Research Ethics Training of Trainers: Developing Capacity of Bolivian Health Science and Civil Society Leaders

Program/Project Purpose: The University of San Andres, Faculty of Medicine in La Paz, Bolivia in collaboration with Touro University California, Public Health Program was awarded a NIH Research Ethics Planning Grant in June, 2013 to develop strategies and processes for implementation of a comprehensive national research ethics program for Bolivia. Although the importance of scientific research based on ethical principles is highlighted in the Bolivian constitution and national health legislation, few Bolivian academics, researchers and health professionals have received formal training in the principles and practices of research ethics. A principle aim of the Planning Grant is to develop and implement a Research Ethics Train the Trainers (TOT) course with the goal of training faculty for future implementation of a national research ethics program. Structure/Method/Design: A Project Directors Committee representing public health science universities from four participating Bolivian Departments/States (La Paz; Santa Cruz, Cochabamba & Chuquisaca) was formed to oversee all project activities including implementation of a three day in-person TOT followed by a 10 week online training. Training modules utilized materials developed by Bolivian academics and scientists and international research ethics programs at PAHO (Pan American Health Organization) and CITI (Collaborative Institutional Training Initiative), University of Miami. TOT University and civil society representatives were selected from each participating Department/State for a total of 26 participants. Upon completion of the training, participants were asked to implement educational research ethics activities in their local communities and institutions. Outcomes & Evaluation: A pre-test/post-test study design was used to assess change in participant knowledge related to research ethics principles and practices. The mean score improved from 73% correct at baseline and 84% at course completion. Participants completed a course evaluation after the in-person and virtual components of the course. Participants highlighted the most useful topics in the course as respect for persons and human rights, principles of bioethics, informed consent and the function of research ethics committees. The most positive aspects of the in-person component of the course were the high level of participation, group work, communication and debate among participants representing different academic disciplines and social sectors. Eighty percent of participants completed the course with five dropping out during the virtual component. Most students reported that the instructions for using the virtual platform were clear and they received sufficient support from the Course Coordinator, however, most stated that some of the teachers provided insufficient academic support. Going Forward: Integrating the group interaction strengths of the in-person TOT component with the flexibility of the virtual component recommends using a mixed methods approach while providing additional training to teachers related to virtual teaching methodologies. Funding: NIH/FIC, International Research Ethics Education and Curriculum Development Award (R25)