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Slide 1 - Clinical and Translational Science Awards: Home

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  • 71% Public
    29% Private
    Little response from emerging institutions
  • Yes = 2174
    No = 3907
  • Principal Activity
    71% Research
    18% Instructional
    3% Clinical
    8% Other
  • Faculty spend 42% of the time they have available to devote to federal research on pre- and post-award administrative activities.
    22% pre-award + 20% post award
    Don’ t read all…
    Pre-award (Further study needed)
    Writing/submitting proposals & budgets
    Applying for approvals
    Developing protocols
    Publishing and presenting research etc.
    Post-award
    - Purchasing supplies/equipment
    - Supervising budgets
    - Managing personnel
    - Complying with regulations
    - Monitoring safety/security plans
    - Writing reports, etc.
  • 1=None, 2=A little, 3=Some, 4=A moderate amount, 5=A great deal
    Reminder: Grant report writing NOT included in this analysis but identified in the pilot study as a major burden
    Grant progress report writing – some to moderate level burden 76%
    Personnel hiring – 61%
    Project revenue management – 61.4%
    Others = about 50% in the aggregate
    Institutional work characteristics
    Public vs. private
    Carnegie classification
    Federal research funding level
    Disciplinary affiliation
    Administrative role
    Principal activity
    Individual work characteristics
    Academic rank
    Tenure status
    - Race/ethnicity
    - Gender
  • Rated 2.7 or above.
    The list of “top burdens” differs somewhat across federal funding agencies, although some of this variation may be due to disciplinary differences in research functions.
  • IRB protocols and training a top burden for everyone, but particularly for…
    3.69 Psychology
    3.11 Medical institutions
    3.11 Not on tenure track
    3.06 Education
    3.05 Female faculty
    3.04 No tenure system
    3.00 Social Sciences
    3.58 Engineering
    3.51 Clinical faculty
    3.28 Health Sciences
    3.69 Psychology
  • 3.27 Clinical faculty
    3.00 Health Sciences
    3.14 Engineering
    3.02 Biological/Life Sciences
    3.01 Biological/Life Sciences
  • Lesser burdens – but not for all faculty = Subcontracting and collaborations + IACUC protocols and training
    Training personnel and students a top burden for everyone, but particularly for…
    3.27 Clinical faculty
    3.00 Health Sciences
    3.14 Engineering
    3.02 Biological/Life Sciences
    3.01 Biological/Life Sciences
  • Looking at institutions with more than 100 respondents…
    “Our institution places a great deal of regulatory burden on investigators that is NOT required by the federal government.
    “The university paperwork is overwhelming and the greatest deterrent to time on research.”
    “University concern about federal auditing requirements has increased our work load noticeably in the past few years.”
  • Example above = IRB Protocol Approvals and Training across Institutions
    HIPPA, IRB approvals, and IRB compliance varied by institutional control (faculty working at private institutions reported more burdened)
    HIPPA, IRB approvals, and IRB compliance also varied by federal research funding level (faculty where funding under $10M most burdened)
    Researchers report spending a great deal of time writing long proposals for short-term, low-level funding they feel has little chance of being awarded.
    Some faculty believe that IRB, IACUC, HIPP regulations are crippling research and that the system is not designed to handle multi-site studies efficiently.
  • Response scale:
    1=No assistance, 2=Very little assistance, 3=Some assistance, 4=A great deal of assistance, 5=Complete assistance
    Embedded examples are listed in descending level of assistance…
    Varies the most by disciplinary affiliation – understandable in some cases, not in others
    The most burdensome tasks linked to federal grant management were not necessarily those for which faculty received the greatest assistance (example above).
    Faculty report low levels of support across all administrative tasks, with variations by disciplinary context most evident.
  • 1) Parallels findings on faculty work life and research productivity
    2) Costs…
    Extrapolated cost x 6081 respondents =
    1,839,787 hours
    $77,843,058
    3) Savings…
    recruitment, retention, teaching/research/service quality
    4) Potential for replicating best practices (IRB esp.)
