Research Strategic Goals 2018-2023
- To be a leader in biomedical and clinical research by narrowing and focusing research areas to enhance success. Focus areas for funding, collaboration, and future hires will include:
- Basic, clinical and translational research has been on-going as part of our collaboration with the Gibbs Cancer Center in Spartanburg, NC
- Focus has been on Informatically-driven validation and cancer etiology genomics studies
- Precision and Functional Medicine
- Neuroscience, neurological injury, and neurodegenerative disease
- Basic, clinical and translational research is planned to be part of the “Integrative Neuro-cognitive Disorder Clinic” (INDC) which is in development
- Focus will be on identification of diagnoses, prognosis and clinical decision-support biomarkers and therapeutic targets
- Precision and Functional Medicine
- Musculoskeletal research
- Osteopathic neuro-musculoskeletal treatment (NMM), treatment of musculoskeletal injury, and the benefits of osteopathic manipulation
- Degenerative arthritis – further delineation of the disease, genetics and personalized prevention and treatment
- Genetics and Personalized Medicine
- To perform research consistent with our mission in population health, rural health, community health, and practice-based research.
- Engage and support appropriate faculty with interests in these areas
- Appoint faculty mentors whose primary area of interest and engagement is student research
- Research areas include:
- Environmental health impacts and strategies for prevention and intervention
- Strategies for prevention, health maintenance, and healthcare access in rural and medically underserved communities
- Methods to evaluate and address health disparities
- Strategies for prevention, health maintenance, and healthcare delivery in the international environment
- Development of strategies, tools, and data analytics in evaluation for practice-based research
- Real-time, geographically disperse population health surveillance research using our CREDO “app”
- Be a leader in educational research, with a robust portfolio of scholarly works recognized in presentations in national arenas and refereed journals. Areas of research include (but not limited to):
- To perform educational research in the areas of:
- Innovative educational technology (learning and review tools)
- New teaching methods and strategies
- New measurement/assessment tools
- Effectiveness of teaching methods
- To be a leader in the profession for the presentation of scholarly works in national arenas and a robust portfolio of publications in peer-reviewed journals
- To perform educational research in the areas of:
- To provide faculty and student development in all areas of research through monthly seminars, annual research days, and research retreats.
- To develop fellowship and certificate programs that recognize mastery in research for interested and capable students, residents, and faculty
- To develop a culture that recognizes and promotes scholarly work for all students, residents, and faculty
- To promote research collaboration across all VCOM campuses and with our University partners.
- To build key collaborations by providing matching funds with key partner university’s colleges
- To collaborate and continue to support the “One Health Research” program
- To create educational research teams across VCOM campuses
- To foster inter-professional education research teams with university partners and certificate programs for those seeking a mastery level in research
- To develop a culture that recognizes and promotes scholarly work for all students, residents, and faculty
- To provide internal funding and support for those research projects deemed appropriate by the following: technical writing, faculty expertise, collaboration, support for new investigators, prior presentations and publications from internal funding, and potential for external funding.
- Continue to build our internal research funding program, REAP, across all campuses to generate preliminary data for improving external grant application competitiveness
- To grow externally funded research and programs by 10% each year.
- To provide a robust research support team with offices and personnel on each campus.
- To develop a “research team” and educational materials to support the resident research of our GME partners.
VCOM Research Division Strategic Plan 2018-2023
The Research Mission of the Edward Via College of Osteopathic Medicine is to promote research to improve human health, specifically by advancing knowledge through medical research in the priority areas of biomedical, clinical and translational research, including precision medicine; prevention and public health research; simulation and educational research; and research on Osteopathic principals and practice. To this end, the Research Division of the College seeks to develop and promote research opportunities in all of these areas by enhancing faculty and student research capabilities, reaching out to academic partners to enhance existing relationships and create new opportunities, fostering collaboration among physicians and scientists within and outside VCOM, and developing and expanding research pathways to create physician scientists who make research an integral part of their career activity while providing top quality medical care for their patients and their communities.
VCOM’s overall goal in research is to become the top ranked Osteopathic Medical School in research in the next 5 years, and become the leader in rural primary care and prevention related research over the next 10 years.
VCOM COMMITMENT TO RESEARCH:
Since its founding, the VCOM Board of Directors, President and Deans have made research and scholarly activity a priority for the College. Research is a fundamental component of the VCOM Mission.
