Grants and Research Overview and Institutional Agenda for Educational Research

P. Gunnar Brolinson, DO, FAOASM, FACOFP, FAAFP

Vice Provost for Research

Discipline Chair for Sports Medicine

Team Physician Virginia Tech

Director of Primary Care Sports Medicine Fellowship

Things that make you go hmmm…

“ My momma always said most people don’t

look dumb until they start talking.”

Forrest Gump

VCOM Grants and Research 2.0

Our Mission…The MISSION of the Edward Via College of Osteopathic Medicine (VCOM) is to prepare globally-minded, community-focused physicians to meet the needs of rural and medically underserved populations and promote research to improve human health.

To foster a culture of faculty growth and institutional excellence through annual review and research on new developments in medical education, new delivery models and technology ; and support for faculty research, innovation, and scholarly work in the areas of biomedical, clinical, educational, public health and health policy research.

To advance scientific knowledge through medical research.

Priority 1:   Biomedical Research

Priority 2:   Clinical Research

Priority 3:   Educational Research/Osteopathic Principals and Practice 

What’s Special About VCOM?

VCOM is uniquely qualified and positioned to introduce innovation and research into

Osteopathic Practice and Education– We will soon be the largest osteopathic medical school in the US and have created

a novel educational process– We target the rural and underserved Appalachian population for medical student

recruitment and residency training as well as the delivery of medical care– Our 3 Campus system is located on the campuses of two national research

universities and one is adjacent to a major cancer research institute

Grants and Research Department Reorganization

• Dr. Gunnar Brolinson named as Vice Provost for Research• Better support for research endeavors across the three VCOM

campuses• Ensure a uniform operating model as the College continues to grow• Provide more formal research development programs

– provide faculty with additional resources to strengthen research proposals such as faculty development programs on research skills, peer review and statistical support.

• Facilitate interdisciplinary and interdepartmental collaborative research

Grants and Research Department Goals

• Become the top ranked Osteopathic Medical School in research in the next 5 years

• Become one of the top 25 ranked Medical schools in research in the next 10 years– 141 current US allopathic medical

schools– 17 Canadian Schools– 30 US osteopathic medical

schools

Research Plan for the Osteopathic Profession

• For a comprehensive medical profession, performing research is not an option. Rather, such a profession has an ethical and societal obligation to systematically study medical conditions and treatment outcomes to determine better ways to improve patient health. A principle within the American Osteopathic Association (AOA) Strategic Plan 2014-16 is to enable a culture of osteopathic research within the osteopathic family. To be successful, such a culture requires that all facets within the osteopathic medical profession actively support research and a substantial number of academics and clinicians perform clinical and translational research. Furthermore, the AOA mission statement—to advance the distinctive philosophy and practice of osteopathic medicine—focuses the profession on a common goal: to emphasize research that investigates and demonstrates its distinctive philosophy and practice.

What challenges do we face?

• One area of criticism has been the relative lack of research and lesser emphasis on scientific inquiry at D.O. schools in comparison with M.D. schools.

• “The inability to institutionalize research, particularly clinical research, at osteopathic institutions has, over the years, weakened the acculturation, socialization, and distinctive beliefs and practices of osteopathic students and graduates”.

• Funding for “seed grant” projects to generate pilot data• Funding for “Endowed Chairs”• Funding for “Research Infrastructure”• “Money isn't everything but it does rank right up

there next to oxygen!”

Strategic Planning• External Reviews: conversations with the experts, going on now

– Funding agencies: Federal, Private, all areas, but especially for Osteopathic Research • Innovative research, translational projects, impact

– Research partners: CCI Alliance as an example• Innovation is key –create a culture of innovation

– Research VPs, Directors of Centers• What does it take to be a great research entity?

– Publish in high tier journals, attend meetings, give talks and posters. Be visible.– Faculty must be at the top of their game– Collaboration within and outside institution key

• Align research Strategic Plan with College Mission– VCOM is not a “research optional” institution

• We need your help!

What is Educational Research?

Educational Research refers to a variety of methods, in which individuals evaluate different aspects of education including:

“student learning, teaching methods, teacher training, and classroom dynamics”.

From Wikipedia, the free encyclopedia

Why should we do educational research?

• Every individual has their own beliefs about the best way to teach. – How do they know that their

beliefs are correct? – Is it possible to support your

beliefs with more valid evidence than just that you believe it to be true, it is true from your personal experiences, or that an expert said that it is true?

Ten Characteristics of Educational Research

• Educational research attempts to solve a problem.• Research involves gathering new data from primary or first-hand sources or using existing data for a new

purpose.• Research is based upon observable experience or empirical evidence.• Research demands accurate observation and description.• Research generally employs carefully designed procedures and rigorous analysis.• Research emphasizes the development of generalizations, principles or theories that will help in

understanding, prediction and/or control.• Research requires expertise—familiarity with the field; competence in methodology; technical skill in

collecting and analyzing the data.• Research attempts to find an objective, unbiased solution to the problem and takes great pains to validate the

procedures employed.• Research is a deliberate and unhurried activity which is directional but often refines the problem or questions

as the research progresses.• Research is carefully recorded and reported to other persons interested in the problem.

Purpose of Educational Research

The purpose of educational research is to develop new knowledge about the teaching-learning situation to improve educational practice. Educational research can address the following variables:• Learning: How do students best learn various subjects?• Teaching: What are the best teaching practices to foster student achievement?• Motivation: What are the best practices for teachers to motivate their students to

achieve?• Development: How do children and adults change over time, including their

cognitive, social, and emotional skills?• Classroom management: What classroom or school practices make the

classroom optimal for student learning?

What’s the benefit of educational research?

• Provide instruction that maximizes students' learning.

• Understand and support the developmental needs of students.

