Research Project

A formal research project is required for the completion of and graduation from the Case Western Reserve University/University Hospitals Cleveland Medical Center Gastroenterology Fellowship Program by the end of the training period.

Research Project Purposes and Benefits

This requirement has multiple purposes and advantages, including:

• Enriches the overall value and quality of the fellowship program
• Exposes a fellow to scientific thinking
• Improves the ability to evaluate and criticize clinical and scientific information
• May open the road to a formal career in research
• May present an opportunity for trying some hands-on bench research
• Presents the chance for publishing a first-authored article in a journal of interest to the gastroenterological community
• Provides the opportunity of presenting the results at a national or international meeting
• Provides the opportunity to interact closely with a variety of faculty members inside and outside of the Division of Gastroenterology & Liver Disease

To achieve these goals a well-organized plan adhering to strict guidelines as outlined below is necessary. The expectation is that this may result in at least one abstract presented at a national meeting and one or more peer-reviewed publications.

Choosing a Research Project and Mentor

Soon after entering the training program each fellow should get acquainted with each divisional faculty member and become familiar with his or her clinical or scientific interests. This will provide the basis for understanding the areas of research available within the division and key faculty members to contact for preliminary discussions on the possibility of developing a research project.

The choice of a research project and formal supervisor should not be restricted to the members of the Division of Gastroenterology & Liver Disease only. Interaction with faculty outside of the division is encouraged but at least one gastroenterology faculty must be involved in the project. The choice of a research project and supervisor must be completed within the first six months of the fellowship (by the end of December).

Supervision and Task Assignment

The choice of the appropriate supervisor is a very important component for the success of any research project. There are no restrictions as to whom to approach to establish a formal relationship, but it is essential that the rapport is honest, open and mutually comfortable. The involvement in the research activities and commitments to achieving the goals of the research project must be mutual and not left entirely to the fellow or supervisor.

However, the primary initiative and most of the hands-on part of the project are the fellow's responsibility while the supervisor must be readily accessible to provide guidance, support and encouragement. Frequent informal meetings between a fellow and supervisor to choose, discuss, analyze data, judge progress and finalize the project are strongly encouraged.

Research Project Approval and Evaluation

Once the final choice of a project has been made, it must be presented and approved at two levels:

1. At the institutional level, approval by the Institutional Review Board (IRB) must be obtained for any study involving human subjects. It is the fellow's responsibility to submit and obtain the approval from the IRB. This should be done as early as possible to ensure that projects start in a timely manner so that there is plenty of time to collect data. This is a very important point since delay in starting is often a major problem in completing the project.
2. At the divisional level, the project must be presented at the Gastroenterology & Liver Disease Division Research Conference. This serves two purposes:
   • To verify that the project adheres to the guidelines established for the fellowship
   • Fellows can receive advice regarding the feasibility and overall merit of their projects

This will be done in a constructive manner so that modifications, corrections and changes in scope or direction are made early, avoiding major or late modifications that could undermine the success. The project presentation at the Research Conference must be done by spring of the first year of training.

Progress Report on Research Activity

The success of any research activity often depends on the continuous and critical evaluation of gathered data and objective analysis of the information being progressively collected. This ensures that a project is proceeding according to plan and allows timely changes that may be necessary to avoid major flaws that might be discovered too late. In some cases, if the goals do not appear to be achievable, switching to another project should be considered. A personal informal progress report by a fellow at the Research Conference must be done twice a year as follows:

• Spring (March-April)
• Fall (September-October)

In addition, a brief written report of a fellow's own impression about the progress of the project and the quantity/quality of supervision being received should be submitted at the Research Conference every six months.

Presentation of Research Results

Peer reviewing is essential to the quality and value of any clinical or scientific work, and this should be an integral part of any research project. To accomplish this each fellow will present his or her data to the faculty and fellows. The first presentation will be in the spring of the first year of fellowship and then every six months. These presentations serve multiple purposes.

The first should be rather informal and is meant to inform the division members what projects are being carried out and receive constructive comments and suggestions. The latter should be considerably more structured and will consist of semi-formal presentations of finished or nearly finished data including methods, analysis of results, discussion and conclusions. This will permit input and evaluation by all members of the audience and should serve as an adjunct to the preparation of a manuscript for publication.

Setting Practical and Achievable Goals

Many factors play a role in the successful completion of a research project. Starting a project is relatively easy, but finishing it may be more difficult and this is an especially important issue when time is limited as is the case of any fellowship. Therefore, it is critically important to pay attention to two practical aspects:

• Number of research projects
• Setting realistic goals for each of them

In principle, each fellow should try to be involved in two projects so that at least one will be finished. This does not mean that the projects should be pursued with different degrees of energy and commitment, but at times unexpected difficulties arise and one project must be drastically modified and/or dropped. The single most critical point to the successful completion of a fellow's project is to set realistic goals.

Failing to set practical and achievable goals is the most common and important cause of failure and must be avoided. Particularly when studying patients type, number and actual recruitment must be carefully considered and the help of a statistician must be sought. Very often patient accrual is slower than anticipated and the project is far from being finished by the end of the fellowship. If fellows choose a project involving more basic research activities, they must be sure that the necessary support system (time, reagents, space, etc.) are actually available or that somebody will help if necessary.

There is no magic formula that ensures the success of all research projects, but commitment and realism are the key ingredients to success. Fellows must be conscientious and practical about their aims and should feel free to seek help and advice from faculty whenever needed.