Michelle Smith – The Early Career Voice

The tension between generalizability and inclusivity in population research

February 2, 2022January 28, 2022 Michelle Smith

As I have continued my journey in epidemiologic research, one of my primary aims is to illuminate health disparities within my projects. Currently located in New York City, identifying diverse populations is hardly an issue. However, I have thought more about populations around the United States as I apply to PhD programs and consider the projects of potential mentors. One project in particular was out of a prestigious university in the Midwest in which the investigators planned to include equal proportions of individuals of different racial groups(e.g. 25% non-Hispanic Black, 25% White, 25% Asian, 25% Hispanic) in an effort to not exclude demographics.

This raises the following important question: How do we choose the best sampling method and accommodate for disparate demographics in research in a way that preserves data validity?

Diversity in health research populations is crucial because data is needed not only on dominant populations but also on populations which are potentially affected disproportionately by the illnesses examined in the studies. When including individuals in studies, random sampling is beneficial because it reduces bias and improves validity. However, random sampling may under-represent individuals in affected demographics when sampling is done among racially disparate populations. Essentially, investigators may need to choose between representativeness of diverse populations and confidence in their ability to make inferences about a general population.

Let us review the most common methods of sampling and recruitment for studies. There are about six main sampling methods which can generally be considered probability sampling or non-probability sampling. Probability sampling consists of random sampling in which there are about equal chances of being selected into a sample; and stratified sampling in which subsets of the population have low incidence relative to other subsets, and individuals are chosen based on and interval selections method (e.g. each n^th individual is selected.¹ In non-probability sampling, individuals are selected by non-random methods.¹ One example is quota sampling, which is a non-probability equivalent of stratified sampling. Convenience sampling is another method in which accessible individuals in the population of interest are chosen.¹ In judgment sampling, a population utilized in the study is considered to be representative of a larger population (e.g. a town in the US is thought to be representative of the US population). Finally, In snowball sampling, participants may recruit other individuals into the study via their own networks.¹ Biases may occur with each sampling method, however minimal bias occurs in random sampling methods.

When it comes to ensuring that individuals of various groups or characteristics are included in the study population, some researchers turn to oversampling. In essence, the number of individuals of a particular group may be included disproportionately to the distribution to accommodate for an imbalance in the data.

The issue of racial diversity in study populations is subtle but needs to be addressed according to the specifics of each project. When necessary, choosing between generalizability and inclusion of disparate populations is a decision which requires careful consideration and may implicate possible biases in study results and findings.

References

Tyrer, S., & Heyman, B. (2016). Sampling in epidemiological research: issues, hazards and pitfalls. BJPsych Bulletin, 40(2), 57–60. https://doi.org/10.1192/pb.bp.114.050203

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Keeping a Pulse on Cardiovascular Health: AHA 2021 Scientific Sessions

December 22, 2021December 20, 2021 Michelle Smith

Before I joined the AHA 2021 Scientific Sessions, I was not sure what to expect from this virtual conference. The COVID-19 pandemic caused a pivot towards virtual events and remote discussion. With every virtual event is the concern of a poor audio or internet connection, or less than smooth transitions between speakers which distract from the content. However, the conference lacked these technical faux paus, and was a great experience. There was so much opportunity to learn about emerging research, and hear from leaders in cardiovascular health. The sessions focused on the future, improving health outcomes and preparing early career professionals. There was significant acknowledgement of the impact of the COVID-19 pandemic on health outcomes and disparities, and implications for the future through the lens of cardiovascular health. What stood out was not only the depth of insight among the speakers and transformative research, but the dynamic conversations and presentations.

As a spectator of these sessions, I was struck by the emphasis on career building and the angles in which this can be addressed and improved upon. Utilization of social media and networking were emphasized as methods to both reach the public and support collaboration. Cardiovascular experts and researchers divulged their best methods for moving forward with research and clinical practice.

I was also inspired by the work of award recipients, such as the Distinguished Achievement Awards and the Early Career Abstract Awards. As an individual in my early career, the experience of the recipients encouraged me to explore unique areas of my own research and delve into projects focused on improving clinical care.

Overall, the AHA 2021 Scientific Sessions were informative, intriguing and motivating. I look forward to future AHA conferences and hope that my career will take me on a similar path to the impressive speakers highlighted during the events.

Lessons from Legends in Cardiovascular Nursing

November 14, 2021November 14, 2021 Michelle Smith

A significant portion of the AHA 2021 Scientific Sessions was focused on mentorship for early career individuals in research and medicine. Insights from the Interview with Nursing Legends in Cardiovascular Science were particularly illuminating. During this session, Dr. Christopher Lee, Professor and Associate Dean for Research at the Boston College William F. Connell School of Nursing; Dr. Kathleen Dracup, Dean Emeritus and Professor Emeritus, University of California, San Francisco, School of Nursing; and Dr. Martha Hill, Dean America at Johns Hopkins University School of Nursing offered advice from their experiences mentoring individuals of varying career levels. Here are some key takeaways for individuals who want to advance their career:

Take the show on the road

Determine professional goals and how to reach them. For those interested in research, a defined program of research and possibly multiple contingency topics of study that are of interest to several funders is needed. It is also necessary to know the road, or what success looks like given the scientific focus and what one wants to accomplish during an academic career. Finally, it is important to acknowledge that there is no one pathway to success and that success is in many ways self-defined.

Do a legacy exercise

The legacy exercise, which is sometimes referred to as a eulogy or obituary exercise involves imagining your retirement party or eulogy and thinking about who you want to speak and what you want them to say about you. This reflection essentially determines what type of legacy you want to leave behind, what you want to be known for and by whom.  The exercise often reveals details which are not on your CV. It might not mirror scientific goals, and possibly will not align with perceived ideas of success. Ultimately, the exercise can help one focus on the rewarding aspects of work and other parts of life, even faced with challenges.

Consider personal challenges

Mentors often observe personal challenges among both colleagues. Dr. Lee pointed out that life outside of work and issues of personal importance need to be taken into consideration. In fact, he mentioned that he sometimes advises against taking on additional work or submitting extra grants because of competing demands and priorities on other aspects of life. Dr. Lee is also adamant that the best way to have a lasting and impactful career as a scientist is to have great fulfillment in personal life.

Diversify your research team

Diversity brings great insight into fields in business and research, and in decision making.  Cardiovascular nurses often do not practice alone, and it would be beneficial for research teams to reflect this. Although diversity was spoken specifically of the multi-professional nature of cardiovascular nursing research, it is not limited to it.  In a general sense, investigators should seek out collaborators who share passion for research, who are concerned about the outcomes of interest, and who are more knowledgeable about the research methods. These elements can help bolster various aspects of projects.

Network

As exemplified by the speakers, connecting at conferences and in research has led to long collaborations and friendships. Whether a mentor, early career or mid careers professional, the benefits of networking can be incredibly gratifying.

Overall, the speakers addressed ways to alleviate challenges for colleagues of all career phases. Their advice diminished the pressure of preconceived ideas of success by supporting the development of personal definitions of achievement. Determining goals and paths, thinking about legacy, including diverse perspectives in projects, and expanding professional networks give individuals more power and opportunity to grow. The speakers have a wealth of knowledge, experience and advice which make them not only legends, but also champions for the success of others.