Research training and credentials are a major consideration for all Biomedical Faculty hires, and research and scholarly activity is strongly encouraged for all Clinical Faculty. Research and scholarly activity is also a critical component for faculty promotion, confirming its importance for VCOM Faculty. VCOM has a strong core of extramurally funded, nationally recognized researchers who serve as mentors for junior faculty at the early career phase of establishing their own independent research career.
In July 2014, VCOM announced a reorganization of the Research Division, and appointed Dr. Gunnar Brolinson as the Vice Provost for Research over all VCOM campuses. This new structure was put into place to provide better support for research endeavors at all campuses as well as to ensure a more uniform operating model as the College continues to grow. As a result of this restructuring, more formal research partnerships are being developed, and faculty have been provided with additional resources to strengthen their research programs, such as faculty development programs on research skills, peer review and statistical/informatics support. Importantly, this move has facilitated much more interdisciplinary and interdepartmental collaborative research focused on VCOM’s unique research strengths and capabilities in rural underserved and primary care, and emerging cutting-edge research areas.
The Vice Provost for Research, Associate Vice Provost for Research Development and the Associate Deans for Research at the four VCOM Campuses have very strong research credentials including: extramural funding and contracts, publications, serving as organizers/speakers at national conferences, oral and poster presentations at national conferences, serving on grant review panels, and serving on the editorial board of journals and intellectual property development. This leadership team is well qualified and positioned to lead all aspects of VCOM’s Instructional, Clinical and Biomedical research and foster its growth and development in the coming years.
Collaborations and Partnerships
VCOM has extensive research infrastructure, and continues to build and develop the research structure on an annual basis. Adequate space is currently available for research and we plan for considerable expansion in the coming years. In addition, VCOM has entered into strategic partnerships with entities that complement and expand the research infrastructure and facilities available to VCOM researchers, and add synergistic expertise and capability to amplify our research productivity:
- Virginia Tech – a major strategic asset for VCOM Research. VCOM Faculty members have active collaborations with VT faculty members in ICTAS, Vet Med, Engineering (and in particular School for Biomedical Engineering and Science) and the College of Arts and Science and College of Agriculture. These and other collaborations have provided an important foundation for Federal funding from the NIH, NSF and Department of Defense projects, which have provided sustained extramural funding for VCOM researchers. VCOM’s latest initiative with VT’s Virginia-Maryland College of Veterinary Medicine (VMCVM), the Center for One Health Research, promotes joint VCOM-VMRCM research programs relevant for humans and animals. Faculty from both VCOM and VMRCVM will utilize research facilities and infrastructure at all locations for a wide variety of clinical and biomedical research as well as supporting graduate student education and research programs conducted within the Center.
- Spartanburg Regional Hospital and Gibbs Cancer Research Center – The VCOM-Gibbs Cancer Research Center facilitates basic, clinical and translational cancer research, including cancer genetics, cell biology, and pharmacology. With the addition of the stem-cell, tissue banking, CRISPR and nextgen sequencing facilities, this laboratory is unique in the region and provides opportunities for large scale collaborative projects. VCOM and Gibbs operate this Stem Cell/CRISPR/sequencing Core Research Facility, and our cooperative research programs continue to flourish. VCOM and Gibbs are involved in several joint research proposals based upon novel cancer detection and genomic diagnostic techniques and VCOM is providing bioinformatics and genomic support for Gibbs in these areas.
- Magnolia Laboratories on VCOM Spartanburg campus – The laboratory is outfitted for basic, clinical and educational research activities. Frequently faculty and medical students conduct collaborative research in these laboratories with external collaborators from Wofford, Converse and USC Upstate students and faculty visitors. The laboratory is well outfitted for a wide variety of cell and molecular biology research activities that span standard cell culture to genetics to microgravity experiments and instrumentation. This laboratory also has a tissue and sample storage facility with freezers and liquid nitrogen systems and serves as a primary and a backup facility available to all VCOM campuses and collaborators.
