The most important factor for a successful research project is adequate planning. Published advice is provided by experienced supervisors and project assessor.
Be SMART
A successful research project requires not only research related knowledge but effective project planning.
A ‘SMART’ project is: Specific, Measurable, Achievable, Realistic, Timely.
Satisfactory research projects include:
- small, compact clinical trials that answer a simple question relevant to paediatric emergency medicine
- well-designed validation studies of a common or important clinical test/tool
- retrospective studies that employ sound research methods and answer important/relevant questions
- comprehensive literature reviews with at least 5 studies to analyse on the topic
- well-designed observational or cross-sectional studies, comparing patient groups
- an audit or quality project is only acceptable if it reports a full audit cycle (audit, intervention and re-audit) and combined with a literature review
Time management
Your research project is likely to take 12 to 18 months from the first idea to its assessment. This timeframe may be considerably longer than you’re used to. Most successful projects require about 200 hours of trainee input over the research project’s duration, so you need to allow for this when organising your schedule.
When planning, you’ll need to consider the availability of your supervisor(s). Supervisors may take leave, attend meetings and/or have periods where they are temporarily unable to assist you due to other commitments. This can be disruptive at key periods of the project. You can avoid unexpected delays in your project by asking your supervisor(s) of their likely availability during the study period. Where possible, having more than one supervisor may help.
Before you start
Funding
Search for sources of funding, if required. Most research projects don’t require funding, just time and enthusiasm.
Know the requirements
Read the training requirement and clarify any areas you’re unsure about with your supervisor. If you have time, read about commonly used study methods and analyses.
Identify tools and resources
Understand what applications or software you’re likely to use before your project starts. Generally, you’ll need to be able to:
- search medical databases
- use Microsoft Word (or equivalent) and its editing and review features
- complete data entry and retrieval using database applications and/or Microsoft Excel
Choose your supervisor
Choosing your project supervisor is very important for your learning and project success. Not all RACP or ACEM consultants are equally skilled or comfortable with supervising research projects.
Choose a supervisor familiar with the Paediatric Emergency Medicine Research Project requirements and that has experience in supervision of research projects, where possible.
Also consider your personal compatibility with potential supervisors — you’ll have close contact with them during the project duration.
Act on advice
A significant proportion of research projects fail because trainees don’t act on their supervisor’s advice.
If your project fails at its first assessment, it’s critical you address all the issues raised in the feedback provided by the assessor in your resubmission. If you do this sufficiently, you’ll give yourself the best chance of success.
Study site selection
Everyone who works in healthcare is busy and helping to conduct research projects is just one of the many demands they need to consider. You should try to be in the department where your research project study is being conducted throughout.
Your strong presence in the department when the research is being conducted is a critical factor for success. If you’re not working in the department for the duration of the study, you’ll need to be able to return to the department on a regular basis.
Project phases
An example of timings for each phase of a research project life cycle.
Developing research idea and determining authorship | 4 weeks
Make sure the idea interests you — enthusiasm for someone else’s idea is unlikely to last for long.
Choose to study something that has some relevance or importance and is not already self-evident. For example, a study to see if patients triaged to the resuscitation room have a higher mortality rate than those triaged to the fast-track area is a waste of time — it’s obvious and already known.
Literature search/refinement of idea into a study outline | 2 weeks
An adequate literature search is crucial in finding out if the answer to your research question is already known. If it is, you need to choose another idea. As well, if someone else has done a similar study to the one you have planned, your study might not be considered to be original.
If your research question hasn't been answered, use the information gained from similar studies to develop the methods you will use.
Develop specific study objectives as vague objectives lead to ambiguous and inconclusive results.
For example, a study that aims to ‘determine the incidence of post-intubation hypotension in emergency patients following poisoning and the factors associated with its occurrence’ is more likely to achieve its aim as it defines population, intervention, outcome and potential comparators. For comparison, a study that aims to ‘determine if there is are any associations between airway manoeuvres and possible adverse effects’ is not specific enough and less likely to succeed.
Develop specific hypothesis before data collection. If you don’t have a specific hypothesis, you’re likely to end up data dredging. Data dredging is a very serious error and should be avoided at all costs. It occurs in studies with vague objectives that collect large amounts of data and perform multiple comparisons between groups to find a statistically significant ‘result’. The study is then written, pretending that the ‘result’ found was one of the study hypotheses. This usually produces false positive results and leads to inaccurate conclusions.
Check that you're heading in the right direction and that your proposed study will be able to meet the learning objectives at this stage. Experienced advisors can usually detect the likely problem areas and help you to modify them — but this is only possible during the planning phase. Receiving advice later in the project is of little use and at that stage cannot change the outcome.
Development of study methodology, sample size calculation | 4 weeks
Deciding the methods that you’ll use is the most important part of the study as it determines the quality of the information you collect. Studies with good methods collect more accurate information and conclusions that are more likely to be correct.
