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Research Curriculum for Residents Based on the Structure of the Scientific Method.

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Title: Research Curriculum for Residents Based on the Structure of the Scientific Method.
Language: English
Authors: Summers, R. L., Woodward, L. H., Sanders, D. Y.
Source: Medical Teacher. Jan 1998 20(1):35-37.
Peer Reviewed: Y
Page Count: 3
Publication Date: 1998
Document Type: Journal Articles
Reports - General
Descriptors: Curriculum Development, Graduate Medical Education, Higher Education, Inquiry, Learning Strategies, Medical Research, Physicians, Scientific Methodology
ISSN: 0142-159X
Abstract: Explains why the research requirement of the resident curriculum should be developed around the scientific method. The method can be stated in the form of: (1) make an observation; (2) make a hypothesis; (3) test the hypothesis; and (4) reach a conclusion. When research topics are broken down under these main steps, residents can see a more complete picture of scientific investigation. (PVD)
Journal Code: CIJNOV1998
Entry Date: 1998
Accession Number: EJ564598
Database: ERIC
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  Value: <anid>AN0000438253;mch01jan.98;2003Aug14.12:49;v2.1</anid> <jsection id="AN0000438253-1"> PERSONAL VIEW</jsection> <title id="AN0000438253-2">Research curriculum for residents based on the structure of the scientific method </title> <p> <bold> SUMMARY </bold> An understanding of the basic tenets of research is an important aspect of advanced training in medicine. Many US residency programs now have a research requirement as part of their educational experience. The purpose of this requirement is to introduce young physicians to the methods of medical research. The structure of this 'general form' of the Scientific Method provides an excellent outline for constructing a coherent research curriculum for residents. Within this outline, research methods and techniques fit into a scheme that allows the resident to see a more complete picture of modem scientific investigation without getting lost in the details of the process. In this curriculum system, all training is first centered around the place within the method and only then focuses on details of the subject to be covered.</p> <p>An understanding of the basic tenets of research is an important aspect of advanced training in medicine. Many residency programs now have a research requirement as a part of their educational experience (Pollack, 1994). The purpose of this requirement is to introduce young physicians to the methods of medical research in hopes that they may:</p> <p>(<reflink idref="bib1" id="ref1">1</reflink>) better understand and evaluate the medical literature; (<reflink idref="bib2" id="ref2">2</reflink>) add to the general fund of medical knowledge; (<reflink idref="bib3" id="ref3">3</reflink>) be stimulated into pursing academic careers.</p> <p>The majority of residents begrudgingly view the research requirement as only another hurdle in the goal of the completion of their residency (Pollack, 1994). Even residents who are academically minded can be dissuaded by the seeming drudgery of scientific inquiry. It is of little surprise that it is difficult to interest young physicians in pursuing academic careers when their only exposure to such a life appears to be so disconcerting. Perhaps it is time to reexamine the way that the research curriculum is presented. Instruction in the methods of medical research can often be confusing for residents with no prior knowledge or expertise in the natural process of scientific discovery. Many of the proposed research curriculums are often presented as didactic lists of required readings or detailed areas to be covered (Cline et al., 1992; Olson et al., 1992). However, there is little attention given to 'the big picture' of the goals of research.</p> <p>Since the time of Galileo and Francis Bacon, the Scientific Method has been the time-honored recipe for all scientific pursuits. This method broke from the Aristotelian view of science in which all knowledge came from deductive reasoning. The new science of the Renaissance required that the objectivity of experimental facts support any proposed hypothesis (Coleman, 1975). It was later that the scientific method became a part of biomedical research when Harvey discovered the circulation (Wilson, 1994). While the scientific method has been presented in varied detail and frameworks, the general form (Summers & Montani, 1991) can be simplified to include:</p> <ulist> <item> observation;</item> <item> make a hypothesis;</item> <item> test the hypothesis;</item> <item> reach a conclusion.