Research and Scholarly Activity Curriculum
I.
Rationale
Research and scholarly activity are increasingly important components of Family Medicine education.
Research and scholarly activity are broadly defined in the context of training family physicians. Research
is a process or activity in which knowledge is tested or developed. Scholarly activity refers to an oral or
written presentation that reflects a thorough and critical collection of knowledge. The audience for
scholarly activity on the part of residents may be faculty, peers, medical students or the public.
II.
Goals
1. Perform an evidence-based and activity-specific literature review and develop an appropriate
outline for a manuscript. (Patient Care, Medical Knowledge, Interpersonal and
Communication Skills, Professionalism)
2. Communicate effectively with a wide range of individuals regarding research and the medical
literature. (Interpersonal and Communication Skills)
III.
Objectives
Attitudes
The resident should develop attitudes that encompass:
A.
A recognition of the importance or scholarly work in family medicine
B.
An appreciation and understanding of the role of research in clinical care
C.
A desire to critically evaluate clinical care as evidence-based
Medical Knowledge
A.
Gain a background in basic research designs.
1.
Research objectives
a.
Exploratory
b.
Descriptive
c.
Analytic
d.
Qualitative
2.
Time frame
a.
Retrospective
b.
Cross-sectional
c.
Prospective
3.
Actions by investigator
a.
Observational
b.
Interventional
B.
Evaluate the components of a research article
1.
Introduction
a. Validity of research questions
b. Relevant literature review
2.
Methods
a. Appropriate sample
b. Familiarity with commonly used statistical tests (e.g., chi-square tests).
c. Measurement of validity and reliability
3.
Results
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4.
a. Complete
b. Consistent
c. Evidence-based
Discussion/conclusions
a. Appropriate
b. Valid
c. Clinical relevant
C.
Learn various modes of written communication.
1.
Review article
2.
Case report
3.
Patient/community education material
4.
Research article
5.
Book groups
D.
Use appropriate resources to complete literature searches.
1.
Use index Medicus or other literature-indexing sources.
2.
Perform a computerized literature search
3.
Critically evaluate a research article
4.
Provide clinical care that is evidence-base
5.
Use audio-visual aids
Advanced Skills
A.
Formulate a research question
1.
Identify a problem or general question to investigate.
2.
Refine the problem so it can be investigated.
3.
Translate the general question into specific hypotheses, recognizing the difference
between research, null and alternative hypotheses.
4.
Establish a clear purpose to the research.
5.
Define variables and terms operationally.
6.
Recognize the difference between independent and dependent variables, when
applicable.
7.
Determine how each variable will be measured, recognize different levels of
measurement.
8.
Evaluate the reliability and validity of a given measurement.
9.
Evaluate variables and their measurement in the area of research.
B.
Design a descriptive and/or explanatory study.
1.
Categorize research designs. (e.g., observational versus interventional, prospective
versus retrospective)
2.
State the purpose, strengths and limitations of each design.
3.
Compare major types of studies, such as case reports and case control studies, crosssectional, longitudinal and epidemiologic studies, clinical trials, survey studies, field
research and evaluation studies.
4.
Explain important threats to internal and external validity as applicable to each study
design.
5.
State the relationship between the chosen research design, the type of data collected
and the necessary statistical techniques.
6.
Prepare for and use design specialist consultation.
7.
Thoroughly analyze the dominant research designs used in the area of study.
8.
Recognize sources or error in the study and methods of minimizing errors.
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C.
Collect and analyze data
1.
Distinguish inferential from descriptive statistics.
2.
Determine the universe, population, appropriate sample, sample size and appropriate
sampling technique for a given study.
3.
Understand the application of commonly used statistical functions. (e.g. chi-square, test,
analysis of variance, correlations and multiple regression)
4.
Construct a plan for managing data files and analyzing data according to level of
measurement and research design.
5.
Be familiar with statistical package (e.g., SPSS) to direct computer personnel in the
proper analysis to use and related decisions. (e.g., how to handle missing data)
6.
