Training to Advance Care Through Implementation Science in Cardiac And Lung Illnesses (TACTICAL)
is a proposed career development program to dramatically accelerate the pace of implementation science
research—and thereby effective delivery of care to patients, beginning with a focus on critically ill patients.
TACTICAL proposes to immerse clinician-scientists in a rigorous training program that carefully integrates
mentored implementation research practica with a formal curriculum. This will be done under the guidance of a
cohesive 15-person multidisciplinary faculty and mentor group drawn from across the University of Michigan.
Core faculty are drawn from the Schools of Medicine (Internal Medicine, Learning Health Sciences, Critical
Care), Nursing, Business (Finance and Operations Management), Education, Public Policy, and Public Health
as well as the Institute for Social Research and the Provost's Office.
This postdoctoral training program will support 5 scholars for 3 years each. This will include a
foundation in implementation science and health services research, including theory from psychology,
sociology, economics, and operations management; research designs, including statistical analysis, qualitative
methods, and randomized evaluations; measurement, including the conduct of surveys, mobile technologies,
non-participant observation, focus groups, elicitation of patient perspectives, stakeholder engagement,
secondary data, electronic medical records, administrative records, and detailed costing and finance; and
comparative effectiveness research using multiple designs. This will be delivered through a structured series of
individualized research practica resulting in published papers; formal coursework; and mentored independent
research. This will culminate in an application for independent funding as an R01, R21, K08, or K23.
Our vision of success is clear. As part of independent research careers focused on bringing evidence-
based best practices to improve critically ill patients' lives, TACTICAL scholars will become independently-
funded leaders who both drive change at their own institutions while also developing and evaluating better
approaches for driving change nationally and internationally.
In order to achieve this vision, we will draw on 5 basic tenets. First, implementation science demands
deep interdisciplinary training. Second, a focus on the complex setting of the intensive care unit (ICU) and the
complexity of implementation interventions required there will drive innovation in both ICU care and
implementation science itself. Third, we will center their learning in mentored research with full and careful
integration of didactics in service of advancing research. Fourth, our training plan builds on modern learning
theory, emphasizing that learners master skills more quickly when didactics are tightly coupled to each
scholar's own program of research. Fifth, we will build a structure, harnessing cohort and peer effects, that
mandates and models productivity while nurturing creativity and tailoring.