Monday, 30 January 2017

Scholarship gives chance to experience sports medicine

With a history of playing competitive softball, Singapore-born medical student Nina Chua knows too well about sports injuries. “I did a lot of training and as a result had an overuse injury.” So while she visited a sports doctor and physiotherapists during rehabilitation, she did a lot of research. The more she read, the more interested she became in sports medicine.

Nina Chua and Dr Naj Soomro
It’s a very small field and the medicine program doesn’t give students any exposure to sports medicine during their clinical training years. So a summer research scholarship in sports medicine in Mildura offered an opportunity to gain some experience. Nina had been to Monash Rural Health in Mildura during her Year 2 rural placement. “That’s why I was comfortable coming here.”

For two weeks she’s been working on a project with Dr Naj Soomro which explore injury prevention training for fast bowlers in cricket. “I’ve never played cricket, I only learned the rules this week,” she laughed. But she figured it was similar to softball and baseball and was keen to take it on.

The project involved writing a research protocol for an evidence-based cricket-specific injury prevention program, which she and Dr Soomro hope to submit in the Journal of Physiotherapy. During this process she has learnt how to design of a cluster randomised control trial.

The injury prevention program is still under development. Among the first “guinea pigs” were Nina, Dr Soomro and one of the Mildura staff members. “We trialled the program in the hallway which was quite hilarious,” she said. That resulted in some modifications to the program before they took it to weekly training for the cricket team that Dr Soomro plays for. The team’s feedback resulted in further modifications and the altered program will go back to their next training session.

Dr Soomro is a keen advocate of the use of technology in research and plans to develop a website similar to FIFA’s online warm-up program for soccer players. That’s outside the scope of Nina’s two weeks in Mildura, but she’s keen to continue her involvement. This year will be a major one for Nina. She begins her clinical training back in Melbourne and also plays on the Monash baseball team. Squeezing research work into that requires a big commitment. “I’m interested in this and I like it, so it will be fine,” she said confidently. “And I might try out some of this on the baseball team too.”

Friday, 27 January 2017

Crunching numbers to find out why people become GP proceduralists

The main lesson Jeremy Day learned from working in Bendigo on a summer research scholarship project is that research is not always a straightforward process. He started out looking at associations between personality and becoming a GP proceduralist using data from the longitudinal MABEL panel study. “It was promising, but there wasn’t enough association there to produce a really interesting article,” he said. “So we’ve gone on to see if we can find other variables we can add into it.”

Originally from central Queensland, Jeremy moved to Melbourne to study medicine where he completed Year 4C in 2016. “I was getting a bit sick of Melbourne and wanted to do something in the country.” So he applied for a two-week research scholarship in Bendigo.

Having never worked in research, Jeremy wasn’t sure what to expect. “I thought we’d be a bit of a lackey just doing data entry. I’ve been surprised that we get to do lots, and work on our own a lot.”

Research scholarship students work for two or three weeks with Monash researchers on their projects. Jeremy’s supervisor, Dr Deborah Russell, gave him a crash course in statistical analysis software, Stata®, “which can be a bit of a minefield for beginners” according to Jeremy. But it wasn’t the software that proved the most challenging aspect of working on the project.

“My project’s been a bit different [to those other students were working on] because it’s shifted around so much,” he explained. “They’ve worked with very strong guidelines. My literature search for personality turned into a dead end, which is sometimes what happens.” And so the direction of the project changed, though the focus remained on procedurally active GPs.

Jeremy knew nothing about research when he applied for a scholarship. He did know that postgraduate training programs are very competitive. “Research is so important with the way medicine is going; I thought it would be good to get some research experience under my belt.”

The summer research scholarship proved to be a “perfect” introduction to research. Some of his friends have completed a Bachelor of Medical Science (Hons) year. “They’ve had to work on a whole project by themselves and it’s taken a whole year. That was their introduction to research. This is a much better introduction: you get to try before you buy.”

Jeremy’s decided he wouldn’t want to pursue research as a career. “But I definitely want to do more research. It’s been a good experience.”

