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Research Associates Program at St. Vincent’s

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  1. Research Associates Program at St. Vincent’s Frank Illuzzi, MD, FACEP Keith Bradley, MD Patrick Eiben, BS Erika Gardner, BS Michael Haydu, BS William Keefe, BA

  2. Research Associates (RAs) RA’s are pre-health professional students who volunteer in the emergency department (ED) as participant identifiers and data collectors in clinical research.

  3. Clinical Research in the EDIs Different Emergency Department experience …

  4. Clinical Research in the EDIs Different Emergency Department experience … vs. Research Lab experience …

  5. RAs: An Answer to Some of the Obstacles to Research • bright, motivated individuals • primary responsibility = research • focused experts on the details of the research • on-site, 24/7, in the ED • available in large numbers • "free“ = paid in a commodity other than money

  6. RAs: An Answer to Some of the Obstacles to Research • bright, motivated individuals • primary responsibility = research • focused experts on the details of the research • on-site, 24/7, in the ED • available in large numbers • "free“ = paid in a commodity other than money Traditionally, whom did they get for the job?

  7. RAs: An Answer to Some of the Obstacles to Research • bright, motivated individuals • primary responsibility = research • focused experts on the details of the research • on-site, 24/7, in the ED • available in large numbers • “free” = paid in a commodity other than money Medical Students!!!

  8. Difference between MS1 and Pre-Med?

  9. Difference between MS1 and Pre-Med? • 1st year of medical school: • anatomy, physiology, biochemistry, neuroscience • real clinical skills?

  10. Difference between MS1 and Pre-Med? • 1st year of medical school: • anatomy, physiology, biochemistry, neuroscience • real clinical skills? Not so much until MS 3,4

  11. Difference between MS1 and Pre-Med? • 1st year of medical school: • anatomy, physiology, biochemistry, neuroscience • real clinical skills? Not so much until MS 3,4 • So … why not ? • health professional school applicants / college Seniors

  12. Difference between MS1 and Pre-Med? • 1st year of medical school: • anatomy, physiology, biochemistry, neuroscience • clinical skills? Not so much until MS 3,4 • So … why not ? • health professional school applicants / college Seniors • Juniors, Sophomores and 2nd semester First Years

  13. We’re Looking for a Lot of Good Pre-Health Professional Students

  14. We’re Looking for a Lot of Good Pre-Health Professional Students Who want: • a significant clinical exposure • a significant research experience • a specific role in the ED (vs. just shadowing) • to work with a diverse patient population • an evaluated patient-care experience

  15. Research Associates Functions • enroll participants in clinical research • obtain demographic and historical information • measure physical parameters • read informed consent • facilitate the research

  16. Research Associates Responsibilities • participate in training and orientation • volunteer one 4-hour shift / week / semester • receive evaluations by RA Program staff on • patient interaction skills • ability to follow research protocol • accurate data collection

  17. Do RA Programs Work?

  18. Do RA Programs Work? Since 1994, • ≈ 40,000 participants enrolled in studies

  19. Do RA Programs Work? Since 1994, • ≈ 40,000 participants enrolled • ≈1000 RAs

  20. Do RA Programs Work? Since 1994, • ≈ 35,000 participants enrolled •  900 RAs • in 22 clinical research studies

  21. Do RA Programs Work? Since 1994, • ≈ 35,000 participants enrolled •  900 RAs • in 22 clinical research studies • traditional, e.g., ankle injuries, trauma, CQI

  22. Do RA Programs Work? Since 1994, • ≈ 35,000 participants enrolled •  900 RAs • in 22 clinical research studies • traditional, e.g., ankle injuries, trauma, CQI • screening, e.g., domestic violence, firearms risk,

  23. Do RA Programs Work? Since 1994, • ≈ 35,000 participants enrolled •  900 RAs • in 22 clinical research studies • traditional, e.g., ankle injuries, trauma, CQI • screening, e.g., domestic violence, firearms risk, Pap, mammogram, PSA, colon-rectal

  24. Tobacco Cessation Pilot Study

  25. Tobacco Cessation Pilot Study • 3125 participants enrolled in 21 weeks by 63 RAs

  26. Tobacco Cessation Pilot Study • 3125 participants enrolled in 21 weeks by 63 RAs • 54% of participants smoked at some time

  27. Tobacco Cessation Pilot Study • 3125 participants enrolled in 21 weeks by 63 RAs • 54% of participants smoked at some time • 22% within the preceding 30 days

  28. Tobacco Cessation Pilot Study • 3125 participants enrolled in 21 weeks by 63 RAs • 54% of participants smoked at some time • 22% within the preceding 30 days • 18% of smokers accepted CT Quitline referral

  29. Tobacco Cessation Pilot Study • 3125 participants enrolled in 21 weeks by 63 RAs • 54% of participants smoked at some time • 22% within the preceding 30 days • 18% of smokers accepted CT Quitline referral • 38% of those who smoked within preceding 30 days

  30. Tobacco Cessation Pilot Study • 3125 participants enrolled in 21 weeks by 63 RAs • 54% of participants smoked at some time • 22% within the preceding 30 days • 18% of smokers accepted CT Quitline referral • 38% of those who smoked within preceding 30 days • ≈ 50% of all CT Quitline referrals in the state during those weeks came from the St. V’s ED!

