Reflecting On Experience Presenting In The Diagnostics Portion Of The 2019 CSRT National Conference

Submitted by Mithin Koshy, SRT

Healthcare is a diverse, demanding, and constantly evolving field of practice. This evolution of practice may dissuade some from pursuing a role in it, however for me, the evolution process was something I knew I needed to be involved with. Healthcare is constantly improving its practices through inter-professional research conducted all over the world. I was given the opportunity to present my research in the Diagnostics portion of the 2019 CSRT National Conference and was astonished at the research being presented by my fellow colleagues.

In Canada, 1 in 30 Canadians live with some form of cardiac disease and 10% of the patients undergoing surgical intervention are re-admitted into the hospital within 30 days. As health care professionals, we should strive to improve these statistics. Along with another first-year student, Remiya Varghese, and a Cardiologist from Rochester New York, Dr. Sabu Thomas, we decided to address whether health care providers could be better prepared to treat these patients as they are already at a higher risk for post-operative complications. The meta-analysis that our team conducted was a 9-month long process. We used 8 strategies to identify eligible trials including database searches of MEDLINE, PubMed, EMBASE and the Cochrane Controlled Trials Registry, until December of 2018. Our research looked at the predictive value of pulmonary function tests when it relates to major cardiac surgery. We compared the values of FEV1, FEV, FEV1/FVC with 5 post-operative outcomes (all-cause mortality, hospital LOS, ICU LOS, ventilation time, and major adverse cardiovascular events). Cardiac and pulmonary disease are thought to be strongly related due to the metabolic association of these 2 systems. We hypothesized that an underlying COPD diagnosis would help risk stratify patients undergoing major cardiac surgery to ensure COPD patients get adequate post-operative recovery. Our project yielded positive results and is now in the process of being accepted for publication where we will share the results.

Students may believe getting involved in research will be overly challenging and not worth the time investment required. These thoughts may stem from a lack of experience or an inability to find an immediate supervisor. We should all remember that the limiting factor in getting involved in research is motivation. The possibilities are endless if you have the motivation to get involved. I would like to debunk some of these common myths regarding the presumed challenges to getting involved in research as a student.

Myth 1 – Supervisors do not want to work with students

Most principle investigators are extremely happy to offer students opportunities, whether that is volunteering, or employment. As an undergraduate student I had the privilege of working at the Population Health Research Institute (Hamilton, ON) in the Perioperative Cardiovascular & Neurosurgery and Hyperbaric Medicine departments. The experiences gained are undoubtedly a benefit to career development. To lay this out in health care terms, the benefits greatly outweigh the risks of merely asking a principle investigator for a possible position in research. Clinicians have a responsibility to see health care and research as two intertwined entities and should be pro-active in getting students involved in this process as early as possible.

Myth 2 – Lack of experience may prevent you from conducting research 

You don’t need to be a world-renowned scientist or investigator to conduct a study. All professionals need to be motivated in order to achieve anything. The same can be said for research. Gaining initial experience in a hospital or research institution may be challenging, however volunteer possibilities are endless, and it only takes one supervisor to give you that initial opportunity. There are several forms of research, which also do not require previous experience (literature review). The possibilities are limitless!

Myth 3 – Starting the research process is overly challenging

There is a very structured approach to research, that is easy to follow. The first step is to frame a research question – Students should refer to areas of interest or patient cases they have come across to formulate and investigate this question. The PICO (patient, intervention, control, outcomes) model gives us the easiest method to formulate this question. When engaging in research there is an obligation to be scientifically responsible. It takes a dedicated team of multi-disciplinary members to execute a study which follows scientific integrity. You can gather this team by approaching your librarian, a statistician, professors and medical professionals. The resources available are infinite, so don’t be afraid to ask for help!

Myth 4 – Results from research must show benefit in patient care to be ‘good’ 

A research study that does not support the original hypothesis positively impacts patient care as well. People may be discouraged after finding that their results were not statistically significant, however these studies are just as necessary to improve patient care as studies that do show statistical and clinical significance.

My experiences with this project were nothing short of amazing. To be a student presenter came with all the benefits and challenges of delivering a presentation to professionals much more experienced in the field than myself. I encourage all student and Registered Respiratory Therapists to try and get involved in research at some level, regardless of previous background, initial doubts and any withstanding fears. Whether you are a first-year student, a recent graduate or an RRT for over 20 years, we all can contribute to advancing health care. The standards of care performed today are not what we did 30 years ago, and they are not what we will do 30 years from now.

I am motivated to be part of this future change by contributing to research throughout my career. My journey in research started 7 years ago, and the relationships made, the experiences gained and the patients I have met along the way have been one of the most humbling and rewarding aspects of my life.  I hope that you will choose to take that first step towards improving patient care and healthcare outcomes and embark on the endless possibilities that await!

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