University of Manitoba



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:

• 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:

• 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:

• 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:

• Maintain and enhance professional activities through ongoing learning and research

▪ Pose an appropriate and clearly-defined research question

▪ 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:

• 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

[pic]

Summary of Research Proposal (1 page)

• 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)

• Introductory paragraph

o Brief overview of topic and why it is important

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

• 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)

• 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

• 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

• 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:



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:

• 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:



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 amckay3@exchange.hsc.mb.ca

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