• Develop an educational environment that supports students' motivation.

• Provide solutions to educational problems.

• Fosters the development of innovative curriculae

Designing your Educational Research Protocol

• The Protocol is a “recipe” or “blueprint”• Strict scientific guidelines: --Purpose of study --How many people will participate --Who is eligible to participate --How the study will be carried out --What information will be gathered about participants --Endpoints

Critical Thinking….PICO

• What are the characteristics of the Participants in the proposed research?

• What is the Intervention being studied? • What is it Compared with? • What Outcomes are measured?

Then ask yourself, “Is this an important question to be asked and answered?”

What is a “Research Question?

• Often begins with a general concern:– Should women take hormones to prevent bone loss?– Can a vegetarian diet reverse cardiovascular disease?– Can a Self Directed Learning experience replace a

classroom learning experience for -------?– Can diabetic patients be taught to control their blood

glucose levels?

Refine your “Research Question”

• Must be narrowed to something measurable and researchable– Is taking estrogen associated with a lower risk of

osteoporosis in women 60+?– Does a plant-based diet reduce serum cholesterol

levels in patients with cardiovascular disease?– Can a structured intensive diabetes education program

help patients with type 2 diabetes control their blood glucose levels?

How to generate a “Research Question”

• Literature• Your previous research/experience• Mentor• Conferences• Participants/subjects

Framing the Research Question…

• "Does my child need antibiotics for this ear infection?" might be rephrased…

• "In children with acute otitis media, how much difference do antibiotics make in comparison with Tylenol alone, in terms of duration of pain, deafness, recurrent infections and serious complications“.

• Patient, Intervention, Comparison and Outcomes

Literature Review

• Good scholarship is key!– no need to re-invent the wheel

• Review a meta-analysis or systematic review to evaluate the existing literature

• Consult our Library staff and other sources for systematic reviews

Significance of your project

• How does your research question – contribute to the scientific knowledge base?– influence teaching models or student outcomes?– or have some bearing on public health policy?

• The significance section provides a rationale for your study, includes relevant previous research, and indicates how your study will take the knowledge base one-step further.

Common Problems• Question too broad

• Reduce variables of interest; narrow focus

• Not enough subjects available• Expand inclusion criteria; lengthen time frame; modify

exclusion criteria

• Too expensive• Consider less costly study designs -- fewer subjects; shorter

duration; fewer follow-ups

Common Problems

• Methods beyond your skills• Collaborate with experts in those areas

• Not interesting, relevant, novel• Consult with mentors; review literature

• Unethical• Consult with IRB; revise research question

Your Hypothesis

• How can you now re-phrase your study question so that it provides the basis for testing the statistical significance of your research findings?

Study Subjects• Selection Criteria: How are you defining your study

population?– Inclusion criteria: What characteristics must your subjects possess

in order to be considered for your study?– Exclusion criteria: What characteristics will preclude subjects from

being considered for your study?• Sampling: How are you selecting your study subjects?

– What subgroup of your overall study population will be chosen to be your study subjects?

– Will they be randomly selected from a large population or will they be a convenience sample from a smaller more specific group?

Inferences• Internal Validity:

– How well do your conclusions correctly describe what actually happened in your study?

• External Validity: – How well do your conclusions generalize to the population outside of

your study sample?

• Causality: – How well does your predictor variable(s) explain a cause and effect

relationship with the outcome?

Designing Your Study• Outline:

– 1-2 page checklist of the components and sequence of your study

• Protocol: – 5-100+ pages of details used for planning your study and (grant)

application or IRB submission

• Operations Manual: – instructions and procedures that assure quality control and a

standardized approach to implementing your study

Create Your Budget

• Internal budget of actual direct costs and indirect costs

• Tool for project management

• Justification to sponsor of requested amounts during negotiation

• Use for planning and fund allocation throughout project

Informed Consent Document

• Use lay language and appropriate reading comprehension level

• Template usually provided by institution and/or sponsor

Study Protocol Outline

• Research question• Significance• Design• Subjects• Sample size• Variables• Analysis plan

IRB Review• PI presents protocol to IRB

• IRB approves or issues a modification request letter with pending approval– Or denies…

• Modifications are reviewed by PI and research study group– May also need approval by the sponsor

• IRB approval letter is issued

Project Implementation

• Feasibility has been determined

• Continue with protocol review and refinement• IRB and regulatory submissions and • Clinical logistics and setup

– Confidential information and HIPAA compliance if needed

Project Completion

• Close out/finish data entry– Begin statistical analysis

• Return of any supplies, etc.

• Inform the IRB of closure of enrollment

• Final data completion and write up

VCOM Simulation Center & Med Trans Corp. Presentation at the

National Aeromedical ConferenceSept. 22, 2014

Educational Research -“ A Course Model of Recertification for Flight Paramedics and Critical Care Nurses Utilizing  High Fidelity  Simulation, Cadaver Based Procedural Skills and Learning Management System- The Odd Couple: How Partnering with a Medical School Changed our Training”

Collaborative Educational Agreement between Med Trans and VCOM that resulted in integration of simulation into Flight Paramedical and Critical Care Recertification Course. CAMTS approved .This Intellectual property has been accepted for marketing thru Sim Venture a division of the Laerdal Corporation.

Podium presentation by Chris Martin MHS, Tina Fey NREMT-P, Jim Mobley NREMT-P and Fred Rawlins DO FACOEP at The Air Medical Transport Conference (AMTC) scheduled September 22-24 at the Music City Center in Nashville, Tennessee

So What’s Next…..?• This workshop and retreat is designed to give you

the tools to begin or enhance your research career!• Start to think about projects that you and your

colleagues can do• Reach out to faculty at your institution as well as

our other branch campuses• Have fun!

Thank You!