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Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
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Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences

Terry C. Pellmar and Leon Eisenberg, Editors

Committee on Building Bridges in the Brain, Behavioral, and Clinical Sciences

Division of Neuroscience and Behavioral Health

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

NATIONAL ACADEMY PRESS
2101 Constitution Avenue, N.W. Washington, DC 20418

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

This project was supported by Task Order No. 52, under Contract No. N01-OD-4-2139 from the National Institutes of Health.

International Standard Book Number 0-309-07078-3

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Copyright 2000 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

“Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Goethe

INSTITUTE OF MEDICINE

Shaping the Future for Health

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

THE NATIONAL ACADEMIES

National Academy of Sciences

National Academy of Engineering

Institute of Medicine

National Research Council

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

COMMITTEE ON BUILDING BRIDGES IN THE BRAIN, BEHAVIORAL, AND CLINICAL SCIENCES

LEON EISENBERG, M.D. (Chair),

Harvard Medical School

RICHARD F. THOMPSON, PH.D. (Vice-Chair),

University of Southern California

GAURDIA BANISTER, PH.D., R.N, C.A.C.,

Seton House at Providence Hospital (until 9/99)

MICHAEL V. L. BENNETT, D. PHIL.,

Albert Einstein College of Medicine

LINDA M. BURTON, PH.D.,

The Pennsylvania State University

DEBORAH J. COTTON, M.D., M.P.H.,

Boston University School of Medicine

SID GILMAN, M.D.,

University of Michigan Medical School

ROBERT J. HAGGERTY, M.D.,

University of Rochester School of Medicine

THOMAS R. INSEL, M.D.,

Emory University

GLORIA L. KRAHN, PH.D., M.P.H.,

Oregon Health Services University (after 9/99)

PETER R. MACLEISH, PH.D.,

Morehouse School of Medicine

PAMELA H. MITCHELL, PH.D., R.N.,

University of Washington, School of Nursing

RICHARD D. TODD, PH.D., M.D.,

Washington University, School of Medicine

MYRNA M. WEISSMAN, PH.D.,

College of Physicians and Surgeons of Columbia University

Board on Neuroscience and Behavioral Health Liaison

ELLEN FRANK, H.D.,

University of Pittsburgh School of Medicine

Study Staff

TERRY C. PELLMAR, PH.D., Study Director

DEBORAH YARNELL, Research Associate

AMELIA MATHIS, Project Assistant

LINDA V. LEONARD, Administrative Assistant

NORMAN GROSSBLATT, Manuscript Editor

CARLOS GABRIEL, Financial Associate

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

BOARD ON NEUROSCIENCE AND BEHAVIORAL HEALTH

JOSEPH T. COYLE, M.D. (Chair)

Harvard Medical School

ELLEN FRANK, PH.D. (Vice-Chair),

University of Pittsburgh School of Medicine

RICHARD J. BONNIE, L.L.B.,

University of Virginia School of Law

WILLIAM E. BUNNEY, M.D.,

University of California at Irvine

MARGARET A. CHESNEY, PH.D.,

University of California at San Francisco School of Medicine

RICHARD G. FRANK, PH.D.,

Harvard Medical School

ANNM. GRAYBIEL, PH.D.,

Massachusetts Institute of Technology

BEATRIX A. HAMBURG, M.D.,

Cornell University Medical College

BEVERLY B. LONG, M.S., M.P.H.,

World Federation for Mental Health, Atlanta, Georgia

KATHLEEN R. MERIKANGAS, PH.D.,

Yale University

STEVEN M. MIRIN, M.D.,

American Psychiatric Association, Washington, D.C.

