Center on Health Services Training and Research (CoHSTAR)
Fellowship Training Program Description
CoHSTAR Training Program Structure:
The CoHSTAR fellowship training program will be 1- or 2-years. Specific fellowship trainee goals and
experiences will vary as a function of their background and level of prior training in health services and
health policy, however all fellowship trainees will be expected to meet CoHSTAR core competencies in
health services research prior to program completion.
Each fellowship trainee, together with his or her mentoring team, will develop an individualized training
plan based upon skills, goals and research interests. All fellowship trainees will engage in:
1) an individual, self-directed, professional learning process;
2) a fellowship training experience derived from a competency-based core curriculum (described
below);
3) an evaluation system that reinforces transformative learning through reflection and provides
trainees with the directed feedback;
4) a team mentoring program which stimulates interdisciplinary research and encourages
mentoring across the spectrum of fellowship trainees; and
5) a comprehensive three-tiered training program in the responsible conduct of research. The
prototypical training experiences for fellowship trainees are shown in Table 1.
Fellowship trainees will “carve out” an independent, but related project, from the mentor’s funded
research and this will become their major project. Fellowship trainees are also encouraged to establish
minor projects which can vary over time and may include finishing publications from their dissertation (for
Ph.D. fellowship trainees) or research initiated in a prior setting. Some fellowship trainees may pursue
formal coursework (auditing or for credit), selecting from available methodological courses. Fellowship
trainees may take specialized courses at summer institutes or training programs as appropriate.
Fellowship trainees are also required to attend selected seminars and are encouraged to attend
numerous others in the CoHSTAR environment.
Table 1. Proposed Prototypical Training Experiences of Postdoctoral Fellowship Trainees
Time Segment
Year One
Summer
Fall
Winter
Spring
Year Two
Summer
Activity
Orientation; design learning plan; SAS Clinic (if needed); Summer Epi Institute
(if needed); Identify major project; specify minor project(s) to be finished.
Attend seminars; work on major project; finish papers from dissertation (1st
minor project).
Advanced SAS Clinic (if needed) or other short course; attend seminars; major
project; select new minor project; prepare 1st abstract for scientific meeting.
Take advanced analysis course; major project; minor project; begin
formulating grant proposal ideas; prepare poster or presentation for scientific
meeting, such as Academy Health ARM, Physical Therapy NEXT or CSM
AcademyHealth ARM or Physical Therapy meeting; major project; finish 2nd
minor project; serious work on grant proposal begins; begin manuscript from
presentation
Fall
Winter
Spring
Present at Brown bag; attend seminars; major project; prepare grant proposal
for Feb. submission; minor project; manuscript preparation; job search and
interviews academic and policy research arenas.
Attend seminars; major project; proposal writing and submission; abstract
submission; manuscript preparation from major project; job interviews.
Prepare and submit manuscripts; meeting presentations; participate in
collaborative research proposal development; finish fellowship & debrief.
CoHSTAR Core Competencies:
All fellowship trainees will be expected to meet a basic set of CoHSTAR core competencies to acquire
the skills, abilities, and knowledge base necessary for conducting informative, pragmatic, and relevant
health services research. These core competencies may be met before or during the fellowship training
program, but must be demonstrated prior to completion of the fellowship. CoHSTAR core competencies
are adapted from the Agency for Healthcare Research and Quality (AHRQ) core competencies for health
services research to specifically address health services research directly relevant to physical therapy.
These competencies focus on the content knowledge, methodological skills as well as skills needed to
succeed as an independent investigator; grantsmanship, communication, administrative and leadership
skills.
CoHSTAR Mentoring:
Primary mentors of fellowship trainees are faculty members with proven track records of funding in the
area of health services research who have prior, current or pending projects and the expertise to guide
the fellowship trainee towards his or her goals. Each fellowship trainee will have his/her own individual
mentoring team, consisting of a CoHSTAR Research and Training Program Core leader, a primary
mentor and a secondary mentor, if desired. The secondary mentor may or may not be collaborating with
the primary mentor, but would have interests that are compatible with those of the fellowship trainee’s.
Having a synergized mentoring team is crucial since there must be both a shared research interest but
also the right “chemistry”. The mentoring team evaluates the fellowship trainee’s skill set in relation to
the competencies and makes recommendations for training experiences individualized to the fellowship
trainee’s needs. Table 2 shows available training faculty, their areas of research, and roles.