Make sure the methods you use are as good as they can be to minimise possible biases. Spend time getting this area right before considering anything else. Large, poor quality studies are less likely to pass at assessment than smaller, but appropriately sized, high quality studies.
Sample size calculation is an essential part of study planning and usually requires access to specialised statistical software. If your study is too small, you reduce the chance of being able to adequately see if your theory is right. If it’s too big, you have wasted people’s time and may have even potentially exposed patients to unnecessary harm.
Information from similar studies can be used to help with the calculation of sample size. You can also conduct a pilot study to test the feasibility of your study plan or to collect data for a sample size calculation — these results will be helpful in deciding whether to continue with your idea or not.
In clinical studies, many potential study subjects are not enrolled for a variety of reasons. Even in well-conducted studies, less than 50% of the eligible population will end up being enrolled. You need to allow for this when calculating how long your proposed study might take.
Research ethics committee approval and trial registration | 6 weeks
Developing the ethics committee submission is worth the effort it requires as it generally forms the basis of the introduction and methods section of your manuscript — that’s half of your manuscript.
This process usually requires 2 to 3 revisions, with input from your supervisor. Most ethics committees meet monthly so submit your proposal at the right time to prevent unnecessary delay.
A variety of trial registers exist, such as the Australian New Zealand Clinical Trials Registry. Trial registration doesn’t take long and is required by many journals if a study is to be considered for publication. It also demonstrates that the study was not a data dredging exercise.
Study | 6 to 12 months
A study’s duration can vary based on its nature. Studies usually run between 6 to 12 months and are rarely less 3 months in length.
Expect activity to be intense for the first month of the study. Schedule a start date at a time when you and your supervisor are freely available.
Unexpected problems always arise when putting study planning into practice. You should plan to conduct staff education sessions and generate material to promote awareness of your study.
With no more than 2 to 3 staff members likely to be available at any given session, due to circumstances like shift work or leave, multiple education sessions are usually required.
After the start-up period, you should focus on staff motivation and data collection for the remainder of the study. If you’re undertaking a retrospective study, be aware that retrieving case notes from medical records for review is often a lengthy process. With many records not available at any given time, requests for record retrieval need to be performed repeatedly and usually in small batches. Electronic or scanned medical records will expedite the process.
Data analysis | 6 weeks
This stage usually requires 1 primary analysis and 1 secondary analysis, to deal with unexpected issues, and should be performed by someone with statistical expertise.
Be prepared to modify the format of collected data so it can be used by the statistical software for analysis. This phase may be longer if external statistical advice is required.
Be aware that availability of assistance from many university statistical departments varies throughout the year, so you should check this prior to commencing the study.
Prior to analysis you should meet the statistical advisor to discuss the study aims and methods. After the analysis, you should meet again to discuss the results, statistical methods used and the reasons for their choice of methods. Taking notes on the methods used and the reasons for their use can be very helpful if your understanding of statistics is limited.
If you don’t use a statistician, you must make sure you analyse the distribution of the data prior to performing any analyses. This is important to make sure the most appropriate statistical methods are used. For example, failing to recognise that data is not normally distributed can lead to the inappropriate description of its central tendency and spread, such as use of mean instead of median or standard deviation instead of interquartile range. This will usually increase the chances of false positive results when subjected to statistical testing.
Manuscript preparation | 3 months
This is an intense period where supervisor availability and input is important.
The ‘methods’ section is the most commonly underdeveloped section in research projects, so it requires your attention. The aim should be to describe the methods used in enough detail to enable someone else to repeat your study.
Most manuscripts require 2 to 3 revisions before being suitable for submission. Keep the language simple, write 1 idea in each sentence and have 1 theme for each paragraph. Check the manuscript for clarity, accuracy, coherence of ideas as well as the objectivity and logic of any arguments used.
Refer to marking criteria and discuss each item with your project supervisor.
Study reporting
No study is perfect and good research is about being honest. Make sure you consider the potential limitations of your study and are open about them in the discussion section of your report.
It’s particularly important that you consider all possible sources of significant bias. Trying to cover up major limitations of your study is much more likely to result in an unsatisfactory assessment than if you are open and honest about them.
Conclude only what is supported by your study data
Trying to make a ‘negative’ study appear like a ‘positive’ one is a lost cause in front of an experienced assessor. Whether the results support or reject your hypotheses has no effect at all on the project result. Research is all about finding out if your theories are correct — but they can’t always be.
If you were already sure of the answer to your research question when you started, then you shouldn’t have done the study.
Resources
Paediatric Emergency Medicine Project Report cover sheet (PDF)
Paediatric Emergency Medicine Project Supervisor Report (PDF)
RACP Online Learning Resource: Research Project
Research Project Checklist and Planner (XLS)