Download GENERAL SURGERY RESIDENCY PROGRAM PGY1 Research Rotation Orientation Manual

GENERAL SURGERY RESIDENCY PROGRAM
PGY1 Research Rotation
Orientation Manual
INTRODUCTION
The goal of providing Residents with a research period is to give an opportunity to make
significant progress establishing or even completing a research study. A total of 4 weeks
where Residents are to be free from other clinical duties are allocated. This should allow
Residents to make significant progress on a research project.
I should be emphasized that this is largely self-directed. Residents must take initiative on
their own to make this a success. To make the most of this opportunity, an appropriate
amount of planning and preparation must be done ahead of time. A preceptor must be
chosen ahead of time and a project planned. Ideally, having a study protocol with ethics
approval already in place at the beginning of the research period will allow many studies to
be completed or nearly completed within the research period. Because the research block
occasionally happens early in the PGY-1 year, it is not always possible to have all the
required approvals in place. In such cases, it is still expected that this period will allow
significant progress to be made. For example, this might allow the protocol to be drafted and
all necessary submissions to Ethics and other committees to be completed and submitted.
This rotation also offers the opportunity to also pursue smaller projects such as the
completion of a case report. In cases where it is not possible to have all the necessary ethics
and other approvals in place ahead of time it is still IMPERATIVE that a supervisor and a
project be chosen prior to the start of this rotation.
GENERAL OBJECTIVES OF THE RESEARCH ROTATION
1. To become familiar with the steps of initiating a research study (e.g. research idea,
writing study protocol, obtaining ethics approval, obtaining necessary funds/grants,
conducting research, etc.)
2. To gain experience writing up a research proposal
3. To become familiar with research methodology
4. To use this time free of other clinical duties to make substantial progress on a
research project.
SPECIFIC OBJECTIVES
At the completion of the Research elective, the General Surgery resident will have acquired
the following competencies and will function as:
Communicator
At the completion of the Research elective, the General Surgery resident will be able to:
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Convey effective oral and written information
 Effectively present information pertaining to his/her research project to
his/her research supervisor and others involved in the project. The resident
must contact his/her research supervisor prior to Research elective and must
discuss the research project with his/her research supervisor on an ongoing
basis during the elective.
 Effectively document the research project (case study report, research
proposal or completed study). The resident should have a major portion of the
research project completed and documented in writing at the end of the
elective.
Collaborator
At the completion of the Research elective, the General Surgery resident will be able to:
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Participate effectively in an interprofessional team
 Recognize and respect the diversity of roles, responsibilities and
competencies of other professionals such as the research
supervisor/coordinator, research assistants, nurse clinicians, health records
personnel and biostatistics consultants in the successful completion of a
research project
Manager
At the completion of the Research elective, the General Surgery resident will be able to:
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Manage his/her professional and personal activities effectively
 Set priorities and manage time in order to ensure completion of the research
project on time
Scholar
At the completion of the Research elective, the General Surgery resident will be able to:
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Maintain and enhance professional activities through ongoing learning and research
 Pose an appropriate and clearly-defined research question
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Provide clear and concise information on existing knowledge related to the
research topic
Choose a study design appropriate for the stated research objective
Conduct the research project using the following methodology:
 Ensure appropriate selection and recruitment of study subjects
 Ensure adequate number of participants used in the study
 Ensure valid and reliable data measurement
 Include appropriate data for analysis
 Conduct appropriate statistical tests
Provide a clear conclusion of the research study supported by the data
provided
Complete a case study report in the following manner:
 Define clearly the purpose for the report of an interesting case (i.e.