</item> </ulist> <p>From observation and personal experience, the scientist identifies problems that need to be solved. These problems are formalized in the context of the 'hypothesis' so that there is a clear direction to the procedure. Testing of the hypothesis is what separates the sciences from other intellectual endeavors as truth is determined from objective measurements. The conclusion is the result of the process and gives meaning to the method. In practice there is never a final conclusion to any question in science since all 'truth' is subject to revision and the scrutiny of continual testing. In fact, the Scientific Method can be thought of as an iterative process (Figure 1) in which all knowledge is a hypothesis that is repeatedly tested and refined.</p> <p>The structure of this 'general form' of the Scientific Method provides an excellent outline for constructing a coherent research curriculum for residents. Within this outline, research methods and techniques fit into a scheme that allows the resident to see a more complete picture of modem scientific investigation without getting lost in the details of the process. In this curriculum system, all training is first centered around the place within the method and only then focuses on the details of subject to be covered. Hence, while one of the lecture sessions may center on the tedious specifics of statistical sampling, the resident is able to see how this fits into the general scheme of research. The research curriculum can be developed to include topics that are broken down under the main steps of the Scientific Method in a configuration such as:</p> <ulist> <item> Observation (the process by which research ideas are first generated):</item> </ulist> <p>(a) personal observations within the resident's daily clinical practice;</p> <p>(b) ideas from journal clubs and textbook study;</p> <p>(c) ideas from group discussions;</p> <p>(d) Medline searches.</p> <ulist> <item> Make a hypothesis (the formal statement of the research idea or question):</item> </ulist> <p>(a) focal point of the research;</p> <p>(b) narrow the scope of the project to a specific question;</p> <p>(c) set the criteria for the study population;</p> <p>(d) discussion on the differences between cause-effect relations and associations.</p> <ulist> <item> Test the hypothesis (the point at which the study is performed):</item> </ulist> <p>(a) general research design methodology and data collection;</p> <p>(b) clinical vs. bench vs. theoretical studies (pros and cons);</p> <p>(c) ethics in human and animal studies (IRB and Animal Care Committees);</p> <p>(d) Retrospective vs. prospective vs. observational studies;</p> <p>(e) Prestudy statistical design, (sampling size, blinding, control subjects, etc.)</p> <ulist> <item> Reach a conclusion (the end point of the scientific process):</item> </ulist> <p>(a) general statistical methods (concepts of significance and relations);</p> <p>(b) analysis of data and choosing the right test (quantitative vs. qualitative);</p> <p>(c) publishing your results (abstracts, papers, meeting presentations).</p> <p>While these topics represent some points in our curriculum, additions under the correct categories can also be included. By using the Scientific Method as an outline, residents have a systematic view of the components of research and can use this as a general recipe to investigate their own ideas with a clear direction. Moreover, they will have a blueprint for the development of research in their careers once they leave the residency.</p> <p>For young physicians who are certain they will never participate in academic research again, there is an added benefit from this methodological approach. While the practice of medicine is considered an art, its foundations are still in science. It has been noted by Peter Medawar (1975) that the use of the Scientific Method also applies to our clinical practice. In this respect the approach to the individual patient is like research with n = 1. Our history and physical exam is our observation while our differential diagnosis represents the hypothesis under consideration. The tests we order confirm or deny the hypothesis (in an iterative process) until the final conclusion of the diagnosis is reached. With a growing emphasis on evidenced-based medicine (Summers, 1996) it is important that physicians are capable of properly evaluating the medical literature. We believe it is possible to find references to support almost any view on any important issue in medicine. Moreover, the popularity of different approaches may change frequently over the course of one's medical career. A broader understanding of the process of science enables us to see that scientific truth must be continually tested (Figure 1) and any hypothesis may be rejected at any time if proven false. The resident holding the results of one poorly done study from some obscure journal needs to know that he or she cannot depend upon this information as dogma.