The 411 on Building a Culture of Scholarship (Part I & II)

The 411 on Building a Culture of Scholarship (Part I & II)

December 12, 2017 How to Get Started Producing Scholarly Work Faculty for Faculty for Tomorrow Tomorrow Webinar Series Webinar Series STFM Faculty for Tomorrow Task Force Stoney Abercrombie, MD AnMed Health

Steven Lin, MD Stanford University Paul Larson, MD, MS University of Pittsburgh Paul Gordon, MD, MPH University of Arizona Cathleen Morrow, MD Geisel School of Medicine Mary Theobald STFM VP of Communications

Kelly Jones, MD Univ. of Southern California Dawn Pruett, MD McKay-Dee FMRP Stan Kozakowski, MD AAFP Emily Walters STFM Project Manager Meaghan Ruddy, MA, PHD, The Wright Center for GME

Sonya Shipley, MD University of Mississippi Faculty for Tomorrow is supported by the American Board of Family Medicine Foundation and the STFM Foundation Faculty for Tomorrow Webinar Series Panelists COL Dean Seehusen, MD, MPH Director of Medical Education / DIO Dwight D Eisenhower Army Medical Center Editorial Board, Family Medicine; Chairman of the CERA Steering

Committee Christopher P. Morley, PhD MA Chair, Public Health & Preventive Medicine Vice-Chair for Research, Family Medicine SUNY Upstate Medical University Editorial Board, Family Medicine; Editor-in-Chief, PRiMER Faculty for Tomorrow Webinar Series Comments or Questions? Please use the webinar chat box to submit

questions at any time! Faculty for Tomorrow Webinar Series Audience Poll Im currently a... A.Resident or Fellow B.Medical School Faculty C.Residency or Fellowship Faculty D.Non-faculty Teacher or Physician Faculty for Tomorrow Webinar Series

Educational Objectives By - the end of this talk, learners will be able to: List reasons for residents to do scholarship List Boyers four categories of scholarship Describe scholarship that is of meaningful and practical Apply criteria to a research idea to determine if the project should be undertaken Faculty for Tomorrow

Webinar Series Agenda 1. 2. 3. 4. 5. 6. Review the ACGME philosophy on scholarly activity Review the basics of scholarship and goals of scholarship Define characteristics of scholarship Define Practical Scholarship

Share some tools for generating and evaluating ideas Tips and Tricks from a Research Professional Faculty for Tomorrow Webinar Series Audience Poll What is the #1 reason YOU want to do scholarship? A. It is required in my current position B. Increase my chances of academic promotion C. To improve my own medical practice D. For the intellectual fun of it

Faculty for Tomorrow Webinar Series COL Dean Seehusen, MD, MPH Director of Medical Education / DIO Dwight D Eisenhower Army Medical Center Editorial Board, Family Medicine; Chairman of the CERA Steering Committee Faculty for Tomorrow Webinar Series Why Should Family

Physicians Perform Scholarly Activity Faculty for Tomorrow Webinar Series Our Answers Develop tacit knowledge of the scientific process Faculty for Tomorrow Webinar Series Our Answers Develop tacit knowledge of the scientific process

Learn the language of scholarship Faculty for Tomorrow Webinar Series Our Answers Develop tacit knowledge of the scientific process Learn the language of scholarship Develop comfort with reading medical literature Faculty for Tomorrow Webinar Series

Our Answers Develop tacit knowledge of the scientific process Learn the language of scholarship Develop comfort with reading medical literature Develop critical appraisal skills Faculty for Tomorrow Webinar Series Our Answers Develop tacit knowledge of the scientific process Learn the language of scholarship Develop comfort with reading medical literature Develop critical appraisal skills

Develop the ability to translate scholarship into clinical practice Faculty for Tomorrow Webinar Series Our Answers Develop tacit knowledge of the scientific process Learn the language of scholarship Develop comfort with reading medical literature Develop critical appraisal skills Develop the ability to translate scholarship into clinical practice Putting that all togetherto become better doctors

Faculty for Tomorrow Webinar Series Our Answers Develop tacit knowledge of the scientific process Learn the language of scholarship Develop comfort with reading medical literature Develop critical appraisal skills Develop the ability to translate scholarship into clinical practice Putting that all togetherTrain better doctors Turn a minority of family physicians into life-long scholars Faculty for Tomorrow

Webinar Series Research Participation Pyramid AGENDA SETTER RESEARCH DIRECTOR PRINCIPAL INVESTIGATOR COLLABORATOR UTILIZER CONSUMER

Seehusen DA, Mainous AG 3rd, Chessman AW. Creating a Centralized Infrastructure to Facilitate Medical Education Research. Annals of Family Medicine. In Press Research Participation Pyramid Leadership Generation Translation Seehusen DA, Mainous AG 3rd, Chessman AW. Creating a Centralized Infrastructure to Facilitate Medical Education Research. Annals of Family Medicine. In Press Audience Poll What level of the research participation pyramid are you currently on?

