Get Involved in Research

This article goes through the various types of research and how students can get involved.

 

Introduction

The world of research can seem so big and there’s so much scope for different kinds of research. What exactly does it involve? There are many different things you can do: clinical trials, biological experiments, surveys, articles and what on earth is the difference between quality improvement and an audit?

This article aims to help clear some of these answers up and give you an overview of the main research methods and what they involve which should help you place whatever research you are currently undertaking in the broader scheme of academia, as well as helping you decide what kind of research projects you might want to get involved in in future.

 

What is Research?

Research is simply solving problems by gathering data and information in an organised way to advance knowledge on a topic.

Formally gathering information on a topic can be carried out in different ways:

1. Opinion piece: An opinion piece may take the form of an article. This is similar to an essay with an introduction, your points backed with evidence on a topic and then a conclusion which may call people to action.

2. One patient/event: Information can be gathered from one patient or one event which would be called a case report or case study.

3. Biological process: Information can be gathered through mechanistic studies designed to understand a biological process, the pathophysiology of a disease, or the mechanism of action of an intervention.

4. Original clinical research: Some students conduct original research by producing and collecting data from research control trials, surveys or cross-sectional studies and write this up in a formal manner.

5. Collate existing data: Alternatively, you may choose to collate existing information to summarize the field on a topic using already-published research control trials. This is called a review article, and this forms the highest quality of evidence (systematic review or meta-analysis)

 

Special Cases

Audits and quality improvement projects are not considered strictly as research. They do however employ principles of research such as a need for ethical considerations and using the appropriate methods. QI and audits both look at healthcare standards and aim to improve them.

 

Types of Primary Research and their Purpose​

 

 

The first step to conducting your own research is actually understanding what the different types are. Most people only think about scientific longitudinal experiments – whilst these are great, they take a lot of time to do and you may get negative results. There are many easier types to get involved in which are equally as fruitful. To make it easy for you, we have summarised the different types below:

1. Editorials​

This is one of the shortest and least time consuming types of research.

Purpose: It aims to provide an opinion which is supported with evidence on a certain topic

 

Time and Effort

Will take approx. 3 full working days:

1. One day planning research and collecting evidence.

>2. One day for write up of 1000-1200 words.

3. One day for admin work involved in submitting the article to the journal.

 

How to get involved

1. Find a journal that you want to submit an editorial to.

2. Look at their style of editorials.

3. Look at the guidelines for authors for that journal.

4. Find a topic to write about that you like.

 

Examples

Author guidelines for the British Journal of Hospital Medicine:

https://www.magonlinelibrary.com/pb-assets/HMED/Authorguidelines/BJHM_instructions_author.pdf

Example editorial:

www.bmj.com/content/367/bmj.l6594

 

2. Mechanistic Studies​

This is a type of original research. Original research papers are based on the analysis and interpretation of data that you collect, whereas review articles analyse other published research and attempt to summarize all the literature on a topic.

Purpose: These studies are designed to understand a biological or behavioural process, the pathophysiology of a disease, or the mechanism of action of an intervention.

Time and Effort

The process from idea to write up can take years

You may be able to contribute a shorter period of your time to help with a project that a team of academics are working.

 

How to get involved

Finding a good project with a keen supervisor is the main part of doing a mechanistic study.

As a student you will need a lot of guidance and these can be best done over a long period of time. For example, if you choose to do an intercalated year.

 

Examples

Example Questions:

“How does X disease cause damage to the body?”

“What is the mechanism of action of this drug on cells?”

https://www.ncbi.nlm.nih.gov/pubmed/26797725

 

3. Case Reports​

This is a detailed report of a patients’ symptoms, signs, diagnosis, treatment and follow-up.</h4>

Purpose: It usually describes an unusual or novel occurrence that provide valuable clinical lessons.

 

Time and Effort

Less than a week: 1000-2000 words

The longest aspect of this is gaining all the data about the patient and obtaining consent. Once you have all the investigations, results and have completed treatment, the write-up is very straightforward, especially if you have been keeping notes throughout.

 

How to get involved

Finding case reports may be opportunistic. If there is a particularly interesting case ask a more senior doctor if they will supervise your write up.

Alternatively, you can ask doctors and they may have cases waiting to be written up which you could offer to help with.

