Never before have there been such opportunities to understand the human brain and behavior. The advances in biomedical science of the last 50 years have provided the foundation for addressing the complex health problems of today's society. Building on those advances, science is now poised for substantial progress as investigators are ready to bridge disciplines. To achieve the health goals of the 21st century, scientific training and research must bring together many scientific fields that offer different insights and technologies. Interdisciplinary efforts need to be facilitated at all levels of teaching and research. This report offers recommendations to delineate, enhance, and accelerate a process that is already reflected in many training and research programs. Although this report focuses on examples from brain and behavioral science, the principles presented should be broadly applicable in scientific research.
Newly emerging health problems, as well as those that have plagued us over time, are proving to be surprisingly complex as scientists and health care providers begin to recognize and appreciate the intricate interplay among environment, behavior, and disease. Within broad fields, such as mental health research, the need to understand the entire human organism, not just one part of it, is driving disciplines toward each other as scientists seek better ways to prevent, diagnose, treat, and control such illnesses as schizophrenia and bipolar affective disorders, and learning disabilities. Solutions to existing and future health problems will likely require drawing on a variety of disciplines and on approaches in which interdisciplinary efforts characterize not only the cutting edge of research,
but also the utilization of knowledge. The next generation of scientists must be prepared to integrate the advances of rapidly progressing disciplines.
The history of science and technology demonstrates that many important advances have come from an interdisciplinary approach. For instance, laser surgery, which involved ophthalmologists, anatomists, and physicists, and has saved thousands of people from severe vision impairment or blindness; “designer” seeds, which were developed by geneticists, bioengineers, and botanists to create crops that resist damage from insects and herbicides. Examples in neuroscience and behavior include cloning the gene associated with Huntington's disease and understanding the contribution of stress to disease.
CHARGE TO THE COMMITTEE
In recognition of the need to train scientists who can address the highly complex problems that challenge us today and fully use new knowledge and technology, the National Institute of Mental Health (NIMH), the National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR), the National Institute on Nursing Research (NINR), and the National Institute on Aging (NIA) asked that an Institute of Medicine (IOM) Committee:
Examine the needs and strategies for interdisciplinary training in the brain, behavioral, social, and clinical sciences to enhance the translation of brain/behavior to clinical settings and vice versa.
Define necessary components of true interdisciplinary training in these areas.
Examine the barriers and obstacles to interdisciplinary training and research.
Review current educational and training programs to identify elements of model programs that best facilitate interdisciplinary training.
The task of the committee is based on the premise that interdisciplinary research and training are important. Because input from nine NIH institute directors indicated full agreement with the premise, the committee focused on how, rather than if, interdisciplinary research and training should be pursued. The committee broadly interpreted its charge as a request to provide guidance on how to bring together scientists from different fields to explore new frontiers and to train new scientists so they would be prepared to interact with multiple disciplines.
Because evaluations of the success of interdisciplinary training programs are scarce, the committee could not specify the “necessary components” or identify the elements that “best facilitate” interdisciplinary training. Instead, after reviewing existing programs and consulting with experts, the committee identified approaches likely to be successful in providing direction for interdis-
ciplinary endeavors at various career stages. The committee is aware of the costs that might be incurred in implementing its recommendations. In many instances, it will be a matter of shifting resources; in others, new resources will be needed. Until program plans are established, detailed accounting cannot be developed.
For the purposes of this report, the following definitions were adopted:
Interdisciplinary research is a cooperative effort by a team of investigators, each expert in the use of different methods and concepts, who have joined in an organized program to attack a challenging problem. Ongoing communication and reexamination of postulates among team members promote broadening of concepts and enrichment of understanding. Although each member is primarily responsible for the efforts in his or her own discipline, all share responsibility for the final product.
Translational research is a subset of interdisciplinary research that integrates information from clinical settings and basic research laboratories.
