Well, here's another session. So we have another session of the Scholar 7. Just a little bit of review. Before we presented this to all of you, we did a little bit of a group session with some internal medicine residents at Richmond. And we went through. We started with a hypothesis, a very simple hypothesis, with one single statement. And we moved from there. And we developed every bit that you guys are doing. We did it at a little bit of a quicker rate. And then at the end of the day, today, we just found out our IRB was approved. So we have an approval. Now we're going to start moving in and collecting the data. And so that's sort of the next step. So we're very excited about that. And I'm hoping that the same kind of thing comes out of these meetings. So we're moving forward with that. All right. So what I want to start this meeting with is exactly what we started out with the smaller group is, let's try to identify, I'd like you to try to identify a meeting that we're going to head to. Where are we going to present our data? So it sort of gives us a goal. For example, with our smaller group, we identified OMID, or the American Thoracic Society. What I'd like you to do in this next few minutes here, I want you to go online, and whatever your topic is. If your topic is sports medicine, maybe it might be a meeting that's in that sort of genre. And then you want to look at that, and you want to find out when the abstract deadline is. So we need to pull, find that data, and then that's sort of our deadline, where we're going to hit. So I want you guys to try it. I want you guys to do a little bit of work now, and give me some ideas of what meetings you would attend. So some of them could be your specialty meeting, your track, could be OMED, could be the Cleveland Academy of Osteopathic Medicine, could be the OOS, which is in April. So I want you to go through real quick. This is going to sort of give us a deadline. I'm going to give you some time here to go through your browsers and figure out a place where we're going to try to do. Now, it's interesting. I was just at the ACGME, and they have their own journal. And what they're doing is, they realize there's this need for scholarly activity. So what they've also done is, they said their journal is looking for shorter, concise articles, because they want to have more opportunities to publish more people to do things. So I think a lot of them are trying to find ways to help out. But what we're going to do is, we're going to try to work this way, the manuscript. First, we're going to look at finding the meeting we can send an abstract to. So that's on your CV. That's scholarly work, just to write an abstract. So you have that abstract. They may ask you to do a poster. They may ask you to do an oral presentation. And that's, again, more scholarly work. And you're sort of getting two more items of scholarly work than you had before. And then, after the presentation, then the manuscript. And the manuscript's important to submit to any type of journal, or especially journal. You'll get there, so we have to get this front-end stuff done first. So I want you to kind of look through it. I need, from that, what meeting you're going to go to, the date. We need to know whether they'll take abstracts, and we need the abstract deadline. And we need to have enough time for that abstract deadline in order to do our work, to submit. So you have to give yourself at least two months, two months for IRB, and the completion of this. So we'll probably be getting done with this in probably another month, or less than a month. At the end of this month, we'll probably be done with it, mostly. And you guys should be able to send in that. So give yourself some time, and then we're going to move forward. So I need that data. So let's go ahead and collect that. Just looking at Cleveland Academy. Now, if yours is, what was yours on again? I forgot. Vitamin D. Vitamin D. And I'm kind of changing it. OK, good. I'm going to be asking that. If you were to do my read more, I'd change that. That's OK. That's good, though. That's good. That's massage. That's good. So if it's on vitamins, you may want to look at something, American Academy of Nutrition, American College of Nutrition, Physician Nutrition, and find one that's going to be more in October, November. And then you can look through that. The deadline for the osteopathic sports medicine conference just passed last weekend. And then the next one, sports medicine was, would be the ASSM in November. That's the next deadline. That would be good. That's the one I would take. That's going to give you enough time to do all that. Perfect. So what's important about this exercise is that once you look at what you're, you have to have some sort of goal, some place to sort of set so that you know when things are ended. And when you're dealing with research projects, in particular with residents, you have about a year to two years. So you don't want to extend things out too far. So you want to pick a meeting that's probably going to be, you know, in the fall, and that the deadline will come sort of maybe in September, so that you have enough time to put together this smaller program, and then, or your research, and then move into the IRB, and then have enough time to collect. Even if you collect enough data, it doesn't have to be all your data, and then you can submit your abstract. Why is that important? When you start developing your CV, and we'll have a little bit of a talk on curriculum vitae, I use the Harvard style, and I'd recommend that you all look up the Harvard style CV. I use that. I've used that all my life, and when I was in academics. And you put in your abstract, and that you submitted, and if it gets accepted, and you put the title, and you put the name of the people involved. Say it gets accepted for a poster, well, that's another line. Then there's a poster. Then you put that poster in. It's going