- Auburn University – A major strategic asset for VCOM Research is our collaborative agreement with Auburn University. Agreements developed with Bioengineering, Kinesiology, the Vet School, and College of Pharmacy provide the foundation for new interdisciplinary collaborative work. In particular, the VCOM collaboration with the Department of Kinesiology creates opportunities for multi-faceted evidence-based research projects on the principles of Osteopathic Manipulative Medicine (OMM) combing osteopathic, physical therapy and kinesiology approaches, which is attractive to national agencies and foundations that fund Osteopathic Research (AOA, OHF, AOF). These collaborations also provide foundational support for Federal funding applications. In addition, our partnership with Auburn allows VCOM access to state-of-the-art medical equipment at Auburn for our OMM research needs, including a 7- Tesla MRI system.
- University of Louisiana at Monroe - Faculty members at VCOM’s Louisiana Campus are building strong research relationships with several colleges and institutes within ULM. The College of Pharmacy has a vivarium with established procedures for the receiving and housing of research animals, and the College of Pharmacy’s Office of Outcomes Research and Evaluation conducts research in illness studies, pharmacoeconomic analyses, quality of care studies and policy and program impact studies. ULM’s Institute of Gerontology received funds from the National Institute on Aging in 1987 to form the first Center on Aging in Louisiana. Mutual research areas of interest with VCOM and ULM Gerontology faculty include precision medicine, diagnostic and therapeutic medicine based on genetic testing, pain management and quality of life research. ULM’s Social Science Research Laboratory was developed to grow interdisciplinary research collaborations aimed at positively impacting the local community. This goal aligns well with VCOM’s mission, and VCOM Louisiana faculty will be working with this group on community health research. VCOM faculty also collaborate with ULM faculty in the Kitty DeGree School of Nursing, the Medical Laboratory Science Program and the ULM TRIO Educational Research Program.
Research Areas of Interest and Clinical Research Sites
VCOM researchers are recognized for their strength in the areas of sports medicine, head injury including concussion and traumatic brain injury/blast injury, neurodegenerative disorders, inflammation, stem cell biology, cancer immunology, cancer genomics/genetics, bioinformatics, infectious disease, public health, and simulation/education research. A strong VCOM research history in these fields naturally creates collaborative opportunities with new partners seeking to build on these strengths, which increases funding opportunities and increases the national reputation of VCOM and VCOM researchers. We have also aligned our research mission to reflect a commitment to osteopathically oriented research. The four basic tenants of Osteopathic Medicine are: body unity, the interrelationship of structure and function, the body is self-healing and that rational treatment is based on these principals. The AOA has recently reorganized its research division to reflect a new emphasis on research that demonstrates uniquely osteopathic approaches and outcomes. There are now 6 focus areas: 1) Osteopathic Philosophy, 2) Research on the Profession, 3) Impact of OMM and OMT, 4) Musculoskeletal Injuries and Prevention, 5) Pain Management and 6) Chronic Diseases and Conditions.
VCOM’s owned and operated local clinics, our network of clinical training sites and partner hospitals (OMNEE network) creates tremendous opportunities for clinical faculty and staff, medical residents, fellows and students to engage in VCOM-sponsored research projects on site and in collaboration with VCOM Faculty. These types of projects are in place at several sites, providing a solid foundation for future growth of our research endeavors.
VCOM’s access to Appalachian, rural and underserved populations also offers great opportunities in primary care and community-based research. Clinicians, medical residents and students often generate pioneering ideas leading to solutions as a matter of course in their work with patients. In addition, VCOM international mission sites, with their infrastructure, organization and outreach programs, are a major strength for conducting a wide variety of research projects spanning basic, clinical and translational research as well as prevention, public health, and educational research.
VCOM has established several continuously-staffed clinics in Central America (Dominican Republic, Honduras and El Salvador). These clinics and their medical staff provide ongoing acute and chronic care to the local population. We are targeting broad governmental and commercial relationships for internationally-relevant biomedical research and clinical trials. All the infrastructure and experience of the VCOM international program provides a unique strategic advantage among U.S. medical schools to develop and test new clinical diagnostics and therapeutics with access to unique clinical samples, conduct basic and translational research, engage in development and promote capacity-building that is mutually beneficial to each country.
