Title: Research Associates Programs
1Research Associates Programs
- Frank Illuzzi, MD, FACEP
- Melanie Dabakis, BS
- Ryan King, BSEE
- Ankur Talati, BS
- Jenna Turocy, BS
- Keith Bradley, MD
- St. Vincents Medical Center
2Research Associates (RA) Programs
- Obstacles to research in the ED
- "Once upon a time "
- An answer to some of these obstacles
- RA programs
- Keys to success
- Future
3Obstacles to Research in ED
4Obstacles to Research in the ED
-
- I was too busy
- Not my job
- All you have to do is this one more, little
thing - 24/7
- carrot and/or the stick
5"Once Upon a Time"
- Lincoln Medical and Mental Health Center
- South Bronx, NY 1993
- Emergency Medicine residency program
- Tremendously motivated faculty, residents and
staff - No clinical research papers in 12 years
- Why?
- 165,000 patients per year
6An Answer to Some of the Obstacles to Research
- Needed
- bright, motivated individuals
- primary responsibility research
- focused experts on the details of the research
- on-site in the
- 24/7 ED
- available in large numbers
- "free
- willing to be paid with something besides
money - Who did we get for the job?
7An Answer to Some of the Obstacles to Research
- Needed
- bright, motivated individuals
- primary responsibility research
- focused experts on the details of the research
- on-site in the
- 24/7 ED
- available in large numbers
- "free
- willing to be paid with something besides
money - Medical Students!!!
8Research Associates
- Is there a practical difference
- in the ability to collect
- focused clinical research data
- between
- today's freshman medical students
- vs.
- themselves one year prior as college seniors?
9Research Associates
- If not, is there a practical difference
- in the ability to collect
- focused, clinical research data
- between
- today's freshman medical students
- vs.
- themselves one year prior as college seniors
- juniors sophomores freshman?
10Research Associates
- Functions
- subject identification
- demographic and historical information
- physical parameters
- read informed consent
- facilitate the research
- stuff
11Research Associates Programat Lincoln
- Process
- recruited from local colleges
- Fordham University
- Lehman College
- Manhattan College
- Mount St. Vincents
- Columbia University
- Iona College
12Research Associates Programat Lincoln
- Process
- recruit from local colleges
- orientation sessions (8 hrs. / weekend day x 2)
- basics of clinical research
- ethical issues
- safety
- volunteer duties
- specifics on data collection for each study
13Research Associates Programat Lincoln
- Process
- recruit from local colleges
- orientation sessions
- a four hour shift / week / academic semester
- faculty evaluation of RAs from each shift
- letter of evaluation from program director
14Do RA Programs Work?
- Lincoln
- first semester, 38 RAs covered ? 80 of 24/7
- by the end of two years, gt 60 RAs per semester
- Bradley K, Osborn HH, Tang M.
- "College research associates a program to
increase emergency - medicine clinical research productivity."
- Ann Emer Med, September 1996.
15Do RA Programs Work ?
- Lincoln
- Studies 1995-1996 w/RA assistance
- Asthma/Cocaine 112 subjects enrolled
- Window Guards 1088 subjects enrolled
- Ankle 350 subjects enrolled
- 9 page data form
- Chest Pain Evaluation limited to subject ID
- TB studies requiring
- CMV Meningitis universal precautions
16Do RA Programs Work?
- Bridgeport Hospital
- Studies
- enrolled
- Troponin T 856
- QT-Prolongation with Erythromycin 63
- CUPID ECG Analysis 100
- 1019
17Do RA Programs Work?
- Bridgeport Hospital
- Studies
- enrolled
- C-Spine X-ray Clearance Protocol 102
- Influenza Vaccine in the Elderly 134
- ED Follow-Up Telephone Calls 113
- Antibiotic Use in Children 377
- 1743
18Do RA Programs Work?
- Bridgeport Hospital
- 1 Health Screening Studies
- enrolled
- Womens Health Screening 2676 including
domestic violence questions - AMAs Firearms Risk Assessment 3370
- AHAs Cardiovascular Risk Assessment 3276
- 9,322
19Do RA Programs Work?
