AWARDED AND USING BEST PRACTICES AND CLARIFYING HOW MONEY CAN BE USED FOR RECRUITMENT >> MAYBE WE CAN CLARIFY ON THE WEBSITE IN THE OFFICE OF THE INTRAMURAL WEBSITE HAS GOOD RESOURCES TO POINT PEOPLE TO MAYBE A BETTER JOB OF DOING THAT AS WELL IT’S A DIFFERENT REGIONAL AND DO OFFICE OF RESEARCH HOLDS REGIONAL MEETING THAT ARE GRANT-WRITING SESSIONS AND WANT AN OPPORTUNITY ABOUT POLICIES OR PROCESSES, WHATEVER IS THAT SOMETHING THIS GROUP IS FAMILIAR WITH? >> YOU ASKED ABOUT THE POST-DOC AND GOING TO MEETINGS AND I WOULDN’T BELIEVE HOW ADMINISTRATIVE IT WAS FILLING OUT FORMS VERSUS GRANT WRITING IF AND WHAT WOULD HELP US UNDERSTAND BETTER ABOUT USE OF OUR MONIES IN TERMLY TO SUPPORT PEOPLE IN TRAVEL AND IF IT WASN’T JUST IN TIME FOR THEM WOULD BE WORTH THE THING GRANT WRITING MIGHT HAVE BEEN >> I ENCOURAGE TO YOU REACH OUT TO YOUR PROGRAM STAFF >> THEY HAVE TRACKS FOR PROPERTY AND INVESTIGATORS FOCUSSING ON GRANT WRITING AND OTHER THINGS RELATED TO INVESTIGATORS >> SO MANY YEARS AG I ATTENDED A COUNCIL MEETING WHERE THE BREAKDOWN OF INDIVIDUALS WHO WERE MEL FEL — FELLOWS ON T32 AND OTHERS AND I DON’T KNOW IF WE HAVE IT ANALYZED BUT IT’S HELPFUL TO SEE HOW IT’S DIFFERENT BETWEEN T FELLOWS AND F FELLOWS AT THAT TIME THERE WAS A STRIKING DIFFERENCE BETWEEN THE SUCCESS RATE ON GRANTS MY POINT IS TELLING THAT STORY IS A POWERFUL THING FOR RESEARCH SCIENTISTS TO LET THEM KNOW IF THEY’RE SUCCESSFUL WITH AN F31 IT’S A PREDICTOR OF PERHAPS THEIR SUBSEQUENT SUCCESS I THINK IT DOES ENCOURAGE PEOPLE TO SUBMIT THOSE F31s >> MAYBE JOHN CAN ELABORATE MORE AND THE FOLKS WHO HAVE Fs TEND TO HAVE BETTER OUTCOMES SINCE REQUIRING THE GRANT AND I THINK WHAT IT BOILS DOWN TO IS THEY

WRITE THEIR OWN APPLICATION AND TO GET THAT EXPERIENCE GUIDED WITH MENTORS OF COURSE AND IT’S REQUIRED TO HAVE THAT OPPORTUNITY >> IT HASN’T CHANGED >> ANYTHING ELSE WE HAVE NOT TALKED ABOUT TODAY REGARDING TRAINEES WE’RE MISSING FROM THE CONVERSATION >> WE DO HAVE LIMITED RESOURCES IN NURSING AND HAVE CERTAIN SCHOOLS THAT ARE STRONG IN TRAINING AND DO A GREAT JOB OF TRAINING AND WE HAVE DATA THAT SHOWS THAT >> A MONTH OR SO AGO WE WERE PEPPING FOR COUNCIL AND ARE LEARNING AND OF COURSE WE WANT TO GET DATA >> I HAVE A QUESTION ON THE MAP AND I CAN’T REALLY READ WHAT’S IN THE BUBBLES WHEN YOU SHOWED US THE CHART AND WALKED US THROUGH THE TOPICS I DID NOT HEAR SPECIFICALLY, PERHAPS IT WASN’T CODED FOR THIS BECAUSE I THINK THIS IS WHERE IS SYMPTOM SCIENCE? >> GOOD QUESTION IT WOULD BE GREAT IF WE CAN