CVAHEC Student Project Reports

Jeffrey Randazza
Freeman Scholar Program

Prior to attending medical school, I was employed as a healthcare consultant. I received my Masters in Public Health with a concentration in Health Care Services. I thought that I was a candidate to quickly climb the corporate ladder because I obtained this degree.

However, I often saw my colleagues, some of whom had not received their Bachelor’s degree, advance quicker than myself. The difference was that they had years of experience in the field. One day, while talking to a supervisor about my observations, she said to me, “Experience beats education any day”. I did not quite believe her at the time, but as I am progressing in my medical education, her words seem more accurate.

To be honest, I believe that my friend got it half right. I truly believe that it is a combination of both formal education and experience in putting that education to use that makes one excel in a field. However, there is some truth to her statement.

There are many aspects of learning that cannot be taught in a classroom, such as instinct, learning from one’s mistakes, and the value of observing something first-hand as opposed to reading about it. Throughout my research experience this summer, the words of my colleague echoed throughout my brain.

I had always heard from others or read in journals how tedious and often difficult research could be. The difficulties in presenting to the IRB, fellow investigators, and participants were aspects that I had only read about in the past.

This summer I had the opportunity to experience the process of organizing and conducting a research study from start to finish. This experience was both educational and frustrating.

I was scheduled to start my research on June 23. I met with my contact person at University Pediatrics in May and learned that the purpose of the study was to investigate the effectiveness of office-based interventions on violence prevention. She told me that she would enroll the providers in her office and obtain IRB approval in time for me to start on June 23.

When June 23 came I expected to arrive at the office and start enrolling patients. I soon learned that I was naïve in this thought. The IRB had not yet approved the study and more than half of the providers were unsure of their commitment to the study. From day one, my inexperience as it relates to research was apparent.

Due to my inexperience, I had not counted on the roadblocks and difficulties I would encounter. I quickly learned that IRB approval was on its way and it was my job to pitch the study to the providers at the next staff meeting.

I was warned that these physicians were feeling tremendous pressure from Fletcher Allen Health Care in that they had to produce revenue during these economically challenging times. The addition of an intervention that would possibly slow their pace during the day was not likely to be received warmly.

I thoroughly prepared for the meeting. I wanted to have all the bases covered. I wanted the providers to know that I was prepared to make this study run as smoothly as possible. I looked up every provider’s schedule for the next seven weeks, and compiled a spreadsheet listing all the patients that met the study criteria by time, office location and provider.

I thought for sure that a fancy looking spreadsheet would impress them and ease their worries. I soon learned otherwise. It is here that my experience in healthcare consulting came into play.

In my role as a healthcare consultant, I often presented financial reports to groups of 50 or more physicians. As a result, I was not nervous at all for this upcoming meeting. The meeting went relatively as expected. I was prepared for all questions and answered them with confidence.

I was not prepared, however, for the lack of interest that many physicians showed for the study. I later learned that it was not a lack of interest, but a fear of taking on more than one could handle in an already pressurized time.

At the conclusion of the meeting, I found myself reflecting on the words of my colleague. It was my experience as a healthcare consultant that allowed me to face this meeting with confidence. It was my history of conducting similar meetings in the past, not specifically something that I learned in a classroom that made me prepared.

However, it was important for me to keep in mind that my classroom experiences also contributed to my readiness for the meeting. I was learning that education and experience make a dynamic team.

After we finally got IRB approval, providers enrolled in the study, and I completed my training, we were ready to start the study. I found it to be a great learning experience to work in a physician’s office.

Talking with the parents of the patients about violence prevention proved to be more difficult than I anticipated. Issues such as gun control and limiting the amount of media (i.e. television and internet) exposure were addressed. It was interesting to observe how defensive some parents were concerning these issues.

I quickly learned that I needed to approach these issues with some care. For the most part, parents were willing to participate in the study. As soon as we started the study, the number of enrolled patients grew quickly.

However, since we started the study later than anticipated, I ran out of time before my classes started. Anticipating this, I recruited two undergraduate students to carry on the study in my absence. With hard work we were able to recruit most of the participants to complete the study, so that a minimal amount of work would be needed in my absence.

The study is still being carried on today with an expected completion date of October.

Performing this research study at University Pediatrics turned out to be a valuable experience. Challenges, such as working with patients and providers to obtain a common goal, approaching patients about a sensitive topic, working with providers to complete the study while minimizing disturbances in their production, and training others to perform the study, were all prevalent.

These challenges were dealt with, however, and valuable lessons and skills were obtained. These skills will prove valuable in my future medical education.

Now that all is said and done, I have to agree with my colleague when it comes to my previous thoughts on research – “Experience does beat education”!