to be the same title, but there's the poster. Then you submit the abstract, and submit the manuscript, and it gets published, and there's another line. They're all the same, and in fact, when you go looking for an academic job, and someone's looking at your CV, and you have 100 abstracts, and 20 posters, and two manuscripts, it doesn't look like you've moved very far. You have to make those movements from abstract poster to manuscript, and that's how that runs, so from an academic standing. So just as a reminder, we put out 10 abstracts a year just from my private practice, and we publish six manuscripts a year, and I'm seeing 35 patients a day, and I have a lot of different things, and I don't think it's unreasonable to think that you can do the same, and move them all towards, and move them at different. As long as you have time, you have to remember, you have to look at those times, whether you're doing anything with your family, or you're doing anything in particular, and you have to make scheduled time out from your practice to make sure you're going to be there. So those are all very important kinds of things to think about when you're moving through it. Did anybody's hypothesis change from the last time? Can you tell me, what was your original hypothesis, and what did you change it to, and why? So off the top of my head, my original hypothesis was that patients with low vitamin D, if they had risk factors like obesity, that it would take them longer to reach an optimum of vitamin D with supplementation, but I find that's going to be way too hard to figure out, so I'm just going to literally correlate my patients in Nashville that already have increased risk because of the latitude, with obese, basically I artificially screen them all by giving them the vitamin D deficiency diagnosis, so basically justifying it as a screening, rather than having to give them a diagnosis before screening, including that in your yearly screening. So it's about getting a variable, two variables, and about the relationship between two variables, so that really will help a lot, make a difference. So one thing is that about a hypothesis, we talked about this, it's a statement, it's not a question, it's an assumption, it's an idea, it's what you think might reflect nature, and because we're all clinicians, we're closer to that, we're closer to the patient, so you may see trends that you may ask about and say, well, you know, like the vitamin D, so this might, vitamin D may reflect certain manifestations, and then, but you look it up, and you look it up and do a literature search, and you might find that there may not be any literature, or there may be some, then you kind of move your hypothesis and change it a little bit, so that you can make a little bit of a change, so that you can make it work and make it doable. Now we talked about specific aims, and so in general, you need about, you know, after you get your hypothesis, we talked about making a three-sentence introduction, and that introduction, three-sentence introduction is basically one sentence leading to the next to your hypothesis, so it's a little bit of your due diligence and your work moving it forward, and then afterwards, three specific aims, we talked about, they build on each other, they're a short paragraph under each aim about how you're going to do that, and this will expand into your material methods, and that's what we're going to try to do today, so we're going to take your three specific aims and move them to material methods, so each specific aim should have at least a paragraph within each material method, so specific aims, and we talked about what they can be, it's the population, so where are they, so are they, you know, are they Richmond, are they Bedford, or is it both, or is it the entire UH community, or is it just my practice, where are they, and then the second specific aim is how are you going to study them, I'm just going to do a questionnaire, I'm going to do something else, I'm going to, you know, I'm going to do a study of their EMR and all their records, or how are we going to, and then the third specific aim is how are we going to analyze them, so what methods am I going to use to analyze them, am I going to use a statistician, and who's a statistician, and how am I going to move that forward, so those are the three kinds of things in the specific aims, and then the preliminary data, we already wrote that up and said could be your own, could be somebody else's, then you want to tell them again, you want to tell them again what you're doing, and then you want to make sure they know what you told them sequentially, logically discuss the data until it reaches your hypothesis, and make an argument for it from the literature, so this is Pat, and I think I showed you this before, so Pat always said hold them by the nose and kick them in the ass, and what that means is tell them, tell them again, and tell them what you told them, then tell them again, so repeat, repeat, and the short period, a short document that we're going to develop, maybe three, one or two pages long, you have to repeat your hypothesis, and as you move through, talk to them about your preliminary data, talk to them a little bit about how, you know, how important it is, and then repeat your hypothesis, your specific aims, and repeat your hypothesis, and move down the line, it sounds funny, but as you're reading it, all kinds of make sense, it comes together once you start looking at that, so material methods, I think we're going to, does everybody have specific aims? We talked about the three specific aims, pretty much, I'll come around, let me look at your specific aims, and we'll work through it, and then we're going to try to expand those into your materials and methods, okay? Let's take a look at those. Very good. Okay, so your introduction to that, you'd want three sentences, and your three sentences would say, you know, physician burnout