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130511P - MEDICAL STUDENT RESEARCH: BENEFITS, EXPERIENCES, AND CHALLENGES

Presented at the student research day of the Faculty of Medicine King Fahad Medical City Riyadh on May 11, 2013 by Omar Hasan Kasule.


BENEFITS OF RESEARCH FROM THE STUDENT’S PERSPECTIVE
·         Educational advantage: Research stimulates scientific curiosity and love for discovery working on the frontiers of knowledge. Research helps students’ better understand of research-based medical literature. Students engaged in research should do better in student centered problem-based learning and can use published papers instead of textbooks as their sources.
·         Curriculum improvement is a main motivator of extracurricular student research[1]. Research publications needed to enter competitive residency programs. Student involvement in research leads to publications[2].

[1] Med Teach. 2012; 34(5):e317-24, [2]Teach Learn Med. 2008 Apr-Jun;20(2):163-7.


BENEFITS OF RESEARCH FROM THE PRACTICE PERSPECTIVE
·         Better clinical knowledge: Physician-investigator / physician-clinician / physician-scientist are preferred by patients because they are thought to have uptodate knowledge. Physician-scientists with a stronger research-based background deliver higher level clinical care, can explain the disease better to their patients[3]
·         Better hospital practice: Research hospitalsare considered of higher quality and are ranked by number of publications

[3] Immunol Res. 2012 Dec;54(1-3):286-91


BENEFITS OF RESEARCH FROM THE CAREER PERSPECTIVE
·         Instilling a future research career: Student research encouraged a research career as shown by experiences: Duke[4], 10 US medical schools[5], South India[6], Norway[7]. Intensive undergraduate research training attracted students to mental health research[8].Training on research imprints moving towards physician scientist career[9]
·         Choice of career: Required research determined choice of women healthcare specialty[10]. Student research strongly associated with postgraduate research[11].

[4] Acad Med. 2010 Mar;85(3):419-28, [5] J Investig Med. 2005 Mar;53(2):73-81, [6] Indian J Community Med. 2009 Oct;34(4):306-9, [7] BMC Med Educ. 2009 Jul 14;9:43, [8] Acad Psychiatry. 2005 Spring;29(1):58-65, [9] Acad Med. 2003 Dec;78(12):1271-80,[10] Am J Obstet Gynecol. 2005 May;192(5):1478-80, [11] Acad Med. 1990 Aug;65(8):530-3.


BENEFITS OF STUDENT RESEARCH FROM THE COLLEGE’S PERSPECTIVE
·         Curriculum required research: Required research at University of Washington[12], Mayo Clinic[13], 4th year community research at KFMC and Community Residency Program in Malaysia[14]. More community research. Lab research limited[15] but 2 KFMC students went to Yale]16].
·         Extra-curricular research: US students overseas[17], 2 KFMC students in Yale, Alfaisal university international summer science and clinical elective research programs[18], Imam Muhammad bin Saud research electives in the US and UK.
·         Experiences of dual degree / intercalation programs: MD/PhD degree Intercalated programs. Work on a doctorate promotes scientific thinking in the future doctor[19]

[12] Acad Med. 2006 Oct;81(10):877-81, [13] Acad Med. 2008 Jun;83(6):604-10, [14] Med J Malaysia. 2002 Dec;57Suppl E:94-8, [15] Med Teach. 2008;30(9-10):875-6, [16] Professor Omar HasanKasuleSr, [17] Am J Trop Med Hyg. 2010 Aug;83(2):211-4, 18] AdvPhysiol Educ. 2012 Mar;36(1):27-33, [19] Dtsch Med Wochenschr. 1998 May 15;123(20):617-20.


ROLES OF STUDENTS IN RESEARCH
·         Research subjects: educational research[20]. Psychometric research. Physiologic research. Ethical issues in students as research subjects[21]
·         Research assistants: laboratory, data collection or computer analysis[22], writing.
·         Degree requirement: course, undergraduate, masters, doctoral
·         Principal investigator in simple exempt research

[20] Med Educ Online. 2013 Feb 25;18:1-6, [21] Acad Med. 2001 Sep;76(9):871-5, [22] J Pak Med Assoc. 2011 Feb;61(2):115-20..


ATTITUDES OF STUDENTS TO RESEARCH
·         High student interest, enjoyment, benefit, and positive attitude to research: New Zealand[23], Germany[24], Egypt[25], Philadelphia[26],Pakistan[27], Canada[28], Norway[29]
·         Student interest can be increased by targeted programs such as student research days and publication[30], research honors and awards[31], summer assistantships[32]
·         Many students involved in research but fewer get their work published(38%)[33]

[23] N Z Med J. 2010 Sep 24;123(1323):34-42, [24] Med Teach. 2009 Jun;31(6):e254-9, [25] J Egypt Public Health Assoc. 2006;81(1-2):99-118, [26] Acad Med. 2005 Aug;80(8):780-5, [27] BMC Med Educ. 2006 Nov 2;6:54, [28] Med Teach. 2004 Nov;26(7):659-61, [29] Tidsskr Nor Laegeforen. 1992 Jun 30;112(17):2205-7, [30] J Investig Med. 2006 May;54(4):201-7, [31] Dermatol Online J. 2006 May 30;12(4):20, [32] Fam Med. 1991 May-Jun;23(4):306-7, [33] Croat Med J. 2005 Feb;46(1):88-95.


