Lasser D H, Chuman A, Ferrara E, Gurwitz J
Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester 01655, USA.
Acad Med. 1999 Jan;74(1 Suppl):S30-5. doi: 10.1097/00001888-199901001-00028.
The authors describe and evaluate an annual competitive "mini-grant" program, funded by The Robert Wood Johnson Foundation's Generalist Physician Initiative established at the University of Massachusetts Medical School as a strategy to stimulate greater faculty involvement in the development of innovative, generalist-oriented projects. The mini-grant program stimulated proposals from across the academic community. The average award was small (mean = $7,039) but at times the awards led to results exceeding the scope of the original funding. In several cases, mini-grant support provided seed funding for faculty to undertake pilot projects to test new initiatives that would otherwise not have been developed. Some projects led to further ideas or to collaborations between generalists and basic scientists or specialists. More than half of funded projects were eventually institutionalized, and nearly 20% led to formal presentations at national meetings. Two problems are identified: (1) there were fewer proposals generated by specialist faculty and fewer collaborative proposals from generalists and specialists than anticipated, and (2) no funded proposals were generated by community-based faculty who were predominantly clinicians, such as preceptors. Despite these problems, and in light of available solutions, the authors conclude that an institutional mini-grant program can provide an ongoing, flexible mechanism to support a shift in institutional culture toward an enhanced status for generalism.
作者描述并评估了一项年度竞争性“小额资助”计划，该计划由罗伯特·伍德·约翰逊基金会的通科医生倡议资助，该倡议在马萨诸塞大学医学院设立，作为一种策略，以激励更多教师参与开发创新的、以通科医生为导向的项目。小额资助计划激发了整个学术界的提案。平均奖励金额较小（平均为7039美元），但有时奖励带来的成果超出了原始资金的范围。在几个案例中，小额资助支持为教师开展试点项目提供了种子资金，以测试原本不会开展的新举措。一些项目引发了进一步的想法，或者促成了通科医生与基础科学家或专科医生之间的合作。超过一半的资助项目最终得以制度化，近20%的项目在全国会议上进行了正式展示。确定了两个问题：（1）专科教师提出的提案较少，通科医生与专科医生之间的合作提案也比预期少；（2）以社区为基础的教师（主要是临床医生，如带教老师）没有提出获得资助的提案。尽管存在这些问题，并鉴于可用的解决方案，作者得出结论，机构小额资助计划可以提供一种持续、灵活的机制，以支持机构文化向提升通科医生地位的转变。