Interpret printouts on common analysis from statistical packages for the research area.
7.
Understand how to graphically summarize data. (e.g., histogram, bar graph, pie chart,
frequency curve)
8.
Report results correctly and be able to cite both strength and limitations of the study
based on data.
9.
Prepare for and use consultation with computer analysts and statisticians.
10.
Understand the more advanced statistical tests that may be used in the research area.
(e.g., discriminate analysis, principal components analysis, multiple logistic analysis)
D.
Evaluate and discuss study findings
1.
Explain the outcome of given analysis in terms of the originally stated hypothesis.
2.
Conduct additional literature reviews needed to elaborate on findings and their
implications for a given body of research.
3.
Integrate the research findings with the existing literature by discussing what is known
and unknown and what requires further study.
4.
Express appropriate cautions in interpreting results and base these cautions on
methodological and theoretic conditions.
6.
Place the study in the context of existing research and justify its contribution to
important questions in the area.
E.
Understand how to write a research paper
1.
State the primary purpose of the project.
2.
Explain what is new, different or important about the findings.
3.
List or diagram the primary points of the message and their connections.
4.
Determine the background information. (e.g. facts, definitions, references)
5.
Determine boundaries for the subject: which points or topics are included, which are
excluded.
6.
Implement a system for abstracting/documenting literature and other sources of
information on a topic.
7.
Use frameworks for structuring material. (e.g., diagrams, notes, content outlines, minidrafts in a publication format)
8.
Schedule a timetable for writing that encourages systematic and frequent writing
sessions.
9.
Build in a mechanism for evaluation and revision.
F.
Apply rules of English usage, style and composition for publication
1.
Write in the active voice at the appropriate reading level.
2.
Avoid sex-biased or culture-biased language.
3.
Decode jargon.
4.
Eliminate redundancy.
5.
Avoid both pompous and overly tentative statements.
6.
Use variety in adjectives, notes and verbs, as well as the pattern of sentence structure.
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7.
8.
9.
10.
G.
Allow humor, warmth or other expressions of feeling to surface when appropriate to the
audience/publication format.
Edit for economy of expression.
Sequence arguments, concepts and facts in a logical manner.
Construct graphs, charts, tables and figures according to reference guidelines.
Consider the development of presentations
1.
Speaking
2.
Audio visual aids
3.
Computer-assisted learning
Professionalism
Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to
ethical principles, and sensitivity to a diverse patient population. Residents are expected to:
A. Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and
society that supersedes self-interest; accountability to patients, society, and the profession; and a
commitment to excellence and on-going professional development.
B. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care,
confidentiality of patient information, informed consent, and business practices.
C. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities.
D. Arrive at the clinic in a timely fashion.
E. Work effectively as a member of a team.
F. Respect patient privacy by guarding medical records and discussion of personal
information about patients.
G. Assist patients and their families in planning for future care needs and care
decisions based on prognosis for the disease.
H. Support the patient in their healthcare decisions.
I. Demonstrate professional, respectful demeanor when addressing team members,
patients, ancillary staff, and consultants.
J. Appear professionally dressed and well groomed.
L. Attends required daily conferences and grand rounds.
M. Responds to pages and floor calls in a timely fashion.
Systems-based Practice
Residents must demonstrate an awareness of and responsiveness to the larger context and system of
health care and the ability to effectively call on system resources to provide care that is of optimal value.
Residents are expected to:
A. Understand how their patient care and other professional practices affect other health care
professionals, the health care organization, and the larger society and how these elements of the
system affect their own practice.
B. Know how types of medical practice and delivery systems differ from one another, including methods
of controlling health care costs and allocating resources.
C. Practice cost-effective health care and resource allocation that does not compromise quality of care.
D. Advocate for quality patient care and assist patients in dealing with system complexities.
E. Know how to partner with health care managers and health care providers to assess, coordinate, and
improve health care and know how these activities can affect system performance.
