INTRODUCTION It's the field that keeps growing, Scientific research, excelled by the pandemic, we now realize more than ever the vital role research plays in our life. People in every aspect rely on research and its outcomes, and everything that we are today, we owe it to the neverending time and effort put by scientists to discover, uncover, guide and develop. Therefore, it is of immense importance to have a solid foundation in this field to learn it and master it. Given all that, SCORE built a vision that focuses on involving medical students in research in their early years in the medical career, this is achieved by the numerous courses, workshops, research projects and opportunities we engage students with during their years of study. And this course is one of the many other courses that makes this vision achievable. Despite that, however, research and research education is not encouraged enough in Palestine, plus the fact that medical students in the palestininan universities suffer a lack in opportunities to get the high quality research education they long for. Considering this, we designated the course.
TABLE OF CONTENT
OC members Overview Course Objectives Course Speakers What We Covered Your Thoughts GTR Course Package Recommendations
OC MEMBERS
Abdallah Ramadan Supervisor
Tareq AbdalJawwad Head of OC
Shahd Idais
Baraa Alhendawi
Beesan Moreb
Abdalrahman Ajjour
External Affairs Coordinator Promotional Coordinator
DB Coordinator
DB Coordinator
Haroun Neiroukh
External Affairs Coordinator
Ghadeer Zourob DB Coordinator
OVERVIEW Our project primarily targeted 43 medical students with ages ranging between 18-22years old who did not have enough knowledge and research background to breakthrough into the research field. We provided them 8 online training sessions with by professional doctors and academics in the field of Medical Research. The first day included an introductory session about SCORE and Academic Quality in SCORE projects. Moving to the second day, an overview of Research Stages, and Searching for Studies using databases was briefly explained to the students. In addition to Reading Research Papers and Evidence-based medicine. Research Methods, basics in the Statistical Analysis, Literature Review and References, and finally, Proposal Writing and examples of proposals were demonstrated. Each training day was followed by a different task and students were asked to complete them.
COURSE OBJECTIVES The main objectives we worked on achieving during the course include: To raise awareness about the importance of medical research between medicalstudents. To expose the students to the new trends of research and Evidence-BasedMedicine. To teach the students basic principles of medical research and assist them in understanding the various stages of the research process. To make students able to read and write an academic paper. To make students able to read statistical findings.
COURSE SPEAKERS SCORE & Academic Quality Medical Student at Al-Azhar University, Gaza.
Tareq AbdalJawwad
Stages of Research & Searching for studies FY2 and Masters from UCL
Dr.Selim Talaat
How to Read Research Papers
Dean of Scientific Research, Al-Quds University
Dr. Elham Khateeb
Research Methods
MD, MRCS, PhD Clinical Lecturer in Neurosurgery
Dr.Malik Zaben
COURSE SPEAKERS Evidence-Based Medicine Core surgical trainee and Master Cambridge University
Dr.Khaled Yaghmour
Basics in Statistics Vascular and General Surgery Trainee in the UK
Dr. Tamer El-Nakhal
Literature Review & References MSc in Clinical Pharmacology, University of Glasgow, UK
Dr. Rasha Bseiso
Proposal Writing Associate professor at NNU
Dr. Basma Damiri
WHAT WE COVERED IN... SESSION 1 We started the series of sessions for the Gateway To Research course with an introductory session; ‘The SCORE in IFMSA + Academic Quality in SCORE’ By the head of the organizing committee; Tareq Abdal Jawad.
Tareq started the course with a brief summary about SCORE, its presence within IFMSA and the types of activities it organizes. We went through the types of research projects that are within the scope of SCORE’s work, including: Basic laboratory research projects, clinical research projects, combination of the basic and laboratory work, and Global Action Project (GAP). We then introduced participants to the concept of Academic Quality in SCORE, discussed its importances and the 9-steps approach to it: from 0 to 8: Step 0: tutor recruitment and LO training. Step 1: Outgoing selection. Step 3: Pre-Departure/Exchange training. Step 4: incoming distribution. Step 5: Upon-Arrival training. Step 6: Quality assessment, logbooks/handbooks. Step 7: Outcomes. Step 8: Impact assessment. Last but not least, we played an interactive game that tested the participants general information regarding SCORE, Academic Quality and the other topics covered during the session.
