Being a Post-Doctoral Fellow at NIH
主編蔡佩珊教授(以下簡稱Tsai)訪談凱斯西儲大學護理學院蕭照彬(Chao-Pin Hsiao) 助理教授(以下簡稱Hsiao).
Dr. Hsiao is currently an Assistant Professor in the Frances Payne Bolton School of Nursing at Case Western Reserve University. Her research interests include molecular-genetic mechanisms of cancer-related fatigue in patients with localized prostate cancer receiving radiation therapy, changes in mitochondrial bioenergetics and fatigue in cancer patients receiving radiation therapy, and stress responses, symptoms, and symptom self-management in localized prostate cancer. She received a Bachelor’s degree in Nursing and 2-years of extended research training in a Master’s program in Nursing Science from National Taiwan University in Taipei, Taiwan. She began her nursing career as an oncology nurse for 3 years in National Taiwan University Hospital. She also gained experience as a research nurse through working with patients undergoing cancer clinical trials in the National Health Research Institutes in Taiwan.
Dr. Hsiao later received a PhD in Nursing from the University of Arizona in December 2008, under the mentorship of Professor Ida (Ki) Moore, RN, DNSc. Her dissertation examined psychological and biological responses to stress, including relationships among salivary cortisol, perceived stress, symptoms, symptom distress, and symptom self-management in patients with prostate cancer receiving prostatectomy or radiation therapy. In this project, she utilized an enzyme-linked immunoabsorbent technique (ELISA) to measure cortisol concentration in 424 saliva samples from 53 patients with localized prostate cancer. She found perceived stress was significantly correlated with increased afternoon cortisol level and symptom distress. These findings were relevant to understanding stress, symptom distress and symptom self-management, and linked a biomarker of stress and symptoms in cancer patients receiving treatments. In addition to understanding and identifying effective strategies for symptom self-management in patient with prostate cancer, as part of this research she have developed and tested a questionnaire that can be used by other researchers. These works have been published in Cancer Nursing in 2011 (“High perceived stress is linked to afternoon cortisol levels and greater symptom distress in patients with Localized Prostate Cancer”) and The Journal of Clinical Nursing in 2013 (“Strategy and Effectiveness of Symptom Self-Management”).
Following her PhD degree, Dr. Hsiao received a NIH Post-Doctoral Intramural Research Training Award (IRTA) in January 2009. With that award, Dr. Hsiao had the privilege to work as a post-doctoral fellow at the National Institute of Nursing Research (NINR), Intramural Research Program, Symptoms Management Branch, Symptom Biology Unit.
Tsai：What was the reason that prompted you to take the post as a postdoctoral fellow at the NIH?
Hsiao：To become a well-prepared and competitive researcher, I planned to learn biological markers and integrate bio-physiological measures into behavioral research. The area of my research interest includes symptom management and quality of life. Being a nurse researcher, I understand the significance of patients’ self-report and experience, but with the evidence of physiological measures I believe it will strengthen the science of symptom and provide a new direction for interventions of symptom management for the development of my career in academia. Although I had learned and performed a biomarker-salivary cortisol for stress indicator in my dissertation, I planned to learn molecular or genetic biomarkers in symptoms related to cancer patients receiving treatments. Therefore, I started to search the opportunity for post-doctoral training in symptom management, specifically in biomarkers or biologic measures to address the complexity of symptom science. Although it was hard for a foreign student to apply for a training position in the States because of the immigration status, I was luckily to find an opportunity of a post-doc fellow at NINR through a circular flyer in emails. After receiving the advice from my advisor, I emailed to the scientific director in the intramural research program of NINR, specifically in respond to the position in the Symptom Management Laboratory. This was my first full time position in the United States since I graduated in 2008.
Tsai：In your case, what were the job descriptions as a postdoc?
Hsiao：From January 2009 to December 2012, I worked as a post-doctoral fellow between 2009 and 2010, and I was promoted to a research fellow from 2011 to 2012, at the National Institutes of Health, the NINR Intramural Division, Symptom Biology and Symptom Management Laboratory. As a post-doctoral fellow, I expected to learn skills and knowledge on how to conduct research projects from established research proposals. For example, how to design different research proposals, how to determine and integrate biomarkers to the research concepts, how to organize and collaborate a multidisciplinary research team, as well as hands on skills and data collection. During the transitional stage of the Internal Research Program of NINR, I did not expect that I have to write my own research proposal without structure and informative training, so I spent 6-month to write my first research proposal entitled “mitochondrial dysfunction and fatigue in prostate cancer patients receiving localized radiation therapy”. In addition to developing research proposal, I was expected to develop an individual development plan and to publish manuscripts from my dissertations in my fellowship. With this intensive training, I have learned how to come up with a novel research idea, to write a research proposal, to incorporate molecular-genetic biomarkers of symptom, and to conduct clinical research projects.
As a research fellow, I became a Principal Investigator (PI) of a clinical research protocol titled “Relationship between Mitochondrial Dysfunction and Fatigue in Cancer Patients Following External Beam Radiation (10-NR-0128)” and Lead Associate Investigator of 2 protocols (Fatigue in Healthy Individuals and Mechanisms of Fatigue in Cancer Patients Receiving Treatments) in the Intramural Research Program in 2010. These protocols pursue a theory-generating, unbiased approach to explore molecular-genetic correlates of fatigue in cancer patients receiving treatment and in healthy individuals. The preliminary findings from these protocols showed promise in understanding mechanisms and possible intervention targets for fatigue. These works have been published in Cancer Nursing in 2013 (“Mitochondria-related gene expression changes are associated with fatigue in patients with nonmetastatic prostate cancer receiving external beam radiation therapy.”) and The Journal of Pain and Symptom Management in 2014 (“Differential Expression of Genes Related to Mitochondrial Biogenesis and Bioenergetics in Fatigued Prostate Cancer Men Receiving External Beam Radiation Therapy”).
Tsai：Do you think having a postdoctoral research or fellowship experience enhances one's competencies as a faculty?
Hsiao：Certainty. My work as a postdoctoral fellow provided me with a considerable amount of knowledge and skills to advance my interest in the science of symptom biology and translational research in symptom management. During this fellowship, I received training in microarray, PCR methodology, and epigenetics from the Foundation for Advanced Education in the Sciences at the National Institutes of Health, as well as hands-on laboratory training in the laboratories investigating genetics and symptom management in NINR. Within this strong research environment, I acquired an interest in developing a better characterization of mechanisms of fatigue in cancer patients. My long term goal is to design and develop interventional studies targeting the molecular-genetic mechanisms identified from my initial study, and to determine the role of these identified mechanisms in eliminating or reducing symptoms. In addition to pharmacologic therapies, nutritional modifications and/or supplements may be an aspect of self-management in which nurses can intervene. Over the course of training, I have built the fundamental knowledge and skills needed to apply molecular-genetic approaches to my research. To become an independent investigator and to develop a solid and integrated translational research program, I believe that fellowship provides me the needed essential training in “Bench to Bed (basic and applied science)” particularly related to symptom management, to successfully produce competitive research proposals integrating bench science, clinical practice, and novel interventions, stemming from a molecular-genetics perspective of symptom management in cancer.