A. Agenda setter/Research director B. Principal investigator C. Collaborator D. Utilizer E. Consumer Faculty for Tomorrow Webinar Series Basics of Scholarship Faculty for Tomorrow Webinar Series

Types of Scholarship Boyers description of scholarship Scholarship of discovery Generates new knowledge utilizing the scientific method Scholarship of application Translating knowledge into practical use Scholarship of integration Taking knowledge from varied sources and connecting them in meaningful ways Scholarship of education Communication of knowledge to learners Faculty for Tomorrow Webinar Series

Boyer, E. (1990). Scholarship reconsidered: Priorities for the professoriate. Princeton, NJ: The Carnegie Foundation for the Advancement of Teaching. Scholarship of Discovery Discovery is foundational Generation new knowledge Should a high priority for residents Direct experience with the scientific method PI/QI done well can be Scholarship of Discovery Faculty for Tomorrow

Webinar Series What are the ingredients of scholarship? Faculty for Faculty for Tomorrow Tomorrow Webinar Series Webinar Series What Counts as Scholarship? Five universal ingredients (steps) of scholarship: Begins with a scholarly question

A systematic search for existing literature Gathering of data Original Existing Analysis and synthesis of the data Presentation of findings Faculty for Tomorrow Webinar Series Case Report Research PI/QI Project

Scholarship of Teaching Begins with a scholarly question What does this How are these case add to the variables related? existing literature? Can "X" outcome be improved by

making "Y" change? What is the evidence-based way to treat this condition? A systematic search for existing knowledge Literature search, discussions with experts

Literature search focused on prior research in the area Literature search, discussions with peers, existing best practices Literature search prioritizing systematic reviews and guidelines

Gather data Collate previous cases, comparing and contrasting Outcomes data Outcomes data Collate data, generated through generated through comparing strength scientific method scientific method of evidence Analyze and synthesize the

data Generate lessons Statistical analysis Analysis (may not Determine best learned, advice for of relationship be statistical) of evidence-based other providers between variables relationship answer and between variables strength of recommendation Present findings

Published paper, poster or oral presentation Published paper, poster or oral presentation Presentation, could result in publication Presentation to learner audience of

choice Barriers to Scholarship Personal interest Personal expertise Mentorship and professional expertise Time Funding Functional information technologies Faculty for Tomorrow Webinar Series Audience Poll

Which of these is the greatest barrier for YOU? A. Personal interest B. Personal expertise C. Lack of access to mentorship or professional expertise D. Resourcestime and/or money E. Functional information Faculty for Tomorrow Webinar Series Practical Research Practice-based Research done everyday

Faculty for Faculty for Tomorrow Tomorrow Webinar Series Webinar Series If You Decide to Do Research. Use your current patient population Or a patient population readily accessible by you Look at something you are already doing Compare outcomes of alternative practice styles Evaluate data that is already being collected Look for previously unrecognized associations

Utilize less rather than more resources Chances are youll have no choice Cleaver study design is the key to inexpensive research Explore practices that could change other physicians practices TOMORROW Faculty for Tomorrow Webinar Series What Do We Know Works? DeHaven et al identified six essentially ubiquitous characteristics of residency programs successful in research: program director support

dedicated time faculty involvement in research (esp. the PD) a formal research curriculum/journal club an easily accessible research professionals opportunities for residents to present their research Faculty for Tomorrow Webinar Series Dehaven MJ, Wilson GR, OConnor-Kettlestrings P. Creating a research culture: what we can learn from residencies that are successful in research. Fam Med 1998; 30(7):501-7. The better the original question, the better the final product

Some Additional Tools Faculty for Tomorrow Webinar Series Three Ideas a Day Do the Math Faculty for Faculty for Tomorrow Tomorrow Webinar Series Webinar Series Three Ideas a Day

If only 1 in 1000 ideas is good: By good I mean leads to a completed project and an associated presentation or publication in the peer-reviewed literature You have one good idea a year Enough to sustain a very busy and successful career If only 1 in 10,000 ideas is great: By great I mean a publication that impacts the way people practice, or the way they think about a topic You have one great idea per decade 2-3 practice changing publications is a highly successful career Faculty for Tomorrow Webinar Series FINER Criteria

