Teaching Lifelong Research Skills in Residency: Implementation and Outcome of a Systematic Review and Meta-Analysis Course

Towards researcher physicians in Palestine: resident doctors' perceptions, practices, and barriers

BACKGROUND

Residency training, a crucial part of postgraduate medical education, allows doctors to engage in research, enhancing their critical thinking and evidence-based practice skills. However, various barriers often impede this process. This study aims to evaluate Palestinian resident doctors' perceptions, practices, and obstacles regarding medical research.

METHODOLOGY

A cross-sectional study was conducted from October to December 2023, focusing on resident doctors in West Bank training centers. A sample size of 250 residents was selected. Data were collected via a self-administered questionnaire that covered demographics, attitudes toward research, barriers to conducting research, and research practices. Data analysis included descriptive statistics, chi-squared tests, and multivariate analysis using binary logistic regression.

RESULTS

Out of 290 residents invited, 256 responded, resulting in an 88.3% response rate. Positive attitudes towards research were common, with 79.7% supporting mandatory teaching of research methodology and 81.3% recognizing the importance of publishing research findings. Nevertheless, 53.9% of residents expressed concerns about the additional burden imposed by research. Research engagement was moderate, with 52.0% involved in research projects, although only 40.6% had published in peer-reviewed journals. Significant barriers identified were inadequate funding (71.9%) and insufficient time for research (71.5%). The presence of a research mentor significantly increased the likelihood of research engagement (aOR: 11.8, 95% CI: 6.2-22.5).

CONCLUSION

Palestinian resident doctors exhibit a positive attitude towards medical research, yet significant barriers hinder their participation. Mentoring, integrating research training into residency programs, and allocating the time and resources needed for research activities are all essential strategies to increase resident research engagement and productivity. These efforts can advance healthcare by promoting evidence-based practices, addressing local health challenges, and strengthening systems through tailored interventions and collaborative efforts.

Assessing research competency development in Canadian psychiatry residency programs: A systematic review and future directions

Objective

We aimed to conduct a systematic review to identify curricular and educational interventions to build research competency among Canadian psychiatry residents and fellows transitioning to the competency-by-design framework.

Methods

The PRISMA guidelines were followed, searching five databases from their inception to February 2023 for relevant evaluation-type studies exploring research competency among psychiatry residents and fellows. We appraised thestudy's quality using the Joanna Briggs Institute's risk of bias tool for observational designs.

Results

Overall, 36 original articles met our inclusion criteria. Surveys (n = 10) showed that participation in scholarly research, quality improvement, or educational projects relevant to psychiatry is needed in most residency programs. However, these vary significantly across programs; few need direct research experience for residency completion. The interventions spanned four categories: externally funded comprehensive research training programs (n = 5); resident research tracks (n = 11); workshops and seminars (n = 7); and specific modules (n = 3). Reported outcomes included overall program ratings, research output, and career trajectory. The quality of most studies was low because of the lack of controls or validated metrics for evaluating outcomes.

Conclusions

While many studies have explored best practices in research curricula, the current literature does not inform competency-based models for Canadian psychiatry residency programs incorporating research training requirements. Further description is needed from Canadian psychiatric training bodies regarding appropriate curricula, milestones, and metrics for evaluating research competencies.

Improving ondansetron use and oral rehydration instructions for pediatric acute gastroenteritis

In paediatric patients with acute gastroenteritis (AGE), ondansetron use decreases the need for intravenous fluids, reduces hospitalisations and shortens illness duration. Oral rehydration is also known to have excellent outcomes for mild to moderate dehydration secondary to AGE. Although these interventions are recommended in guidelines from international professional societies, baseline data at our clinic showed that <2% of these patients were offered ondansetron, and that few patients received appropriately detailed rehydration instructions. Therefore, we engaged residents and fellows as teachers and leaders in our university clinic’s quality improvement programme to promote evidence-based practice for paediatric AGE. Our gap analysis identified opportunities for interventions including educating paediatricians and paediatrics residents on the safety and utility of the medication. We created standardised oral rehydration after-visit instructions and implemented a trainee-led educational approach that encouraged appropriate medication use. We used a follow-up survey to uncover provider concerns and tailor future interventions. The process metrics included: proportion of paediatric patients appropriately treated with ondansetron (goal of 80%), and proportion of patients given appropriate oral rehydration instructions. The outcome metric was 7-day representation rates. To achieve sustainability, we restructured our process to have senior residents take ownership of teaching and data collection. Trainee-driven interventions increased ondansetron prescription rates to a median of 66.6%. Patients prescribed ondansetron were less likely to represent to care, although representation rate was low overall. Postintervention data suggests that prescription rates decreased without continued interventions and additional systems redesign may help sustain impact.