WHAT WE COVERED IN... SESSION 2 The session opened with valuable advice from Dr. Selim saying that “ best way to learn about literature search is to actually go through it “ We started the session with a brief introduction about what Research means and the basic characteristics that it should have, he explained that research should be: systematic-follow the research process, logical (induction and deduction), empirical- evidence based, reductive-generalization, replicable- methodology. We began with how to understand what we are looking for and what our interest field is in order to help us create our idea and breakthrough in our search. We moved to how we can start our Research by defining our search area , formulating our idea and then creating our question by following some steps: First after developing the idea and creating our question we can divide it up into core concepts using the PICO formula. Second, we create lists of synonyms for each of the core concepts. Third, we run searches on each of the core concepts separately Finally, we combine those searches using Boolean operators AND, OR ( and NOT).
Then we had an exercise following these steps which was interactive. We also offered the participants the best Research database platforms such as HDAS (Healthcare Databases Advanced Search), PubMed and Cochrane and Dr. Selim pointed that we should never use google or other web articles as a source of search information as they lack evidence and reliability so we should avoid them . We learned how we can achieve the right evaluation process by following basic guidelines while reading papers and we knew what things to look out for in papers using critical appraisal methods. We had an idea about the types of Bias we may face while searching and reading papers accompanied by a clear example of each type. Finally, we came through an overview of study designs including the advantages and disadvantages of each type.
WHAT WE COVERED IN... SESSION 3 Dr Elham talked about the reading process of different research papers, how to master it, and what steps you should follow when you have piles of research articles that you have to read and analyze. We started by defining academic journals then we differentiated academic journals from other types of journals, such as those interested in news, politics or natural sciences and so on, that the latter are biased, they want you to know what they want you to know, adding to that the subjectivity when judging, presenting and reporting information, the absolute opposite to the academic journals. Then we digged a little bit in the process of peer-review, a mandatory process to getting published in refereed academic journals, and it involves the following steps: Firstly you submit an article manuscript for consideration, Secondly, journal editors will skim through the article and do their initial screening, then send it to other scholars who do the same, generally there are three editors who do the initial screening. Then these editors will evaluate the reviews and decide accordingly and clindly to either: accept with minor revision, accept with major revision, accept without revision, this almost never happens, or reject the article. Another round of reviews follows if the author was asked to make revisions. If the article is acceptable, it can be published, however, this process may take many revisions and resubmissions and reviewing by authors till the article is ready to be published. Moving on, we covered the different types of articles as they fall under the realms of: Research reports, literature review article, theoretical article. We discussed the fundamental difference between each of them, some examples of articles published in research journals include; primary literature such as original research articles, surveys, case reports/ case series and so on, in addition to secondary literature such as, narrative reviews, systematic reviews, meta-analysis, book reviews, guidelines and commentaries.
Then we come to the process of reading an academic article, after emphasizing the critical role it plays when it comes to staying updated with progress in specific field of study, finding out solutions to problems, understand and deepen the knowledge one have in a particular subject, discover the gaps in the existing literature regarding a particular subject, and try to cover it. Reading a research paper can not be mastered without practice, and the content of an academic article cannot be grasped by a single reading, you have to go over it, and engage with it several times in different ways; Step 1: skim the whole article, go over the two types of chunks in each paper, sections and paragraphs, for each section you'll have to the read the first paragraph , then the first sentence for each paragraph, always remember to read the entire last paragraph of the introduction and conclusion, for they help set you to carry on with reading the article or stop. Step 2: determining purpose for reading the article, are you reading the article because you just want an overview of a specific topic, looking for research ideas, planning an experiment, assignment for a class, or just for your general knowledge. Step 3: critically reading each section of the article, how to grow this skill? why should you do it? How could you do it? By looking for specific details in each section including: the title, abstract, introduction, methods, results, discussions, and referencing, and asking and answering questions regarding every section to decide whether it's answered and you should consider taking this article. Last but not least, we come to the end of the session, and the doctor ends it with a piece of advice for us, to practice reading and keep on improving and learning, as great readers are not born with it, but they become great with practice and hard work.
