LMMHC Medicine Research rotation B Kanna MD, MPH, FACP Associate Program Director of Internal Medicine Associate Director of Graduate Medical Education for Research

Part I Introduction Goals & Objectives Structure of rotation Required Elements Topics Required reading Research plan

Introduction Research education is a requirement for all residents as per ACGME Research project requirement at LMMHC Research rotation – Educating residents in research – Provides a customized learning experience – Assists in “kick off “ of research ideas

Goals & Objectives The goals of the curriculum in Evidence Based Medicine and Research elective is to ensure that All Internal Medicine residents are able to: 1. Ascertain limitations in their critical appraisal of literature and means to address those deficiencies. 2. Understand the limitations and advantages of original peer-reviewed medical literature. 3. Discuss and understand sensitivity, specificity and predictive values of diagnostic tests, how they are used, and how tests are selected and interpreted; understand the impact of the underlying prevalence of disease on the predictive values (and the interpretation) of a diagnostic test. 4. Understand the meaning of statistical significance and differentiate it from clinical significance. 5.To know the ways to evaluate risk and prognosis, including the differences between observational study designs such as cross-sectional, case-control, and cohort studies. 6. Understand the anatomy of the randomized control trial, its strengths and weaknesses; discuss the importance of power and the number-needed-to-treat in the interpretation of a treatment. 7. Comprehend if a treatment actually works or not based on the medical literature; Adapted and modified for our residents from Ref:

Structure of rotation 2 week rotation Could be repeated based on assessment & needs Rotation supervisor Mentor No clinics Calls as per Schedule Holidays off ACGME competency based evaluation

Elements of the rotation Critique of a study – Recent – Randomized trial – Area of interest Research topics review – Research module test Designing a study – Initiate and organize a study plan

Research Topics review 1.p-value 2.Confidence Intervals 3.Odds ratio & Relative risk 4.Study designs 5.Number needed to treat & Number needed to harm 6.Sensitivity, specificity, PPV, NPV 7.Measures of central tendency- mean, median, mode 8.How to critique an article with randomized controlled trial 9.Bias 10.Confounding and how to analyze the effect of confounding in studies 11.How to write a research protocol

Required reading Available in a research rotation binder Will be based on critique of literature

Resident research portfolio Research portfolio meetings annually Research rotation elements to be completed Case reports QA/PI projects Publications Research presentations – LMMHC – Local/regional – National Designing a study – Protocol – Time lines – IRB approval – Research assistant / volunteer support available