LOOK THROUGH THE PORTFOLIOS IN THE REPORTER AND SEE WHAT WE HAVE OUT THERE IN THESE VARIOUS AREAS IN THIS CASE PARTICULARLY FROM OUR TRAINING AWARD >> I HAD A QUESTION AND IF THIS EXISTS AND I DON’T KNOW ABOUT IT, I APOLOGIZE, BUT THERE’S CALLS THAT COME OUT FROM OTHER INSTITUTES PERIODICALLY THAT DISCUSS OPPORTUNITIES FOR UNDER GRADS AND SOME ARE YEARLONG OPPORTUNITIES AND IT’S STRIKING NINR IS NOT PART OF THOSE AND I COULD HAVE MISSED SOME OF THOSE OPPORTUNITIES BUT WHEN WE THINK ABOUT INCREASING DIVERSITY IN OUR TRAINING PROGRAMS, WE CAN ONLY PICK FROM WHAT’S THERE IF OUR BSN PROGRAMS AREN’T PROMOTING SOMEHOW ABLE TO PROMOTE THAT THEN OUR GRADUATE PROGRAMS AND POST-DOCS AND FACULTY IT CONTINUES DOWN THE LINE ARE THERE OPPORTUNITIES FOR NINR TO HAVE UNDER GRAD RESEARCH FUNDING AND DOLLARS TOWARDS

INCREASING DIVERSITY SO THEY GO TO THE UNDER GRAD DOLLARS AND IT SEEMS COUNTERINTUITIVE WITH THE SUPPORT IN NINR I WONDER IF IT’S A CONSCIOUS DECISION OR IF THERE’S BETTER OPPORTUNITIES OUT THERE WHY WOULD WE NOT BE INTERESTED IN FUNDING MECHANISMS SUCH AS THAT >> QUESTIONS I DON’T HAVE HISTORICAL ANSWER TO I THINK WE HEARD SOME REALLY GOOD SUGGESTIONS HERE I’M WONDERING WHETHER OR NOT WE SHOULD FORM A WORKING GROUP OF OUR COUNCIL TO EXPLORE SOME OF THESE ISSUES WE’LL LOOK AT DEFINITIONS AROUND IT MEMBERS FROM THE EXTRAMURAL COMMUNITY TO COME PRACTICE I DON’T KNOW HOW MUCH IT’S BEEN USED AT THE NINR COUNCIL WONDERING IF THERE WOULD BE INTEREST IN THERE I WOULD THINK IT’D BE INFORMATIVE TO HAVE SOME FURTHER ASSESSMENT OF THIS FROM FOLKS >> JACKIE WAS MENTIONED [INAUDIBLE] AND I’VE HAD FRIENDS FUNDED AND GRANTS AND RESEARCH CHANGED THE PROJECTIONS RESEARCH IS REALLY IMPORTANT >> WE’LL MOVE FORWARD IN A WORKING GROUP AND WE’LL REACH OUT TO JOIN MAYBE FOLKS ROTATING OFF MAY HAVE A ROLE TO PLAY WE MAY NOT BE DONE WITH YOU YET REMEMBER HOW WE TALKED ABOUT WE LET OGGI RETIRE BUT NOT REALLY RETIRE NEXT ON THE AGENDA IS A BREAK I THINK UNLESS WE HAVE ANYTHING ELSE TO DISCUSS ON THE TOPIC, WE SHOULD GO AHEAD AND TAKE THAT BREAK IF WE COULD BE BACK AT 3:15, THAT WAY WE COULD GET STARTED A COUPLE MINUTES EARLY WITH THE CONCEPT DISCUSSION THANK YOU, GUYS THANK YOU, JOHN THANK YOU, DAVID >> WE HAVE CONCEPT CLEARANCE TO PRESENT TO YOU TODAY WE’LL HAVE THE PROGRAM DIRECTOR FOR THE HIV-AIDS DIRECTOR AND WITH A LITTLE HAVE A DISCUSSION AND THEN OPEN IT UP TO COUNCIL DISCUSSION OF THE CONCEPT >> THANK YOU THIS IS GOING TO BE A SUPER BRIEF PRESENTATION OF THE CON CEMENT WE HAVE