F. Know how evidence based medicine fits into the larger health system.
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Practice-based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate
scientific evidence, and improve their patient care practices. Residents are expected to:
A. Analyze practice experience and perform practice-based improvement activities using a systematic
methodology.
B. Locate, appraise, and assimilate evidence from scientific studies related to their patients' health
problems.
C. Obtain and use information about their own population of patients and the larger population from
which their patients are drawn.
D. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and
other information on diagnostic and therapeutic effectiveness.
E. Use information technology to manage information, access on-line medical information; and support
their own education.
F. Learn to incorporate health promotion and disease prevention into patient care.
G. Use evidence-based medicine, evaluation of available evidence, and use of best available evidence at
morning report meetings and during routine clinical care.
IV.
Instructional Strategies
Assessment of medical research literature is integrated into Emory’s Family Practice residency training
through didactic sessions and a journal club. Production of scholarly work is accomplished by expecting
all residents to deliver at least one scholarly publishable quality document during their residency. All
faculty in the program have basic research knowledge so they can assist the residents as mentors.
Residents have access to other faculty in the Department of Family and Preventative Medicine who are
researchers. Practice of the skills involved in actually conducting research may require utilization of
elective time in the residency program. Residents have four months of elective time.
The research and scholarly endeavor curriculum is a longitudinal one. There is the possibility of each
resident doing an elective in research, if they have a definite research project in mind with deliverables
that can be attained by the end of the elective.
The faculty coordinator for this curriculum is Dr. Ashley Owen, PhD.
Learning Activities
Attending Rounds
Multidisciplinary Rounds
Grand Rounds
Sub-Specialty
Conference
Morning Report
X
Didactics
Other
X
X
Research Conference
Ethics/Comm Conference
Specialty Conference
Noon Conference
X
X
X
Outpatient Clinics
Direct Patient care
Resident Seminar
Journal Club
Faculty Supervision
Procedures
X
Readings
Scholarly Project
A scholarly project is required of each resident prior to completion of the residency. The goal of the
scholarly project is to have the resident demonstrate that they can obtain information, synthesize the
information, and then communicate this information to others. Any of the following may satisfy the
scholarly project requirements: literature review, book chapter, case report with literature review, design
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of a research study, or actual implementation of, or participation in research. These activities are
directed by a research advisor who may be specific for the project, however, the entire program is
directed by one of the family practice faculty and is subject to approval by the program director. The
residents’ progress on their scholarly projects is monitored by their academic advisor. A form
documenting approval and the timeline is in the attached section (Attachment A).
The timeline for the project will be:
The scholarly project must be turned in 60 days prior to the completion of the residency to allow for
comments and rewrites. Failure to turn the project in by this date may cause the resident’s date for
completion of the residency to be delayed.
Attend Family Medicine Thursday morning didactics weekly.
Assessment of actual patients in preceptor's office and on orthopedic service.
Management of actual patients in continuity clinic case discussions.
V.
Evaluation Strategies
The resident will be evaluated on the basis of achievement of rotation objectives by preceptors in the FPC
clinic, the resident’s research advisor, and by the rotation coordinator. The written evaluation will be done
on the FPC Rotation Evaluation Form.
A.
B.
C.
E.
Observation of resident by family medicine preceptors
Observation of resident by research advisor faculty
Attendance at conference series
End of rotation evaluation
Evaluation Methods
X
Attending Evaluation
X
X
X
Program Director
X
Review
360 ᵒ evaluation
Other (Final manuscript)
Directly Supervised
Procedures
In-Training Exam
Morning Report
X
Videotape Review
X
Faculty Supervision
and Feedback
Quarterly Review
Resources
Dans AL, Dans LF, Guyatt GH, Richardson S. Users’ guides to the medical literature. XIV. How to decide
on the applicability of clinical trial results to your patient. Evidence-based Medicine Working Group. JAMA
1998; 279: 545-9
O’Brien BJ, Heyland D, Richardson WS, Levine M, Drummond MF. Users’ guides to the medical literature.