The aim of interdisciplinary training should be to produce researchers who are capable of participating in or directing interdisciplinary research. These researchers are critical to an interdisciplinary team. It is analogous to an orchestra, whose leader (the conductor or the director of an interdisciplinary team) coordinates highly specialized individuals to produce harmonious outcomes. The leader would be expected to be able to converse freely with persons in disparate fields and to facilitate the interactions among team members. The team members would be responsible for issues involving their expertise and would develop a working knowledge of each others' fields. The composition of the “orchestra” would not be fixed, but, rather, would change depending on the particular problem at hand. With time, participants would expand their understanding of other fields while continuing to contribute their own expertise.
THE POTENTIAL OF INTERDISCIPLINARY RESEARCH
Both single disciplinary research and interdisciplinary research are needed to develop methods for prevention, diagnosis, and treatment of disease and to understand the basic mechanisms of brain and behavior. Many problems are best approached within a single discipline. Investigators in single disciplinary work have contributed enormously to our understanding of basic biology and human health—B. F. Skinner in operant conditioning, von Bekesey in audition, and Hodgkin and Huxley in nerve conduction are examples. Interdisciplinary approaches often build on single disciplinary discoveries. Disciplines evolve from interdisciplinary efforts as exemplified by neuroscience. This relatively new discipline developed as scientists from different fields came together to solve common scientific problems about the nervous system. Neuroscience is a dynamic discipline in which new fields continue to be integrated.
Many research problems facing today's society require coordinated efforts from multiple disciplines. Cross-fertilization between clinical and basic scientists can stimulate research and enhance understanding of pathologies. For example, genetic analyses and imaging techniques have significantly advanced our understanding of the pathophysiology of schizophrenia. Clinical observations of patients with memory loss, in conjunction with basic research on memory, provided insights into the numerous types of memory that exist. Funding of Alzheimer's Disease Research Centers brought together clinical and basic scientists from multiple disciplines and produced striking progress in the development of promising interventions. A great many interdisciplinary programs currently exist. Whether developed through the encouragement of a funding agency or the leadership of an individual, these programs illustrate the breadth of what can be achieved when disciplines come together to solve a problem. To ensure the future of interdisciplinary research for solutions to complex problems, training is essential to prepare the next generation of investigators to tackle these interdisciplinary tasks.
Interdisciplinary research is an approach, not an end. It should arise out of a challenge; that is, it should develop in response to a problem that cannot be embraced by a single discipline. Interdisciplinary research should not be conducted for its own sake, but, rather, as a deliberate response to specific research needs. It is important to identify the scientific problems for which an interdisciplinary focus is important and to avoid indiscriminate support of anything interdisciplinary. To assist funding agencies in this identification process, the scientific community should be consulted.
Federal and private research sponsors should seek to identify areas that can be most effectively investigated with interdisciplinary approaches. This should be done by engaging the scientific community through symposia, working groups, or ad hoc committees. Funding mechanisms, such as Requests for Applications or Proposals, should be developed to address the identified areas.
BARRIERS TO INTERDISCIPLINARY RESEARCH AND TRAINING
The literature is replete with descriptions of the traditional and persistent barriers to interdisciplinary research. Disciplinary jargon and cultural differences among disciplines are serious problems. Surveys show concerns among researchers about perceptions of interdisciplinary science as second-rate. A
sense of superiority within each discipline and the view that other disciplines are less rigorous or important also present barriers. Good communication skills help to alleviate such problems, but scientists often lack the appropriate training and proficiency. Interactions among investigators (both planned and unplanned) can promote communication and encourage interdisciplinary collaboration; the creation of central facilities or common areas can increase the probability of such interactions.
There are concerns that training in interdisciplinary fields will not prepare graduates for a career. The explosion of information within each scientific discipline raises concerns about how long it would take to attain expertise in one, let alone two or more, fields. The duration and cost of education are increasing, and added interdisciplinary requirements could be discouraging. Debt is an issue, especially for medical students, among whom the mean debt of graduates was over $80,000 in 1997. To encourage clinicians to engage in research, NIH's loan repayment programs can repay educational loans up to $35,000 per year for eligible researchers employed at NIH. Extending these debt repayment programs could provide an increased incentive to pursue interdisciplinary research training.