is very important and a big issue in the medical community. The relationship is not clear of what really causes it. I'm just making this up. I feel, and my hypothesis is that there's a relationship between physician burnout and medical errors, more, yeah, preliminary data, or short introduction. So the way this would work is that this is good. This is your hypothesis. Underneath that, you need a three-sentence introduction. I can't tell you how nice, that's smooth. That's very smooth. Okay. Now let's go through your specific aims. Do you have an idea? Yeah, so three aims. And this is your, I'm sorry, this is your introduction? Good. Great, great. Okay, so specific. So once you get your preliminary data and you write that out, then I need you to take the specific aims. So it's again the same thing, your next thing is material methods. So each specific aim then becomes a larger paragraph, and so it's sort of painful detail. It's like, you know, I'm going to Bedford, and I'm going to UH systems, and I'm going to be looking through these numbers, and, you know, very painful. So you may have one or two paragraphs for each specific, like this already. This, once you get this done, this is cut and paste. You'll find out in one session, we'll be sitting together, and we're going to cut and paste into the IRB application. Once that's through the IRB application, you get approved, you start collecting your data. So essentially, that translates to an abstract, because your introduction and discussion. And podiatric participants. Okay, and your introduction, do you have an introduction sentence? Yeah. Three sentences. Three sentences. Yeah, number one, scholarly activity is a requirement of all CPME training programs. Number two, the literature suggests that educational initiatives to promote scholarly activity and other healthcare disciplines have been successful. Number three, I believe that podiatric residents participating in annual research will lead to a more successful education. That's a great, that is great. I mean, I really like that introduction. Let's hear your aims. So the aims. The population of this study consists of 13 participants in the annual scholarly activity at Richmond Medical Center from 2010 to 2015. There were seven males and six female residents in this group, with a compatriot of 13 other residents. They had no exposure to scholarly activity. And then we talked about the tool that we used. Yep, tool. Next. Oh, our tool is a questionnaire consisting of five questions ranging from obtaining additional appointments and privileges, license, publication, and presentations at local, state, or national, or international meetings. This was sent via email, responsibly collected electronically. And stored in REDCap. Stored in REDCap. Stored in REDCap. We have to have that in there. You have to store it in REDCap? Oh, that's right. Yeah, we have to store it. REDCap is just a UH Excel, protected Excel sheet. So here's the next step. The next step, so preliminary data. So with the preliminary data, so you take that three-sentence introduction, that wonderful introduction, and each sentence is going to become a paragraph now. Which I think you worked on. So you have that. Okay, so if you're working on that, that's good. Then you're using your literature, too, to back that up. Now, lastly is your material methods. And your material, so the title, material methods, and each specific aim becomes one to two paragraphs in your material methods. And so you have to go into painful detail on how you're going to do this. So the aims go right to material methods. Just like the introduction goes to preliminary data, specific aims goes right to material methods. And it's an expansion. And then you're almost done. So I think we're moving really well. I think your groups are starting to come together. And so here's where we're headed. So now you pretty much all have a hypothesis that you believe in, that you feel comfortable with, and that you've massaged or changed to make fit. And that's very good. That's really important. I think you all have an introduction. You have a three-sentence introduction, and that's very good. And then you also have taken three specific aims with short little paragraphs. And then next you have expanded from your introduction. You've taken each sentence and made a paragraph out of each one of them using the literature and making three paragraphs, and that's your preliminary data. And then now you've looked at your specific aims, and you took each one of the specific aims and expanded each specific aim into a paragraph, and that's your material methods. That's where I want you to be. So we need to work forward on that. And then we'll finish that up. And then what we hope to do, so in between times, those of you guys have stuff, keep moving. We're going to do the next thing. It's called the conclusion. So you see how close we are. We are so close to the end. So the conclusion is you tell them again. So it's another paragraph. Similar to your introduction, use different words. Just like your introduction, use different words. All right? And then walk through logic of the hypothesis, that's your first sentence. Walk through the preliminary data, that's your first and second sentence. Walk through your specific aims and material methods, that's two sentences. And then end with your hypothesis, and we aim to show. So that's your conclusion. That's the end. So once we have that done, that is your document. That document you just created, you can send that off to a grant, and I really recommend you write this up and submit to LECOM. LECOM's grants deadline's coming. You can get some money on that. There are other grants. Yeah, there's about $5,000. So there's a seed money for things you need to assist with it, and you hook up with any kind of a resident or fellow or intern, and it gets access for their opportunity of doing that. So the other schools will do things