What is Healthcare Research?
Contributions by:
Amelia Snook is a third year medical student at University College London, currently undertaking an iBSc in Surgical Sciences, and Current Students Co-Director at Future Frontline
Shir is a second year MSc Occupational Therapy (Pre-Registration) course student at Oxford Brookes University and an Occupational Therapy Officer at Future Frontline.
Precious is a fourth year medical student at the University of Leeds.
Lucy Bird is a third year medical student at the University of Leeds and Medical Officer at Future Frontline.
Katherine Brock is a qualified dental hygeinist and dental therapist as well as Healthcare Professionals Co-Director at Future Frontline.
Dr Anna Harvey Bluemel is an academic FY2 in the Northern Deanery and soon to be Academic Clinical Fellow in Obstetrics and Gynaecology and Education. Her main research interests are in qualitative methods, (professional) identity and the culture of clinical practice.
“Research and experimental development (R&D) comprise creative and systematic work undertaken in order to increase the stock of knowledge – including knowledge of humankind, culture and society – and to devise new applications of available knowledge” - Frascati definition of research
Research may be aimed at achieving general or specific objectives and it is comprised of five core criteria:
Novel: aimed at new findings
Creative: based on original, not obvious, concepts and hypotheses (theories)
Uncertain: there is uncertainty about the final outcome (or at least about the quantity of time and resources needed to achieve the outcome)
Systematic: planned for and budgeted
Transferable and/or reproducible: aimed at producing results that are transferable and/or reproducible
Who is involved in research?
Research is multidisciplinary: a variety of healthcare and non-healthcare professionals collaborate in order to achieve the best outcomes.
What are the two main types of research?
The two main types of research include quantitative and qualitative research.
Quantitative research is a research strategy that focuses on quantifying the collection and analysis of data. It is formed from a deductive approach where emphasis is placed on the testing of theory.
This approach is advantageous because it allows for larger sample sizes;data is impartial and accurate; it is often faster, easier and requires fewer resources; can be anonymised, and offers reliable and continuous information. However, this is limited to a set of pre-determined answers, the research is often not carried out in a person’s normal or natural environment and follow-up is often limited.
In contrast, Qualitative research is a type of research that aims to gather and analyse non-numerical data in order to gain an understanding of individuals' social reality, including understanding their attitudes, beliefs, and motivation.
This is beneficial as it explores attitudes and behaviours in depth, encourages discussion and is highly flexible. However, the sample size may be too small and therefore not representative of the whole population; bias may exist in the sample selection, and there is often limited privacy.
Research Settings
There are also two primary research settings: lab and clinical settings.
Laboratory research occurs in the lab, and does not involve working with humans. This involves performing tests, developing new laboratory processes and experiments, or the interpretation of results. The aim is to help healthcare professionals understand the causes of a particular disease and to analyse how well treatments that are currently being used work. This is advantageous because it is a controlled environment that allows for the regulation of extraneous (irrelevant or unrelated) variables and replication of the research results is possible. However, this may lack generalizability, has a low degree of external validity and realism.
Clinical research involves the use of human beings as research subjects to validate the use of treatment approaches or medications. Clinical research involves clinical trials which can take various forms, and a variety of research protocols and regulations. The purpose of clinical research is to evaluate new treatments and therapies. This type of research can be beneficial because the results generally have greater real-world applicability and therefore are more likely to reflect real impact/use. The results are likely to be more generalisable and externally valid. However, variables are more difficult to control as this takes places in uncontrolled environments; some patients may need to be given a placebo medication which may be perceived as unethical; participant recruitment and ethical processes may be lengthy and patients may find conditions to be demanding and burdensome.
5 Types of Research Design
Experimental Research: This aims to look at a problem scientifically thereby trying to establish a clear cause and effect. This research design tries to understand the impact of the independent variable on the dependable variable. As a result, this research is used to solve issues that try to analyse independent variables and their effect on dependable variables or vice-versa.
Correlational Research: establishes a relationship between two related variables. Over time, the researcher observes the variables and then draws conclusions based on them. As a result, this type of research design requires two types of variables to function to draw favourable results.