Key is to be proactive – don’t be afraid of asking. Many new conditions are found by writing up new cases – so you are potentially doing something positive for the world.

 

Examples

Read the BMJ case report guide and an example by clicking on the following links:

BMJ case report guide

BMJ example case report

 

4. Cross Sectional Studies and Surveys​

These are types of observational studies that analyse data from a population, or a representative subset, at a specific point in time.

Cross-sectional studies are also known as a transverse study or a prevalence study.</span></h4>

Surveys are another method to gather this data at a point in time.

 

Time and Effort

 

Varies depending on if you start it from scratch and how much help you get from other people eg. supervisor.

 

How to get involved

It may be easier to think this kind of study up yourself. If you think of a good question you might like to answer. Perhaps you could do an

NHS staff survey e.g. Association between work satisfaction and extra hours worked.

Once you have thought of an idea consider getting somebody senior to supervise your project for guidance.

 

Examples

5. Case-control, cohort studies and RCT’s​

The case-control studies identify a group of individuals who had developed the disease (the cases) and a comparison of individuals who did not have the disease of interest (controls). The cases and controls are then compared with respect to the frequency of one or more past exposures.

Cohort studies identify people exposed to a particular factor and a comparison group that was not exposed to that factor and measures and compares the incidence of disease in the two groups.

Randomized control trials (RCT’s) test the effectiveness of an intervention and are considered the highest level of evidence for causality. It does this via random sorting of subjects into a experimental group (with intervention being assessed) and control group (placebo or no intervention).

 

Time and Effort

These studies are in two parts. There is data collection and analysis, which takes up a significant amount of time and there is the write-up which may take comparatively less time.

<h5>These are big projects and before taking on a project ask your supervisor for rough timescales and be clear about which aspect they want you to get involved in (e.g. Data collection, analysis or write-up?)

 

How to get involved

1. Find a supervisor with a good project going. Find out whether you will receive credit for your contribution (THIS IS VERY IMPORTANT)

2. Find out exactly how far through the overall project they have progressed. If they are still at the data collecting stage, this could take over a year.

3. Find out how they plan to analyse the results. Many use complex statistics so make sure you can actually do it.

4. Make sure you are interested in the topic!

 

These are the main types of primary research, which really underpin all of modern science. However, if you are looking to do research or get a publication, keep in mind that there are many more ways of doing this, often more time saving and easier to do. Read on to learn more about these…

Other Projects

Research doesn’t always have to be about discovering the next drug, or finding a significant result. There are many other ways of demonstrating that you are interested in the academic aspect of medicine. These are often a lot easier to get involved, since they need less training, ethical approval and time involved. For people doing research for the first time, they are a great place to start or do alongside a primary research project.

 

1. Review Articles

These articles form valuable literature as they summarize the science of a topic allowing people to form an idea without them having to read all of the published work on the topic. They involved conducting a literature search of some kind on a scientific database, searching through that, collating the information and then, most crucially, drawing your own conclusion which may offer a new veiwpoint on the current data out there.

There are a few different types of review articles:

a) Literature/narrative review explains the existing knowledge on a topic based on all the published research available on the topic. They involve a general search without specific search criteria of all the data on a particular topic and then a collation of the relevant information.

These type of reviews such as a dissertation form the introduction or foundation for research projects.

b) Systematic review searches for the answer to a particular question by summarising all the existing scientific literature on a topic that fits into pre-specified eligibility criteria. These have specific search key-words and exclusion criteria. The hardest  step it to sieve out all the articles which do not satisfy the criteria. After that you can proceed in the normal way like a narrative review.

c) Meta-analysis: uses statistical procedures to compare and combine the findings of previously published studies, usually to assess the effectiveness of an intervention or mode of treatment.

 

Time and Effort

Literature/narrative reviews can be done over a few weeks.

Systematic reviews require more vigorous methods than literature reviews and as a result can take 6 months to 2 years. The more authors involved the less work it will be for you individually.

Meta-analysis takes the systematic review one step further by using statistical methods to summarise the results of the studies. This requires you to learn statistical skills. Takes over one year.

How to get involved

Ideally, start with a literature review. To do this read lots of scientific literature to get a flavour of scientific writing and how to do a literature review. Literature reviews form the background information or introduction section of most original research papers.

Then if you are feeling ambitious you can find a systematic review through talking to doctors or perhaps you have peers who need a helping hand.