Because publications and successful grants are essential for promotion and tenure, the concern that interdisciplinary research will reduce the likelihood of first-authorship and of funding presents an additional obstacle. New journal policies that call for defining the contribution of each author of multiauthor papers can offer a means to provide appropriate credit for a collaborative effort. NIH recently developed a new peer review system intended to eliminate any disadvantage for translational and interdisciplinary science. It will be important to monitor the new system for the success of interdisciplinary proposals relative to single disciplinary proposals. Despite the abundance of requests for interdisciplinary proposals from funding agencies and interagency collaborations that bring together multiple perspectives, scientists express concerns about obtaining support for interdisciplinary research. Partnerships among NIH institutes, among government agencies, or between government and the private sector often provide a broad base of support for interdisciplinary research and training.
Interdisciplinary programs are growing at academic institutions. Institutions vary, however, in their policies on distribution of credit for interdisciplinary efforts. Some allocate resources among the investigators and their units, but others credit only the person listed as the principal investigator. University leadership can promote collaboration by crediting participating faculty fairly. Some funding programs call for evidence of institutional commitment to an interdisciplinary effort, which can range from an annual meeting with investigators and university administrators to substantiation of a supportive infrastructure.
Funding agencies and universities should remove the barriers to interdisciplinary research and training.
To that end, funding agencies should:
PREDOCTORAL AND POSTDOCTORAL TRAINING PROGRAMS
There is currently a multitude of interdisciplinary predoctoral and postdoctoral training programs. The committee examined over 100 of these training programs and the variety of mechanisms they use to promote interdisciplinary research. Most predoctoral and postdoctoral training programs try to provide trainees with grounding in a particular discipline while encouraging interdisciplinary interactions. Often they focus on a particular problem, such as emotion, sleep, aging, or affective disorders. In addition, the programs aim to provide the skills necessary to understand other disciplines and to communicate with those in other fields. Training mechanisms include coursework, seminar series, journal clubs (to promote critical thinking about the scientific literature), laboratory rotations (to expose students to a range of faculty, techniques, and experimental approaches), and research presentations (to improve communication skills). Interdisciplinary programs often encourage mentorships from more than one sponsor to ensure multiple perspectives. Many provide students with a forum (e.g., summer courses, symposia, and off-site meetings) in which to interact with experts in relevant fields. These gatherings are generally intended to encourage bonding of students with each other and the faculty and to provide students with a network of experts that includes both their contemporaries and more senior scientists, creating a resource for interaction and collaboration throughout the career.
Support for predoctoral and postdoctoral fellows can be provided by an investigator's grant, individual fellowships, and institutional training grants. Under an investigator's award, the postdoctoral fellow is an employee who provides a vector for interaction between two or more laboratories. Fellowships award a stipend directly to the person, who can elect to participate in ancillary training opportunities. Institutional training grants (for example, the T32 National Research Service Award from NIH, the Integrative Graduate Education and Research Training Program from NSF, and some support mechanisms from private foundations) provide coordinated training activities for a cohort of students. The T32 grants do not cover completely the direct costs associated with the administration of the programs. The financial burdens resulting from the administrative costs of training programs can limit the motivation of universities, departments, and faculties to participate. That is especially true of interdisciplinary programs, which are more expensive because they require more coordination.
TRANSLATIONAL RESEARCH TRAINING
In recognition of the need to bridge the bench-to-bedside gap, many federally and privately funded programs support the training of physician-scientists. Foundations have played a key role in encouraging translational research and
training through funding efforts such as the Markey Charitable Trust grants and the Robert Wood Johnson Clinical Scholars Program. Programs leading to MD/PhD degrees, such as the Medical Scientist Training Program (MSTP) of the National Institute of General Medical Sciences, can be effective in producing clinical researchers. To support nonphysician clinicians as contributors to translational research, NIH offers training programs for dentists and nurses that are similar to those tailored to MDs. (e.g., the Dental Scientist Training Program and NINR's Career Transition Award).