- St. Vincents Medical Center
- Cancer Screening Studies
- enrolled
- American Cancer Society recs. 3644
- Cervical and Breast Cancer 2589
- Prostate Cancer 521
- Tobacco Cessation 3125
- Colon-Rectal Cancer (to date) 1091
- 10,970
20Do RA Programs Work?
- 20-50 RAs per semester during the school year
- ? 20-45 RAs from around the country
- for each summer semester
21Do RA Programs Work?
- 24,441 subjects
- entered in research protocols by RAs
22Do RA Programs Work?
- Sustainability
- RAs continue providing service from successful
studies - (e.g., at St.Vincents
- cervical, breast and prostate cancer screening
- and tobacco cessation)
- To date, 2112 patients and visitors received such
service - e.g., 245 additional CT Tobacco Quitline
referrals
23Do RA Programs Work?
- To date,
- Research and Service interactions with 26,553
patients and visitors - with
- Cost 0
- Patient complaints about RAs 0
24RA Programs
- Benefits?
- research is done effectively, efficiently, while
minimizing impact on clinical care - RAs get clinical exposure and research experience
- Advisers have a guaranteed evaluated clinical
experience for their students - Win-Win-Win
25RA ProgramsKeys to Success
- From the Medical Side
- preparation and organization
- dedicated director
- principle and associate investigators
- buy-in by faculty and residents
- enthusiasm
- welcoming
- teaching
26RA ProgramsKeys to Success
- From the College Side
- linkage with health professions advisor
- identifying target audience
- recruiting lecture and materials
- advisor early warning of any problems
- receive letters of evaluation
- synergy
27Chief RA
- undergraduate degree already completed
- applying to medical school
- Program Director's assistant for the academic
year - first port of call for RAs' on-line issues
- involved in all aspects of clinical research
- attends didactic sessions and research meetings
- is the principal or associate investigator on a
study
28Chief RA
- To date 18 CRAs
- 12 accepted to medical school
- 6 in the application cycle
29RA Program Development
- ? research requirements
-
- ? financial and personnel resources
-
- ? clinical pressures
-
- need for innovative solutions
- ?
- Research Associates Programs
30RA Program at St. Vincents Medical Center
- 65,000 patient visit ED
- largest ED in largest city in CT
- diverse patient population
- residencies and fellowships
- major teaching affiliate of
- University of Connecticut School of Medicine
31RA Program at St. Vincents Medical Center
- Focus of studies on 1? care screening in ED
- ? each RA sees a large number of patients
- Provides an evaluated clinical experience for
large numbers of pre-health professions students - School year RAs from local colleges
- Summer RAs from around the country
32Starting a Research Associates Program
- Guarantee clinical experience for large numbers
of pre-health professions students - Linkage with local medical centers with
- value added free research workers
- residency programs in any specialty must do
research - hospitals without residencies need data
collection for quality improvement programs
33Think of These Numbers
- gt 1/2
- half the U.S. population goes to an emergency
department each year as a patient or visitor - 3.3
- - Average number of hours in an ED visit
- ? 500,000
- college students and post-bacs interested in
medical school
34Think of This Number
- 60 million
- potential work hours
- if pre-meds served as RAs for one 4-hr shift per
week - in the nations emergency departments
- helping patients and visitors
- with their primary health care issues
35What Would Coca-Cola Pay?
- Access to ½ the people in the U.S.
- For several hours each year
- With a work force numbering hundreds of thousands
of bright, committed people - Eager to work millions of hours for compensation
other than money
36Future
- RAs as primary health care screeners
- RAs moving health care forward through clinical
research - RAs as a preparatory step for careers in the
health professions
37Watch ER on TVand guess what its like Be a
Research Associate in the Emergency Department
and know the reality.
38If You See the Potential
- www.RAProgram.org
- - program details and application materials
- Fall semester 2009 orientation sessions
- Saturday and Sunday, 3 and 4 October
- Keith Bradley, MD
- Director, Research Associates Program,
- KeithBradleyConsult_at_gmail.com
39