Miner Thomas J, Richardson Pamela, Cioffi William G, Harrington David T
Department of Surgery, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Department of Surgery, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
J Surg Educ. 2019 Nov-Dec;76(6):e161-e166. doi: 10.1016/j.jsurg.2019.07.016. Epub 2019 Aug 3.
A formal 2-year clinical research project in conjunction with a system-based practice and practice-based learning and improvement curriculum was initiated for all residents in our program. Within the structure of this formal clinical research curriculum, residents are required to develop a research hypothesis, develop an appropriate study design, collect and analyze data, and present a completed project.
At the end of the PGY1 year, residents select a project with an emphasis on quality improvement or clinical outcomes. The first 6 months of the 2-year program are dedicated to the identification of a faculty mentor and submission of a formal proposal to both the departmental education committee and to the institutional IRB. Over the following 12 months, residents meet monthly for required group research meetings. The final 6 months are focused on data analysis and project completion.
Seventy-five residents have successfully completed the clinical research program since it was initiated in 2002. Completed projects led to abstracts accepted at 33 national or regional meetings and 11 peer reviewed publications to date. In addition, 3 major hospital wide quality improvement measures were initiated based on project findings. Following the first peer reviewed publication associated with these research projects in 2006, there have been significant increases in not only the number of accepted abstracts from these resident projects (3/18 [17%] vs 30/57 [53%], p = 0.008) but also the total number of all accepted resident clinical research (mean accepted abstracts per year 7.9 vs 1.0, p = 0.009 and mean peer reviewed publications per year 6.8 vs 2.0, p = 0.003.) DISCUSSION: Increased academic productivity was observed after a formal resident clinical research program was initiated in our program. Resident research efforts extended beyond the specific initial outcome projects as skills gained allowed for future independent clinical research.
我们为项目中的所有住院医师启动了一个为期两年的正式临床研究项目，该项目与基于系统的实践以及基于实践的学习与改进课程相结合。在这个正式临床研究课程的框架内，住院医师需要提出研究假设、制定合适的研究设计、收集和分析数据，并展示一个完整的项目。
在第一年住院医师培训（PGY1）结束时，住院医师选择一个侧重于质量改进或临床结果的项目。在为期两年的项目的前6个月，致力于确定一名教师导师，并向部门教育委员会和机构审查委员会提交一份正式提案。在接下来的12个月里，住院医师每月参加所需的小组研究会议。最后6个月专注于数据分析和项目完成。
自2002年启动临床研究项目以来，已有75名住院医师成功完成该项目。截至目前，已完成的项目产生的摘要在33次全国或地区会议上被接受，并发表了11篇同行评审的出版物。此外，基于项目结果启动了3项全院范围的主要质量改进措施。在2006年与这些研究项目相关的第一篇同行评审出版物发表之后，不仅这些住院医师项目被接受的摘要数量显著增加（3/18 [17%] 对30/57 [53%]，p = 0.008），而且所有被接受的住院医师临床研究的总数也显著增加（每年平均接受的摘要数量7.9对1.0，p = 0.009；每年平均同行评审出版物数量6.8对2.0，p = 0.003）。讨论：在我们的项目中启动正式的住院医师临床研究项目后，观察到学术产出有所增加。住院医师的研究工作超出了最初特定的结果项目，因为所获得的技能使他们能够开展未来的独立临床研究。
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