</p> <p>In a busy residency program, research is often pushed to the side as an afterthought. This makes inclusion of research training in any established clinical training curriculum difficult. By using the 'scientific method' approach outline here, the research curriculum becomes a necessary part of the general curriculum in that it is the machinery and methodology by which the residents learn decision making and evidence-based medical practice. Therefore the research didactics can be interjected throughout the residents' training as the tools needed for developing their clinical skills. This is as opposed to a separate dedicated month or block set aside for research. For instance, if a resident is taught how to approach the patient with acute chest pain he or she learns that the observations and working diagnosis or hypothesis for the patient are tested using objective data collection and laboratory analysis until a conclusion or final diagnosis is secured. The resident then sees that the methods used in this process are the same as for their research protocols. This results in a training program that teaches clinical practice with a scientific foundation.</p> <p>While the concepts presented here seem simple it is surprising how often they are overlooked. The research requirement will remain an important part of residency training. We need to train good academic physicians for our future, but we also need to teach the techniques necessary to the practice of good medicine. A comprehensive view and understanding of research is critical to this endeavor. The devil may be in the details but, as always, truth is all encompassing.</p> <p>Correspondence: Richard L. Summers, MD, Assistant Professor, Research Director, Dept. of Emergency Medicine, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA. Tel: 601-984-5586. Fax: 601-984-5583.</p> <p>DIAGRAM: Figure 1. The Scientific Method: an iterative process.</p> <hd id="AN0000438253-3"> References </hd> <p>CLINE, D., HENNEMAN, P., VAN LIGTEN, P., SPIVEY, W., OLSON, J., LEVITT, A., DIRE, D., ZINK, B., LOWE, R., SEABERG, D., MANNING, J., MARTIN, G., MICKEL, H., BIROS, M. & YEALY, D. (1992) A model research curriculum for emergency medicine, Annals of Emergency Medicine, 21, pp. 184-192.</p> <p>COLEMAN, T.G. (1975) From Aristotle to modem computers: the role of theories in biological research, The Physiologist, 18, pp. 509-518.</p> <p>MEDAWAR, P. (1975) Scientific method in science and medicine, Perspectives in Biology and Medicine, 18(<reflink idref="bib3" id="ref4">3</reflink>), pp. 345-352.</p> <p>OLSON, J.E., HAMILTON, G.C., ANGELOS, M.G., SINGER, J.I., EILERS, M.E. & GADDIS, M. (1992) Objectives to direct the training of emergency medicine residents on off-service rotations: research, Journal of Emergency Medicine, 10, pp. 631-636.</p> <p>POLLACK, C.V. JR. (1994) Residency research requirements: time for a reappraisal?, Journal of Emergency Medicine, 12(<reflink idref="bib1" id="ref5">1</reflink>), pp. 75-76.</p> <p>SUMMERS, R.L. (1996) Evidenced based medicine vs scientific reasoning, Academic Emergency Medicine, 3(<reflink idref="bib2" id="ref6">2</reflink>), pp. 183-184.</p> <p>SUMMERS, R.L. & MONTANI, J.-P. (1991) Hypothesis testing in physiology: a proposed methodology using computer simulation studies, Journal of Mississippi Academy of Sciences, 35, pp. 49-54.</p> <p>WILSON, K.C. (1994) Discovery of blood circulation and the subsequent creation of the scientific method, Pharos, 57(<reflink idref="bib3" id="ref7">3</reflink>), pp. 33-35.</p> <aug> <p>By R. L. SUMMERS, L.H. WOODWARD, D. Y. SANDERS & R. L. GALLI,</p> </aug> <nolink nlid="nl1" bibid="bib1" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib2" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib3" firstref="ref3"></nolink>
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  Data: Explains why the research requirement of the resident curriculum should be developed around the scientific method. The method can be stated in the form of: (1) make an observation; (2) make a hypothesis; (3) test the hypothesis; and (4) reach a conclusion. When research topics are broken down under these main steps, residents can see a more complete picture of scientific investigation. (PVD)
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