    5) Future directions
    Possible need for macro-level analysis of each system and the interaction between the two – consider potential for systemic change
    Demonstration project – clearly defined w/narrow parameters
  • Transcript

    • 1. CTSA Clinical Management Workshop, June 24, 2008 Faculty Perspective: Challenges of Implementing Change Sara Rockwell, PhD Professor of Therapeutic Radiology and Pharmacology Director, Office of Scientific Affairs Yale University School of Medicine Chair, Faculty Committee, Federal Demonstration Partnership Vice-Chair, Federal Demonstration Partnership
    • 2. CTSA Clinical Management Workshop, June 24, 2008 A Profile of Federal-Grant Administrative Burden among Federal Demonstration Partnership Faculty Report of the Faculty Standing Committee of the Federal Demonstration Partnership Robert S. Decker, Ph.D., Principal Investigator Leslie Wimsatt, Ph.D. Andrea G. Trice, Ph.D. Joseph A. Konstan, Ph.D. Summary, full survey, all data are available on the FDP website http://thefdp.org/Faculty_Committee.html http://thefdp.org/Faculty%20burden%20survey%20report%20- %20complete.pdf
    • 3. CTSA Clinical Management Workshop, June 24, 2008 What is the FDP? • The Federal Demonstration Partnership is a cooperative initiative among 10 federal agencies and ~100 institutional recipients of federal funds • Its purpose is to reduce the administrative burdens associated with research grants and contracts • Begun in 1988 • http://thefdp.org
    • 4. CTSA Clinical Management Workshop, June 24, 2008 ~100 Academic Organizations are FDP members • Many large research universities • Some smaller universities • 9 Emerging Research Institutions • State Schools and Private Schools • Some systems UC, Nebraska, SUNY • Many universities with medical schools • Some health oriented campuses and institutions OHSU, Dana Farber Cancer Institute
    • 5. CTSA Clinical Management Workshop, June 24, 2008 Federal Agency Members of the FPD • National Institutes of Health (NIH) • National Science Foundation (NSF) • Office of Naval Research (ONR) • Department of Energy (DOE) • Department of Agriculture (USDA) • Air Force Office of Scientific Research (AFOSR) • Army Research Office (ARO) • Army Medical Research and Material Command (AMRMC) • National Aeronautics & Space Administration (NASA) • Environmental Protection Agency (EPA)
    • 6. CTSA Clinical Management Workshop, June 24, 2008 Affiliate Members of the FDP • Council on Governmental Relations (COGR) • National Council of University Research Administrators (NCURA) • Society of Research Administrators International (SRA) • Association of Independent Research Institutes (AIRI)
    • 7. CTSA Clinical Management Workshop, June 24, 2008 FDP Meetings – 3 per year • Open meetings • Other Agencies and Organizations are invited to participate or choose to attend OMB OIG Other Federal Agencies Professional Societies Charitable Health Organizations
    • 8. CTSA Clinical Management Workshop, June 24, 2008 Each University designates 3 official representatives • Administrative Representative • Faculty Representative • Technical Representative • All representatives are encouraged to attend all meetings and to be active participants in FDP committees and activities. • Universities may send other attendees.
    • 9. CTSA Clinical Management Workshop, June 24, 2008 The FDP provides a unique venue for faculty members to interact with university administrators and with federal agencies • Platform for discussing faculty issues related to research administration • Ability to have formal and informal discussions with federal decision makers • Ability to identify issues and problems that span scientific disciplines, individual funding agencies and different schools • Ability to participate in the development and performance of pilots and projects aimed at solving specific problems
    • 10. CTSA Clinical Management Workshop, June 24, 2008 Some past successes of FDP • Streamlined terms and conditions on NIH grants • “Expanded authorities”  University approval of rebudgeting  University approval of NCE • Increased budget flexibility  Carry forward of NIH funds  Modular NIH budgets • Minimization of continuation proposals • Most recent: ending requirement that NIH study section members get personal DUNS numbers and register as government contractors with CCR
    • 11. CTSA Clinical Management Workshop, June 24, 2008 Many problems and issues remain • Faculty Administrative Burden Survey was an important step in identifying and attacking these problems • Origin: requests for data on the administrative burdens of the faculty  Magnitude  Nature  Source • The results of the survey have led to many discussions (including this one) and to several new initiatives