XIII. How to use an article on economic analysis of clinical practice. B. What are the results and will
they help me in caring for my patients? Evidence-based Medicine Working Group. JAMA 1997; 277:18026
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Drummond NF, Richard WS, O’Brien BJ, Levine M, Heyland D. Users’ guides to the medical literature.
XIII. How to use an article on economic analysis of clinical practice. A. Are the results of the study
valid? Evidence-based Medicine Working Group. JAMA 1997; 277:1552-7
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literature. XII. How to use articles about health-related quality of life. Evidence-based Medicine Working
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variations in the outcomes of health services. Evidence-based Medicine Working Group. JAMA 1996;
275:554-8
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IX. A method for grading health care recommendations. Evidence-based Medicine Working Group. JAMA
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to use clinical practice guidelines. B. What are the recommendations that will help you in caring for your
patients? Evidence-based Medicine Working Group. JAMA 1995; 274:1630-2
Hayward RS, Wilson MC, Tunis SR, Bass EB, Guyatt G. Users’ guides to the medical literature. VIII.
How to use clinical practice guidelines. A. Are the recommendations valid? Evidence-based Medicine
Working Group. JAMA 1995; 274:570
Richardson WS, Detsky AS. Users’ guides to the medical literature. VII. How to use clinical decision
analysis. B. What are the results and will they help me in caring or my patients? Evidence-based
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Richardson WS, Detsky AS. Users’ guides to the medical literature. VII. How to use clinical decision
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Laupacis A, Wells G, Richardson WS, Tugwell P. Users’ guides to the medical literature. V. How to use
an article about prognosis. Evidence-based Medicine Working Group. JAMA 1994; 272:234-7
Levine M, WalterS, Lee H, Haines T, Holbrook A, Moyer V. Users’ guides to the medical literature. IV.
How to use an article about harm. Evidence-based Medicine Working Group. JAMA 1994; 271:1615-9
Jaeschke R, Guy att GH, Sackett DL. Users’ guides to the medical literature. III. How to use an article
about a diagnostic test. B. What are the results and will they help me in caring for my patients?
Evidence-based Medicine Working Group. JAMA 1994; 271:1703-7
Guyatt GH, Sackett DL, Cook DJ. Users’ guides to the medical literature. II. How to use an article
about therapy or prevention.. B. What were the results and will they help me in caring for my patients?
Evidence-based Medicine Working Group. JAMA 1994; 271:59-63
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Guyatt GH, Sackett DL, Cook DJ. Users’ guides to the medical literature. II. How to use an article
about therapy or prevention.. A. Are the results of the study valid? Evidence-based Medicine Working
Group. JAMA 1993; 270:2598-601
Guyatt GH, Rennie D. Users’ guides to the medical literature (Editorial). JAMA 1993; 270:2069-7
Oxman AD, Sackett DL, Guyatt GH. Users’ guides to the medical literature. I.
Evidence-based Medicine Working Group. JAMA 1993; 270:2093-5
How to get started.
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Springer, 1990
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Ewigman BG. Fire in the belly: doing what it takes to produce excellent research. Fam Med 1996;
42:199-203
Henry R. Developing research skills for medical school faculty. Fam Med 1997; 29:258-61
Nutting PA, Practice-based research networks: building the infrastructure of primary care research. J
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Starfield B. A frame work for primary care research. J. Fam Pract 1996; 42:181-5
Stange KC. Primary care research: barriers and opportunities. J, Fam Pract 1996; 42:192-8
Berg AO. Practice-based research in family medicine. Kansas City, Mo.: American Academy of Family
Physicians, 1986
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Riegelman RK. Studying a study and testing a test: how to read the health science literature. Boston:
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Web Sites
www.aafp/org/family/research/resource.html
www.fammed/wisc.edu/research/dataset
www.jfp.msu.edu/fammed.htm#research_Rresources
www.fammed.uokhsc.edu/tutor/welcome.htm
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