STEVEN M. PAUL, M.D.,

Lilly Research Laboratories, Indianapolis, Indiana

RHONDA J. ROBINSON-BEALE, M.D.,

Blue Cross/Blue Shield of Michigan, Southfield

STANLEY J. WATSON, M.D., PH.D.,

University of Michigan

STEPHEN WAXMAN, M.D., PH.D.,

Yale Medical School

KENNETH B. WELLS, M.D., M.P.H.,

Neuropsychiatric Institute, University of California at Los Angeles

NANCY S. WEXLER, PH.D.,

Columbia University

ANNE B. YOUNG, M.D., PH.D.,

Massachusetts General Hospital, Boston

Staff

TERRY C. PELLMAR, PH.D., Director

CAROLE A. CHRVALA, M.A., PH.D., Senior Program Officer

JANET E. JOY, PH.D., Senior Program Officer

DEBORAH O. YARNELL, Research Associate

JOHN A. ROCKWELL , Research Assistant

ALLISON L. FRIEDMAN , Research Assistant

LINDA V. LEONARD, Administrative Assistant

AMELIA B. MATHIS , Project Assistant/Senior Secretary

WENDY BLANPIED , Project Assistant

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

Preface

As never before, behavioral and neurological diseases are moving to the forefront of public health concerns; witness the Surgeon General 's Report on Mental Health. Many of the leading causes of morbidity and mortality in the United States are recognized as having major social and behavioral determinants. Psychological stress has been linked to many health outcomes; researchers and public health officials are becoming increasingly interested in unraveling the mechanisms behind this relationship. Sociologists have identified changes in the age, ethnic, racial, and cultural makeup of the American population, changes that have an impact on biological, psychological, and social processes. As scientists and health care providers examine the intricate interplay among genes, environments, behaviors, and diseases, health problems newly emerging, as well as those that have plagued us over time, present complex challenges for research. The biomedical advances of the past decades have dramatically increased our understanding of the links between behavioral and neural processes and disease. These advances make it clear that fuller understanding demands the integration of knowledge and concepts from multiple disciplines.

To make that understanding possible, we must create an environment to promote interdisciplinary research and training. Although its importance has been stressed many times in the past decades, there is now a groundswell of support for interdisciplinary research. Universities, funding agencies, and groups of investigators are looking for ways to make it occur. New research centers are being created with the specific goal of promoting interactions among the disciplines.

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
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Peer review at NIH has been recently revamped, in part to facilitate interdisciplinary research. Nonetheless, obstacles persist.

This Committee was charged with examining the need for interdisciplinary research and training, identifying the obstacles that stand in the way, and defining the components of training necessary to create scientists able to bridge disciplines in the brain, behavioral, and clinical sciences. The committee includes members with expertise ranging from sociology to neurophysiology, from basic science to the clinic, from investigators with a single discipline to leaders of broad interdisciplinary programs. We met four times. At our first meeting, we heard from the Directors of the National Institute of Mental Health and the Office of Behavior and Social Science Research. They described their goal of developing scientists able to bring an integrated approach to the health problems facing today's society. NIH and NSF program officers described the mechanisms currently available to fund training programs.

At the workshop we convened, university and industry program directors described their existing training programs and the obstacles they encounter. We discussed potential solutions with an invited panel of scientists and university administrators. The directors of several NIH institutes were invited to comment on whether and why they felt interdisciplinary research and training were necessary. There was a clear consensus that such is an appropriate direction for today 's science, but the evidence on the best way to proceed is limited. IOM staff read through dozens of funded grant proposals, reviewed program descriptions and brochures, and talked with program directors to learn the scope of the mechanisms currently in use. They reviewed hundreds of requests for applications to identify the interests and opportunities of the funding agencies.

Early in our deliberations we agreed that that interdisciplinary research itself is not the goal; rather the need for it emerges from research questions. Some problems are best tackled with the methods and concepts of a single discipline; others require integration across disciplines. It is important to define the issues appropriate for interdisciplinary techniques and to carefully consider the disciplines that should be involved in developing the solutions.

Examples of interdisciplinary efforts are diverse. They include the collaboration of investigators working together on a difficult problem, the stimulation of thought and direction that occurs with facilitated interactions, the translation of clinical and basic science findings through exchanges between clinicians and researchers. Because definitions of interdisciplinary research are so varied, identifying interdisciplinary publications, grants, training, and research proved to be extremely challenging. Furthermore, data on the successes (or failures) of existing funding mechanisms are limited. Without outcome data, we cannot assert definitively what are the “best” or the “necessary” approaches to encourage interdisciplinary training. For future evaluations, this gap needs to be filled. It will not be easy to develop mechanisms to track training outcomes, but to do so is essential and merits a major investment of effort.

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

Training in existing single disciplines should be broadened so that all graduates become aware of the ideas and methods at the borderlines of their own fields. On the one hand, basic scientists should be introduced to the scope of clinical problems; clinical investigators should be kept abreast of laboratory research. The aim is to create “informed consumers,” able to understand other disciplines and to recognize ideas applicable to their own work.

