Speakers
Amit Goyal, MD, MAS
Interventional/Structural Fellow, Cleveland Clinic
Cofounder of CardioNerds
Keywords
Clinical Trial, Medical Education
Key Points
- The goal of the CardioNerds Clinical Trials Network is to pair equitable enrollment with trainee development. CardioNerds started as an educational podcast, which in the first month had 5,000 downloads and now has had more than 3 million downloads in 192 countries. The success of the podcast shows the need and value for asynchronous training.
- The mission and the people involved with CardioNerds are the key ingredients for its success. The mission is to democratize cardiovascular education by creating and disseminating education, fostering wellness and humanism, promoting diversity, equity and inclusion, providing mentorship and sponsorship, and invigorating a love of cardiovascular science.
- The biggest inflection point for CardioNerds was COVID-era recruitment, when residents were asked to decide where to train for fellowship without having in-person visits. CardioNerds collaborated with ACA to invite every fellowship to share case-based learning and the training opportunities of their program. They also included a message from the fellowship program director or leadership. Forty-four programs participated.
- CardioNerds identified a need to develop a pilot clinical trials network for the PARAGLIDE-HF trial, a multicenter, randomized, double-blind, double-dummy, parallel group, active controlled study to evaluate the effect of sacubitril/valsartan verses valsartan on changes in NT-proBNP, safety, and tolerability in HFpEF patients with a WHF event who have been stabilized and initiated at the time of or within 30 days post-decompensation.
- Like many trials during the COVID-19 pandemic, there were significant challenges and recruitment delays. To address these challenges, we decided to work with the CardioNerds network with a goal of pairing trial enrollment with trainee professional development. Among trial sites with affiliated programs, we invited program directors to nominate fellows to participate. We engaged fellows by making them part of the research team, ensured mentorship, networking, etc. We built the first trainee-based CardioNerds Clinical Trials Network that enhanced recruitment and education.
- The network ended up with 20 sites and 22 trialists. The fellows were responsible for 45% of enrollment during the time of the trial. The CardioNerds fellows enrolled 54% women compared to 45% non-fellow enrolled and 71% BIPOC compared to 23% non-fellow enrolled patients. The network also built a community of fellows who took great pride in the work they were doing. For every of the 70+ recruitments an email went out celebrating the work of the fellows and site mentors, which reinvigorated interest and enthusiasm among the site PIs, who had the opportunity to mentor the next generation of trialists.
- In the future, we would like to study this in greater detail and find out what happened at CardioNerd sites compared to other sites. We would like to do a qualitative study for everyone involved and understand the career impact for the fellows.
Learn more
Visit the CardioNerds website.
Discussion Themes
-What did this activity displace in a busy cardiology fellow’s day? What we tried to emphasis was engaging cardiovascular fellows in year 2 or 3 when there are less clinical responsibilities and more elective time. There are a lot of ways to use the available time. The emphasis was identifying fellows who are interested in developing careers in clinical science. We did not want the fellows to take the place of the site coordinators but to use their experience taking care of the patient. It was matched to their career goals, and it fit into the rubric of what they are already doing, caring for patients and being involved in education.
-Why do you think fellows were more successful in enrolling women and BIPOC? There can be a general level of mistrust. If a patient is approached by a fellow, the perspective of the fellow is to prioritize patient care, so there is a built-in level of trust that may come with that and is something we want to explore more. We asked site PIs to prioritize nominating fellows who were women and URMs. A lot of this was also related to the sites that were involved.
Tags
#pctGR, @Collaboratory1