A time of accelerated change in academic cardiovascular medicine
Implications for academic divisions of cardiology and their training programs
Robert M. Califf, MD*,
Thomas Ryan, MD,
Pamela Douglas, MD and
Pascal J. Goldschmidt-Clermont, MD
Duke Clinical Research Institute, the Duke Heart Center, and the Division of Cardiology, Duke University Medical Center, Durham, North Carolina

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Figure 1 The cycle of quality portrays the steps in the development of scientific constructs, evaluating them in clinical trials, constructing guidelines and performance measures based on the evidence, and measuring adoption into practice. Cardiovascular training programs should impart a fundamental understanding of this cycle into their trainees and develop training programs leading to expertise in each of the depicted areas, including measurement of clinical quality. Reprinted with permission from Califf et al. (9).
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Figure 2 Translational blocks identified by the Institute of Medicine Clinical Research Roundtable. Training programs should be focused on overcoming these blocks.
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