publication, education, change in practice)
 Describe the case concisely and interpret the findings appropriately
 Provide a literature review and a clear and concise summary of the
importance of the case
Professional
At the completion of the Research elective, the General Surgery resident will be able to:
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Demonstrate a commitment to patients through ethical practice
 Ensure approval for the research project (where indicated) by the appropriate
Research Ethics Committee
 Recognize the principles and limits of patient confidentiality when conducting
and presenting the research project or case study report
RESEARCH REQUIREMENTS OF THE GENERAL SURGERY PROGRAM
1. Completion of 2 research projects during residency
2. Presentations in at least 3 General Surgery Resident Research Days (case reports
and presentations of research study proposals are highly encouraged at the junior
resident level)
Note: The definition of a research project is a research study of sufficient quality that it
would be considered “publishable”. There are no formal requirements for publications
during residency. However, Residents are highly encouraged to submit completed projects
for publication in journals, and to present their research projects at national or international
meetings and conferences. Case reports are not considered to be equivalent to research
projects, however, PGY-1 residents are still highly encouraged to present case reports at
their first Research Day. Presenting a case report at Research day will satisfy the criteria for
one of the 3 required presentations. (One of the goals of research day is to provide practice
presenting projects, case reports, or study proposals in front of an audience and to learn to
prepare presentations within the format required by scientific meetings and conferences.)
TIPS FOR WRITING A RESEARCH PROPOSAL
Summary of Research Proposal (1 page)
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Like an abstract
o Intro – 1/3
o Methods – 1/3
o Importance – 1/3
Not just an afterthought
May be the only thing a reviewer actually reads
Background and Rationale (half the allotted pages)
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Introductory paragraph
o Brief overview of topic and why it is important
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o What are the big questions
Rest of section gives info and builds support for importance of research question
End with paragraph of why this project is important
Objectives/Specific Aims
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State hypothesis
List Specific Aims clearly
o Research plan/methods should be used to explain how the project will
achieve these specific aims/objectives
Methods (half the allotted pages)
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General Methods
o Study design – a sentence or two
o Patients/participants – inclusion exclusion
o Procedure
o STATS
Address each Specific Aim/Objective
Expected results
Potential pitfalls
Timeline
Budget
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Personnel
o Research assistants, data collectors
o Programmer/analysts in database studies
Supplies and Services
o Medications and pharmacy time
o Surgical devices
o Statisticians
o Chart pulling
o Laptop/software
o Travel?
Must be reasonable and justified
o Over-inflation of budget is a mistake
o Underestimation just as bad
o Must provide clear justification for each item
o E.g. clearly define duties and responsibilities of personnel
Feasibility
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Assemble a team with various backgrounds and skills to get the job done
Important for new investigators
Important in major grant competitions
Include timetable
HELPFUL RESOURCES
Here are some helpful resources which are attached at the end of this document:
1. Frontiers in Bioscience – Guidelines for Writing Grant Applications
2. Joseph Levine, Michigan State University – Guide for Writing a Funding Proposal
3. CIHR New Investigator Guide
OBTAINING ETHICS APPROVAL
There are two Research Ethics Boards (REBs) at the Bannatyne Campus:
1. The Biomedical Research Ethics Board (BREB) – reviews clinical trials and other
biomedical research interventions
2. The Health Research Ethics Board (HREB) –reviews research from the Bannatyne
campus involving the behavioural sciences, surveys, examinations of medical records
and protocols of generally lesser risk
The vast majority of ethics applications from General Surgery Residents will be to the
HREB, and most will be eligible for expedited review. The following website will provide
access to all the necessary forms and guides for ethics applications:
http://umanitoba.ca/faculties/medicine/ethics/6000.html
In addition to ethical approval from the University of Manitoba, several other institutional
review boards may also require approval before research can begin. This will depend on
where the research will be conducted. Other agencies that may require submissions for
approval include:
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U of MB – Bannatyne Campus Health Research Ethics Board
HSC – Research Impact Committee
SBGH – Research Review Committee
CancerCare MB – Research Resource Impact Committee
Manitoba Health – HIPC (Health Information Privacy Committee)
GRANTS AND FUNDING
Obtaining funding for a project will generally be the responsibility of your supervisor, however
you may be involved in the process of applying for and receiving grants for funding. An
extensive list of potential funding sources is available from the Faculty of Medicine:
http://umanitoba.ca/faculties/medicine/research/
OTHER ADVICE OR ASSISTANCE
Please get in touch with me if there are any concerns, questions, or problems related to
establishing a research project.
Andrew McKay, MD MSc FRCSC FACS
Assistant Professor, University of Manitoba
Departments of Surgery and Community Health Sciences
Health Sciences Centre
GF-441, 820 Sherbrook St
Winnipeg, MB, R3A 1R9
P (204) 787 1127
F (204) 787 4851
Email [email protected]