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EMERGE: Enabling Medical Research Growth in Emergency Medicine



Those interested in becoming an Emergency Care Scholar must have demonstrated prior interest in emergency care research and be committed to an academic career in this field. Only clinicians are eligible. Scholars without prior formal clinical research training enroll in the two- to three-year Master of Science in Clinical Epidemiology (MSCE) degree program and take classes and work alongside MSCE trainees with interests in the application of epidemiologic methods to other health-related issues and questions. These Scholars receive an MSCE degree upon completion of the training program. Scholars who already have been trained in clinical research receive highly individualized training that could include enrollment in the PhD in Epidemiology degree program, if desired.

Upon admission, Scholars are assigned to a methodologic preceptor (a clinical epidemiologist and faculty member with an appointment in the Center for Clinical Epidemiology and Biostatistics (CCEB)) and an emergency care preceptor (a clinician with expertise and research experience in emergency medicine with an academic appointment in an appropriate department/division). Shortly thereafter, each Scholar is assigned a biostatistics preceptor (a biostatistician and CCEB faculty member) to assist in the statistical aspects of the design of the protocol. Together, the methodologic, emergency care, and biostatistics preceptors serve as the Scholar's mentoring team; the methodologic preceptor acts as the team leader. All preceptors are chosen by the Program Directors, in concert with the Scholar, to provide the best fit for the Scholar's interests and prior training.

The methodologic preceptor and Scholar meet weekly to develop the Scholar's program of study, discuss the research protocol, clarify questions arising in courses, and identify sources of information in and outside Penn. The emergency care preceptor and Scholar meet frequently to discuss academic and career issues and to ensure that the research protocol has an appropriate clinical focus. The mentoring team meets formally several times and informally throughout the Scholar’s course of study to review progress. Generally, the biostatistician joins team meetings on an as needed basis and/or meets separately with the Scholar as desired.

The training program for Scholars who enroll in the MSCE program consists of:

  1. core courses in clinical epidemiology, biostatistics, and logistical and ethical issues specific to research in the emergency setting;
  2. advanced elective courses in research methods and policy and implementation strategies;
  3. emergency medicine research conferences;
  4. instruction in the responsible conduct of research, regulatory affairs, and the ethics of research in emergency medicine;
  5. a professional development seminar series;
  6. a research apprenticeship;
  7. development and completion of a research project in cardiovascular, pulmonary, hematological, or trauma-related emergency medicine, under the close supervision of the mentoring team; and
  8. development of a grant proposal. The training program for those with prior formal clinical research training is highly individualized and will be customized with the training components above to meet the needs of the Scholar.

The courses and activities (#1 through #6 above) are designed to provide direction for the focus of the training program, which is the completion of a closely mentored research project. Each Scholar conducts an independent research project while working closely with his/her mentoring team. Scholars are expected to develop, implement, and analyze a research project and summarize the results in a publishable manuscript. The research project provides hands-on experience in formulating one or more research questions; searching the medical literature; translating research questions into an appropriate research design; assessing study feasibility; writing a detailed study protocol; designing data collection instruments; conducting field work; performing data analysis; and preparing a manuscript for publication. Thus, Scholars experience in all facets of clinical research.

Each Scholar's project must consist of clinical research into an important question in emergency care and be of publishable caliber. The project must be able to stand on its own, with a sufficient sample size to answer a research question. Scholars are encouraged to design studies that address important questions that need to be answered before undertaking major studies such as those suitable for grant funding. Cohort or case-control studies based on chart abstraction or use of an existing computerized patient database are acceptable, as are clinical decision analyses and meta-analyses, often in combination. Also acceptable are methodological studies such as studies of inter-observer reliability or validating information from databases against primary sources. Scholars also are required to participate in a primary data collection activity to provide a meaningful experience in this critical area.

Clinical responsibilities for Scholars are minimal, as this is primarily a research fellowship. Clinical activities entail no more than 25% effort. This should be the maximum amount needed for Scholars to maintain clinical skills, and should be directly relevant to their training in research.

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