The practice of evidence-based medicine requires an awareness of the strengths and limitations of different research methodologies and the skills to critically appraise the research publications of others. Residents develop these skills through discussion of latest evidence during teaching sessions and in clinical scenarios such as clinic, labour and delivery and the operating room.
All residents attend an introductory course on research methodology and critical appraisal in first year. At this course a research road map is presented and residents receive guidance about on-line and local resources to facilitate their involvement in research. Each resident is expected to develop her or his personal skills through participation in journal clubs, presentation of cutting-edge or controversial data at rounds and by conducting one or more personal research project(s). The resident research coordinator meets regularly with residents to monitor their progress and to confirm that they are “on-track” to meet departmental expectations for resident involvement in scholarly work (eg. Q/A audits, book chapters, articles or reviews, and original research).
The Program offers strong research mentorship. Residents are paired with faculty members who oversee and facilitate research. Departmental resources including epidemiology expertise and funding are available to foster research and residents receive financial support to present their findings at regional and national meetings.
Innovation and creativity are the underpinnings of a culture within the department of Obstetrics and Gynaecology that drive faculty and residents to pursue clinical “best practices” while looking to the future and, through research, trying continually to do better.
Resident Research Coordinator: Dr. Maria P. Velez
A Research Road Map: Fifteen Steps to a Successful Research Project
By Philip M. Hahn, MSc
The Research Road Map In Detail
1. Meet with your program director or departmental research coordinator as soon as possible.
- Find out what is expected by your program or department.
- Talk about potential research areas and suitable faculty members who might be available to support you in the completion of a research project.
2. Look for resources that provide an introduction to the basic concepts of research methodology and critical appraisal.
- Attend a local or national resource course or training program.
- Consult the references and additional resources listed at the end of this road map.
3. Find a research supervisor.
- Look for someone whose expertise is relevant to your field of interest and who is able to devote sufficient time and effort to supporting and supervising your work. Most health trainees and junior practitioners have limited research experience and will need someone to guide and advise them along the way. Finding a suitable supervisor is one of the most important steps to success in planning and completing a research project.
- Consider the following in your selection of a research supervisor:
- access to research funding
- availability to provide timely advice
- reports from current and former research trainees
- Agree on expectations, including those with regard to authorship of any publications that result from your project.
4. Pose a focussed and specific research question.
- Make sure your research question is novel, answerable and feasible.
- Consider the PICOT approach to framing a research question . This involves describing:
- the Intervention
- the Comparator
- the Outcome
- the Timframe
- Also consider the FINER criteria . Is your research question:
5. Develop a research outline .
- If your project is designed to examine a therapeutic intervention, check for applicable systematic reviews in the cochrane library.
- Collaborate with content and methodological experts. Your supervisor should be able to suggest suitable individuals and to facilitate an introduction to them.
- Determine which study design is the best fit and the most practical approach to framing your research project.
- Write an outline:
- Include a brief background statement highlighting the importance of your research question.
- Estimate how much time you will need to complete each of the anticipated stages of the research.
- List available and required resources and, if applicable, provide a budget estimate.
- If you already have a variety of interesting ideas to talk about, be sure to keep track of them, but for the purposes of your study outline you will need to boil them down to a single, focussed, primary study objective.
- Make sure your outline is concise - a maximum of two pages is best at this point.
- With the outline of your proposed research project in hand, arrange to meet with methodological specialists in preparation for writing a more detailed protocol.
6. Meet with methodological specialists with particular expertise in your area of study.
- Discuss pertinent design issues, focussing on the primary study objective.
- Be realistic:
- Consider conducting a clinical audit, systematic review or survey as a manageable project for your first venture in to research.
- Select the tools that will be appropriate for your analysis of the study data (databases, data entry software).
- Investigate which file formats for data recording will allow your study data to be imported into an appropriate application for statistical analysis (Excel spreadsheet).