CALLED STRENGTHENING THE IMPACT ON IMPROVING THE HIV CARE CONTINUUM THE OFFICE OF AIDS RESEARCH IS SUPPORTIVE THE CONCEPT IT HANDS OUT ALL THE MONEY FOR HIV, NIH LED AND PAID FOR A WORKSHOP THAT BROUGHT TOGETHER COMMUNITY WORKERS AND IT WAS A TWO-DAY WORKERS AVAILABLE ON THE NIH ARCHIVES THE GOAL AND WE HAVE POPULATIONS FOR THE POOREST TREATMENT OUTCOMES WE’RE USING A POPULATION-BASED

COMMUNITY ENGAGED RESEARCH APPROACH WE’RE TESTING EXISTING AUGMENTED OR NEW STRATEGIES AND PROGRAMS IN THE HIV EPIDEMIC AREAS THE HIV CARE CONTINUUM IS A SERIES OF STEPS A PERSON WITH HIV TAKES FROM INITIAL DIAGNOSIS THROUGH SUCCESSFUL TREATMENT OF HIV MEDICATIONS WHICH ARE ANTIRETROVIRALS AND WE NOW KNOW IF PEOPLE ARE DURABLY VIRALLY SUPPRESSED THEY LITERALLY CANNOT TRANSMIT THE VIRUS THAT WAS GREAT NEWS A COMMUNITY HEALTH WORKER IS THE FRONTLINE HEALTH WORKER WHO IS A CLOSE UNDERSTANDING OF THE COMMUNITY AND FUNCTION AS A LIAISON BETWEEN HEALTH AND SOCIAL SERVICES AND COMMUNITY MEMBERS AND THEY HAVE JUST A VERY BROAD RANGE OF PRACTICE THE TWO BULLETS ARE TAKEN FROM AN AGREED UPON DEFINITION AS WELL AS THE ASSOCIATION FOR COMMUNITY HEALTH WORKERS WHICH INFORMED OFFICIAL ORGANIZATION IN 2019 SO COMMUNITY BACK IN THE 80s I WORKED WITH THE HEALTH DEPARTMENT AS PART OF OUR TEAM CURRENTLY THERE’S A LARGE GAP BETWEEN ANTIRETROVIRAL SUPPRESSION AND PRESCRIPTIONS AND THE CAUSES INCLUDE POVERTY AND THE HIV STIGMA ILLNESS-RELATED STIGMA COMPOUNDED BIN INTERSECTIONAL AND GENDER, RACE, CLASS AND ETHNICITY AND PEOPLE LIVING WITH HIV ARE LIKELY TO HAVE SUBSTANCE USE DISORDERS AND UNTREATED MENTAL ILLNESS AND EXPERIENCE INCARCERATION WE FELT COMMUNITY WORKERS UNDERSTAND AND ADDRESS THE HEALTH CARE BARRIERS AND SOCIAL ISOLATION PEOPLE EXPERIENCE SO THE RESEARCH OBJECTIVES INCLUDE PRAGMATIC TRIALS OF ACTIVE OR AUGMENTED COMMUNITY HEALTH WORKER PROGRAMS THAT STUDY THE CARE AND HIV CARE AND ADHERENCE IN PLENTATION RESEARC THAT — IMPLEMENTATION RESEARCH THAT EXTENDS AND STRATEGY TO UNDER RESOURCED COMMUNITIES HARDEST HIT BY THE HIV EPIDEMIC AND ALL THE METHODS INCLUDE PARTICIPATORY METHODS FOR BUY-IN OF RESULTS THE RESEARCH WILL PROVIDE GUIDANCE FOR SCALE AS A FORCE IN SOLVING THE GAPS IN CONTINUUM OF CARE DEVELOP A RESOURCE FOR COMORBIDITIES AND OTHER HEALTH PROGRAMS FOR THE INITIATIVE TO END THE HIV EPIDEMIC AT THE END OF THE DAY WE HOPE TO ESTABLISH AND DISSEMINATE EVIDENCE-BASED STRATEGIES TO IMPROVE ENGAGEMENT AND HIV VIRAL SUPPRESSION IN NEGLECTED COMMUNITIES NOW I’LL TURN IT OVER TO JEFFERY KELLY >> I THINK IT’S A TIMELY CONCEPT I’M OLD ENOUGH I REMEMBER EARLY DAYS WHEN PEOPLE WERE DIAGNOSED AND THERE WAS NO TREATMENT AND THERE WERE