Descriptive Research: a hypothesis-based method that defines the primary subject matter of the research and tries to analyze it using different assumptions and techniques. This type of research design uses data collection techniques like natural observation, case studies, and surveys to derive results.
Diagnostic: aims to evaluate medical tests, markers, prediction models, decision tools and apps. Diagnostic research focuses on estimating the sensitivity and specificity of individual diagnostic tests, their predictive values, and other parameters of interest. This is often used in pharmacological research, testing of biotechnologies, or in the development of new diagnostic categories. In the current literature, the emphasis is currently on predictive models of disease based on people's specific factors.
Exploratory Research: approach the topic of study primarily in an inductive fashion to investigate the areas of potential research interest that remain mostly or wholly unexamined by the scientific community. Investigators undertaking exploratory studies typically have few expectations for what they might find, and their research design and approach may shift dramatically as they learn more about the phenomena of interest. Uses convenience sampling and unstructured interviews to explore new ideas.
Example Research Approaches
Observational Studies: Aim to identify and analyse patterns in data or in biological samples, such as tissue or blood provided by study participants. These are done passively, as in the investigators do not manipulate the setting or conditions.
Clinical Trials: Clinical trials, which are also called interventional studies, test the safety and effectiveness of interventions — such as medications, procedures and tools — in living people.
Note that these are just two of the possible approaches, while these are the most dominant in medical research, many other approaches exist in biopsychosocial research frameworks.
What do you want to research?
Lucy Bird, third year medical student at the University of Leeds
One of the biggest hurdles is finding out what you actually want to research. What hasn’t been done already? What has been done but needs extra work? It is often really difficult as a student to know what can be done with your skill level because often you don’t know what don’t know.
How do I come up with research topics?
The way I’ve come up with research topics is usually originally a rough idea of what I want to do which is then finalised by someone in research, or a supervisor. I’ve often found that there is a rough project that I have an idea of, for instance I’m interested in Parkinson’s disease and also general oncology. I looked into both of these to find what is currently going on with them (something which you can find through different websites like Medical News Today) and you can decide from that what is most likely to get funding. It’s often easiest as a student to start with a literature review because it’s something you can do relatively independently and also means that you don’t have to completely come up with an idea by yourself. For me, I looked at CAR-T-cell therapy and saw it’s only used for ALL currently, but there is a lot of ongoing research about trialling it on different solid tumours. That meant I could come up with the idea of doing a literature review into the general efficacy of CAR-T-cell therapy in solid tumours, then looking at the downfalls of it too.
I would also recommend doing a literature review because it can help you lead into lab ideas for research projects. Using the example of the CAR-T-cell literature review, I then started thinking about the issues that are commonly faced with CAR-T-cell therapy and solid tumours, and from that I have come up with a preliminary lab-based project on modifying CAR-T-cell therapy in order to attempt to make it more effective against solid tumours. One bit of research ends up leading into another, and realistically for any lab based project you would need to read up on current literature so you may as well do a literature review as well and get two papers out of the same project. Otherwise, if you don’t know what you want to research but have a general field idea, your best bet is to find a researcher in that field and ask them if they need any medical students.
How do I find a supervisor?
The next hurdle that a lot of people face is finding a supervisor. Don’t get me wrong, it can feel really awkward or uncomfortable to find people and email them to ask them to help you when they have no idea, or very little idea, who you are. I’ve tended to realise over time that a lot of people are so busy that if you email them and they aren’t available, or you emailed the wrong person, they do not have enough time to think badly of you and they genuinely, just won’t care. More often than not I’ve emailed people and it’s been the completely wrong person, but they’ve either not responded at all or sent me the email of someone who would be more suited to it. The best starting point is to email someone who is in that rough field, be it a doctor or a researcher. I’ve done this through straight out googling people until I find their emails online (sometimes they’re available on the NHS website), but oftentimes it’s better to find people who have links to your university. This could be lecturers, or tutors who run small group sessions, or module leads. Going up to people after lectures really does make such a difference with getting contact details. Finally, asking your friends! People can have contacts in all sorts of areas so you can really get ahead just by using those contacts. I then finalise the email saying that if they wouldn’t be suitable, do they know anyone who could be? It’s a lot of emailing back and forth, but trust me, it becomes a lot less awkward over time.
