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Research Year ACGME Competencies are numbered and coded by number from 1-6 following each learning objective. - Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and promotion of health
- Medical Knowledge about established and evolving biomedical, clinical, and cognate sciences and application of this knowledge to patient care
- Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
- Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their patients’ families, and other health professionals
- Professionalism as manifested through commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
- Systems-Based Practice as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value
Research Year Goals:
- Demonstrate an understanding of research principles and their application to the practice of general surgery.
- Demonstrate knowledge about the use and application of study designs and statistical methods.
- Demonstrate knowledge of the role of clinical databases in clinical research/patient care.
- Demonstrate knowledge of the principles underlying evidence-based surgery.
- Demonstrate the ability to critically evaluate the information provided by drug companies and medical instrument and equipment manufacturers.
- Obtain peer-reviewed funding and/or publish original research in a peer-reviewed journal.
- Prepare review articles or chapters in textbooks.
- Publish/present case reports or clinical series at local, regional, or national professional/ scientific society meetings.
Knowledge Objectives: - Differentiate between research study designs such as: Descriptive or case series, Case control (retrospective), Cross sectional (prevalence), Cohort (prospective/incidence), Clinical trial, Sequential (repeated measures), Crossover (Comp 2, 3)
- Discuss concepts related to study design such as: Internal versus external validity (generalizability), Major threats to internal and external validity, Randomization, random selection, random assignment (Comp 2, 3)
- Distinguish between techniques/methods for exploring and presenting data such as: frequency distribution, histogram, bar chart, frequency polygon, contingency table, scatterplot (Comp 2)
- Distinguish between statistics used to summarize or describe data such as: mean, mode, median, range, standard deviation, percentile, interquartile range, proportion, ratio, rate (Comp 2, 3, 4)
- Interpret the following vital statistics rates: mortality, morbidity, cause specific mortality rates, prevalence, incidence, adjusted rates (Comp 1, 2, 3, 6)
- Distinguish between the following measures of relationship between two variables: Pearson correlation coefficient, coefficient of determination, Spearman rank correlation, relative risk, odds ratio (Comp 2, 3, 6)
- Interpret the following terms and concepts related to drawing inferences from research data: (Comp 1, 2, 3, 4, 6)
- Population versus sample
- Population distribution, sampling distribution, standard normal distribution
- Standard error versus standard deviation
- Hypothesis testing, null and alternative (research) hypothesis
- Parametric versus nonparametric tests
- Confidence intervals, confidence limits
- One tailed versus two tailed tests
- Level of significance, alpha level, P value
- Type I error, type II error, power
- Identify the following tests of significance and concepts related to the comparison of means: (Comp 1, 2, 3, 4, 6)
- Independent and paired t-test (parametric tests)
- Wilcoxon rank sum test (also called the Mann Whitney U or the Mann Whitney Wilcoxon rank sum test) (nonparametric test)
- Wilcoxon signed ranks test (nonparametric test)
- One way analysis of variance (ANOVA)
- Two way ANOVA
- Repeated measures ANOVA
- Statistical interaction
- Planned comparisons
- Posterior or post hoc comparisons such as the Tukey, Scheffe, Newman Keuls, Bonferroni, and Dunnett procedures
- Identify the following tests of significance and concepts related to the comparison of proportions: (Comp 2, 3, 4)
- Z approximation test
- Chi square test
- McNemar test for comparing proportions in paired groups
- Sample size and strength of association in the interpretation of the Chi square statistic
- Fisher's Exact Test
- Identify the following tests of significance and concepts related to investigating the relationship between two or more variables: (Comp 2, 3, 4)
- t-test for testing the significance of the correlation
- Fisher's Z transformation
- Confidence intervals for the relative risk and odds ratio
- Simple and multiple linear regression
- Standard error of estimate
- Confidence bands for a regression line
- Comparing two regression lines
- Testing the significance of the regression line and the regression coefficients
- Stepwise multiple regression
- Logistic regression
- Interpret the following concepts related to evaluating diagnostic tests and procedures: (Comp 1, 2, 3, 6)
- Sensitivity and specificity
- Gold standard
- Predictive value of a positive or negative test
- Index of suspicion or prior probability
- Likelihood ratio method
- Discuss the following principles, methods, and concepts related to evidence-based surgery: (Comp 1, 2, 3, 4, 5, 6)
Basic skills needed to critically evaluate the published evidence:
- Defining the clinical question
- Translating the question into searchable keywords
- Conducting the search
- Selecting the best articles
- Selection and evaluation of integrative articles such as review articles, meta-analyses, practice guidelines, and decision analyses
- Use of administrative databases to link patient outcomes to costs related to producing these outcomes
- Use of patient-reported outcome measures as another method for evaluating the success of surgical treatments
Skills Objectives: - Critically evaluate the published evidence for a surgical therapy using a computer search engine such as MEDLINE, using the users’ guide for evaluating therapy articles, and summarizing your findings in writing, to include your recommendation for surgical practice (Comp 1, 2, 3, 4, 5, 6)
- Write a summary of the literature review, including a synthesis of the major findings and a recommendation for surgical practice (Comp 1, 2, 3, 4, 5, 6)
- Identify and prepare a case study suitable for presentation or publication (Comp 1, 2, 3, 4, 5, 6)
- Design and conduct a surgical research study, utilizing the following activities (Comp 1, 2, 3, 4, 5, 6):
- Select/search for a researchable project, involving an attending or other clinician-mentor
- Search and review the literature
- Formulate hypotheses
- Identify key variables (both predictor and outcome), decide on the optimal level of measurement, create operational definitions, and assess reliability
- Develop a research design
- Identify population and study sample
- Develop sample selection procedures
- Select or develop measures
- Develop study protocol and prepare institutional review board (IRB) proposal
- Collect and analyze data
- Interpret results
- Identify various journal formats and related instructions to authors
- Write paper
- Review techniques for optimal presentation of papers and posters, including related media
- Convert paper into an appropriate presentation
- Deliver the presentation
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