16 - Increasing Research by Medical Residents and Fellows While Promoting Human Subjects Protections at a Rural Teaching Hospital

Background: Medical residents and fellows at teaching hospitals are expected to complete scholarly activity including research and quality improvement to meet the requirements of the American College of Graduate Medical Education. Time is a limiting factor for these busy clinicians. Therefore, efficiency and incentive are necessary for successful scholarly activity.

Program

Description: At a rural teaching hospital, the director of research aimed to improve efficiency and incentive for scholarly activity. For efficiency, the role of research education coordinator was added to provide research education to residents/fellows and provide guidance to the IRB for adherence to federal regulations. This position reports to the Director of Research in the department of research administration. This role provides a point of contact for researchers to navigate the research process and access research related resources, and also aims to reduce incomplete IRB submissions. For incentive, the director of research implemented a research day event that showcases scholarly activity and provides awards and recognition to residents/fellows. Research day takes place annually at the end of the academic year and includes categories of investigator-initiated research, quality improvement (QI), and case reports. Awards for the top three oral presentations, top three research posters, top two QI posters, and top case report provide incentive to promote scholarly activity.

Program

Assessment: For six years the research education coordinator role has served a dual purpose to provide education to researchers and IRB guidance. The role supports 10 residency and fellowship programs with: contacting resources (librarian, grant writer, statistician), writing research protocols, meeting IRB requirements, posting to Clinicaltrials.gov, and reviewing manuscripts to ensure deidentification and accurate citations. Annual investigator-initiated studies reviewed by the IRB during the six years increased by 51%. The turn-around time for IRB review remains efficient (median 24 days convened meeting, seven days expedited, two days exempt). Though efficient, the IRB maintains thorough review by experienced IRB reviewers. Researcher education about IRB requirements improves completeness of protocols and IRB submissions and improves efficiency of the research process. The 6th annual research day was a success with a 66% increase in scholarly activity since the first year. Scholarly activity categories were 36% research, 30% QI, and 34% case reports. The half day event includes opening remarks by the chief executive officer and provides recognition, monetary awards, and incentive to residents/fellows for scholarly activity.

Limitations: Potential conflict of interest for research support services of the research education coordinator must be recognized. The role provides education to researchers on submitting IRB applications and also provides guidance to the IRB in maintaining accreditation standards and writing IRB policies. The person in this role does not serve as an IRB member, assign IRB reviewers, or serve as IRB staff conducting pre-review. Other confounding factors contribute to growth in scholarly activity. The program has not assessed impact on compliance.

Discussion: A research educator knowledgeable of IRB processes and a research day event provide efficiency and incentive to promote scholarly activity. Future goals for education at our institution are to consolidate training materials for online access, and to assess the impact of education on compliance. Future efforts to incentivize researchers are aimed at increasing high quality publications. While larger institutions have more resources overall than a smaller, rural center, this program can be scaled up to include research educators and a research day with a virtual component.