CURRENT STRATEGIES AND INITIATIVES:
Interdisciplinary and Cross-Campus Research
Each VCOM Campus has several unique research focus areas defined by groups of faculty members with similar research interests. The Virginia Campus has concussion, TBI/Blast Injury, Simulation, bioinformatics, cancer genomics, sports medicine, neurodegenerative disorders and Inflammation. The Carolinas Campus has stem cell biology, cancer biology, inflammation, and neurobiology. The Auburn Campus has kinesiology, biomechanics and sports medicine. The Louisiana campus has kinesiology/physical therapy, OMM, sports medicine, geriatrics and genomics. Identifying campus-specific focus areas is critical for creating opportunities for new faculty hires. Multi-disciplinary teams have formed around these research focus areas. Formalizing these teams by the creation of virtual centers and shared research cores provides an excellent recruitment tool when adding new faculty members or collaborators.
Given the nature of federal funding, it is critical to identify multi-investigator, multi-disciplinary teams that have a track record (i.e., published papers) of working together (and with external collaborators of note) on a unified set of research problems. Groups of researchers working on focus areas are being identified and formalized, and their work facilitated in terms of shared resources, space and supplies, to promote scholarly activity as a group. Furthermore, future faculty recruits at each campus would be aligned with specific research focus areas.
Research with Collaborative Partners
Multi-disciplinary collaborative research teams are the most competitive when applying for federal and foundation funding. Equally important is to have very-well established, nationally recognized investigators as real participants on the team, and having access to state-of the-art research facilities and expertise. Collaboration with our partners creates exciting new opportunities for expansion of VCOM research, and for increasing the impact of that research. Many VCOM faculty members hold joint appointments at these partner institutions, and many faculty members at these institutions hold dual appointments at VCOM or hold joint appointments, facilitating this closer collaboration.
The development of the Center for One Health Research, together with Virginia Tech College of Veterinary Medicine promotes joint research programs relevant for humans and animals. The Center includes the Veterinary College at Virginia Tech and all VCOM campuses, and also includes research projects at the VCOM international mission sites. The development of the Center allows VCOM to pursue an innovative and cross-disciplinary research agenda that is aligned with our core mission and values. VCOM and VMRCVM researchers have a long history of fruitful collaboration, and this formalized enterprise will only enhance opportunities and increase our overall success. We will continue to actively support research within this Center with seed funding programs and specific RFPs, which will lead to extramural funding from NIH and other funding agencies.
The VCOM-Gibbs Cancer Research Center laboratory brings together significant expertise on stem cell biology and cancer biology, and represents exactly the type of research collaborative that is attractive for extramural funding agencies. With the recent addition of the Center for Bioinformatics and Genomics, the time is right for significant rejuvenation of the joint research activities, increased faculty participation, reassessment of infrastructure for optimization, in investment in terms of new faculty and staff hires, equipment and support.
VCOM is expanding collaborations with Greenwood Genetics Center, including the development of a focused program in human genetics and osteopathic medicine. It is critical that the direction of this program advance genetic research and physician education in medical genetics, while incorporating principles and philosophy of osteopathic medicine. The goal of this new program aligns with the overall goal of VCOM, and will advance precision medicine through the use of genetics in primary care clinical practice, which will ultimately improve the health of medically underserved, rural populations.
A Motion Analysis Research Laboratory at the Auburn Campus has been developed with the Jack Hughston Foundation. This laboratory will be critical in addressing pre- and post-operative management of orthopedic injuries and the application of basic principles of osteopathic medicine to gait, movement disorders and other muscular-skeletal maladies. Further, the Auburn Campus has established an educational endeavor with the Hudson Alpha Institute for the application of genomic technologies in clinical networks. This gives us an excellent opportunity to create clinical research pathways focused on primary care, precision medicine and osteopathic medicine.
With the addition of VCOM’s Louisiana Campus on the ULM Campus and the subsequent partner agreements, there is now a complete “healthcare campus” in Monroe. This campus includes VCOM, ULM’s Colleges of Pharmacy and Nursing and their proposed school of Physical Therapy. Collaborative research with the ULM College of Pharmacy will include studies in cancer, pharmaceutical and nutraceutical product research, toxicological research, inflammation, cardiovascular function and health disparities. Collaborative research programs with the Kitty DeGree School of Nursing include public health and population research as well as program aimed at increasing access to care. VCOM also aims to increase research in the areas of OMM therapy, sports medicine, obesity research and areas of biomechanics. With ULM’s Kinesiology and Physical Therapy program, VCOM Louisiana faculty will have access to an exercise physiology lab and a state-of-the-art motion capture lab.