    • 12. CTSA Clinical Management Workshop, June 24, 2008 Survey Overview • All FDP research institutions were invited to participate; 73 of 99 agreed (Some IRB problems) • Institutions identified full time faculty members who were PIs or Co-PIs on active federally-funded research grants (23,325) • Invitations, links to web-based survey, reminders sent to faculty in Fall of 2005 • 6,081 “valid” responses from the FDP faculty • 90% PIs and 10% Co-PIs • Mostly male (71%), white (92%), in sciences, from large research institutions • Many with affiliated medical schools
    • 13. CTSA Clinical Management Workshop, June 24, 2008 Institution Funding Level Under $10M- $100M 11% Over $200M 67% $150M-$200M 10% $100M-$150M 12%
    • 14. CTSA Clinical Management Workshop, June 24, 2008 Principal Field of Research Psychology or Social Sciences 4% Other 9% Agriculture 4% Mathematics 3% Computer Science 3% Education 2% Biological/Life Sciences 35% Engineering 11% Physical Sciences 13% Health Sciences 16%
    • 15. CTSA Clinical Management Workshop, June 24, 2008 Administrative Duties Associate Dean 2% None 64% Chair 5%Center Director 12% Other 17%
    • 16. CTSA Clinical Management Workshop, June 24, 2008 Academic Rank Professor 54% Assistant Professor 22% Associate Professor 24%
    • 17. CTSA Clinical Management Workshop, June 24, 2008 Tenure Status No tenure system 5% Not on tenure track 6% On tenure track 22% Tenured 67%
    • 18. CTSA Clinical Management Workshop, June 24, 2008 Research Grants Average number of grants to… Federal PI Co-PI PI Total Direct Cost Funding Median Mean Professors 2.0 1.0 $ 260,000 $ 560,320 Associate Professors 1.5 1.0 $ 200,000 $ 337,543 Assistant Professors 1.3 1.0 $ 150,000 $ 224,804
    • 19. CTSA Clinical Management Workshop, June 24, 2008 Time Spent on Work Activities • 20% Teaching • 58% Research o Mentoring students & postdoctoral fellows (14%) o Conducting research (44%) • 9% Professional Service o Associations, societies (8%) o Regulatory committees (1%) • 11% Service (other) • 3% Other Work Duties *Total due to rounding (101%)
    • 20. CTSA Clinical Management Workshop, June 24, 2008 Time Spent on Federal Research 42% of research time is actually spent administering the project Active Research 58% Post-Award Research Administration 20% Pre-Award Research Administration 22%
    • 21. CTSA Clinical Management Workshop, June 24, 2008 Top Administrative Burdens (average for all respondents, including those who reported no burdens in specific areas)* 1. Grant progress report submission 2. Personnel hiring 3. Project revenue management 4. Equipment and supply purchases 5. IRB protocol approvals and training* 6. Training personnel and students 7. Personnel evaluations * For those who used human subjects or animals, IRB or IACUC was the #1 burden
    • 22. CTSA Clinical Management Workshop, June 24, 2008 Many burdens varied by federal agency Federal Funding Agency Top burdens All agencies (top 3 burdens) • Grant progress report submissions • Personnel hiring • Project revenue management (all but DOC) DOI, DOD, DOE, EPA, USDA, NASA • Equipment and supply purchases EPA, ED, DOC, and DOI • Subcontracting and collaborations HHS, ED, and NIH • IRB protocol approvals and training • IRB compliance issues • HIPPA compliance
    • 23. CTSA Clinical Management Workshop, June 24, 2008 Top burdens by federal agency (cont.) Federal Funding Agency Top burdens DOC and NIH • IACUC protocols and training DOI • Cost accounting issues NIH • Training personnel & students USDA • Time & effort reporting
    • 24. CTSA Clinical Management Workshop, June 24, 2008 Burdensome tasks varied by faculty subgroup Burden Faculty Subgroup (s) IRB protocols and training Medical institutions Psychology Education Social Sciences Not on tenure track On tenure track – not tenured No tenure system Private institutions Female faculty Underrepresented minorities Associate/assistant professors Faculty with administrative role
    • 25. CTSA Clinical Management Workshop, June 24, 2008 Burdensome tasks by faculty subgroup (cont.) Burden Faculty Subgroup (s) Patent/copyright applications Engineering IRB compliance issues Note that this is in addition to the burden of protocol development and training Clinical faculty Health Sciences Psychology Medical institutions Education Not on tenure track No tenure system Female faculty HIPPA compliance Clinical faculty Health Sciences Medical institutions