Although the doctoral training of the MSTP is primarily in the biological, chemical, and physical sciences, the program also will support degrees in social and behavioral sciences, computer sciences, economics, epidemiology, public health, bioengineering, biostatistics, and bioethics. However, it is unusual for universities to implement the provision for degrees outside the traditional biomedical disciplines despite evidence that MD/PhD graduates with a PhD in the humanities are strong contributors to academic medicine. In recognition of the need for MDs to understand the behavioral and sociological aspects of disease, to address the important issues of behavior change and adherence, and to think globally about population and environmental factors in disease, training in these nontraditional fields should be strongly encouraged.
Exposing basic scientists to clinical problems also can enhance translational research. Several university programs now provide clinical experience for trainees that allow students to see patients, handle pathology, and become informed about major diagnostic and therapeutic facilities, as well as to learn about the mechanisms of disease. In addition, to train doctoral fellows in clinical research and drug development, some pharmaceutical companies have developed fellowships in partnership with universities.
CAREER-LONG TRAINING OPPORTUNITIES
Training opportunities need to be available at all stages of a career. Granting mechanisms specifically aimed at junior faculty and new investigators can provide an incentive to move toward interdisciplinary research questions. Training for those established in their careers can encourage scientists to acquire new approaches or to obtain a different perspective in their research efforts. Such opportunities do exist, some geared toward developing an interdisciplinary perspective, but others could easily be adapted to that purpose.
Federal funding agencies and private foundations have several programs that support junior faculty, providing opportunities to broaden their scope. One innovative mechanism available through NIH is the Supplement to Promote Reentry into Biomedical and Behavioral Research Careers (NIH Program Announcement 99-105). It provides up to 3 years of support to people who have been out of research for several years but are ready for an independent research position. Principal Investigators on eligible NIH awards can submit an adminis-
trative supplement to support the reentering researcher on an effort directly related to the funded parent grant. The decision to fund a supplement takes about 8 weeks. Administrative supplements are also available for Underrepresented Minorities and Individuals with Disabilities (NIH Program Announcements 99-104 and 99-106). The committee recognizes the potential for this type of mechanism to promote interdisciplinary research.
Foundations have been at the forefront of the effort to support interdisciplinary efforts among faculty. Examples include the Bridging Brain, Mind, and Behavior initiative from the McDonnell Foundation and The William T. Grant Foundation Faculty Scholars Program, which strongly encourage interdisciplinary efforts that otherwise might not be funded by traditional sources. The MacArthur Fellows Program uses an alternative approach, investing in the individual rather than a particular project and allowing the fellows to work in multiple disciplines, to train in a new field, or to change direction in their careers.
Although midcareer training often occurs informally, several funding approaches provide additional opportunities. Career development awards are available through NIH and various foundations for established scientists to expand their scope. Sabbaticals often allow an opportunity for researchers to learn new techniques and explore new ideas. Faculty development programs, including departmental seminars or formalized courses at a person's home institution, can present interdisciplinary perspectives. Meetings and workshops provide informal training to senior investigators. Federal and private programs supporting these approaches are available and should be encouraged.
Consortia and multi-institutional programs also provide opportunities for continued learning and far-reaching integration of research efforts in multiple disciplines. An example of a successful consortium is MacArthur Foundation's Program on Human and Community Development that encompasses several research networks to address economic opportunities, community capacity, child development, and mental health. Each network individually has a broad scope. The full program further integrates the networks in an effort to obtain real solutions for community problems.
Interdisciplinary research is not intended to supplant disciplinary efforts; rather, such training should be available to provide opportunities to explore new areas outside a single discipline. Broad training early in a career and continued training throughout a career can provide the tools to integrate multiple disciplines when required by the research question.
Scientific education at early career stages should be sufficiently broad to produce graduates who can understand essential components of other disciplines while receiving a solid grounding in one or more fields. Criteria for NIH-supported research training should include both breadth and depth of education. Funding mechanisms to support interdisciplinary training in appropriate fields (as identified in Recommendation 1) should provide additional incentives to the universities and the trainees along the following lines:
Funding agencies should establish a grant supplement program to foster interdisciplinary training and research. This would be administratively modeled after the supplements that exist for minorities and people with disabilities, and for people reentering research after a hiatus. Investigators with research grants who have interdisciplinary training opportunities should be able to obtain supplemental funds for qualified candidates through a relatively short application form with expedited review. Successful pilot efforts will provide data to support further applications for career development and research.
