Demystifying Research for Medical and Healthcare Students

Demystifying Research for Medical and Healthcare Students
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[b]DEMYSTIFYING RESEARCH FOR MEDICAL & HEALTHCARE STUDENTS All healthcare students need to understand research methods to be able to understand research articles and to actively engage in research where necessary. Most clinical programs include research training within their courses, and many students are required to undertake an assessed research project—both at undergraduate and postgraduate levels. Breaking down the jargon barriers of research methods, and designed for those new to the world of research, Demystifying Research is a straightforward and highly accessible guide to fundamental research methods, approaches, and skills. This student-friendly resource describes quantitative and qualitative research approaches, mixed research methods, research ethics and governance, research skills and more. Step-by-step, students learn to appraise research in scholarly articles, design a project, and conduct research in the lab, in clinical practice, and other real-life situations. Technical jargon and classic research are explained in plain English, while relevant theory is illustrated through relatable examples of research in practice. Designed to make learning about research easy, this valuable guide: Explains basic research methods in a direct and engaging style Breaks research methods down into manageable, easy-to-digest pieces Defines what research is, and provides an overview of its methods and methodologies Covers all key areas of research, including observational and experimental approaches, and clinical trials Includes real-life examples of successful student research projects Features a companion website containing lecture slides available to download in PowerPoint Demystifying Research is a must-have for undergraduate and postgraduate medical, nursing, other healthcare and social sciences students, as well as professionals looking to refresh their knowledge.

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John L. Anderson. Demystifying Research for Medical and Healthcare Students

Table of Contents

List of Tables

List of Illustrations

Guide

Pages

Demystifying Research for Medical & Healthcare Students. An Essential Guide

Preface

About the Companion Website

CHAPTER 1 Introduction: What is ‘Research’? The Aims of this Book

What is ‘Research’?

How Early Do we Start ‘Researching’?

But What Makes our Research a Science?

OK – So we all Do ‘Research’ but I Am Not Good Enough to Do Meaningful Research

Overview of Research Methods. Introduction

Quantitative Approaches

Observational or Non‐experimental Approaches

Experimental Approaches

Qualitative Approaches

Mixed‐Methods Approaches

The ‘Sciences’ of Research

Ontology

Epistemology

Methodology

Methods

To Sum Up

Final Word

References

CHAPTER 2 Experimental Quantitative Approaches: Laboratory Experiments. Introduction

The ‘Logic’ of the Experimental Approach

A Basic Experiment

Experimental Designs

Using Yourself as a Guinea‐Pig

Why Have a Control Group?

The ‘Hawthorne Effect’

Example 1: Martin Seligman's Learned Helplessness Experiments

Note about Giving Electric Shocks to Student Subjects in Research

Example 2: My Own Experiment

Randomisation

To Sum Up

References

CHAPTER 3 Experimental Quantitative Approaches: Real‐Life (Field) Experiments. Introduction

Example 1: The Nineteenth‐Century Cholera Epidemic in London

Example 2: The Paddington Station Experiment

Example 3: Urban Sound Planning in Brighton and Hove

Example 4: An Experiment to Examine T2DM Decision Making

Example 5: Reduction of Postoperative Pain by Encouragement and Instruction of Patients

To Sum Up

References

CHAPTER 4 Experimental Quantitative Approaches: Non‐randomised Clinical Trials. Introduction

Phase 0 Clinical Trials

Phase I Clinical Trials

Phase I Clinical Trials in Oncology

Phase II Clinical Trials

Safety in Clinical Trials

TGN 1412 Trial

Fialuridine

BIA 10–2474 Trial

Why Do People Take Part in these Trials?

To Sum Up

References

CHAPTER 5 Experimental Quantitative Approaches: Randomised Control Trials. Introduction

Equipoise

RCT Research Design

Blinding

Example 1: Streptomycin treatment of pulmonary tuberculosis

Example 2: Randomised, prospective, single‐blind comparison of laparoscopic versus small‐incision cholecystectomy

Example 3: Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear

Discussion

To Sum Up

References

CHAPTER 6 Observational Quantitative Approaches: Cohort Studies. Introduction

Example 1: The 1946 National Birth Cohort (MRC National Survey of Health and Development)

Example 2: The mortality of doctors in relation to their smoking habits – a preliminary report

Example 3: The Framingham Heart Study

Example 4: Psycho‐Social Aspects of Breast Disease and Its Treatment

Sampling in Cohort Studies

Data collection

Issues around Recruitment and Retention

Pros and Cons of Cohort Studies

Physical Activity and Risk of Ovarian Cancer: A Prospective Cohort Study in the United States

Critique

Beware!