Table 2. CoHSTAR Mentors by Institution
NAMES
Brown University
Linda Resnik, PT, PhD, Associate
Professor Health Services, Policy
& Practice
Vincent Mor, PhD, Professor
Health Services, Policy & Practice
Issa Dahabreh, MD, MS
Assistant Professor
Health Services, Policy & Practice
Omar Galarraga, Ph.D., Assistant
Professor Health Services, Policy
& Practice
Pedro Gozalo, Ph.D, Associate
Professor Health Services, Policy
and Practice
RESEARCH INTERESTS
Quality Measurement, Provider profiling, Functional status,
Rehabilitation service delivery
Organizational and policy factors affecting quality of care in long
term care & chronic disease
Evidence based Medicine, Clinical research methodology
Health economics, behavioral economics, impact of behavioral
incentives on health
Econometrics, Instrumental Variables, long term care, rehabilitation
Joseph Lau, MD , Professor
Health Services, Policy & Practice
Co-Director Center for Evidence
Based Medicine
Theresa Shireman, PhD,
Professor
Health Services, Policy & Practice
Thomas Trikalinos, MD, PhD
Associate Professor, Health
Services, Policy & Practice
Amal Trivedi, MD, MPH,
Associate Professor, Health
Services, Policy & Practice
Boston University
Alan M. Jette, PT, PhD,
Professor, Health Policy &
Management Department,
Director, Health & Disability
Research Institute, BU SPH
Mary D. Slavin, PT, PhD, Director
of Education and Dissemination
Health & Disability Research
Institute, BU SPH
Sara Bachman, PhD, Research
Associate Professor, Healthy
Policy & Management
Department, BU SPH
Dan Berlowitz, MD, Professor
Health Policy & Management
Department, Director, Center for
Healthy Quality, Outcomes &
Economic Research, BU SPH
James Burgess, PhD, Professor
Health Policy & Management
Department, BU SPH
Martin Charns, PhD, Professor
Health Policy & Management
Department, Director, Program on
Healthcare Organizational
Studies, BUSPH, Director, Center
for Organization, Leadership and
Management Research (a VA
Health services research COE)
Wendy J. Coster, PhD. OTR/L,
FAOTA, Professor and Chair,
Department of Occupational
Therapy, Director, Behavior and
Health Program, BU Sargent
College, Director,
Patient/Clinician Reported
Outcomes Core, Boston ROC
Sue Eisen, PhD, Professor
Health Policy & Management
Department
Systematic review, meta-analysis methodology, decision analysis,
clinical practice guidelines
Medicaid programs around the country provide home- and
community-based care services for people with advanced multiple
sclerosis, pharmaco-epidemiology
EBM, meta-analysis, CER, machine learning, evidence synthesis,
decision modelling
Insurance Benefit design effects on Medicare beneficiaries’
outcomes
Evaluation of rehabilitation treatment outcomes, and the
measurement, epidemiology, and prevention of disability;
development and dissemination of contemporary outcome
measurement instruments to evaluate health care quality and
outcomes.
Development and evaluation of rehabilitation outcome measures;
dissemination and communication; organizing and implementing
training activities and conferences
Health policy, disability, children and youth with special health care
needs, program evaluation; health care for children with special
health care needs and adults with complex health conditions
Assessing and improving the quality of health care in both
ambulatory and long-term care settings, ambulatory care,
management of chronic conditions, and assessment of nursing
home care using risk-adjusted outcomes calculated from
administrative databases.
Health economist with expertise in putting health services research
into practice in diverse settings; effects of local context in efficiency
analysis; pay for performance, organizational learning and change,
and patient heterogeneity in risk adjustment.
Organization design and change, implementation of evidencebased practices, coordination of care, quality improvement,
systems redesign and patient safety.