COMMUNITY MEMBERS AND THE PROGRAMS WERE CALLED BUDDY PROGRAMS SOMETIMES THEY HAD NAMES LIKE LIFE SAVER OTHER PROGRAMS WHERE A PERSON WAS DIAGNOSED WITH AIDS AND HELP THEM NEGOTIATE THE THINGS THEY HAD TO NEGOTIATE UNFORTUNATELY IT WAS ALWAYS ON A DOWNWARD BUT THEN I WHEN I HEARD ABOUT THE CONCEPT I THOUGHT IT EVOLVED AND NOW WE CALL THEM NAVIGATORS THE IDEA’S THE SAME TO HELP A PERSON WITH HIV NAVIGATE DIFFERENT PSYCHOLOGICAL AND SOCIAL AND HEALTH CHALLENGES THEY’RE GOING TO FACE AND THE CONSENT THROUGH ALL THIS IS SOCIAL SUPPORT SUPPORT COMING FROM SOMEONE YOU KNOW AND TRUST AND HAS INVESTMENT IN YOU AND YOUR CARE IN BECOMING VIRALLY SUPPRESSED AND LIVING A LONG HEALTHY LIFE AND NOT TRANSMITTING HIV TO ANYBODY ELSE I THINK THAT’S BEEN A CONSTANT SOMETHING ELSE FOR A NUMBER OF YEARS, WE’VE KNOWN PEOPLE WITH HIV USUALLY HAVE OTHER THINGS GOING ON IN THEIR LIFE ALCOHOL USE PREDICTS VIRAL SUPPRESSION AND MENTAL HEALTH PROBLEMS AND OTHER KINDS OF DRUG USE HOUSING INSTABILITY INTIMATE PARTNER VIOLENCE MANY OTHER IF UNADDRESSED WILL PREVENT SOMEBODY FROM TREATMENT ADVANCES GOING ON NOW AN EXCITING THING ABOUT THE CONCEPT IS USING COMMUNITY HEALTH WORKERS AS LIFE SAVERS AND NAVIGATORS FROM THE SAME COMMUNITY CAN USUALLY UNDERSTAND AND CONNECT AND CAN BE ENORMOUSLY USEFUL REBECCA MENTIONED THE NATIONAL PLAN THE PLAN IS AN AMBITIOUS ONE IN SEVEN OR EIGHT COUNTIES WITH THE HIGHEST BURDEN OF HIV AND RURAL EPIDEMICS AND DRIVE DOWN HIV INCIDENTS AND THERE’S FOUR PILLARS OF THE PLAN ONE IS DIAGNOSING PEOPLE EARLY TO BECOME VIRALLY SUPPRESSED THEN THIRD IS PREVENTION AND FOURTH IS BEING ABLE TO RESPOND TO OUTBREAKS IN THE EMERGING PUBLIC HEALTH LEVEL IT SOUNDS GOOD HOW DO YOU IMPLEMENT AND THE CONCEPT TAKES ADVANTAGE OF THE STAFFING PROFESSIONAL AND COMMUNITY HEALTH WORKERS WHO ARE ALREADY IN PLACE AND BROADEN THE ABILITY TO MEET THE NEEDS PEOPLE WITH HIV IN ORDER TO IMPLEMENT THIS STRATEGY I THINK IT’S AN EXCITING CONCEPT WE THINK OF THE ISSUES AS URBAN AND THEY ARE BUT NOT ALWAYS YOU CAN IMAGINE COMMUNITY HEALTH WORKERS IN RURAL AREAS THEY CAN USE MODALITIES TO MAKE THE SAME CONNECTION AND HOW THE CONCEPT UNFOLDS SEEMS LIKE AN EXCITING PRACTICAL WAY TO IMPLEMENT WHAT IS POSSIBLE TO DO >> I WAS EXCITED TO SEE THIS CONCEPT BECAUSE I THINK IT’S AN IMPORTANT CONCEPT AND VERY NEEDED