Before engaging with a systematic review have a clear plan and timeline for each person involved to make the process smoother.

Examples

2. Letter to the editor

This is a short review of an existing publication that is critical of some aspect of the original paper.

Purpose: Though articles are heavily vetted before publication many journals have a letters section where readers can point out misleading material or errors by writing a letter to the editor. Letters must be concise and have a clear purpose and message.

Time and Effort

Can be done in one evening

350 words approximately

 

How to get involved

1. Look through a journal that covers topics that you are interested in.

2. Find a paper which you think there is a flaw in the conclusions or analysis.

3. Write a letter to editor in line with the journal’s guidelines.

Examples

Letter to the editor example:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387381

 

3. Audits

Whilst not strictly research articles, audits and quality improvement projects provide a great opportunity to demonstrate your interest in academic medicine and improvement of services. In addition, they provide another chance to get published or do posters presentations at conferences.

Audit: An audit assesses if a certain aspect of health care is attaining a recognized standard. An audit cycle then involves taking action to bring practice in line with these standards and measuring if there has been a change.

Quality improvement (QI): Audits are more clinically focused whereas quality improvement focuses on more holistic issues such as availability of hot drinks in A&E. QI projects use the plan-do-study-act (PDSA) method.

Therefore, QI and audits are essentially the same thing in that they both look at healthcare standards and aim to improve them. They differ in the methods they employ (audit cycles versus PDSA cycle) and audits tend to be more clinically focused.

It is clear that there are many many options for research and getting publications. The key is starting early and just being dedicated. Read on to discover our final tips on how to get involved in research…

 

Time and Effort

Often there will be two or three people working on an audit and some can be very quick (few days) whereas others may take months to complete a cycle.

The key thing to remember that a full audit can involve many rounds. First you collect data, then stage an intervention, then 2nd round of data collection and analysis.

Therefore we would advise you give yourself at least 6 months to complete a full audit.

 

How to get involved

The best places to find audits and QI projects are GP surgeries of healthcare organisations. These are constantly looking into improving the quality of their services. Make sure sure you have access to the data and a supervisor.

For a more detailed guide:

How to conduct an audit and QI project

 

How to get started in research?

 

There are many different ways to get started in research:

1. A good place to get started if you are on your own is by writing letters to editors. (see previous page). By doing this you will get an idea of the style of writing that people use in research. You will gain an idea of how journals work and the different kinds of publications and research that exists.

2. Make opportunity in your student selected components to get projects.

3. Google the consultants on your ward. Ask for projects of ones which are involved in research.

4. Junior doctors are often doing audits for their appraisals and are sometimes looking for extra help.

5. Doing an intercalated year out will enable you to carry out longer term research projects if you wish to do so.

 

Focus on the 3 P’s

First of all, what do the 3 P’s (posters, presentations and publications) mean?

1. Poster presentations are used in the academic community to summarize information from research to help publicise it and generate discussion. They are often displayed at conferences

2. The best research projects are selected for oral presentations at conferences as a way to publicise your research.

3. Lastly research may be published in an academic journal or book. This is important as good research gets added to scientific literature that other scientists can use and cite in their own research.

 

Don’t just apply to the best journals

BMJ information for authors

The Lancet

Nature Medicine

BMC Medicine

British Journal of Hospital Medicine

… this is a list of the top and most competitive journals. There are so many more! Do a google search of your specialty to find the best journal for yourself to submit to. Remember, any journal is worthy if you can get a PUBMed ID from it, so make sure you check this out before submitting your piece of research.

 

Focus on getting posters and presentations

You can gain a poster or oral presentation by submitting to subject specific conferences: Look out for conferences in your area or ask around/google conferences that may be specific to your subject. Traditionally, the hierarchy of recognition that you gain from conferences depends on whether they are local, national or international conferences.

Make sure you don’t miss the opportunity to present the hard work you have done, submitting to conferences is the easy bit! Usually they will have an online application form requiring some details of the authors and your abstract. For academic foundation programmes, each publication is worth 2 points, but keep in mind that each presentation is also worth 1. So no matter whether you are presenting your research, a small poster, or even an abstract, these are easy ways to get much needed application points.
 

Siimran Goyal
University of Cambridge

About The Author

Simran is a recent graduate from the University of Cambridge who will be working as a junior doctor in London.