    • 26. CTSA Clinical Management Workshop, June 24, 2008 Burdensome tasks by faculty subgroup (cont.) Burden Faculty Subgroup (s) Subcontracting and collaborations Engineering Education Training personnel and students Biological/Life Sciences Medical institutions Asian/Pacific Islanders Underrepresented minorities On tenure track – not tenured Assistant professors IACUC protocols and training Biological/Life Sciences Medical institutions
    • 27. CTSA Clinical Management Workshop, June 24, 2008 0 1 2 3 4 Grant Report Submissions ( 1 = no burden → 5 = worst burden) Bars = different universities (schools with >100 respondents) Little variation between schools
    • 28. CTSA Clinical Management Workshop, June 24, 2008 0 1 2 3 4 Personnel Hiring ( 1 = no burden → 5 = worst burden) Bars = different universities (schools with >100 respondents)
    • 29. CTSA Clinical Management Workshop, June 24, 2008 0 1 2 3 4 Project Revenue Management ( 1 = no burden → 5 = worst burden) Bars = different universities (schools with >100 respondents)
    • 30. CTSA Clinical Management Workshop, June 24, 2008 0 1 2 3 4 IRB Protocol Approvals and Training ( 1= no burden → 5 = worst burden) Bars = different universities (schools with >100 respondents) Notable variation between schools
    • 31. CTSA Clinical Management Workshop, June 24, 2008 Institutional variations • For many administrative burdens there is remarkably little variation among universities • Some differences among universities; may reflect differences in scientific disciplines rather than differences in institutional policies or procedures • Some differences may reflect institutional practices; these should be examined to find best practices • Faculty at medical schools report more burdens and a greater cross section of burdens • Faculty at ERI have special problems because of the lack of institutional support for research
    • 32. CTSA Clinical Management Workshop, June 24, 2008 There is variation in the impact of burdens • IRB hits hardest on medical schools, private schools, social sciences, education, junior faculty, women and underrepresented minorities • HIPPA hits hardest on medical schools, clinical faculty, health sciences • Patent applications hit hardest on engineers • Women, minorities, and junior faculty tend to report greater administrative burdens and less administrative support • Some burdens, like reporting and personnel management, are remarkably consistent across faculty groups, universities and funding agencies
    • 33. CTSA Clinical Management Workshop, June 24, 2008 Burden vs. Existing Administrative Assistance • Faculty report low levels of institutional support across all administrative tasks, with variations by disciplinary context very evident • Most assistance = financial management  Payroll, budget transfers, cost accounting issues, cost sharing agreements, project revenue management  Project revenue management remains a top burden • Least assistance = research-related activities  IRB, IACUC, COI monitoring, grant progress reports, patent/copyright applications, intellectual property applications  Grant progress report submission is the #1 reported burden • Personnel evaluations  7th most burdensome of the 25 burdens  2nd lowest level of assistance
    • 34. CTSA Clinical Management Workshop, June 24, 2008 Support for research-related administration • 97% of faculty stated that at least some time they spend managing Federal grants could be conducted by appropriate support personnel • 95% of reporting faculty believed that they could devote 4-8 additional hours each to week to active research if they had more assistance with administrative tasks • 76% of faculty would be willing to reallocate direct costs from their grants to pay for this research-related administrative support if this were allowed • This administrative help would need to come from highly trained research staff, with expertise in the area of the research, who could help with administrative tasks directly related to the research such as preparation of IRB and IACUC protocols and reports, data management, scientific reports, staff training etc. They would be scientific staff acting as “project managers” rather than office staff.
    • 35. CTSA Clinical Management Workshop, June 24, 2008 No Single Culprit (The death of a thousand cuts) Burdens come from several sources  Federal regulations  Agency implementation of regulations  Differences in agency requirements  Institutional requirements and implementation  Audit fears and auditor interpretations and comments  Inherent part of research  Lack of administrative support 84% of the faculty members reported that the administrative burdens associated with their research have increased in recent years.