WHAT WE COVERED IN... SESSION 4 Dr. Malik Zaben started his session with such an exciting question which is “Why should we bother with research?”, then he answer it by mentioning the following:1- organ transplantation2- treatment of infectious diseases3- Discovery of vaccines and antibiotics.All of these things couldn't be found without Clinical Research, He also said “ from my point of view, Clinical Research is the most important intervention in the last century” He continued talking about Clinical Research mentioning a very important topic that is Clinical Audit, he explained it by saying “ it is a quality improvement measure that can highlight researchable questions and fields. And he gave a quick insight on The Audit Cycle beginning from choosing the topic until Re-Auditing. After that, he defined what the research is by saying that it is the systematic approach to obtaining and confirming new and reliable knowledge. Then, he started to get into details of the process of research, explaining how to get your own research question, how to formulate goals and objectives, planning and designing research, generation of research results and finally how to interpret results and draw conclusions. He continued his session by numerating types of research and gave a simple overview about each of them making a comparison between Randomized clinical trials, cohort studies and case control studies, he categorized them into retrospective and prospective explaining the difference between the 2 categories. At the end of the session and before starting to receive participants' questions in the last 30 minutes of the session, he summarized the main points he mentioned throughout the session and gifted us with some tips and advice from his experience, saying that: Research questions are directed toward solving a clinical problem or to advance knowledge in an area of interest. Research questions have to be very precise. Spend sometime designing your research question. You will definitely need to consult others. One of the most characteristics that has to be in every researcher is “Patience” Unless you try it, you would not know how good you are at it.
WHAT WE COVERED IN... SESSION 5 Dr. Khalid has started his informative session with the history of EBM by the guidance of the father of EBM the Scottish doctor Archibald Cochrane and the interesting story of his research and its results that lead us to the EBM concept. Then he asked the golden question about “What is Evidence-Based Medicine?” and he continued with the answer that EBM is the management of patients according to what we have of evidence in terms of research and publication, terms of doctor’s experiences and terms of patient’s values. illustrated the basic three components that enable us to achieve EBM: 1. Publications: reviewing the clinical aspects and researches regarding our disease case or condition and all the possible treatment available in the light of scientific approaches and he viewed an example of the best Appendicitis treatment for further understanding. He emphasized that we have to choose high quality relevant evidence and valid research with a low risk of bias while searching. 2. Patient values and performances: he explained how this section is neglected and doctors don't take it into consideration, viewing this point with rich examples. 3. Doctor’s judgments and experience: he stressed in the importance of this section He asked if any component is more important than the other, the answer was NO but he illustrated that the weight given to each of these three EBM varies according to the clinical situation, giving a full understood example on this point.-The following question was “WHY EBM?” He explained the crucial part of EBM of training doctors all over the world whether they are doing research or just work on treating patients as: It is evidence-based: as it depends on researches which scientifically value Cost-effective Quality care: the best care for your patients regardless of what the pathology is based on your research Equality: No bias, decreasing complications by offering the best care for patients regardless of who and what the condition of the patient is.
He moved to one of the most important points to understand the EBM as he described which was the Evidence-Based Pyramid as we should choose the scientifically sound papers with high validity and low risk bias and he described the strength of research types on the pyramid. He clarified what bias in research means and its importance in selecting the most valuable strong papers for our question. He continued with detailing the 5 steps of EBM: 1. Ask: involved asking the right clinical question using the PICO format for several searching electronic databases in order to choose the most relevant articles. Detailing the body of the PICO format being an efficient framework in narrowing down the area of search. Supporting the idea with 3 cases as practical training on how to use PICO format with an integral interaction from participants. 2. Access: Involved in how to get information and collect the data for our question from different databases on the internet. Introducing the best research database platforms such as PubMed, Embase, Science Direct and Cochrane library. Supporting this point with a practical exercise on the PubMed platform using the PICO format clarifying how to identify keywords and use mesh terms to limit our search and ask the right question. 3. Appraise: After accessing our research papers, we should use methods to appraise the power of the study by asking important questions about the quality, validity, blindness, randomization, bias, the ethical considerations to choose the right evidence. Supporting the point with 3 scenarios as examples of how we should ask the right questions to appraise and assess the validity of the study. Defining some important terms such as sensitivity, specificity, positive predictive value and negative predictive value. 4. Apply: application of the results and the experience of our search after asking the question, analyzing the data and appraising the methods. 5. Assess: After implementing the EBM we should monitor and assess the outcomes of the patients if they are favorable and benefiting the patient or not so that positive effects can be supported and negative ones remedied. He ended the lecture with an interactive questions section to evaluate our complete understanding.