  31. Study for 2012 Tobacco Cessation Study national, multicenter • based on the pilot work at St. Vincent’s • 14 hospitals around the country, hundreds of RAs • in less than 40 weeks • projected to enroll 50 – 75,000 participants • potentially the largest prospective, interventional clinical trial

  32. Study for 2012 Tobacco Cessation Study national, multicenter • based on the pilot work at St. Vincent’s • 15 hospitals around the country, hundreds of RAs • in less than 40 weeks • projected to enroll 50 – 75,000 participants • potentially the largest prospective, interventional clinical trial ever done

  33. Study for 2012 Tobacco Cessation Study national, multicenter • based on the pilot work at St. Vincent’s • 15 hospitals around the country, hundreds of RAs • in less than 40 weeks • projected to enroll 50 – 75,000 participants • potentially the largest prospective, interventional clinical trial ever done Nice topic at health professional school interview?

  34. Think of These Numbers

  35. Think of These Numbers • > 1/2

  36. Think of These Numbers • > 1/2 • more than half the U.S. population goes to ED every year as a patient or visitor

  37. Think of These Numbers • > 1/2 • more than half the U.S. population goes to ED every year as a patient or visitor • 4

  38. Think of These Numbers • > 1/2 • more than half the U.S. population goes to ED every year as a patient or visitor • 4 • average number of hours for an ED visit

  39. Think of These Numbers • > 1/2 • more than half the U.S. population goes to ED every year as a patient or visitor • 4 • average number of hours for an ED visit •  500,000

  40. Think of These Numbers • > 1/2 • more than half the U.S. population goes to ED every year as a patient or visitor • 4 • average number of hours for an ED visit •  500,000 • college students and post-bacs interested in medical school

  41. National Alliance of Research Associates Programs(NARAP) • RA programs in multiple hospitals around the U.S. • clinical research consortium on the ED as a site to facilitate primary care screening • tens of thousands of participants enrolled in clinical studies over short time periods A Research JUGGERNAUT!!!

  42. NARAP Member Institutions CT Hartford Hospital/UConn Lawrence & Memorial St. Vincent’s. Bridgeport DC Georgetown MA UMass MO St. Louis University NE Creighton University NJ Hackensack U. Med Center NY University of Rochester NV University of Nevada PA Jefferson TN Delta Med Center, Memphis TX Seton / U Texas, Austin VT UVM WA Pullman Regional

  43. Research Associates Program Process • recruit - local colleges during the school year - nationally for the summer semester • orientation sessions (8 hrs. / weekend day x 2) • basics of clinical research • ethical issues • safety • specifics on data collection for each study

  44. RA Program at St. Vincent’s Medical Center • 85,000 patient visit ED • largest ED in largest city in CT • diverse patient population • Level 2 Trauma Center • the major teaching affiliate of Quinnipiac University School of Medicine

  45. RA Programs Benefits • Research is done effectively, efficiently, while minimizing impact on clinical care • RAs get clinical exposure and research experience • Advisers have a guaranteed evaluated clinical experience for their students • Study participants and future patients benefit most Win-Win-Win-Win

  46. Research Associates at St. V’s Becoming a RA • Application: www.RAProgram.org • Application fee: $200 non-refundable! • Criminal Background Check • drug testing • health clearance (varicella/chickepox, hepatitis B, TB) • uniform shirts x 2 • administrative fee • HPA letter of endorsement (Cut/Paste from website)

  47. Research Associates at St. V’s Shifts chosen according to time application and payment received ! Summer semesters, 2012 mandatory orientation Saturday and Sunday, 2 and 3 June or Saturday and Sunday, 16 and 17 June at St. Vincent’s Medical Center, Bridgeport

  48. Chief RAs Responsibilities • post-bacs in the application cycle • Program Director's assistants • develop their RA Program’s • recruiting, personnel management, scheduling, website, database management • “first port of call” for line-RAs' on-shift issues

  49. So, If You See the Potential … RA Program at St. Vincent’s www.RAProgram.org Chief RA in NARAP hospital • www.theNARAP.org