To Sum Up

References

CHAPTER 7 Observational Quantitative Approaches: Case‐Control Studies. Introduction

Example 1: Smoking and Lung Cancer

The Case‐Control Study Approach

Example 2: Depression and disability in people with podoconiosis

Measuring Your ‘Suspect Variable’

Uses

Matching Cases and Controls

To Sum Up

References

CHAPTER 8 Observational Quantitative Approaches: Cross‐Sectional Studies (Surveys) Introduction

Example 1: Life Before Death

Example 2: Health and Sickness: The Choice of Treatment: Perception of Illness and Use of Services in an Urban Community

Example 3: Musculoskeletal Injuries in Real Tennis

Questionnaires and Interviews

Telephone and Online Interviews

To Sum Up

References

CHAPTER 9 Observational Quantitative Approaches: Cross‐Sectional Studies – Other Types of Study. Introduction

Example 1: Patients’ Recall of Information In a Rheumatology Out‐Patient Clinic

Using Cross‐Sectional Approaches Instead of Cohort Studies

Example 2: An Exploration of Listening Concepts in UK Medical Students

Example 3: A Study of the Use of Complementary and Alternative Medicines by Breast Cancer Patients

Studies of Patients’ Records

To Sum Up

References

CHAPTER 10 Qualitative Ethnographic Approaches: Using Participant Observation. Introduction

Example 1: Crime and Custom in Savage Society

Example 2: Street Corner Society: The Social Structure of an Italian Slum

Example 3: Boys in White: Student Culture in Medical School

Example 4: Being Sane in Insane Places

Discussion

Problems of approach

To Sum Up

References

CHAPTER 11 Qualitative Ethnographic Approaches: Using Interviews and Focus Groups. Introduction

Interview methods

Example 1: ‘A comparison of HIV‐related risk behaviour and risk reduction between female street working prostitutes and male rent boys in Glasgow’ and ‘HIV‐Related Risk Practices among Glasgow Male Prostitutes: Reframing Concepts of Risk Behaviour’

Example 2: Traditional Beliefs about Respiratory Infections in Children in a Rural Area in Southeast Nigeria

Focus Groups

Focused Ethnographic Study (FES) of ARI

To Sum Up

References

CHAPTER 12 Qualitative Ethnographic Approaches: Autoethnography. Introduction

Example 1: Studying Medicine with Dyslexia: A Collaborative Autoethnography

Types of Autoethnography

Example 2: Ulcerative Colitis: An Autoethnographic Case Study

The Method

Example 3: Being An Echocardiographer in the UK NHS: An Autoethnographic Study

Autoethnography vs. participant observation

To Sum Up

References

CHAPTER 13 Qualitative Approaches: Phenomenology. Introduction

Two Main Schools of Phenomenology

Descriptive Phenomenology

Interpretive Phenomenology

Example 1: The lived experience of postpartum depression: a phenomenological study

Example 2: The experiences of medical students with dyslexia: an interpretive phenomenological study

Example 3: Coping with Medical School: An Interpretive Phenomenological Study

To Sum Up

References

CHAPTER 14 Qualitative Approaches: Grounded Theory. Introduction

Grounded theory: an overview

Example 1: Handling Hopelessness –Doctor–Patient Interactions in Phase 1 Oncology Trials. Introduction

Methods

Results

Revision of Theory

Study Conclusions

To Sum Up

References

CHAPTER 15 Mixed Methods: Case Study Methods. Introduction

Case studies: an overview

Example 1: First clinical use of penicillin

Example 2: First Case of 2019 Novel Coronavirus in the United States

Case Series

Example 3: Coping with Medical School

Case 1: ‘Amy’

Case 2: ‘Jess’

Case 3: ‘Ryan’

To Sum Up

References

CHAPTER 16 Mixed Methods: Policy Analysis. Introduction

Analysis of an Existing Policy

Example 1: The Discovery of Hyperkinesis: Notes on the Medicalisation of Deviant Behaviour