The many obstacles that discourage interdisciplinary efforts are summarized in our report. The point we emphasize here is that they can be surmounted with the support of universities and funding agencies. With appropriate incentives, trainees can be encouraged to broaden their horizons. Not all those trained with an interdisciplinary perspective will do interdisciplinary research, but the education they receive should provide the capacity to integrate information from other disciplines when, and as, it becomes appropriate over a lifetime in research. Funding agencies can deploy the large variety of mechanisms available to them to promote interdisciplinary training in order to overcome obstacles and enhance research.

Because interdisciplinary research is flourishing at many universities, some might feel that additional attention is unnecessary. We believe that despite this activity, there is a need to set directions, facilitate training, and evaluate the programs. We view our recommendations as guidelines to enhance training opportunities for all scientists and allow them to participate in interdisciplinary efforts to solve today's complex health problems.

Leon Eisenberg

Chair

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
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Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
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Acknowledgments

The committee wishes to thank the many people who contributed to this report. Terry Pellmar, as Study Director, made the work of this Committee possible by her intellectual clarity, her resourcefulness in identifying and providing background materials, and her diligence in keeping us on task. Deborah Yarnell's assistance as research associate was exceptional. She was tireless in tracking down information, identifying programs, and obtaining interviews. Her insights and her dedication were much appreciated. Amelia Mathis took wonderful care of the committee, handling their travel and meals and all the meeting logistics. Wendy Blanpied was invaluable in her program support, especially for the workshop. We also thank Linda Leonard for administrative assistance, Kathi Hanna for consultation and writing, Carlos Gabriel for financial accounting, Claudia Carl for guiding the report through review, Norman Grossblatt for expert editing, Susan Fourt for help with library resources, and Linda Kilroy for contract support. Clyde Behney provided valuable guidance throughout the study process. Many other individuals from government, private industry, foundations, and academia provided expert consultation and are acknowledged in Appendix B.

REVIEWERS

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that

Suggested Citation:"Front Matter." Institute of Medicine. 2000. Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Washington, DC: The National Academies Press. doi: 10.17226/9942.
×

will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report: Boris Astrachan, University of Illinois; Jack D. Barchas, Weill Medical College of Cornell University and Weill Cornell Medical Center; Samuel H. Barondes, University of California at San Francisco; Michael Gazzaniga, Dartmouth College; Zach W. Hall, University of California at San Francisco; Robert Langer, Massachusetts Institute of Technology; Joe L. Martinez, Jr., The University of Texas at San Antonio; and Anne Petersen, W. K. Kellogg Foundation.

While the individuals listed above have provided constructive comments and suggestions, it must be emphasized that responsibility for the final content of this report rests entirely with the Committee on Building Bridges in the Brain, Behavioral, and Clinical Sciences and the Institute of Medicine.

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Interdisciplinary research is a cooperative effort by a team of investigators, each an expert in the use of different methods and concepts, who have joined in an organized program to attack a challenging problem. Each investigator is responsible for the research in their area of discipline that applies to the problem, but together the investigators are responsible for the final product. The need for interdisciplinary training activities has been detailed over the last 25 years in both public and private reports. The history of science and technology has even shown the important advances that arose from interdisciplinary research, including plate tectonics which brought together geologists, oceanographers, paleomagnetists, seismologists, and geophysicists to advance the ability to forecast earthquakes and volcanic eruptions.

In recognition of this, the need to train scientists who can address the highly complex problems that challenge us today and fully use new knowledge and technology, and the fact that cooperative efforts have proved difficult, 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) requested that an Institute of Medicine (IOM) Committee be created to complete several tasks including: examining the needs and strategies for interdisciplinary training in the brain, behavioral, social, and clinical sciences, defining necessary components of true interdisciplinary training in these areas, and reviewing current educational and training programs to identify elements of model programs that best facilitate interdisciplinary training.

Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences provides the conclusions and recommendations of this committee. Due to 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. However, after reviewing existing programs and consulting with experts, the committee identified approaches likely to be successful in providing direction for interdisciplinary endeavors at various career stages. This report also includes interviews, training programs, and workshop agendas used.

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