VCOM Clinical Training Sites
VCOM’s network of clinical training sites and partner hospitals creates some of the most significant opportunities for increasing clinical research activity by the faculty and staff, medical residents, fellows and students. Continuing to foster research at established clinical training sites and developing new research activities at additional sites will provide the greatest opportunity for VCOM faculty, students, residents, fellows and associated partners to participate in VCOM-sponsored research projects and IP development. Moreover, VCOM’s Primary Care Research Network (PCRN) has greatly benefited from alignment with VCOM-associated Appalachian, rural and underserved area clinics. This has created a powerful opportunity for large-scope, multi-site clinical research activities to address big problems in rural health care delivery and patient management.
The Vice Provost for Research and the Associate Vice Provost for Research Development, in conjunction with the Deans and Associate Deans, will work to develop a systematic, site-specific plan to reach out to and engage with clinical training sites to create, facilitate and foster research activities. For hospitals and clinics with established research activity, VCOM can partner and add synergy for existing programs. For hospitals without established research programs or infrastructure, VCOM can serve to facilitate all research (IRB, grants and research office support). For example, we have several agreements executed with HCA South Atlantic hospitals, including Grand Strand Medical Center and Orange Park Medical Center, wherein residents and physicians can utilize the services of VCOM’s IRB, grant development officers and Office of Research Administration. This includes training in human subjects’ research and the creation and development of a clinical research programs. The first component of the VCOM Physician-Based Research Network, the Primary Care Research Network (PCRN) is focused on Public Health surveillance identification of genetic/genomic disease components of diseases common to rural populations, and the pursuit of underlying genotype/phenotype relations in those diseases. It is desired to increase the effectiveness of these networks by growing the actively participating members to identify opportunities for genetic disease-specific research. VCOM faculty across all campuses will have access to the data for epidemiological and public health research, derived primarily from VCOM’s CREDO System. CREDO (Clinical Rotation Evaluation and Documentation Organizer) continuously documents the clinical experiences of medical trainees while providing real-time feedback on each student’s individual progress. CREDO is a Health Information Technology, specifically an “app” that captures details of each student clinical encounter via ICD diagnostic and procedural codes and WHO drug codes entered by trainees using their mobile devices or computers.
VCOM has conducted a considerable number of small-scope research projects conducted in conjunction with medical mission trips, and this activity will continue. Many of these projects have highly successful outcomes (documented in research posters, published papers), and have the capacity to become major, sustainable research projects of high significance, impact, and innovation. Capitalizing on these successful projects and taking them forward to the next stage creates a tremendous opportunity for high-quality research in a unique geographical area and with unique patient groups.
STRATEGIC GOALS AND PLANS: HOW WE ARE GOING TO DO IT
We are looking to reach goals that will significantly strengthen VCOM research in its scope, significance, innovation and impact. This should greatly increase our academic reputation and national visibility, leading to increased competitiveness for, and success with, extramural funding. Together these changes will move VCOM to the forefront of osteopathic medical schools engaged in research, with the endpoint outcome of becoming the Number One Osteopathic School in terms of Research.
VCOM’s strategic goal for research will also be aligned with that of the AOA’s, wherein we strive to enable a culture of osteopathic research within the osteopathic family. In short, we plan to emphasize research that investigates and demonstrates the distinctive philosophy and practice of osteopathic medicine.
Our plan is to integrate the unique tenants of osteopathic medicine, particularly in clinical and biomedical research with an emphasis on OMM and osteopathic philosophy, with disease specific research funding entities for maximum competitiveness for extramural funding. To this end, we will boost our research infrastructure, develop more formal and robust seed funding programs, fund endowed chairs and clinical research fellows and emphasize osteopathic-centered research within VCOM and with our collaborative partners.
OVERALL RESEARCH STRATEGY
Formalize and Strengthen Research Focus Areas
Each campus will have a number of research focus areas suitable for that campus, and research-active faculty members will be distributed among these groups. The groups will be dynamic, allowing faculty members to move between research focus areas as needed based on interest, when projects expand, or end, or become redirected. Direct collaboration between similar groups (e.g., Sports Medicine, Simulation, Inflammation, TBI/Blast injury, OMM, etc.) on each campus will be encouraged. In particular, biomedical and clinical research faculty interested in team-projects directed toward translational research involving drugs, diagnostics, therapeutics, and in health enhancement and disease prevention programs (NIH Roadmap initiative) will be identified. Enhance clinical investigation via medical informatics systems that promote access to health care data and outcome analysis (e.g., PCRN). New faculty hires will be recruited for these focus areas to build synergy and critical mass. Establish new and build up existing shared equipment, shared laboratory/clinical facilities and “core” capabilities directed to these research focus areas. Establish new and facilitate research collaborations that provide access to equipment and experts at premier facilities in proximity to VCOM.
