Research Is a Team Sport: Ralph Nitkin on the Research Relationship Between the Foundation and NIH

How can early-career funding and mentoring help emerging investigators? Why do the Foundation and NIH share application and review standards, and how can Foundation awards set up an investigator for future funding? To answer those questions and more, we sat down with Ralph Nitkin, PhD, the deputy director of the National Institute of Child Health and Human Development National Center for Medical Rehabilitation Research.

Can you tell us a little bit about your background and how you came to be in your current position?

Throughout my graduate and post-doc studies I was intent on emulating my mentors and establishing myself as an independent academic researcher. My one big regret was that throughout the training I wasn’t really trained to think in broader terms, to identify research opportunities, and to really go after things that are more clinically significant.

Shortly after establishing my own research lab at Rutgers University, I made a significant career switch: I became a research administrator at the National Institutes of Health, first in the area of intellectual and developmental disabilities, and then I moved over to the National Center for Medical Rehabilitation Research.

Although I’m no longer actually doing the research, I’ve not only learned a lot from discussing research proposals, but I developed a deep understanding of the peer-review process. This puts me in a special position to help researchers and to provide access to NIH research support.

Can you give us some examples of how you’ve observed early career funding affecting future research success and help us picture what that success looks like?

I’ve been impressed with how collaborative the field of physical therapy and the broader rehab field is, especially how committed some of the senior folks are to mentoring and supporting the next generation. Early career funding is key to providing access to new techniques and patient populations, and to building pilot data and support of early career activities.

It also has this cohort effect that creates the next generation of rehabilitation researchers. The researchers who we support have a responsibility to connect to the broader physical therapy community, to patients and families, to highlight research findings, and to listen to make sure they understand future needs and opportunities.

What do you think are some of the best ways for the physical therapy community to continue to grow the research capacity for the field?

We have to support clinicians and therapists who are committed to their patients but want to go into research to promote further opportunities and more targeted treatment approaches. We need to attract clinical and basic researchers from allied fields into some of our exciting opportunities that are happening in rehab research, because research is very much a team sport. The Foundation has a role in the broader sense, promoting patient and family support and health literacy and helping people understand the impact and value of research.

More specifically, maybe the Foundation should seek opportunities to complement — not compete with — federal funding, industry research resources, health services systems, and other drivers of research and translation. We need to incorporate people with the lived experience, to keep the focus on real-world goals, and to promote more scalable and sustainable outcomes.

A lot of researchers who the Foundation funds go on to win NIH awards. What do you think are the most important ways that the Foundation’s seed funding can help prepare researchers for securing this larger, more competitive funding from NIH?

The Foundation could continue to provide support to attend workshops and hands-on activities, to participate in national research meetings, and to give them pilot funding so they can test out innovative approaches, and build their credibility, their personal CV.

The Foundation should help them with access to mentors in training and grantsmanship and to internal peer review and self-evaluation, and it could highlight stories of recently successful researchers who would serve as accessible role models.

The Foundation should also think about support for more experienced researchers who need to retool, recharge, and develop new collaborations.

The Foundation’s grant awards program follows NIH application and review standards. We know that NIH is providing leadership in how these processes and standards can be improved, for example, reducing bias in peer reviewing. What do you think are the most important areas in which NIH is working or should be working to improve the grant application process?

The peer-review system is always evolving to try to promote the highest standards of evaluation, objectivity, and transparency. But there is a constant battle to keep the reviewers focused on innovation, significance and impact and not get bogged down with technical details and academic elegance, especially now that we’re getting into times of increasingly competitive resources and tight pay lines.

We also have to battle the economic and geographical bias toward the more elite institutions. We need to support a more diverse range of approaches, ideas, and opportunities. This is especially true with respect to training and career development mechanisms. Peer reviewers should be more open to supporting novel, maybe less predictable proposals. And we, as NIH administrators, must provide more opportunities to broaden the range of research perspectives.

How important do you believe the Foundation’s support of initiatives such as TiDe, CoHSTAR or LEARRN, has been to the success of these programs?

CoHSTAR has been a great model to highlight the value of physical therapy services to patients, payers, and providers. They have developed the complementary NIH research resource program, LEARRN. Both programs have been important for supporting researchers who are at the interface of health care systems, informatics, and implementation science.

The TiDe program is focused on promoting diversity and inclusion in rehabilitation research through support of broader communities of researchers and a focus on peer mentoring. There’s a need to promote diversity of ideas, to identify health disparities, and create more diverse role models of research careers. We really look forward to the growth and success of what I think is a very bold program.