WHAT WE COVERED IN... SESSION 6 Dr. Tamer El-Nakhal began his session with a great advice to us to read at least one medical article daily to stay up to date with what is new in Medicine. Then, he showed us the outline including all the topics that we would discuss during the session. The first topic was “Types of Data”, he started explaining it by classifying the data into two main categories which are qualitative and quantitative. He also subdivided qualitative data into nominal, ordinal data and categorical data, while quantitative data branched into interval, ratio and discrete or continuous data. He continued talking about “Variables” by differentiating between independent and independent variables, mentioning that dependent variables are those that change, while dependent variables are those that are affected by the change. He gave multiple examples to clarify the picture well. After that, Dr. El-Nakhal explained “Data distribution” showing the difference between the normal and skewed distribution, and emphasizing how important it is to understand the difference very clearly. He moved to “the 3 Ms” in statistics which are: Mean Median Mode He discussed with us the definition, when to use, why should we use and how to use each single one of them. And this normally led him to explain the concept of IQR. Since his session was mainly about statistics, inevitably he would talk in details about Standard Deviation (SD) and Confidence interval (CI). After explaining them in a very simple way away from all the complications we would find when searching on the internet, he made a simple schedule comparing between the two concepts.
He also came into the “P Value” demonstrating the figures of this value and when it's considered statistically significant and when it is insignificant. Also, He differentiated between two terms that are “Parametric statistical” and “Nonparametric statistical”, following that with talking about Parametric tests including t test (students test) and χ2 test (chi-squared test). Then, he explained “Testing the hypothesis”,how to test the hypothesis, and what is the significance of doing it. As for the Nonparametric test, he mentioned Man-Whitney and other tests. Then in the next half of the session he talked about “Risk Ratio” as well as “Odds Ratio” , when to use them? and what do they mean?. He defined “Survival rate” and “Kaplan meier survival plot” and discussed the significance of them. Dr. El-Nakhal was keen on simplifying information as possible as he could, and being sure of participants' understanding so he made an interesting interactive activity at the end of the session by asking multiple questions including information was mentioned earlier throughout the session.
WHAT WE COVERED IN... SESSION 7 We started the session by defining the meaning of literature review, a type of review article (usually referring to narrative review) that presents comprehensive, critical, and objective analysis of the current knowledge. And its types: the Narrative and Systematic review. Then, we discussed the need for literature review and its role in evaluating the literature, discovering what has been written about a particular topic, determining the relationship between the sources, assertion what has been done already, and what still needs to be done. Then we discussed why we should review the literature before carrying out a research, to better understand the research topic, establish the importance of the topic, develop your own ideas and perspectives, avoid replicating previous articles, and position your current work within the earlier publications. Then we carefully followed the process of conducting a literature review, and the multi-step approach to it: Step one starts from finding the research idea that is related to your field of study,Then; formulating the research question that will answer three questions: what? How? And why? Note that question/objective/aim/hypothesis all serve the same purpose, and are stated in the abstract and statement form. Then, searching for relevant literature in databases and research engines such as: PubMed, Ovid(Medline), Cochrane, UpToDate, Google scholar and the list goes on.Then, justify your approach, by the need for a literature review, a review of reviews, the identification of research questions, a review pointing out the need for mare research, to make searching easier for others, Then, critical appraisal and evaluation of the selected sources, identify gaps, outline the structure based on what you are emphasizing, is it chronological(follows the order of time), thematic(all around one them), or theoretical( discuss opposing theories).