Wednesday, 25 January 2017

Summer research scholarship tackles rural ED presentations

A two-week placement in the Bendigo emergency department during Year 3B brought Samara Cua face-to-face with the often overwhelming demand on the service and staff feeling that some of the cases didn’t belong there.

While the problem was apparent, a clinical placement didn’t provide any opportunities to explore the reasons. So when a summer research scholarship was offered in Bendigo looking at how to reduce unnecessary presentations to regional emergency departments, she applied without hesitation.

Meeting the services: Samara Cua (front right) met staff at the Maryborough urgent care centre as part of the research project she worked on with Dr Bernadette Ward (standing beind her).

“In my first clinical year, I was interested in learning how to apply theory in a clinical setting,” said Samara. She’d never had any experience with research but was interested to learn how theory-to-practice works in a research setting. “I had a really positive experience in Bendigo in 2016 and thought I might get the same out of research.”

Under the supervision of Associate Professor Rebecca Kippen and Dr Bernadette Ward, Samara researched and wrote a report on the policy environment in which after hour primary health care services have operated from the mid-1990s to the present. “One of the hypotheses is that that [environment] could affect the number of presentations at ED,” she explained. “I learned that you have to be quite patient and persistent looking for the right articles and reading through big documents to tease out exactly what you’re looking for.”

Samara wasn’t tied to her desk for two weeks though. She and fellow students working on this and other research projects toured four health services to learn how they manage after hours and emergency presentations. Bendigo ED was a short walk away, but Mildura involved a long road trip. They also visited Maryborough and Heathcote which have urgent care centres rather than emergency departments. It broadened her understanding of the different approaches taken to provide such services. “I didn’t know about urgent care centres before this,” she said.

She’s also gained an appreciation of other factors that contribute to the problem. “Sometimes other issues within ED might be the cause of blockages and overcrowding. And I’ve learned that politics can determine which services are supported with funding.”

The summer research scholarship is a good way to gain exposure to research and Samara would definitely recommend it to other students. And she’s definitely planning to work on further research projects once she completes Year 4C.

“It ties in well with evidence-based medicine,” she said, harking back to her interest in how theory applies in clinical settings. “With a summer research scholarship you can start learning more about research and what you can do in it as a student and in the future as a doctor.”

Tuesday, 24 January 2017

Learning the research process

Aun Chian Yeoh is used to squeezing extra-curricular interests into his busy schedule as a medical student. An interest in research led to stints working on data collection for short research projects based at Frankston hospital last year. His appetite whetted, he then spent two weeks of his summer break in Bendigo as a summer research scholar working on advanced care planning for primary care patients over 75 years-old.

Bendigo research team: Aun Chian Yeoh with Pam Harvey, Dr Bernadette Ward and Dr Dennis O'Connor

Aun Chian first visited Bendigo with the Year 2 rural program. “Pam Harvey and Michelle Moon did an amazing job showing us around rural health.” Comparing the Malaysian and Australian rural health systems continues to interest him, so, thinking he might not get another rural rotation, he applied to come back to Bendigo for a summer research scholarship working with supervisors Dr Bernadette Ward and Pam Harvey.

While he’s worked on projects after hours, two weeks dedicated to research gave him the chance to learn more about the research process. “I haven’t been involved in the planning process before or defining the research questions and I’m learning this is the tough bit,” he said. “But it’s a skill I wanted to learn.”

Far from spending his days in front of a computer, Aun Chian has also learned more about general practice in regional towns. Sitting in on sessions with Bendigo Year 4C academic coordinator, Dr Dennis O’Connor at the Bendigo Primary Health Centre, Aun Chian been working on over-75 health assessments as this is the cohort research subjects will come from. “Last Friday Dennis put me in a room by myself with a patient,” he said, still surprised at the experience. “This is what’s expected of a Year 4C student!” (Dr O’Connor did keep an eye on him as he would with Year 4C students.)

He’d definitely recommend the experience to students interested in research. “I’m lucky that I’ve been able to learn about the research process and have my contribution appreciated.

“The School of Rural Health staff were very encouraging and friendly, and always there to help. And the clinicians have time to speak to you – even medical students!”