Stimulating Resident Research in a General Surgery Residency Community Program

1
(No Transcript)
2
Stimulating Resident Research in a General
Surgery Residency Community Program

• Joann M Lohr MD, J. Michael Smith MD, Richard
  Welling MD, Amy Engel MA, Kim Hasselfeld BS, Joy
  Rusche
• APDS Annual Meeting
• March 21-23, 2006
• Tucson, Arizona

3
Good Samaritan Hospital
Cincinnati Ohio
4
The Problem

• ACGME advocate each program provide opportunity
  to participate in research and other scholarly
  activities
• Frequent RRC citations

5
Research Mountain
6
Research WorkBook

• Distributed during orientation
• Sets goals/expectations
• Ground rules Team
• Team Structure
• Examples of forms
• Deadlines
• Contact phone numbers

7
Research Teams

• Established 1997-98
• Faculty mentor
• Senior resident
• Mid level resident
• Junior resident
• Research facilitator

8
Expectations

• Monthly meeting
• Mandatory participation
• Team project
• Case report
• Individual project

9
Alone
10
Research Protocol

• Analyze planned project
• Formulate main idea
• Focus data collection
• Assure meaningful data and competitive

11
(No Transcript)
12
With Help
13
Benefits

• Project design
• Data reduction
• Statistical analysis
• Manuscript preparation
• Meet deadlines

14
Goal Setting

• Active/Contributing coinvestigator
• Able to defend the study
• Case report
• Team project
• Third year resident competition
• Publication ready manuscript

15
Hatton Institute

• Established 1967
• Director
• Research nurses (18)
• Research specialists (6)
• Senior chemist
• Animal veterinary technologist
• Epidemiologists(3)
• Administrative secretary

16
Hatton Research Specialists
17
Hatton Institute Facilities

• Biochemical laboratory
• Integrated mass spectrophotometer
• Dynamic reactive cell inductivity coupled plasma
  spectrophotometer
• Meta analysis capabilities
• Life sciences laboratory
• 2 O.R.s
• Conference room
• Office space
• Wired to main OR for video conferencing

18
Hatton Institute Facilities

• Minimally invasive surgical training center
• Simulators
• G.I. Mentor
• Laparoscopic Trainer
• LTS 2000 Laparoscopic Training Simulator
• The da Vinci surgical system - robotics

19
Biochemical laboratory
20
Life sciences laboratory
21
Life sciences laboratory
22
Robotic da Vinci surgical system
23
Information Technology

• Unified medical record
• Medline
• Microsoft Office
• Excel, Access, Word, Powerpoint
• Creative Suite (Photoshop)
• InDesign and Illustrator
• N-Query analysis software (sample size)
• Statistical analysis (SPSS)

24
Research Specialist

• Study design
• Protocol development
• Grant formulation
• Data tabulation
• Statistical analysis
• Abstract writing
• Abstract submission
• Deadlines timeliness
• Minutes
• Coordinating paperwork
• Committees

25
Committees

• IRB
• IACUC
• Funding
• Privacy Board/HIPAA
• Residency Advisory

26
Surgical Residency Research Director

• Position established
• Actively engaged research
• Enforce ground rules
• Review attendance and participation
• Report to Program Director

27
Authorship

• Rules established at the outset
• Substantial participation
• Conception and design
• Analysis and interpretation
• Drafting the manuscript
• Critically revising

28
Results

• Prior to teams 69 presentations
• 60 publications
• After research 92 presentations
• teams established 67 publications
• (92.5 peer reviewed journals)
• Increased local presentations

29
Reward/Consequences

• Fun, collegial improved relationships between
  residents and staff
• Yearly team prize (extra vacation week)
• Fellowships/continuing education opportunities
• Negative performance reviews opportunities for
  improvement
• Promotion denial

30
Most Common Causes of Unproductive Research
Resident View Point

• Lack of new/original ideas
• Confusing, superficial research plans
• Lack of knowledge regarding previously published,
  relevant work
• Lack of experience
• Lack of essential methodology

31
Common Obstacles - Residents

• Resistance from the residents
• Poor knowledge of research methods prior to
  beginning research
• Lack of resident motivation
• Resident misconceptions
• Failure to meet deadlines
• Disagreement about authorship
• Poor resident attendance at research seminars

32
Common Obstacles - Faculty

• Lack of faculty experience supervising residents
  in research
• Resistance from faculty
• Time/intense demands
• Lack of faculty motivation for supervising
  residents
• Faculty greater expectations than project could
  be reasonably accomplished
• Lack of faculty authority to persuade residents
  to participate

33
Common Obstacles - Institution

• Lack of time in residency curriculum (scheduling
  difficulties)
• Financial barriers
• Resistive administration
• Lack of clinical support staff

34
Team Structure
Surgery Program Director
Surgery Research Director
Faculty Research Mentors
Surgery Residents
Hatton Research Department Staff
35
Research Team Concept Conclusion

• Results in more focused effort
• Accomplishment of tasks in timely fashion
• Improved morale and relationships FUN
• Residency research curriculum coordination,
  support, and staff critical
• Protected time necessary

36
Research Team ConceptConclusion

• Expectations
• Resources
• Mentors
• Technical support
• Positive results
• 33 increase in presentations
• 13 increase in publications
• Peer reviewed publications (83 92.5)

37
Summit alone
38
Summit together
39
(No Transcript)
40
(No Transcript)
41
Team Structure
42
(No Transcript)
43
(No Transcript)
44
(No Transcript)
45
(No Transcript)
46
(No Transcript)