Then on to the writing process, being completely subjective and avoiding personal opinions, and following the structure of literature review papers. Finally, we reviewed the most important things to avoid in the writing process, such as falsification, fabrication, improper citations and plagiarism; the act of taking others’ work and using it as your own without acknowledging or referring to the original author. We reviewed the citation and referencing styles, APA, Chicago and others. And the reference managers that can be used including Mendeley, the doctor illustrated to us step by step how to use Mendeley while working on writing the literature review paper.
WHAT WE COVERED IN... SESSION 8 Dr. Basma Dmairi started the session with such powerful words saying “ your proposal must be as strong as your research, because your research paper won't shine in the night without a very good proposal”. She really grabbed our attention with these words. Then she began talking about the components of a proposal, starting with the title. Title: reflects the research question , aim or objectives. It should be concise and informative as possible. It should also contain keywords that explain the whole content. She also gave the participants examples of good and bad titles. Abstract: it should contain your research problem and objectives, your methods, your key results or arguments and your conclusion. Introduction: she described the introduction with a very good metaphor saying that “our research is the product and the introduction is the marketing campaign that would attract the customers, which in our case are the readers and scientist, to buy it.”. We should mention in it how important our topic of research is and how it is going to affect the various aspects of life. And at the end, it should include the goals and aims of our study. Dr. Dmairi emphasized on how important it is to distinguish between the impact and the aim in our introduction. She also said that the introduction should be composed of 3 paragraphs and she specified each paragraph to include a certain topic. After that, she shared a research paper with the participants asking them to check the criteria of the abstract and the introduction and to extrapolate the mistakes or the weaknesses in them. She mentioned the concept of “problem statement”. Problem statement is not compulsory for every study but it can be required sometimes. It is composed of only one page including the title, introduction, objectives, hypothesis and a very brief methodology. For every research we should write either a problem statement or a proposal but not both.
She continued talking about the components of the proposal mentioning the methodology. The first thing she said, that it should be in details. It has to include the following: 1. Study design and setting 2. Target population 3. Sample size and calculation 4. Sampling technique 5. Inclusion criteria 6. Exclusion criteria 7. Data collection instrument Another component is Variable operational definition, including dependent and independent variables. Proposal also contains Data analysis. One of the most important components is ethical consideration, “A common mistake is that this section gets neglected from students� she said. References is also one of the proposals' components. You have to attach a questionnaire (or data collection sheets if it is used) and also if you used Informed consent in Arabic. At the end, Dr. Dmiri opened the door for participants' questions. And she thanked them all for their interest in research and for their questions.
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GTR COURSE PACKAGE As a huge number of you, passionate researchers, expressed their high interest in this course, and as we could not accept all of you, this is a gift from us to all of you. Here you can find the material of the course, records, slides, and some external resources sent from some speakers.
RECOMMENDATIONS After opening our gate for students to sail with us and to dive into the depth of the research field, we would like to present our participants with some recommendations that will help them pave their road. There is no “right time” to start research, It’s very important to start your way in an early stage during university as this would support you either in the scientific or academic approach. Remember that the best way to learn about research is to actually go through it. The most important thing in research is to have a strong PASSION for the idea of your research. Choose the appropriate type of research method that suits your study topic, the data available, your interests and ideas. Be confident about where to collect your data from and ensure that they are reliable scientific resources. It's crucial to know how to appraise papers while searching which is going to be reflected on the reliability of your data. Connect, connect, connect, make connections with other researchers as much as you can. Stay in touch with others working in areas related to your interests, and keep this in your mind “connection is the key for everything” Seek out the advice or mentorship from more experienced academics you admire. If you want to be a researcher, then you need to have a very wide range of skill sets, including very good writing and editing skills as well as excellent exploring skills. A researcher has to be a good statistician too. Not to forget the strong communication and leadership skills that are required. In conclusion, to be a researcher means to be a superhero! Finally, don't ever get disappointed by any rejection you will have or any disrespectful words you will hear, and always remember that even the greatest scientists failed dozens of times before their first success.
Do not hesitate to contact us for any inquiries: Tareq Ziyad AbdalJawwad Head of Organizing Committee tareqziyad2001@gmail.com