I’VE DONE A LOT OF WITH HIV AND I WANDED TO ADD MORE BUT I’M APPRECIATE WE SPOKE ABOUT THE 90, 90, 90 I THINK WE CAN BROAD JEFF THE CONCEPT MORE — BROADEN THE CONCEPT MORE BY ADDING TO THE IDENTIFICATION OF PEOPLE LIVING WITH HIV THAT’S PART OF THE SPECTRUM OF HIV CARE I RECOMMEND PROMOTING HIV TESTING WHATEVER WAY IT MAY BE SELF-TESTING OR GOING TO AGENCIES WE KNOW LOTS OF PEOPLE WON’T GO FORMALLY TO AGENCIES AND OFFER THE PROMISE OF PROMOTING SELF-TESTING WITH THE SUPPORT THERE’S STILL A LOT OF STIGMA IN MANY COMMUNITIES AND IN SOME PLACES THERE MAY BE ONE OR TWO CLINICS TO GO TO TO NAVIGATE THAT I’D LIKE TO SEE THE CONCEPT BROADENED AND I HAVE ANOTHER RECOMMENDATION THERE ARE MANY DIFFERENT MODELS BY WHICH COMMUNITY HEALTH WORKERS ARE EMPLOYED THEY COULD BE AT THE GRASS ROOT LEVEL BUT THE MODELS MAY INVOLVE DIFFERENT SUPPORT AND A WROTE IT OUT TO DESCRIBE AND EVALUATE THE MODELS FOR COLLABORATION OF COMMUNITY HEALTH WORKERS WITH NURSES AND OTHER HEALTH PROFESSIONALS I THINK THE OUTCOMES MAY BE A LITTLE DIFFERENT DEPENDING ON THE EDUCATIONAL PREPARATION THERE MAY BE A VARIABLE ON WHAT WE SEE IN OUR RESEARCH THANK YOU >> IN MY RESEARCH ON HIV AND PREVENTION, WHAT YOU SEE IN SOME COMMUNITIES AND I WORK IN AN UNDER REPRESENTED COMMUNITY, PEOPLE LIKE THE CONCEPT OF HAVING SOMEBODY FROM THEIR COMMUNITY BUT THERE’S ELIMINATIONS I DON’T WANT PEOPLE TO KNOW THEIR INTIMACIES AND I THINK WITH THE HIV EPIDEMIC WHAT WE’RE MISSING IS WE DIAGNOSE PEOPLE AND BRING THEM TO TREATMENT AND PUT THEM IN TREATMENT AND MANY TIMES I THINK IT HAS TO DO WITH CERTAIN COMMUNITIES BECAUSE OF THE KNOWLEDGE ABOUT THEIR TREATMENT THEY’RE NOT KNOWLEDGEABLE ENOUGH AND WE’VE SEEM TO DO A GOOD JOB WHEN WE TEST AND COUNCIL THEM BUT THEN THE MAINTENANCE OF THOSE BEHAVIORS THROUGH THE COURSE OF THE TREATMENT AND WHERE THE CONCEPT OF SUPPORTING WITH HEALTH CARE NURSES WOULD MAKE A DIFFERENCE IT’S NOT ONLY NAVIGATE BUT BEYOND THAT IT’S HOW DO YOU SUPPORT THE PERSON AND BEHAVIORS WHAT STRIKES ME ABOUT THE MODEL IS AN ENDURING COUNCIL AND WE THINK IT WILL GO ON FOREVER AND IT DOESN’T THE IDEA THAT IT ATTACHES TO A PERSON YOU CAN GO ABOUT BEING FROM THE SAME COMMUNITY ACKNOWLEDGE WHAT THEY KNOW ABOUT THEM >> ALL THOSE THINGS ARE THINGS WE DISCUSSED HEAVILY IN THE LAST NINE MONTHS WE DECIDED TO LIMIT IT TO THE HEAVY LIFT WHICH IS ADHERENCE I THOUGHT NURSING CAN BRING THAT