too. Yeah, so that's a grant. And then what we're going to do with that document is that you individually will meet with myself and my fellow in PREA, and we will cut and paste this into an IRB document. And then we will review it and move it along with the submission to your IRB. And that's where Scholar 7 ends. We'll start another session, which will be the next part, will be data collection and data analysis. It'll be a little different. We're going to walk you through this whole thing, and my goal is to have a scholarly project in all the institutions, at least one, and moving through. And I know you can do it because it all sounds just like what we did with the smaller group. So your goal for next time is homework. So I want all of the material in one document. I want everything in one Word document. So when you come in next week, it's going to be on a Word document starting with your hypothesis, introduction, specific aims, preliminary data, material methods, and then I want you to come up with some type of conclusion. So that has to be done by next time. I want you to review everything, too. I want you to review your hypothesis and all those components to make sure that sounds good so that you feel very comfortable in moving forward. Does it fit somewhere in the literature? That means if it wasn't written, if you weren't doing it, somebody would need to do it to put it into the literature. So complete your conclusion. And like I said, in the last Scholar 7, each group will be facilitated. You'll have an individual facilitator to move this forward. Please complete your CITI training. So those of you, anyone who is going to consent to anyone, put in that. You do your CITI. Priya, if you do me a favor, you come up here. I just want you to read your material methods for them. This is another way of making your material methods, and I showed some of you this. This is actually a good thing. I advise that inhaled corticosteroids, in addition to short course of oral corticosteroids upon discharge, will yield similar 30-day readmission rates for asthma relapse in a community-based hospital population in the United States when compared to tertiary care centers outside of the United States. So our research plan, number one, study population. Inclusion criteria. This study will include individuals between the ages of 18 to 65 with codes specific to asthma exacerbation at UH regional hospitals. Exclusion criteria. Subjects will be excluded if they have any of the following known or suspected conditions on admission. COPD, including chronic bronchitis and emphysema, fever above 38, a past year history of smoking above 15 years, history of pregnancy or currently pregnant, lactating, severe mental illness in present or past, extra abnormalities on admission, diabetes, peptic ulcer disease, or extra pulmonary infections. Number two, subject recruitment and enrollment. Subjects will be enrolled from UH regional hospital system at Richmond Heights and Bedford Community Hospitals in the Northeast Ohio. Number three, plan for obtaining consent. No consent will be needed as this is a retrospective study. Number four, privacy protection and data confidentiality. Subjects' privacy will be protected. For enrolled subjects, research data obtained from the EMR will be stored on UH RedCap for data compiling and handled by HIPAA certified investigators. Subject identifiers will be removed when exported from secure database for statistical analysis. Number five, study design. So study design has three parts. Number one, this is a retrospective study involving patients between the ages of 18 to 65 at UH regional hospitals. All patients have a code specific to asthma excisvation upon discharge from the hospital. Two, all research materials will be obtained from chart review found in UH Richmond hospitals or regional hospitals EMR and physician portals. Each subject's UH medical record will be used to organize our database on UH RedCap. The patient's medical history will be assessed along with their hospital admission frequency. Study procedure is its own part, so this is number six. We will obtain data regarding specific asthma exacerbations from UH's billing and coding department. Once we have collected the data and organized it in the RedCap, we will compare our group data to the data obtained from studies at tertiary care centers with the help of a statistician. The statistician will not be able to view any of the patient identifiers. Once the data is analyzed, we can then formulate our conclusion regarding 30-day admission rates for asthma relapse in a community-based hospital in the United States versus tertiary care center outside of the United States for patients discharged on ICS and short course of systemic corticosteroids. And once again, we share the hypothesis. We hypothesize that the combination therapy upon discharge from a United States community-based hospital will demonstrate similar admission rates for tertiary care centers outside of the United States. And lastly is the methods, which is the collected data will be blinded and analyzed by a LECOM statistician. We have consulted with Dr. Terrell, a statistician from LECOM, regarding the statistical analysis of our data. A student's T-test will be most appropriate in determining whether there is a statistical significant difference in the 30-day admission rate between the two groups in our study. Good. Thank you. So you notice some things that I didn't talk about, inclusion and exclusion. So while you were doing all your literature searches and you were looking at it, so you may want to take a look at what they excluded and included in your study. So use those and copy those into those. So once we get through that, then we're going to go on and work it out. So thanks for your attention again. We'll do it up again next time.

research project

hypothesis development

academic conference

IRB submission

grant funding

research proposal