Funding opportunities for interdisciplinary training should be pro vided for scientists at all stages of their careers.
EVALUATION—HOW DO YOU KNOW WHICH PROGRAMS WORK TO ENCOURAGE INTERDISCIPLINARY EFFORTS?
Despite decades of discussion about interdisciplinary needs, data to support the requirement for and effectiveness of the available mechanisms are scanty. Why is there a lack of data when there is so much interest? The committee faced this obstacle in its review of interdisciplinary programs and determined that a process for evaluation of programs is needed. The collection and evaluation of interdisciplinary training outcomes, however, are tremendously complex and difficult. To know whether interdisciplinary training promotes interdisciplinary research, it is necessary to have a method of identification for interdisciplinary research and training programs. To measure the outcome of the programs, it is necessary to have methods that will accurately reflect their success in promoting interdisciplinary research.
The challenges of deciding what is classified as “interdisciplinary,” defining the markers of “success,” and providing mechanisms to identify and track the efforts are daunting. Universal and meaningful definitions of interdisciplinary and translational are needed to begin developing evaluation methods. Once these definitions are agreed on, an appropriate labeling mechanism would allow the funding agencies to define which training programs are to be tracked as interdisciplinary and to define which projects are interdisciplinary for outcome analysis.
Defining success is complex. The general measures of success for those who conduct interdisciplinary research are the same as for those who conduct single disciplinary research—grants awarded, publications, tenure and rank, and laboratory size. To address the effectiveness of interdisciplinary training programs, however, requires additional measures, such as whether graduates maintain an interdisciplinary approach in their work, as reflected by the nature of their collaborations, joint appointments in multiple departments, publishing of interdisciplinary papers, or obtaining grants with interdisciplinary themes. Most funding agencies require training programs to report on the achievements of previous trainees. Reporting provides data for the evaluation of each individual program; but because data are not collated across programs, reporting does not allow assessment of the granting mechanism. Furthermore, it does not answer the question, Did the training produce more interdisciplinary research? The success of interdisciplinary initiatives can also be evaluated through the resulting changes in universities and in funding agencies. Opportunities for interdisciplinary research and training might encourage academic institutions to revise promotion policies, actively encourage collaborations across departments, or promote training programs with interdisciplinary perspectives. Funding agencies might alter the peer review system, improve profiles for funding of interdisciplinary proposals, or introduce new mechanisms to support interdisciplinary efforts. Devising an approach to track and evaluate interdisciplinary training and research programs will be extraordinarily challenging and should be the subject of extensive analysis by people with appropriate expertise.
NIH should develop and implement mechanisms to evaluate the outcomes of interdisciplinary training and research programs.
The committee encourages interdisciplinary training and research, not from a philosophic belief in “interdisciplinarity,” but from the knowledge that many scientific problems are refractory to solution by the methods of a single discipline and require the incorporation of concepts and methods from several disciplines simultaneously. Interdisciplinary research is flourishing in our institutions—despite the barriers. The question is how best to facilitate, direct, and evaluate its growth.
Federal and private research sponsors should seek to identify areas that can be most effectively investigated with interdisciplinary approaches.
Funding agencies and universities should remove the barriers to interdisciplinary research and training identified in this report. To that end, funding agencies should:
Scientific education at early career stages should be sufficiently broad to produce graduates who can understand essential components of other disciplines while receiving a solid grounding in one or more fields. Criteria for NIH-supported research training should include both breadth and depth of education.
Funding agencies should establish a grant supplement program to foster interdisciplinary training and research.
Funding opportunities for interdisciplinary training should be provided for scientists at all stages of their careers.
NIH should develop and implement mechanisms to evaluate the outcomes of interdisciplinary training and research programs.