RESEARCH TRAINING: HOW
·         On the job training while reaching the underserved[34]
·         One month program improved student research knowledge and skills[35]
·         Fostering research through mentored research projects[36]
·         4th year community research
·         Extra-curricular research

[34] Fam Med. 2005 May;37(5):315-7, [35] Ann Emerg Med. 1987 Jun;16(6):686-8, [36] Kathmandu Univ Med J (KUMJ). 2010 Jul-Sep;8(31):294-8.


RESEARCH TRAINING: WHAT
·         Students need research skills: research methods; information gathering, critical analysis and review, and data processing[37]
·         Methodological courses of epidemiology and biostatistics taught in the first year at Kuantan, Malaysia[38], Brunei[39], and Karachi[40]. Courses on methodology in Croatia[41,42].
·         Introduction of courses on critical thinking[43]
·         Research and publication ethics at Mt Sinai[44], Korea[45], and Wisconsin[46]

[37] Med Teach. 2010;32(3):e152-60, [38] Prof Omar Hasan KasuleSr, [39] Prof Omar Hasan Kasule Sr., [40] J Pak Med Assoc. 2009 May;59(5):307-10, [41] J Investig Med. 2010 Feb;58(2):282-6, 42] Med Educ. 2004 Jan;38(1):81-6, [43] Immunol Res. 2012 Dec;54(1-3):286-91, [44] Acad Med. 2013 Mar;88(3):364-8, [45] J EducEval Health Prof. 2008;5:3, [46] Acad Med. 2005 Oct;80(10):925-30.


CHALLENGES OF RESEARCH
·         Teaching in the first year: (a) research methodology (bio and epi) (b) authorship and publication ethics (c) research ethics
·         Enhancing interest/attitude to research and publications
·         Finding time for research in a crowded curriculum, clinical time vs research time, research experience associated with low surgical skills among finalist students[47]. Student interests and balance of research and clinical develop over time[48].
·         The challenge of mentors: busy clinicians and scientists may not have the time to mentor students they may just use them for routine research tasks

[47] J Surg Res. 2002 Feb;102(2):178-84, [48] Acad Med. 2007 Jul;82(7):633-45..


PROPOSALS FOR ENHACING STUDENT RESEARCH-12 TIPS[49]
·         Educate students on the benefits of research.
·         Encourage students:  to take the initiative to create opportunities for themselves, to undertake extracurricular research, to network with other researchers, to engage with student-selected components of their courses, and to apply for summer research programmes, to attend scientific conferences, and to do research during elective placements.
·         Advise students to consider intercalated degrees and to balance their academic and research interests
·         Make students aware of the MD/PhD courses.
·         Emphasize research as a learning process and reduce focus on output.

[49] Med Teach. 2012;34(9):705-9..


THE CURRICULUM AND STUDENT RESEARCH
·         Configure the curriculum to accommodate research:
·         The expectation is that the traditional curriculum encourages research interest by discipline depth. The PBL curriculum encourages a spirit of inquiry. At Agakhan University in Karachi PBL students had a slightly higher research interest than those in the traditional curriculum[50]
·         Research track vs non-research tracks in the medical school: some students not interested in patient care for lifestyle reasons while other not interested in research because of earning potential[51]

[50] PLoS One. 2007 Jul 18;2(7):e632, [51] Can Fam Physician. 2011 Jun;57(6):e216-27


POLICY INITIATIVES TO SUPPORT STUDENT RESEARCH
·         Create avenues for publication of student research: student journals or student corner in the general journal.
·         Create special programs for student research eg University of Iowa clinician-scientist program with early exposure to research assuring many benefits[52], Mt Sinai office for student research opportunities[53], research project program at Calgary[54]
·         Research faculty vs non-research medical schools. Non-research universities do minimal research and focus on producing GPs to cover the unmet medical needs and they employ the PBL approach. Research universities work on the frontiers of knowledge and commercialization of research products such as drugs etc. The research universities will hire professors with research track and give them protected time to do research and teach / mentor students.\

[52] J Investig Med. 2001 Nov;49(6):486-90, [53] Acad Med. 2001 Jul;76(7):743-7, [54] Acad Med. 2001 Feb;76(2):189-94..


Video


Writings of Professor Omar Hasan Kasule, Sr








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