IN I THINK KEEPING PEOPLE ADHERENT OVER TIME AND THERE’S A LOT OF PEOPLE IN THIS COMMUNITY IN PARTICULAR THAT ARE PROBABLY GOING TO GO OFF THE RAILS EVERY SO OFTEN AND WILL NEED LONG-TERM SUPPORT AND THIS IS GEARED TO BEEFING UP THE PROGRAMS THAT HAVE WORKED IN OTHER PARTS OF THE COUNTRY TRYING TO EMBED THIS IN PLACES THAT ARE HEALTH CARE DESERTS I SEE IT AS A POSSIBLE STRATEGY TO DEAL WITH WHAT WE HAVE AND I HOPE IT WILL BE A SUITE OF STRATEGIES AS THE MONEY COMES IN FROM THE HIV EPIDEMIC >> ARE THERE OVERLAPS IN INITIATIVES >> THE REASON WHY IT’S NINR LEADING THIS IS BECAUSE IT’S NURSING IT’S ALWAYS BEEN THE NURSES AND HEALTH CARE WORKERS THAT INTERFACED AND THAT CAME UP DURING THE SYMPOSIUM AND WHY WE WANT TO PULL THEM INTO THIS THEY HAVE TO HAVE A POINT OF REFERENCE AS FAR AS MENTAL HEALTH, THEIR ADHERENCE GUY, THIS HAS BEEN FROM THE VERY BEGINNING BECAUSE OF THE TIMING WAS SO GOOD WITH THE EPIDEMIC, I HAD ALREADY STARTED THIS A COUPLE YEARS AGO IT HIT AT THE RIGHT TIME AND WE BROUGHT IN PEOPLE FROM OTHER INSTITUTES AND CDC AND HRSA TO GET ON THE SAME PAGE WITH THIS >> I WAS NOT CLEAR HOW THE COMMUNITY HEALTH WORKERS WERE LINKED TO ME YOU WANT TO MAKE IT CLEAR >> I LIKE THE IDEA THAT IT’S A TENSION BETWEEN NOBODY SOMEBODY WHEN MAYBE THEY DON’T WANT TO KNOW YOU >> I KNOW PHYSICIANS THAT RUN PROGRAMS WHO COULD APPLY AND A NURSE COULD BE IN THE PROGRAM WHAT IS IT THE ROLE OF NURSING SYMPTOM MANAGEMENT AND CARE WITH THE HIV PATIENT BUT THERE’S GOING TO BE COMMUNITY WORKERS NURSES INTERFACE WITH WE CALLED IT OUT IN THE RFA AND I’VE BEEN THINKING HARD HOW WE MAKE THAT OR IN THE CONCEPT IT’S SOCIAL WORK AND NURSING IN TERM OF MANAGEMENT AND I SEE THAT AS NOT AN INDIVIDUAL RESPONSIBILITY BUT GROUP THE COMMUNITY HEALTH WORKER, NURSE, SOCIAL WORKER ALL THE PEOPLE INVOLVED IT’S NOT AN INDIVIDUAL PERSON TO MAKE IT HAPPEN COMMENTS OR QUESTIONS PERHAPS

>> YOU MAY HAVE SEEN LAST WEEK THE NEW ENGLAND JOURNAL OF MEDICINE A PROGRAM THAT WAS NOT EFFECTIVE IN REDUCING RECIDIVISM IN INDIVIDUALS WITH CHRONIC ILLNESS I BRING THAT UP BECAUSE IT’S INTERESTING THE CAMERON PROJECT OR PROGRAM INVOLVED THE USE OF COMMUNITY HEALTH WORKERS AND NURSES AND SOCIAL WORKERS TO HELP INDIVIDUALS WHO RECENTLY HAVE BEEN HOSPITALIZED FOR A CHRONIC CONDITION AND HAVE GONE HOME AND TRYING TO REDUCE THEIR REHOSPITALIZATION OVER 180 DAYS IT’S AN INTERESTING REPORT THAT CAME OUT JANUARY 9 IN THE NEW ENGLAND JOURNAL IF YOU LOOK AT THE CONCERNS WE KNOW KEEP PEOPLE FROM PERHAPS DOING THE THINGS THAT WE THINK THEY SHOULD DO IN ORDER TO MAINTAIN WELLNESS AND THINGS GETTING IN THE WAY FOLLOWING ADHERENCE OR WHATEVER IT IS THE PROGRAM AND MY POINT IN BRINGING IT UP IS