Growing Research Among Osteopathic Residents and Medical Students: A Consortium-Based Research Education Continuum Model

Research Knowledge and Skills

Although active research is conducted by tenure-track faculty at OU-HCOM, few studies have been conducted in the partner community hospitals in which education is provided by volunteer clinical faculty. Students may have engaged in research involving biomedical science in medical school, but there was a weak research infrastructure to nurture their interest in research once they transitioned to hospitals for clinical rotation and residency.

In my experience, unlike nonmedical scientists who are immersed in research training during graduate school, the majority of osteopathic clinical faculty and residents have little or no research experience and training, and few possess master’s or nonmedical doctorate degrees. Similar situations exist at the CORE OPTI and at other clinical training sites. Novice researchers may find developing a research idea or a full research proposal and applying statistical and research design concepts to the process to be difficult. The education of medical students and residents in basic research concepts fills a tremendous need for broad-based research education as a critical foundation to establishing and growing a culture of research.

Methodologic and Other Support Services

The CORE’s community hospital partners vary in size and resources. A few have access to limited research resources, and most have no access. Methodologists and statisticians are often not available to develop well-designed studies and analyze and interpret data, and hospital staff are not available to monitor research activity, gauge productivity, and oversee compliance. The lack of resources in these areas pose huge challenges and create barriers to the development of a research culture.

Training Physician Research Mentors

The AOA’s research requirements that focus on research conducted by residents instead of physician faculty contributes to an environment of diminished interest in research by potential mentors. In my experience at CORE, focusing requirements on mentors and residents rather than on residents alone provides a more longitudinal approach to creating a sustainable research culture. However, mentor research training depends on hospital resources and faculty interest. Although some physicians are involved in case reports and quality improvement projects, their efforts rarely reach the publication or dissemination stage. Training community-based physician mentors in research and developing their skills can help build the culture of research within the hospital and consortium.

Clinical Research Mentorship Triangle

The CORE Research Office complements and supports the work of physician mentors. A student or resident (implementer), physician mentor (clinical expert), and the research education office (methodologic experts and research mentors) make up a research triangle model (Figure 1). Through this collaborative approach, the research task is less daunting, and the clinical and methodologic soundness of the study is strengthened. The constraints and challenges discussed previously compelled the CORE Research Office’s decision to focus on growing the residents’ interest and skills in research while co-mentoring with physician faculty.

Figure 1.

Clinical research mentorship triangle. The student or resident, physician mentor, and research education office collaborate to achieve clinical and methodologic soundness in research.

Seamless Education

Rivera et al⁴ discovered that residents find research skills to be important in achieving successful completion of a research project. However, “only 19% to 38% felt these skills are thoroughly taught at their residency program.”^4(p367) On inception, the focus of the CORE Research Office was to work with third- and fourth-year students and residents at clinical sites. However, it is my experience that research education has to start with all first- and second-year medical students to provide a seamless transition to the clinical sites. The CORE Research Office has integrated research orientation and training into the student and resident curricula and conducts 1-on-1 consultations in person, electronically, and by phone. This model offers a continuum of customized research education, training, and support for all members of the CORE community—students, interns, residents, fellows, and CORE clinical faculty (Figure 2).

Figure 2.

Timeline of research education and support at the Centers for Osteopathic Research and Education (CORE). Travel and seed funding was provided before the CORE Research Office was established, and 1-on-1 project assistance was provided after the CORE Research Office was established. Opportunities for students, residents, and faculty include Ohio Osteopathic Symposium regional and state poster competitions, publications, and CORE multisite studies; support includes an institutional review board liaison and project tracking.

Research Services

Providing funding for research projects and dissemination is not enough. The CORE Research Office collaborates with novice researchers to develop ideas, design studies, navigate the institutional review board process of assessing studies involving human participants, analyze statistics, interpret data, and offer editorial and dissemination support. Research opportunities are generated by providing project seed funding, partnering on projects, linking clinical mentors with medical students, and creating fellowships with external partners. The chance of approval during the first submission increases when the CORE Research Office’s team of experienced researchers scrutinizes a proposal. Although providing poster templates and editing assistance may seem elementary, this work often makes the difference in enabling researchers to disseminate their research. Travel funding is available to offset researchers’ expenses when presenting at conferences. These individual support services do not create a research culture, but weaving all of them together removes barriers and creates a strong support system on which to build well-designed, successful projects with a greater likelihood of dissemination.

Broad-Based Training

Every student, resident, and clinical faculty member should have hands-on experience in research and scholarly activities regardless of whether they are interested in a dual-degree program. The Centers for Osteopathic Research and Education equips residents with research experience through broad-based training with the goal of increasing the number of physician scientists. These efforts complement the dual-degree program and other research initiatives at OU-HCOM.

Database System

A critical piece in the CORE Research Office’s approach to research education is documentation. An online database was created to track research projects conducted at all levels. Students and residents register each research and scholarly work project with CORE by entering their contact information, mentors, affiliation, and research design in the database. Reports can be generated for administrative, gap analysis, accreditation inspection, and planning purposes. Reports are shared with partner hospitals and residency programs so that they can monitor their own research productivity. This reporting mechanism creates a level of accountability and contributes to the overall research culture growth. In addition, an electronic shared drive is used to house individual student and resident folders so that each member of the CORE staff can access documents as they provide assistance.

Medical Students’ Research Education Program Growth