    • 36. CTSA Clinical Management Workshop, June 24, 2008 Burdens add up… Considering only our respondents:  About $97 million of the direct costs of federal grants is spent on faculty salaries devoted to administration efforts directly related to those research grants  This survey considers only the grant-funded research administrative work of the PIs. It does not consider the work performed by ○ Other faculty investigators ○ Laboratory staff ○ Institutional administrative staff ○ Compliance committees ○ The PIs under support from other funding mechanisms
    • 37. CTSA Clinical Management Workshop, June 24, 2008 This survey does not consider the other research-related administrative tasks of the faculty, which are not project-specific and therefore cannot be charged as direct costs on federal grants • Writing and submitting new grants and competitive renewal applications • Service on Study Sections • Service on institutional compliance committees (IRB, IACUC, Biosafety, COI) • Attending general mandatory training modules
    • 38. CTSA Clinical Management Workshop, June 24, 2008 The cost of the faculty time is divided Sponsor share Paid effort spent on administration of project (42%) University share Effort diverted from other tasks Societal share Effort diverted from actual research and teaching Personal share Extra effort added to job (and taken from family/life)
    • 39. CTSA Clinical Management Workshop, June 24, 2008 These burdens have impacts on trainees 62% of the respondents felt that students are less likely to pursue academic research careers now than in the past  Multiple causes (workload, salary, funding competition, sense of job worth.)  “They see what we really do and they don’t want to do that.”  A particular challenge with American-born students  This echoes the concern voiced in many medical schools about the loss of physician scientists from the research pool
    • 40. CTSA Clinical Management Workshop, June 24, 2008 Conclusions from Survey • Faculty spend about 42% of their federal research time (not their total paid time) on administration of the research • No single overriding burden; pressure is on faculty from many sources (death of a thousand cuts) • Significant costs are associated with these burdens • Potential savings from decreasing burdens or providing faculty with more administrative support (very important in period of level/decreasing research funding) • Potential gain from identifying and replicating best practices at agencies and funding institutions • Potential gain from harmonizing requirements of different agencies
    • 41. CTSA Clinical Management Workshop, June 24, 2008 What is the message for the CTSAs? This problem merits attention from the CTSAs • Many of the top burdens disproportionately affect clinical and translational research • Problems impact the training and career development of young researchers • Lack of institutional infrastructure to support research-related administrative activities is a problem – CTSAs can help provide these • Coordinated efforts involving groups of organizations are needed to address some problems
    • 42. CTSA Clinical Management Workshop, June 24, 2008 Poster from YCCI • Outlines review/approval process occurring during the development and implementation of a clinical protocol  Complex and daunting process  Help from YCCI at several points  Such help was reported to be rare in the FDP survey • The process outlined on the poster does not include many of the elements that the PI is dealing with  Writing and submitting any grant applications associated with the protocol  Most personnel issues  Reporting to sponsors, compliance committees  Many training and compliance issues
    • 43. CTSA Clinical Management Workshop, June 24, 2008 Mandatory training of faculty an staff is a huge problem Training/activities related to my research projects Biosafety Bloodborne Pathogen for Laboratory Personnel Bloodborne Pathogen for Lab and Clinic Personnel Bloodborne Pathogen Refresher Course* Biosafety Level 3 Regulatory Training for Animal Care & Use YARC Facilities Orientation Rodent: Humane Euthanasia Medical Surveillance for Animal Handlers State Controlled Substances Laboratory License* Federal Controlled Substances Laboratory License* Radiation Safety Orientation Radiation Safety Training Seminar Radiation Safety Training for Principal Investigators Radiation Safety Special Training Seminar Irradiator training (x-rays) Irradiator training (Cesium 137 irradiator) Radiation Safety Retraining* FBI background check and fingerprinting Laboratory Chemical Safety TB tests Hep B vaccine/titer Tetanus immunization Human Subject Protection Training HIPAA for Research Staff Conflict of Interest in Human Subjects Research Developing a Repository Protocol Ethical Considerations in Human Embryonic Stem Cell Research Developing a Repository Protocol Assent and Pediatric Research Other training/activity requirements Not directly related to my research Training requirements assessment* Sponsored Projects Administration for Faculty Sponsored Projects Administration Self Assessment Fire Extinguisher Training* Conflict of Interest/Commitment Disclosure* Sexual Harassment for Supervisors HIPAA General Security Training Training in use of Yale Credit Card Training in use of various databases/IT systems Because of work with federal agencies Duns registration Central Contractor Registration Various security clearances Various background checks Numerous additional COI disclosures Registration with Grants.gov and increasing numbers of other databases
