research associates programs
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Research Associates Programs
Frank Illuzzi, MD, FACEPStephanie Carro-Kowalcyk, BS
Chava Freund, BSDaniel Glaser, BSRyan King, BSEE
Michael Molloy, BSKeith Bradley, MD
Research 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
Obstacles to Research in ED
?
Obstacles 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
"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
An Answer to Some 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?
An Answer to Some 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!!!
Research Associates
Is there a practical difference in the ability to collect focused clinical research data between:
today's freshman medical studentsvs.
themselves one year prior as college seniors?
Research AssociatesIf not, is there a practical difference in the ability tocollect focused, clinical research data between:
today's freshman medical studentsvs.
themselves one year prior as college seniors… juniors … sophomores …freshman?
Research Associates
Functions subject identification demographic and historical information physical parameters read informed consent facilitate the research “stuff”
Research Associates Programat Lincoln
Process
recruited from local colleges– Fordham University– Lehman College– Manhattan College– Mount St. Vincent’s– Columbia University– Iona College
Research 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
Research 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
Do RA Programs Work?
Lincoln first semester, 38 RAs covered 80% of 24/7 by the end of two years, > 60 RAs per semester
Bradley K, Osborn HH, Tang M. "College research associates: a program to increase emergencymedicine clinical research productivity." Ann Emer Med, September 1996.
Do RA Programs Work ?LincolnStudies
Asthma/Cocaine 112 participants enrolled Window Guards 1088 participants
enrolled Ankle 350 participants
enrolled9 page data form
Chest Pain Evaluationlimited to subject ID TB studies requiring CMV Meningitis universal precautions
Do RA Programs Work?Bridgeport Hospital
“Traditional” Studiesenrolled
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
Do RA Programs Work?Bridgeport Hospital
Cardiac Studiesenrolled
Troponin T 856
QT-Prolongation with Erythromycin 63
CUPID ECG Analysis 100
1019
Do RA Programs Work?Bridgeport Hospital
1° Health Screening Studies
enrolled
Women’s Health Screening 2676
including domestic violence questions
AMA’s Firearms Risk Assessment 3370
AHA’s Cardiovascular Risk Assessment 3276 9,322
Do RA Programs Work?St. Vincent’s 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) 127911,158
Do RA Programs Work?
20-50 RAs per semester during the school year
20-45 RAs from around the country for the summer semesters
Do RA Programs Work?
27,575 participants entered in research protocols by RAs
as of end of summer semester, 2010
Do RA Programs Work?Sustainability
RAs provide service based on successful studies (e.g., at St.Vincent’s: cervical, breast and prostate
cancer screening and tobacco cessation)
To date, 5901 patients and visitors received such service
as of end of summer semester, 2010
Do RA Programs Work?
Research + Service interactions with
33,476 patients and visitors
as of end of summer semester, 2010
Do RA Programs Work?
Research + Service interactions with
33,476 patients and visitors
Institutional cost = $ 0
as of end of summer semester, 2010
Do RA Programs Work?
Research + Service interactions with
33,476 patients and visitors
Institutional cost = $ 0Complaints about RAs = 0
as of end of summer semester, 2010
RA ProgramsBenefits?
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
Patients and visitors get value-added to their ED visit
Win-Win-Win-Win
RA 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
RA 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
Chief 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
Chief RA
To date: 20 CRAs
15 accepted to medical school
1 accepted to dental school
1 accepted to PhD in clinical research
3 in the application cycle
RA Program Development
research requirements+
financial and personnel resources +
clinical pressures=
need for innovative solutions
Research Associates Programs
RA Program at St. Vincent’s 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
RA Program at St. Vincent’s 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
Starting a Research Associates Program Guarantee clinical experience for large numbers of
pre-health professions students
Linkage between medical centers and colleges →value added to ED visits by “free” research workers – residency programs in every specialty must do research– hospitals without residencies need data collection,
e.g., for continuous quality improvement (CQI) programs
Think of These Numbers > 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
Think of This Number
60 millionpotential work hours at no institutional cost if pre-meds served as RAs for one 4-hr shift per week in the nation’s emergency departments helping patients and visitors with their 1 care issues
What Would Coca-Cola Pay?
Access – to ½ the people in the U.S. – for several hours each year
Work force –hundreds of thousands of bright, committed
people– eager to work millions of hours – for compensation other than money
National Alliance of Research Associates Programs
(NARAP) RA programs in multiple hospitals around the U.S. united in clinical research on the ED as a site to
facilitate primary care screening
tens of thousands of participants enrolled in clinical studies over short time periods
NARAPCharter Members
Connecticut New Jersey St Vincent’s Medical Center Hackensack Univ. Medical
Center Hartford Hospital Lawrence and Memorial Hospital
Massachusetts New York UMass Medical Center University of Rochester
Nebraska Pennsylvania Creighton U. Medical Center Thomas Jefferson Univ. Hospital
If You See the Potential as a RA in CT Summer semester, 2011
– Session One» orientation sessions = Saturday and Sunday, 4 and 5 June» Shifts = 6 June – 14 August
– Session Two» orientation sessions = Saturday and Sunday, 25 and 26 June» Shifts = 27 June – 5 September August
www.RAProgram.org - program details and application materials
If You See the Potential as a Chief RA Training Session
– 2 weeks at St. Vincent’s (21 May-5 June)– Learn techniques and protocols for
Recruiting Personnel Management EvaluatingWebsite Development and MaintenanceDatabase Management
– Serve as a line RA for tobacco cessation study
Ready to develop the RA Program at ________ for the tobacco cessation study in spring semester, 2012 and ________’s clinical studies
If You See the Potential as a Chief RA
www.theNARAP.org.
Future
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
Watch “ER” on TVand guess;
Be a Research Associate and know.
?
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