Development and use of assessments and functional outcome
measures for both children and adults
Assessment of the quality and outcomes of mental health and
substance abuse services, consumer-centered care, recovery from
Lewis E. Kazis, Sc.D, Professor,
Health Policy & Management
Department, Director, Center for
the Assessment of
Pharmaceutical Practices
(CAPP), BU SPH
Julie Keysor, PT, PhD, Associate
Professor Department of Physical
Therapy & Athletic Training
Director, Center for Enhancing
Activity and Participation among
Persons with Arthritis (ENACT),
BU Sargent College
Nancy Latham, PT, PhD,
Research Assistant Professor
Health Policy & Management
Department, BU SPH
Christine McDonough, PhD, MS,
PT, Research Assistant
Professor, Health Policy &
Management Department, BU
SPH
Mark Meterko, PhD, Research
Associate Professor
Health Policy & Management
Department, BU SPH
University of Pittsburgh
Anthony Delitto, PT, PhD,
FAPTA, Professor and Chair,
Department of Physical Therapy
G. Kelley Fitzgerald, PT, PhD,
FAPTA, Professor, Department of
Physical Therapy
Jennifer Brach, PT, PhD,
Associate Professor, Department
of Physical Therapy
Leslie Hausmann, PhD, Assistant
Professor of Medicine; Core
Investigator, Center for Health
Equity Research and Promotion,
VA Pittsburgh Healthcare System
James J. Irrgang, PT, PhD,
FAPTA, Professor, Department of
Orthopaedic Surgery
Michael Schneider, DC, PhD,
Associate Professor, Department
of Physical Therapy
Joel Stevans, DC, PhD, Assistant
Professor, Department of
Physical Therapy
mental illness, and performance measurement in mental health
care
Health outcomes and effectiveness
Studies that examine the intersection of function, environment, and
psychology in the creation of disability and enhancement of
participation among older adults and persons with arthritis; clinical
epidemiology research to examine disablement and clinical trials to
evaluate interventions designed to enhance participation (e.g.,
minimize disability).
Clinical epidemiology, randomized controlled trials, cohort studies
and meta-analyses
Decision sciences and measurement
Quality improvement processes and survey design.
Healthcare quality assessment and assurance research,
implementation science
Healthcare quality assessment and assurance research, costeffectiveness research
Aging research, community health and fitness programs,
epidemiological methods
Health disparities and health equity research
Healthcare quality assessment and assurance research, clinical
outcomes research
Dissemination and implementation science, Qualitative methods
Healthcare quality assessment and assurance research,
implementation science
CoHSTAR Fellowship Trainee Research Focus Areas/Specialization Tracks:
CoHSTAR fellowship trainees may focus their activities at one of three sites, each with a unique
research focus area, or specialized track, or they may craft an individual experience that may involve
activities at two or three sites.
CoHSTAR research focus areas/specialization tracks are:
I. Analysis of large data sets (Brown University)
II. Rehabilitation outcome measurement (Boston University)
III. Implementation science and quality assurance research (University of Pittsburgh)
Fellowship trainees will be expected to meet the specific CoHSTAR core competencies for their chosen
research focus area/specialization track as outlined below:
I. Analysis of large data sets
1. Critically review and appraise research designs utilizing large datasets for health services
research.
2. Pose physical therapy-relevant and important research questions that can be addressed using
large datasets.
3. Assemble and manage large datasets from public and private sources.
4. Diagnose administrative data quality via the application of established diagnostic techniques.
5. Demonstrate proficiency in the selection of advanced quantitative analytical techniques for study
designs utilizing large datasets.
6. Develop skills to conduct advanced statistical analyses to adjust for confounding and bias in
observational studies (i.e. propensity scores, instrumental variables, handling of missing data
etc.) matching.
II. Rehabilitation outcome measurement
1. Define the meaning, purpose, and utility of outcomes research.
2. Understand the role of epidemiology, health economics, databases, and information technology in
conducting outcomes research.
3. Develop skills to build and evaluate contemporary (IRT, CAT) as well as classical measures of
patient-reported outcomes.
4. Recognize and critically evaluate different types of measures used in outcomes research,
including clinical, health status, quality-of-life, work/role performance, health care utilization, and
patient satisfaction.
5. Obtain skill to conduct statistical analyses appropriate for outcomes research.
6. Critically evaluate the usefulness and utility of outcomes measures to make informed choices
among existing instruments.
III. Implementation science and quality assurance research
1. Acquire knowledge in and apply theoretical and conceptual frameworks relevant to
implementation science and quality assurance research. Examples include systems theory,
knowledge translation, clinical guideline development, clinical decision support systems, and
shared decision-making.
2. Describe the strengths and weaknesses of study designs commonly used in implementation and
quality assurance research such as randomized, clinical/ implementation hybrid, mixed methods,
and quasi-experimental designs.
3. Acquire knowledge and practical experience with various measurement and analytical methods
commonly used for implementation and quality assurance research. This would include cost-
effectiveness analysis methods, measurement and analysis of program fidelity and adherence,
and measurement and analysis of program outcomes.
4. Describe similarities and differences in individual, system, and community level implementation
strategies.
5. Obtain knowledge in healthcare financing and re-imbursement.
6. Describe various strategies for fostering multidisciplinary stakeholder engagement and
partnership development.