Analysis of a Proposed Policy

Example 2: School Closure and Management Practices during Coronavirus Outbreaks Including COVID‐19: A Rapid Systematic Review

Methods

Results

To Sum Up

EXERCISE

References

CHAPTER 17 Mixed Methods: Multi‐Stage Studies. Introduction

Example 1: The Experiences of Medical Students with Dyslexia

The experiences of medical students with dyslexia: An interpretive phenomenological study

The Experiences of Medical Students and Junior Doctors with Dyslexia: A Survey Study

Example 2: An Experiment to Examine T2DM Decision Making

The Survey

The Experiment

To Sum Up

References

CHAPTER 18 Research Ethics and Governance: The Need for Regulation. Introduction

Guiding Principles

Past Abuses in Research. Let's Start at World War II

The Tuskegee and Guatemala Syphilis Studies

Guatemala Syphilis Experiments

Drug Testing in the Third World

Generally

Clinical Trials (Phase I Trials)

Falsification in Research

Corruption in research? Not in our time???

A Swine Flu Conspiracy?

Fraud in Research

International Regulations and General Principles

The Declaration of Helsinki

To Sum Up

References

CHAPTER 19 Research Ethics and Governance: Regulations, Approvals, and Permissions. Introduction

Research vs Practice

Not all Research Activities are Classed as Research by the HRA

Research Sponsorship

Chief/Principal Investigator (CI/PI)

Research and Development Departments (R&D)

Example 1: ‘Audrey’s story

Example 2: ‘Sunny's’ Story

How to Apply for HRA REC Approvals: IRAS – The Integrated Research Application Service

Good Clinical Practice (GCP)

Do It!

GDPR

Research Conducted Overseas

Research Passports/Honorary Contracts

Example 3: Kavi's Story

Student Safety

Competence

Publications

To Sum Up

References

Further Resources

Appendix A Research Skills: Obtaining Informed Consent. Introduction

Giving Information about the Research and What Is Wanted from the Potential Participant in Obtaining Informed Consent

Giving Oral Information

Giving Written Information

The Next Issue Is: Can Everyone Read it and Understand it?

To Sum Up

References

Appendix B Research Skills: Searching the Literature. Introduction

Conducting a Literature Search

The Grey Literature

De‐duplication

Keep Records of all Your Searches and the Results

The Prisma Diagram

Assessing the Quality of Published Work

Data Extraction

Data Analysis

References

Appendix C Research Skills: Laboratory Safety. Lab Safety Is a Serious Matter

The Researcher's Safety

Other People in the Lab

The Environment

Society in General

References

Appendix D Research Skills: Interviewing. Introduction

Unstructured Interviews

Phase 1: Introduction

Facilitation

Silence

Probing in Depth

Clarification

Re‐Focusing

Dealing with Sensitive Topics

Dealing with Tears

Endings

Managing Recordings

Transcribing Interviews

The One‐Question Interview

Multiple and Leading Questions

Interviewing People you Know

References

Appendix E Research Skills: Focus Groups. Introduction

Numbers

Participants

The Setting

Facilitator and Co‐facilitator

Issues of Social Power

Dominant/Reticent Participants

Dealing with Disclosures

The Structure of a Focus Group Discussion

Ground Rules

Communications Between Facilitators (Signals)

Additional Reading

Appendix F Research Skills: Analysing Qualitative Data. Introduction

General Thematic Analysis (GTA)

Framework Analysis

Colaizzi's Approach

Verification

‘Quantifying’ Qualitative Data

References

Appendix G Research Skills: Writing Research Reports. Overview

What do you Want to Say?

Writing in English as a Second Language

A ‘Writing Blank’

References

POSTSCRIPT

Index. A

B

C

D

E

F

G

H

I

K

L

M

N

O

P

Q

R

S

T

U

V

W

Y

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To my wife, Clair.

.....

Why indeed? Have a guess …!

That's right – we need to check that the ‘Fleming Effect’ has not happened. That is, we need to check that any changes we observe after introducing the experimental ‘variable’ are, in fact, due to the experimental variable and not to some outside variable, like, for example, dirt blown in through an open window which might contaminate our results!

.....

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