READ THIS AS YOU ARE DEVELOPING THE CONCEPT INTO AN RFA SO WE LEARN FROM A RECENT STUDY OF A RECENT STUDY OF A SIMILAR IDEA THAT MIGHT HELP INFORM US SO THAT WOE GET GOOD STUFF TO ADDRESS THIS VERY PRESSING PROBLEM THE OTHER COMMENT I WOULD SUGGEST IS THINK ABOUT COST ANALYSIS BEING A PART >> THE CAMERON PROGRAM IS ABOUT $5,000 A PERSON TO KEEP INDIVIDUALS FROM BEING REHOSPITALIZED IT MAY NOT BE A VERY BIG COST WHEN YOU THINK OF IT BUT IT BECOMES A BIG COST >> I LISTENED TO THE COMMENTS AND THEY FORGOT HOUSING THAT’S HUGE WITH THIS POPULATION AND WE KNOW THAT BUT IT STARTED A LONG TIME AGO F IF IT STARTED NOW IT’D BE A HUGE CONCERN WE ALREADY KNOW WITH HIV IT’S HOUSING AND UNSTABLE HOUSING IS CRITICAL THAT’S PART OF THIS WHOLE PICTURE OF HOOKING PEOPLE TO SOCIAL SERVICES AS WELL AS HEALTH SERVICES >> THANK YOU DO YOU HAVE EVERYTHING YOU NEED REBECCA WE HAVE ONE MORE BIT OF BUSINESS BEFORE THE OPEN SESSION TODAY THIS IS THE TIME OF YEAR THAT WE REVIEW THE STATEMENT OF UNDERSTANDING IT WAS INCLUDED IN YOUR MATERIALS THAT WERE IN THE ELECTRONIC COUNCIL BOOK AND PDI I HOPE YOU HAD A CHANCE TO REVIEW IT WE MADE NO SUBSTANTIVE CHANGES FOR 2020 SO I WANTED TO ASK IF YOU HAD QUESTIONS >> IT OUTLINES YOUR COUNCIL APPLICATIONS IT’S TWO OR THREE PAGES IT TALKS ABOUT YOUR ROLE IN THE SECOND LEVEL REVIEW OF GRANTS ANYBODY HAVE QUESTIONS ABOUT IT? OKAY THANK YOU ONLY THING I WANTED TO REMIND YOU OF TODAY IS THE NEXT COUNCIL MEETING IS MAY 19 AND 20 ADDITIONAL COUNCIL MEETINGS IN ’20 AND ’21 AND LET ME KNOW AS SOON AS POSSIBLE >> WITH THAT WE ARE ADJOURNED A BIT EARLY I HAVE A PROPOSAL FOR YOU ALL BEFORE I BANG THE GAVEL SO WE HAVE THIS ROOM UNTIL 5:30 AND I THINK THAT STILLS GIVES US

PLENTY OF TIME IS THERE ANY INTEREST IN GOING AHEAD WITH CLOSED SESSION TONIGHT AND VENTURE OUT TOMORROW AND HAVE THE DAY FREE TO DO WHATEVER WORK NEEDS TO BE DONE WE WOULD TAKE A LITTLE BREAK AND CLEAR THE ROOM BEFORE WE GO INTO CLOSED SESSION >> OKAY SO THEN WITH THAT IN MIND BECAUSE SOME FOLKS MIGHT HAVE THEIR HAND WRITTEN NOTES IN THE HOTEL, THEN WE WILL ADJOURN FOR THE DAY BUT BEFORE WE DO, I WANT TO THANK YOU ALL FOR YOUR EXCELLENT COMMENTS AND FEEDBACK AND THOUGHTFUL DISCUSSION WE HAD TODAY AND THANK OUR PRESENTERS PARTICULARLY THE EARLY-STAGE INVESTIGATORS THAT CAME HERE AND PRESENTED A LITTLE BIT ABOUT THEIR EXPERIENCE AND THEN OF COURSE THREW TO THE NINR STAFF FOR ORGANIZING TODAY’S MEETING 04:36:35.179,00:00:00.000 THANK YOU

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