7. Develop the research protocol .
- Include details on:
- Recruitment of study participants
- Inclusion and exclusion criteria
- Design features such as criterion standard for a clinical practice audit , the sampling technique for a survey , or the random allocation technique and creation of placebos for a randomized controlled trial 
- Any secondary objectives, questions and outcomes
- Statistical issues such as estimating sample size and methods to analyze the data
- Your timetable for starting and finishing the project, as well as the anticipated timeframe for each phase of the project
- ethical considerations such as safety, confidentiality, and informed consent 
8. As applicable, obtain institutional and research ethics approval.
- Seek help from your research supervisor and other university and hospital personnel who are knowledgeable about and experienced with approval process and requirements.
- Find out whether your project is eligible for an expedited review, which will take less time tha a full Research Ethics Board (REB) review. A clincial practice audit, for example, might be eligible for an expedited review.
- If your research involves humans or human tissues, review the Tri-Council policy statement  and complete the Tri-Council tutorial on the ethical conduct for research involving humans .
9. Seek necessary funding.
- Seek departmental and university funds first.
- If appropriate, submit a grant to an external funding agency such as the Physicians' Services Incorporated Foundation or the Canadian Institutes of Health Research.
10. If you are conducting a clinical trial, ensure that it is registerd with ClinicalTrials.gov.
11. Collect and analyze the data.
- Report confidence intervals, if appropriate, in addition to p-values for the results of the primary and any secondary research questions .
12. Present your findings.
- Find appropriate venues in which to present your work as soon as possible, such as your department's annual research day and relevant local, national and international meetings.
13. Prepare and submit a manuscript describing the study and its results to a suitable journal.
- Focus your attention on what readers are most likely to look at; the title, abstract, tables and figures
- Develop a systematic approach to the introduction, methods, results,and discussion
- Improve the paper by learning how to obtain and incorporate useful feedback
- Establish authorship and the order of authorship:
- The ICMJE criteria for authorship credit states that authorship requires: (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published .
- Be prepared to describe the contribution of each author.
- Also consider those whose contribution should be acknowledged in the published article.
14. If your manuscript is accepted, revise it according to the editors' and reviewers' comments.
15. Celebrate with your coauthors.
1. Thabane L, Thomas T, Ye C, Paul J. Posing the research question: not so simple. Can J Anaesth. 2009;56(1):71-9.
2. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing clinical research: an epidemiologic approach. 3rd ed. Philidelphia: Lippincott Williams & Wilkins; 2007. Appendix 1.1; p15.
3. Altman DG. Statistics and ethics in medical research: How large a samples? Br Med J. 1980;281(6251):1336-8.
4. Schulz KF, Grimes DA. Sample size calculations in randomised trials: mandatory and mystical. Lancet. 205;365(9467):1348-53.
5. McAlister FA, Straus SE, Sackett DL. Why we need large, simple studies of the clinical examination: the problem and a proposed solution. CARE-COAD1 group. Clincal Assessment of the reliability of the Examination-Chrinic Obstructive Airways Disease Group. Lancet. 1999;354(9191):1721-4.
6. Cummings SR, Hullet SB. Writing and funding a research proposal. In: hullet SB, Cummings SR, Browner WS, Grady DG, Newman TB, editors. Designing clinical research: an epidemiological approach. 3rd ed. Philidelphia: Lippincott Williams & Wilkins; 2007. p. 301-16.
7. Goodwin M. 2001. Conducting a clinical practice audit. Fourteen steps to better patiennt care. Can Fam Phys. 2001;47(11):2331-3.
8. Salant P, Dillman DA. How to conduct your own survey. New York: John Wiley & Sons; 1994. Chapter 5, When and how to select a sample; p. 53-72.
9. Pocock SJ. Clinical trials: a practical approach. Toronto: John Wiley & Sons; 1983. Chapter 5, Methods of randomization, and chapter 6, Blinding and Placebos; p. 66-89, 90-9.
