Classical graduate studies are usually centered on scientific learning and have not typically emphasized the development of important crosscutting competencies such as data quality and management, communication abilities and techniques, grantsmanship and scientific writing. It was often assumed that these essential competencies were simply transferred from supervisor to trainee, without any formal training or structure.

The CIHR - Quebec Respiratory Health Training Program was developed in 2003 to create a training environment that fostered additional learning in areas not covered by existing graduate programs. We used several pedagogical strategies including web-based courses, workshops and seminars to achieve our objectives.

1- Cellular and Molecular Biology of the Lung
Professor in charge: Dr Elyse Bissonnette
This 3-credit course will allow the student to understand the basic pathophysiological mechanisms of inflammatory diseases of the lung. The course will be delivered on-line in the forms of disease-specific teaching modules.

Module	Title	Professors
1	Basic principles of respiratory physiology	Anne-Marie Lauzon
2	Sleep apnea: role of inflammation	Basil Petrof & John Kimoff
3	Pathophysiology of cystic fibrosis: inflammation and ion transport	André Cantin & Emmanuelle Brochiero
4	Pathophysiology of asthma: Th2 diseases and inflammatory response	Elyse Bissonnette
5	Pathophysiology of COPD and related systemic manifestation	Richard Debigaré
6	Response to aggression: lung fibrosis and ARDS	Yves Berthiaume
7	Investigation génomique et épidémiologie génétique des maladies pulmonaires	Yohan Bossé
8	Exam

2- Clinical Aspects of Research in Respiratory Diseases
Professor in charge: Dr Kevin Schwartzman
Clinical Aspects of Research in Respiratory Diseases is a 3-credit, graduate-level course offered in the winter semester. It follows the fall semester course devoted to cellular and molecular biology of the lung, and shares an emphasis on key respiratory diseases. It also shares the same distance learning format, and modular organization.
The major goals of this course are 1) to familiarize students with important clinical aspects of major respiratory conditions, including the burden of illness imposed by these conditions; and 2) to familiarize students with key concepts of clinical and epidemiologic research, as applied to respiratory disease. Specific conditions addressed include asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, tuberculosis, pneumonia, adult respiratory distress syndrome (ARDS), interstitial and pulmonary vascular diseases.

The course is divided into 8 modules, including the final exam. Modules and faculty are as follows:

Module	Title	Faculty
1	Clinical and epidemiologic research in respiratory disease: Key concepts in study design and conduct	Dr. Kevin Schwartzman
2	Asthma	Dr. Pierre Ernst
3	Cystic fibrosis	Dr. Jennifer Landry
4	COPD	Dr. Jean Bourbeau
5	Interstitial disease/pulmonary vascular disease	Dr. Geneviève Dion
6	Pneumonia and tuberculosis	Dr. Sal Qureshi, Dr. Dick Menzies, Dr. Madhukar Pai
7	Adult respiratory distress syndrome	Dr. Olivier Lesur
8	Final exam	All faculty

3- Core career skills
Professors in charge: Yves Berthiaume
We began last year to incorporate some web-based lectures on our course Integrated approach to respiratory health research. However, we now recognize that the web-based format may not be optimal for development of these leadership and communication skills. In our new program we will develop a 3-credit, 3-day intensive course that will be mandatory for all trainees, and will be considered part of the microprogram. The course will include some formal lectures, but will focus on interactive workshops to better develop core skills. The content will include the following:

1. The grant application and review process: how to write a successful research grant application, and how to improve an unsuccessful application;
2. Basic management skills needed to run a research laboratory;
3. The art of delivering a successful lecture;
4. Scientific writing skills (based on Essentials of Writing Biomedical Research Papers, by M. Zeiger);
5. Good clinical and laboratory practice;
6. The academic career: Achieving work-life balance.

In a small-group setting, trainees will evaluate their own and their peers' oral and written communication (e.g. writing a scientific abstract, writing a grant application summary), and receive coaching and feedback from the program's mentors.

The students of the training program participate in various workshops and symposia that are considered essential to their research training. The contents of these workshops and symposia are gradually modified over time to stay up to date.

Ethics and scientific integrity in medical research (2 days)
Our trainees are required to attend the annual ethics and scientific integrity symposium. World class speakers from CIHR, Health Canada, hospital boards, ethics committees, animal experimentation ethics committees, and legal experts are involved and cover several topics related to ethics and the good conduct of research. This bilingual symposium has become a tremendous success. It attracts over 250 attendees annually, and its impact already extends well beyond the respiratory community. In 2008, we had participants from 3 provinces (Quebec, Ontario and British Columbia). This symposium is endorsed by the Institute of Circulatory and Respiratory health (ICRH) as well as the FRQS. The objective of this high-level symposium is to help achieve high standards of ethics and scientific integrity in medical research in Canada. It is intended not only to our trainees but also to Research Ethics Board (REB) members, research program administrators, professionals involved in clinical and biomedical research (assessment, implementation or management), educators interested in research ethics, and finally those involved in the development/elaboration of research policies. The symposium is recorded digitally on CDs in a uniform format. Each student enrolled in the training program receives a package of these CDs, allowing to review the presentations at their leisure. Students have the unique opportunity to exchange with ethicist, lawyers, members of REB so they can have a grasp of the importance of ethics in medical research.

Knowledge Transfer symposium
Dr. Louis-Philippe Boulet inaugurated in 2008, a Research Chair in Knowledge Transfer in respiratory and cardiovascular medicine. The goals of this new Chair are to increase awareness of respiratory and cardiovascular research among practitioners, decision makers, and the public, and to foster research in the area of knowledge transfer. The training program, in collaboration with this Chair, organized the first symposium on knowledge transfer in March 2008, which attracted 100 participants (for the complete program, see appendix III). All trainees of the training program are expected to participate. Expenses related to their participation are covered by the Respiratory Health Network of the FRQS. Trainees learn to integrate knowledge transfer into the research process, and how to work with the lay media in order to better understand their role as communicators of research results to the public. Trainees will be also expected to participate to informal meetings with the general population in order to discuss recent development in the field of respiratory medicine (café scientifique).

Another important knowledge translation activity of is the joined annual meeting of the Association des Pneumologues du Québec and of the Respiratory Health Network. This is one forum where trainees present (oral or poster) their scientific work to respirologists. This gives a first hand experience to the trainees to present their scientific work to health care professionals but also to build a network of collaboration between researchers and clinicians. Three 500$ prizes given by the Association des Pneumologues du Québec highlight the best presentations.

Other specialized symposia and workshops
Trainees also participate to the Tissue and Data Banking workshop (0.5 days) and to the Meakins-Christie Laboratories Workshop on advanced technologies for exploring cellular and molecular biology of the respiratory system (2 days).

Students of the training program may also attend specialized workshops and symposia depending on their specific needs. For examples, our trainees are strongly encouraged to attend the CIHR's ICRH Young Investigators Forum to which the Respiratory Health Network contributes financially. Other workshops such as the annual meeting of the COPD group of the Respiratory Health Network and the annual Critical Care Network workshop are other learning opportunities.

The program has important structures developed by the RHN and participating Universities :

• Videoconferencing and other communication technologies,
• joint scientific meetings with other scientific associations,
• timesharing (it will be possible for trainees to acquire additional knowledge in different Universities), and
• common use of tissue bank and data. The RHN has databases and tissue bank that are well established available for Program mentors and trainees.