While the primary outcome was the development of the survey to gather data on the effect of LEND Training (see the attached versions of the survey), analysis of preliminary data also offers some notable findings.  We found that LEND trainees were more likely to endorse high-level leadership skills than were comparison peers. LEND trainees were more likely to regularly work with interdisciplinary teams. Compared to comparison peers, LEND trainees were more likely to have accepted their current positions because of opportunities to ‘do good' or work with special needs populations than because of location or organizational values. LEND trainees were more likely to consider themselves leaders in research. Compared to comparison peers, LEND trainees were more likely to have supported the advocacy efforts of individuals or families, to have participated in program evaluation, to have participated in research related to vulnerable populations, or to have evaluated a health care policy. LEND trainees were more likely to believe that people with special needs should be able to take on the same adult roles as people without special needs. They were also more likely to consciously change the way that they present information for different groups. Finally, LEND trainees were more likely than comparison peers to know how to develop plans of care incorporating a medical home, know how to access state and federal health data, and be able to discuss the ethical implications of health care disparities. Finally, based on preliminary findings from the NIRS survey at two of our sites, LEND trainees participated in about one more leadership activity since completing their training and were more likely than comparison peers to work with individuals with disabilities and maternal and child health populations. For a details on these findings and more, see the attached presentation from the AUCD 2018 Conference.  

• Survey creation is typically quite challenging, however, creating a survey that can effectively measure key outcomes of LEND training proved particularly challenging. The development of the LEND Outcomes Follow-Up Survey took longer than expected, but resulted in a set of robust questions that differentiate between LEND trainees and comparison peers. We chose to take more time to develop a better survey rather than stick to our anticipated timeline.
• After testing an initial set of questions in our first pilot, we found limited variance in responses to questions; trainees who had not participated in LEND training reported high levels of competency on the questions that we created. This pilot led us to pursue expanding our questions to focus on evaluating clinical, research, teaching, and advocacy outcomes in a more nuanced way.
• Measuring the impact that LEND training has on trainees' career trajectories is a high priority for the LEND network in the current fiscal and political climate. Domains that suggested no differences might be highlighted to establish best practices. Our work has shown this approach is feasible and not expensive in terms of direct research costs or personnel expenses. Similar training programs
  can learn from these results which areas to emphasize with training and best practices, and build on training experiences that reinforce these skills.