As a recipient of the Duke Clinical and Translational Science Award (CTSA) KL2 career development award, Michael Paul Cary, PhD, RN, FAAN, exemplifies the type of researcher who best benefits from the unique program that supports early-stage translational investigators.
“The Duke CTSA KL2 Program was instrumental in facilitating my access to valuable research resources, providing me with guidance from expert mentors, and offering professional development opportunities. Through the program’s provision of protected time for pursuing my interests, I was able to build on my training as a health services researcher and gain knowledge and skills as an applied health data scientist,” said Cary. “As one of the only PhD-prepared nurses in the U.S. with this unique and dual training, I have the capability to effectively utilize big datasets and apply innovative machine learning approaches to predict populations at higher risk for rehospitalization and identify those with a greater need for rehabilitation services.”
CTSAs, launched by the NIH in 2006, create academic homes for clinical and translational research and provide vital resources to develop the translational scientific workforce, including the KL2 program. The KL2 is shaped by competency-aligned training opportunities and interdisciplinary mentorship that inform translational research pathways.
Cary credits the Duke KL2 award with facilitating and supporting his career journey, which has been focused on improving care delivery to older adults who receive institutional care following an acute illness or injury, as well as their health outcomes.
The Duke KL2, established with Duke’s first CTSA in 2006, provides training and research opportunities for junior investigators. Duke’s KL2 leverages both group and individually tailored activities to equip its scholars to:
- Participate in and ultimately lead transdisciplinary research teams that both transcend traditional scientific silos and embrace diverse stakeholder input
- Facilitate advancement of discoveries to their next translational phase
- Represent a more diverse workforce to meet evolving translational science priorities
- Leverage partnerships locally, regionally, and nationally to enhance the impact of their discoveries
The KL2 award provides support for three years of consecutive funding for scholars like Cary, consisting of consecutive 12-month appointments. Each scholar is awarded 75% total protected effort for three years, as well as funding for research expenses and travel to professional meetings. The program’s protected effort for investigator research is one of the most appealing aspects of the award.
“For early-career scientists who might be responsible for heavy teaching or clinical duties, this protected time is incredibly helpful. It was a game changer for me,” Cary said.
In addition to protected time for research, Cary acknowledges the invaluable guidance from expert mentors who helped to guide him through a variety of experiences, challenges, and skill-building opportunities. He worked most closely with his primary mentor, Cathleen S. Colon-Emeric, MD, FACP, MHS, professor of medicine and chief of the Division of Geriatrics. As a scientist and an exceptional mentor, Colon-Emeric played a pivotal role in Cary's development. Cary highlights the generosity of Colon-Emeric's time and advice, emphasizing her instrumental role in refining his research program and enhancing his grantsmanship and leadership skills. “Despite her incredibly busy schedule, she always made time for me,” said Cary.
KL2 Award Goals and Opportunities
Cary’s goals as a KL2 recipient were to better understand the impact of multiple chronic conditions on hospital readmission of hip fracture patients treated in inpatient rehabilitation facilities using large secondary datasets, as well as to build robust hospital readmission risk prediction models using advanced statistical and machine learning approaches.
Tapping into Duke CTSA’s Biostatistics, Epidemiology, and Research Design (BERD) and Data Science cores with leaders Lesley Curtis, Gina-Maria Pomann, and Larry Carin was essential to Cary’s understanding of complicated statistical results, particularly when his project shifted to using machine learning approaches. Meeting quarterly with the CTSA KL2 program leaders (Kimberly Johnson, Rasheed Gbadegesin, and Laura Svetky) was invaluable as Cary reported on his progress to date and received helpful feedback and guidance.
As part of his KL2 award, Cary was offered the opportunity to participate in several leadership programs within and beyond Duke, where he learned skills from resolving conflict and team building to strategies for increasing visibility and career advancement.
According to Cary, these opportunities helped him achieve career goals including publishing several manuscripts each year, submitting an NIH R01 proposal, and being promoted from assistant to associate professor.
After the KL2 program, Cary leveraged his new knowledge and skills to become the faculty lead for data science within the Duke University School of Nursing (DUSON). In this leadership role, he worked to develop educational and training opportunities to increase the number of faculty and students engaged in data science research and collaborative work. As an educator, he prepares nursing students and clinicians to extract meaningful clinical insights knowledgeably and skillfully from data in response to the growing demand for data science education and training in real-world clinical settings. And as an independent investigator, he has developed a coherent research program and led interdisciplinary teams to transform research into knowledge and practice.
From KL2 Mentee to Mentor and Leader
At DUSON, Cary chaired the racial justice taskforce, which developed recruitment, hiring, and retention strategies for minoritized and historically marginalized groups in nursing. Many of these strategies were published in a manuscript titled, Creating a culture that values diversity and inclusion: An action-oriented framework for schools of nursing. This manuscript earned the Wiley/Nursing Forum Top Cited Article Award in 2022. These local scalable contributions have informed strategies to combat structural racism at the national level.
Nationally, Cary has advanced equity, diversity, and inclusivity (EDI) of minoritized and historically marginalized groups in nursing who face inequities in academia by creating a national mentoring program for AcademyHealth’s Interdisciplinary Research Group on Nursing Issues (IRGNI). He served as one of the primary architects of the Emerging Diversity Leaders (EDL) mentoring program, which included 20 mentees representing 12 schools of nursing in the U.S. and abroad.
Recently, Cary assumed the role of chair of the DUSON faculty search committee, leading the committee’s groundbreaking three-year Social Determinants of Health Hiring Initiative. This widely popular and fiercely competitive recruitment effort resulted in the evaluation of more than 70 candidates and the successful recruitment of six exceptional new faculty members, all dedicated to reducing health inequities.
In perhaps the most notable example of his transition as a KL2 recipient from mentee to leader, Cary in 2022 was selected by Duke AI Health to serve as the inaugural Equity Scholar. In this groundbreaking position, he spearheads an interdisciplinary team tasked with detecting and mitigating bias in clinical algorithms that perpetuate racial and ethnic health inequities. This leadership position underscores recognition by the organization, as well as the health system, of the pressing need for system-wide standards to prevent the harmful discriminatory effects of clinical algorithms on patients. The role also demonstrates Cary’s commitment to translating research findings into real-world strategies that drive positive change within healthcare systems. Cary and his team produced the most comprehensive scoping review to date and developed guiding principles for mitigating harmful racial and ethnic bias in clinical algorithms. This manuscript was published in 2023 Health Affairs special collection focused on Tackling Structural Racism in Healthcare.
Cary's remarkable journey from KL2 mentee to mentor, translational scientist, and health system leader is evident in his impactful contributions to nursing and healthcare. This evolution reached a pinnacle when he was selected as a Duke University distinguished professor in 2021, inducted as a fellow in the American Academy of Nursing in 2022, and became the first African American PhD-prepared nurse at DUSON to be awarded the status of associate professor with tenure in 2023.