F I N E R Faculty for Tomorrow Webinar Series FINER Criteria F Feasible I

Interesting N - Novel E Ethical R Relevant Faculty for

Tomorrow Webinar Series Exercise: Apply the FINER Criteria A resident in a small rural residency would like to investigate whether or not offering $1 lottery tickets to patients in the month of their 50th birthday will increase the rate of colonoscopy uptake within the residencys family medicine clinic population. A local supermarket has agree with donate the ticket in exchange for minimal advertising. Faculty for Tomorrow Webinar Series

Q&A What other questions do you have? Please use the webinar chat box to submit your questions! Faculty for Tomorrow Webinar Series Christopher P. Morley, PhD MA Chair, Public Health & Preventive Medicine Vice-Chair for Research, Family Medicine SUNY Upstate Medical University Editorial Board, Family Medicine; Editor-in-Chief, PRiMER

Faculty for Tomorrow Webinar Series Lets Go Back to the RESEARCH QUESTION This is your FIRST STEP. A good Research Question will Guide Study Design Suggest Methods Will point to necessary data sources & variables and Will be ANSWERABLE A HYPOTHESIS might be part of the research question, although some research questions may be descriptive See: Research questions, hypotheses and objectives, Farrugia et al, 2010.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912019/ Faculty for Tomorrow Webinar Series RESEARCH QUESTIONS The Good, the Bad, and the Ugly GOOD Research Questions Descriptive Study: What demographic and clinical factors predict poor A1C control in low-income patients in our practice? (Retrospective exploratory analysis) Hypothesis Test: Do Low-Income Patients (LIPs) have poorer A1C outcomes in our patient panel, when controlling for other predictors? BAD Research Question

How many of our patients have poorly-controlled A1C? UGLY Research Question How bad is our diabetic patient panel? Faculty for Tomorrow Webinar Series RESEARCH NEEDS Now that you have a research question, use it to help identify: Where you need help (teams should be complementary, not completely duplicative) Your sources of data What you will need to clean and analyze your data Will you need IRB approval? Start early!

Do you have an eventual target journal in mind? (More on this in a second) Faculty for Tomorrow Webinar Series RESEARCH Methods and Team Form your team early! If you need statistical, methodological, or design support, incorporate those individuals as co-investigators from the start. Bad design or poor data collection at the start is often not fixable by adding a skilled methodologist or analyst at the middle or end of a project! You dont like cleaning up after another clinicians mistakes, do you? Andsometimes it is not possible. Keep that analogy in mind talk to methods partners and mentors early in the process.

Partnership is key. Faculty for Tomorrow Webinar Series RESEARCH Methods and Team Statistical analysis: possibly a colleague with a Masters degree (e.g. MPH), but look outside as well Database support: skill set overlaps with, but is not the same as, statistical support e.g. an EHR query writer may know nothing about statistical analysis, and vice versa) Qualitative Analysis: Not all projects involve quantitative analysis. Consider open interviews, focus groups, content analysis etc. Potential Partners:

Grad students or Junior Faculty in Health Services Research, Public Health, Sociology, Medical Anthropology, Psychology, Biostatistics, Economics etc. may all have expertise you needand you have content THEY need! Other residents or residency faculty with background training in these areas Faculty for Tomorrow Webinar Series Targeting Presentation & Publication Do you have a conference in mind? Try writing your abstract ahead of time. These often are short (~300 words), and help visualize the end product of what you are trying to achieve. Look at relevant journal content. Are you answering a question that needs

answering? See the JANE interface at Biosemantics.org: http://jane.biosemantics.org/ Faculty for Tomorrow Webinar Series Faculty for Tomorrow Webinar Series http://jane.biosemantics.org/ Faculty for Tomorrow

Webinar Series http://jane.biosemantics.org/ Faculty for Tomorrow Webinar Series http://jane.biosemantics.org/ Resources Research Methods Knowledge Base: https://socialresearchmethods.net/ Office of Behavioral & Social Science Research: http://www.esourceresearch.org/tabid/36/Default.aspx

Robert Wood Johnson Foundation Qualitative Research: http://www.qualres.org/ Very basic online statistics text: http://onlinestatbook.com/2/index.html Faculty for Tomorrow Webinar Series Take Homes Performing scholarship will make you a better doctor (provider) Five characteristics of scholarship Three ideas a day FINER criteria

Refine your research question Identify and incorporate all team members as early as possible Faculty for Tomorrow Webinar Series Q&A What other questions do you have? Please use the webinar chat box to submit your questions! Faculty for Tomorrow Webinar Series

Post-Webinar Survey We appreciate your feedback! Please complete the brief survey we will send via e-mail. THANK YOU! Faculty for Tomorrow Webinar Series

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