Graduate student confidence following a for-credit systematic review course pilot

BACKGROUND

In 2015, librarians at Purdue University began fielding requests from many disciplines to consult or collaborate on systematic review projects, and in 2016, health sciences librarians led the launch of a formal systematic review service. In 2019, Purdue University Libraries was reorganized as the Libraries and School of Information Studies (PULSIS) and assigned its own course designation, ILS. The increase in calls for systematic review services and the ability to teach ILS courses inspired the development of a credit-bearing ILS systematic review course.

CASE PRESENTATION

We designed, taught, and assessed a one-credit systematic review course for graduate students, using a backward-design course development model and applying self-determination theoretical concepts into lessons, assignments, and assessments. Using qualitative pre- and post-assessments, we discovered a variety of themes around student motivations, expectations, and preferences for the course. In quantitative post-class assessments, students reported improved confidence in all systematic review processes, with the highest confidence in their ability to choose and use citation management managers, describe the steps in the systematic review process, and understand the importance of a reproducible and systematic search strategy.

CONCLUSIONS

We considered our pilot a success. Next steps include testing 2- and 3-credit- hour models and working to formally integrate the course into departmental and certificate curriculums. This case report provides a model for course design principles, learning outcomes, and assessments that librarians and library administrators can use to adjust their systematic review services.

Residents Take the Lead: A Modern Collaborative Approach to Research During Residency

BACKGROUND

Participation in scholarship is a requirement for Internal Medicine (IM) residencies, but programs struggle to successfully integrate research into busy clinical schedules. In 2013, the IM residency at Brigham and Women's Hospital implemented the Housestaff Research Project (HRP)- a novel residency-wide research initiative designed to facilitate participation in scholarship. The HRP had two components-a formal research curriculum and an infrastructure that provided funding and mentorship for resident-led, housestaff wide projects.

METHODS

This is a mixed-methods study of 190 IM residents and two HRP-supported research projects. Seventy-seven residents responded to an electronic survey about their interests in research exposure in residency. Fifty-six residents responded to an electronic survey about their participation in the HRP. The success of HRP-supported projects was evaluated through resident comments, interviews with three residents leading the first two HRPs and a description of the success of the projects based on resident involvement and dissemination of the results.

RESULTS

Eighty-seven percent (n= 67/77) of residents were interested in additional research exposure during residency. Ninety-five percent (n = 53/56) of residents had heard of the HRP, and 77% had participate in at least one aspect of it. Approximately 20 residents were directly involved in the two resident-led projects. HRP-supported projects resulted in presentations at three local and three national conferences, one manuscript in press, and one manuscript in preparation. The resident project leaders felt that a strength and unique aspect of the HRP was the collaboration with co-residents.

CONCLUSION

The HRP successfully created a culture of research and scholarship within the residency. The HRP leaders and residents that participated in HRP-supported projects expressed the most direct benefits from the program. All residents were exposed to research concepts and methods. Future directions for the HRP include selecting projects that maximize the number of resident participants and integrating a more robust research curriculum.

Supporting Resident Research Learning in the Workplace: A Rapid Realist Review

PURPOSE

Residents are increasingly expected to engage in practice-based research; however, engagement in research whilst also fulfilling clinical duties is often challenging. Evidence suggests that residents require specific developmental experiences, along with clinical practice, to become effective researchers. The authors therefore conducted a rapid realist review to explore strategies and key mechanisms supporting effective resident research activities in clinical settings. They examined relationships amongst different clinical contexts, learning mechanisms, and research engagement outcomes to provide evidence-based, theory-informed recommendations for improving resident research engagement and extending understandings of workplace learning in health care settings.

METHOD

In 2015-2016, the authors used a rapid realist methodology informed by workplace learning theory to review international literature published between January 2005 and December 2015. The review drew upon sources from OVID Medline, ERIC, Embase, and AustHealth. The authors screened articles for eligibility using inclusion criteria and appraised articles using realist review quality criteria.

RESULTS

The authors included 51 articles in the review. The review process identified three key mechanisms for effective integration and support of resident research engagement, as informed by workplace learning theory: (1) opportunities to engage in practice-informed research supported by longitudinal curricula, (2) guidance by clinician-researchers, and (3) assessing residents' research readiness and promoting their intentionality for engagement.

CONCLUSIONS

This review extends existing literature and informs workplace-based research engagement strategies for residents whilst demonstrating the applicability of workplace learning theory to improving residents' research engagement. The authors propose a learning model to support effective resident research engagement through clinical practice.

The hidden benefits of helping students with systematic reviews

Helping students with systematic reviews goes against the instinct of many librarians, who see it as their duty to talk researchers out of these projects rather than to assist them. My perspective on helping students with systematic reviews changed after meeting with one student a few years ago. However, the question of whether the finished product will be publication-worthy or entirely free of error is secondary, in my view, to other potential benefits to the student in completing the assignment.