Research is an important part of the residency program at UTHSCSA Department of Orthopaedics. Each resident is required to complete a publishable research project by the end of their fourth year. An oral presentation of the project is also required. A well structured format, designed by the Orthopaedic Resident Research Committee (ORRC), is in place to ensure a positive and productive outcome. Opportunities are available for basic and clinical science topics. It is our hope that the resident will gain an understanding of the research process from doing a project. Our goals are for the resident to learn and be comfortable with the research process, to be able to critically evaluate available literature, to understand how to practice evidence based medicine, and to apply findings to their clinical practice.
Since the last ACGME site visit, a number of changes have been implemented for the training of residents in research activity. These modifications are intended to introduce residents to the principles of scientific inquiry and the application of these principles to clinical practice. Residents participate in a one month Research Rotation during their first year. Through independent study and daily interaction with both the Research Rotation Advisor for Interns (Dr. Victor Sylvia) and the Research Coordinator (Patricia Cathcart, B.A.), the resident is exposed to areas of ongoing research within the Department, based on the resident’s own interests. During the rotation, the resident identifies a research project that he/she will complete under the direction and mentorship of a faculty member during his/her residency. The project must address a previously unanswered question and be publishable in the peer-reviewed scientific literature. At the conclusion of the rotation, the resident is required to present a description of his/her project using Microsoft PowerPoint. The presentation is to demonstrate not only a command of PowerPoint, but an understanding of the relevant literature, the scientific method (using an hypothesis-driven approach), the appropriate tools or methods for collecting data and statistically assessing the results, and the costs for materials and other expenses to complete the project. The resident and faculty mentor are responsible for determining how expenses associated with performing the project will be paid. During PGY2, the resident is required to make this presentation to the Orthopaedic community at large during Grand Rounds. At that time, any progress during the prior 6-9 months can be included and time will be allocated for open discussion with the audience.
During the Research Rotation (PGY1), individualized instruction is supplemented with reading materials designed to introduce the resident to evidence-based medicine, the scientific literature, and PowerPoint (User’s Guides to the Medical Literature. Essentials of Evidence Based Clinical Practice by G. Guyatt and D. Rennie, AMA Press, 2002; How to Read a Paper: The Basics of Evidence Based Medicine by T. Greenhalgh, BMJ Books, 2001; Evidence Based Medicine: How to Practice and Teach EBM by D.L. Sackett, S.E. Straus, W.S. Richardson, W. Rosenberg, and R.B. Haynes, Churchill Livingston, 2000; Where’s the Evidence? Debates in Modern Medicine by W.A. Silverman, Oxford University Press, 1998; Power Point 2000 by K. Murray, Sybex, 1999). At the end of the month, the resident is given a written exam on the reading materials which focus on the principles of evidence-based medicine.
The entire research process is facilitated and administered by the Research Coordinator and faculty in the Research Division. The Research Coordinator is the primary point of contact for the residents and is responsible for coordinating and assisting residents in all aspects of their research. This would include assisting with such tasks as completing and submitting IRB protocols, developing data collection tools and spreadsheets (Access and Excel), and locating individuals at the Health Science Center (or elsewhere) who have expertise in specific areas, such as epidemiology, statistics, or imaging. The Research Coordinator is also involved in maintaining records which document the progress of each resident in completing his/her project. To accomplish this, the Research Coordinator schedules meetings with each resident every quarter; a written summary of progress is provided by the resident prior to the scheduled meeting time. These meetings are typically attended by the Research Coordinator, the Chairman of the ORRC, and a member of the ORRC from the clinical faculty. The results of this meeting are compiled and forwarded to the Program Director and Department Chairman. The Research Coordinator also maintains spreadsheets with information on presentations made by residents at research conferences and publications.