10. Pocock SJ. Clinical trials: a practical approach. Toronto: John Wiley & Sons; 1983. Chapter 7, Ethical issues; p. 100-9.
11. Canadian Institutes of Health Research, Natural Sciences and Enginerring Council of Canada, Social Science and Humanities Research Council of Canada. Tri-Council policy statement: ethical conduct for research involving humans (December 2010). Ottawa: Interagency Secretariat of Research Ethics; 1998.
12. Panel on Research Ethics. Introductory tutorial for the Tri-Council policy statement: ethical condict for research involving humans.
13. DeAngelis C, Drazen JM, Frizelle FA, Haug C, Hoey J, Horton R, et al. 2004. Clinical trial registration: a statement from the International Committee of Medical Journal Editors. CMAJ. 2004;171(6):606-7.
14. Gardner MJ, Altman DG. Confidence intervals rather than P values: estimation rather than hypothesis testing. BMJ. 1986;292(6522):746-50.
15. Welch HG. Preparing manuscripts for submission to medical journals: the paper trail. Eff Clin Pract. 1999;2(3):131-7.
16. Rochon PA, Hoey J, Chan AW, Ferris LE, Lexchin J, Kalkar SR, et al. Financial conflicts of interest checklist 2010 for clinical research studies. Open Med. 2010;4(1):69-91.
17. Hoey J. Who wrote this paper anyway? The new Vancouver Group statement refines the definition of authorship. CMAJ. 2000;163(6):716-7.
1. Not establishing a focused, answerable question.
2. Enlisting a research supervisor who doesn't make sufficient time to advise and help you throughout the stages of the project.
3. Picking a topic about which you have little interest.
4. Planning a small, compicated study that attempts to answer many questions, rather than an appropriately sized simple study focussed on one primary objective/question.
5. Not taking the tme to draft a research outline to keep your research team coordinated and on schedule.
6. Not being realistic about how much time and effort your project requires.
7. Basing a prospective study on outcomes that are rare or take a long time to occur.
8. Entering data into a spreadsheet using formats that are not compatible with analytical software.The only thing worse than entering data is having to enter it twice!
9. Not meeting with a statistician to talk about the analysis before you begin collecting the data.
10. Waiting too long to begin.
As you have no doubt already recognized, your biggest obstacle to successfully completing a research project wull likely be finding the time [1-3]. Here are some tips for staying on track to finish a research project.
1. Carving out one or more blocks of protected time is key . Use this time to develop your research proposal and start off o the right foot. Additional blocks of time can be used for data collection, analysis or write-up.
2. If you are in a two or three year program, consider a study design that will allow you to finish on time, such as a medical record review or practice audit, for which data should be comparatively easy to access and for which an expedited ethics review might be feasible.
3. If you are in a longer program, such as a five year medical or surgical specialty, consider the following timelines and milestones.
- In your first year, introduce yourself to the basic concepts of research methodology by taking a dedicated course or intensive workshop. Identify a research supervisor.
- Identify a methodological specialist to help you develop your research question, study design and research protocol in your second year. Submit your study for ethics approval and funding opportunities. If you are conducting a clinical trial, register the trial before you begin.
- Collect and analyze your data, and then present your findings locally, nationally, or beyond by the end of your third or fourth year.
- Begin drafting your manuscript, aiming for completing in year four,
- Submit your manuscript to a suitable journal early in year five, leaving your final term free to prepare for your certification exam and life after graduation.
1. Chan RK, Lockyer J. Hutchison C. Block to succeed: the Canadian orthopedic resident research experience. Can J Surg. 2009;52(3):187-95.
2. Silcox LC, Ashbury TL, VanDenKerkhof EG, Milne B. Residents' and program directors' attittudes toward research during anesthesiology training: a Canadian perspective. Anesth Analg. 2006;102(3):859-64.
3. Gill S, Levin A, Djurdjev O, Yoshida EM. Obstacles to residents' conducting research and predictors of publication. Acad Med. 2001;76(5):477.