Scientific research: approach and challenges among Family Medicine Residents

Scientific research: approach and challenges among Family Medicine ResidentsA presentation by Dr Yakubu, K (FMCFM, MB.BS)Department of Family Medicine, University of Jos / JUTHOutlineIntroductionThe Research processObservations in our own contextObservations among residents in other countriesExisting interventions RecommendationsConclusion IntroductionResearch is defined as the creation of new knowledge and/or the use of existing knowledge in a new and creative way so as to generate new concepts, methodologies and understandings. This could include synthesis and analysis of previous research to the extent that it leads to new and creative outcomes.1

Broadly speaking, science is interested in answering questions and acquiring knowledge concerning the observable universe. Various research methods are used in an attempt to satisfy these interests. 2The research process.3Step 1: Find a research ideaObserving the phenomena of interest, asking research questions, reviewing the literature (previous research)

Step 2: Convert your research idea into a specific research hypothesisHypothesis is a statement about the relationship between two (or more) variablesa good hypothesis must be testable (all of the variables, events, and individuals are real and can be defined and observed)a good hypothesis is refutable (it can be demonstrated to be false, allows for the possibility that the outcome will differ from the prediction)The research process (cont.)Step 3: Determine how you will define and measure your variablesmake a specific prediction about the outcome of empirical observatione.g. people who watch more violent programs are more aggressive than those who watch less TV violence

Step 4: Identify the participants or subjectsselect the subject groupThe research process (cont.)Step 5: Select a research strategythe type of question asked (existence of a relationship vs. causal relationship)ethics and other constraints

Step 6: Select a research designmake decisions about the specific methods and procedures you will use to conduct the research study (one individual vs. more, comparisons at the same time or over a period of time)The research process (cont.)Step 7: Conduct the studydecide whether the study will be conducted in an institiution or in the field

Step 8: Evaluate the datause statistical methods to examine and evaluate the dataThe research process (cont.)Step 9: Report the resultsdescribe what was done and how the findings were interpreted

Step 10: Refine or reformulate your research ideatest the boundaries of the resultsrefine the original researchWhy are Residents frustrated?

Observations in our own context

A failure to accept that research is a scientific process with its traditions, rules and values.A lack of an intentional, systematic and measurable process to learn / acquire skills in research methodsLack of mentorship / mentee-shipLack of a connect between imbibing the rules and values of research, its demand for rigour and exam success.Poor reward systemsA disconnect between clinical and academic medicine.Lack of awareness of Family Medicine, Family Health and Primary care being separate academic disciplines.

Observations among residents in other countriesAwareness about medical research among resident doctors in a tertiary care hospital: A cross-sectional survey in India. 4The concept of research hypothesis was known to 58% of the residents. Ninety-eight percent of the residents were aware of the procedure to obtain informed consent. Seventy-six percent agreed that research training should be mandatory. Although 88% of the residents were interested in conducting research in future, 50% had participated in research other than a dissertation project, 28% had made scientific presentations, and only 4% had publications. Lack of time (74%), lack of research curriculum (42%), and inadequate facilities (38%) were stated as major obstacles for pursuing research

Reasons elicited

Areas identified by Residents as being challenging in conducting a research.4

Types of researches conducted by Residents in Saudi Arabia.5

Perceptions, attitudes, and practices towards research among resident physicians in training in Saudi Arabia. 5

InterventionsNeeds assessment & Research Curriculum implementation at Lincoln Medical & Mental health Center. 6A detailed survey was administered to understand specific needs of residents. Based on their findings, the following structural components and processes were initiated or strengthened if already pre-existing. Structure elements-Dedicated Faculty: A qualified faculty member with masters of public health was appointed as research director to plan and oversee the implementation of a structured approach to research training. The research director was allowed protected time to administer, teach and evaluate all research components. -On-line resources: Computer and software programs required for literature searches and on-line databases were made available to all residents and faculty with 24/7 access from any computer terminal. Cont Needs assessment & Research Curriculum implementationat Lincoln Medical & Mental health Center. 6Process elements-An intensive 2-hour weekly sessions on research methodology was conducted for 4 weeks every year for all residents by qualified public health and statistics faculty from the university affiliation. -During these sessions, fundamental concepts in biostatistics and research designs were discussed. In addition, residents were provided dedicated time to attend didactic lectures in an annual core curriculum series of lectures on basic biostatistics, how to do research, search strategies and critical appraisal of literature. -Opportunities for presentation of research projectsAn annual Research competition was conducted by the department, where residents were invited to present posters and individual prizes were awarded for best research posters, evidenced based topic reviews and clinical vignettes. All residents were required to participate and complete at least one scholarly activity during their training period under guidance of a faculty mentor. All research projects completed by residents and presented at regional, national conferences or published were communicated to all program residents and faculty through a poster board as well as in monthly resident meetings by the research director.

Research rotation.6

All residents rotated through a research elective under the supervision of the faculty research director. A pre-selected faculty mentor could also act as project guide. Residents were expected to participate actively in the components of the rotation. Guidelines were provided as hand-outs for all components of the rotation. The faculty research director met the resident daily during the research rotation to oversee participation of the resident in the various components as well as discuss topics required for understanding biostatistics and research methodology. A detailed timetable of daily activities was provided at the beginning of the rotation to guide the resident through the different days and components of the rotation.

Resident research outcomes (n = 81). 6

ItemResearch rotators (n = 43)Non-rotators (n = 38)P value*# of residents with at least one scholarly activity4019