    • 44. CTSA Clinical Management Workshop, June 24, 2008 For Clinicians, there are additional requirements needed for credentialing by YNHH Reading required training documents Medical Staff Bylaws Medical Staff Rules and Regulations Guidelines or requirements for reference writers Infection Control/Standard Precautions Readings include: Hospital infection control, standard precautions, bloodborne pathogens, TB control and airborne precautions. The post-test must be passed with a score of 75%. HIPAA Privacy and Security Reading Materials. Post-Test also required. Information on Interpreter Services Immunization /Test Records to comply with OSHA/AHA/JCAHO If applying for special privileges, requirements as noted in individual “Criteria for Privileges” documents. Reading materials for Conscious Sedation Privileges. Test must be passed. Proof of basic/advanced life support training in the past 4 years or has completed YNHH sponsored airway management training for Tier 1 or standard privileges. For Tier 2 privileges, the applicant must have the appropriate expertise as defined by an appointment in Anesthesia, Section of Emergency Medicine, or ICU Intensivist. YNHH Policy on Medical Staff Health Medical Staff Policy on Focused Professional Practice Evaluation Medical Staff Policy on Hand Hygiene and Contact Precautions Providing with the application Completed application form. Check for Fee Applicant checklist Claim-Suit Report Form Written statement from the applicant explaining his/her reasons for requesting privileges and what contributions he/she expects to make to the clinical and teaching mission of the hospital. Clinical Privilege Delineation form based on clinical area of specialty Copy of medical school diploma or ECFMG Certificate (for foreign medical school graduates) All current licenses, including Connecticut Immunization Documentation Form including evidence of PPD in the past 12 months. Hepatitis B declination, as appropriate. DEA certificates and Current CT narcotics certificate Current malpractice insurance Identity verification Board Certifications Copy of CV Completed competency post-tests as noted above. Medicare/CHAMPUS declaration
    • 45. CTSA Clinical Management Workshop, June 24, 2008 More things for physicians In case you think credentialing is a one-time activity: I was told that the re-credentialing process is essentially the same. Other required training listed on the website*: Medical Billing Compliance Compliance Clinical Research Training Module Research Form training Research Registration Training YMG Customer Service Training (listed as “required, but not available”) ***I did not dig – I suspect there are many other requirements on the hospital side
    • 46. CTSA Clinical Management Workshop, June 24, 2008 And if a researcher has an appointment at our affiliated VA… • Different rules • Different requirements • Additional requirements • Duplication of some training requirements • Duplication of many review/approval requirements • This produces a large additional burden, with no obvious benefit to compliance, safety, or the quality of the research
    • 47. CTSA Clinical Management Workshop, June 24, 2008 Some thoughts on what CTSAs should do At our home institutions • Provide infrastructure and resources to help researchers • Look at CTSA processes and requirements in the context of the total administrative burden on translational researchers at their institution  Where can processes be streamlined?  Where can requirements and processes be harmonized?  Which requirements and processes are unnecessary or redundant?  When can we avoid going to faculty for information by using information already available in our institutional databases? • Identify especially burdensome elements that add little value and work to change them
    • 48. CTSA Clinical Management Workshop, June 24, 2008 Some thoughts on what CTSAs should do At our home institutions • Every proposed new procedure, requirement and process should be examined to ensure that it adds sufficient value  Can the problem be addressed by using or modifying an existing element? • We should always question whether/how often retraining is necessary and what form “refresher” training should take  Does it need to be a repeat of the original course?  Would advanced or area-specific training suffice or even be better?  What really needs to be done every year
    • 49. CTSA Clinical Management Workshop, June 24, 2008 Some thoughts on what CTSAs should do On a national level • Present to the agencies the potential benefits of harmonizing and streamlining administrative and compliance requirements/procedures  Facilitating important translational research  Increasing the impact of federal research dollars  Improving the efficiency of the research enterprise • Work on streamlining and harmonizing requirements and procedures  Among CTSAs  Among academic institutions  Among federal agencies  Help bring VA to the table • Demonstrate the value of providing improved infrastructures that assist faculty and trainees who are performing translational research
    • 50. CTSA Clinical Management Workshop, June 24, 2008 Thanks !! • The Members of the FDP  Bob Decker and Joe Konstan (whose slides I have used)  Marv Paule  Leslie Wimsatt and Andrea Trice  Nancy Wray, Jerry Stuck and David Wright  Scott Crawford, Survey Sciences Inc.  Research Administrators from the FDP institutions (who got the survey approved by their institutions and IRBs) • Yale University • The YCCI and the organizers of this meeting