A VCOM-wide Osteopathic Research Focus Area has been created with major emphasis on (1) the mechanistic and scientific bases of Osteopathic Manipulative Therapy, and (2) comparative treatment modalities of OMT/physical therapy/other therapies, which currently offer the best opportunities for obtaining extramural funding. Because of our biomedical engineering and kinesiology expertise along with our biologic and genomic capabilities we are well positioned to apply evidence- based approaches to OMT research. Seed grants are available internally and from the AOA as well as other agencies to help establish and grow these programs. The primary goal of this area is to publish peer-reviewed papers to provide the necessary support for extramural grant applications.
The Research Department is working closely with the Directors of Simulation Medicine for the four campus system to refine an education and simulation research program. This program will drive research into the delivery of the best medical simulation experience and educational outcomes for our students. We desire to exploit our significant investment in simulation systems to attract new external users and research funding opportunities. VCOM Research Deans and the Research Department will work with teams of investigators and the Directors to develop extramural funding applications based on the strongest projects in each area.
Continue to Invest in Internal Seed Grant Programs
VCOM has several research seed grant programs that have been active for several years. The One Health Research Funding Program, first opened in 2015 and REAP (Research Eureka Accelerator Program) first announced in 2016, were developed to drive synergy within research focus areas with sizable internal grants. We specifically want to encourage: (1) multi-investigator teams (which may also include collaboration across campuses and outside VCOM), (2) basic and translational investigation in all focus areas, (3) development of the most competitive ideas through rigorous review and feedback modeled after the NIH process and (4) specific deliverables and outcomes (meeting posters, manuscripts, extramural grant applications submitted), Progress on One Health and REAP funded projects will be closely monitored to ensure adequate progress toward completion of specific aims.
Funded projects can include specialized technical help (lab technicians, Post-doctoral researchers, specific health care workers), to provide support for the funded group. In the ensuing years. VCOM has expanded our seed grant programs: The One Health Research Funding Program now also includes collaboration with Auburn University’s College of Veterinary Medicine (originally this program was developed with Virginia Tech’s Virginia Maryland College of Veterinary Medicine). Matching seed programs focused on biomedical engineering have also been created with Virginia Tech’s Institute for Critical Technology and Applied Science (ICTAS) and Auburn University’s Samuel Ginn College of Engineering.
Create a Culture of Innovation and Support for Intellectual Property Development
The VCOM Research Department continues to provide administrative and technical support for innovative and unique ideas generated by VCOM clinical and biomedical faculty. This includes providing seed funding for project development, patent protection, prototype testing and development, produce licensing and consulting in areas where we do not have the specific expertise in house. This will at times mean creating commercialization vehicles, for example, ViaStar, to ensure that VCOM intellectual property is effectively and efficiently translated into new products.
Create A Formalized Research Program for Students and Incorporate Research Design into the Student Educational Experience
A key component of successful research institutions is the training of students in research and fostering their contributions to the overall research endeavor. Specifically, we have created a DO with Research Distinction Diploma program that enable students who contribute significantly to a research program to be recognized. A longer-range goal is to re-institute collaborative educational programming leading to advanced degrees awarded concomitantly with the medical degree thus enabling the best student minds to become clinician-researchers and leaders.
We have also developed programs designed specifically to facilitate medical student exposure to grants, biostatistics, bioinformatics and project management. A Summer Research Internship for students has been created, which identifies clinical, biomedical faculty, and research administration personnel interested in working with student researchers (via VCOM’s Research Matcher program). This will result in an increased number of osteopathic students participating in research programs and the number of students authoring publications or presenting research at local, regional and national conferences. VCOM faculty are encouraged to apply for funding for research training programs available through National Institutes of Health and other funding agencies to facilitate the training of young physician scientists. And we continue to incorporate exposure to evidence based medicine into clinical teaching and simulation medicine scenarios working with the simulation center team to drive the use of evidence based medicine into the clinical educational experience.