Preparing to conduct research
Introduction to psychiatric research
Research is an integral part of how the medical profession makes new discoveries and improves the practice of clinicians and services. Being a researcher is about having an opportunity to be a part of the scientific process, and allows you to give back to the profession. It is a time-consuming and sometimes frustrating process, but a rewarding one! You can expect to gain (and produce) new knowledge over the course of a research project, and one of the other useful benefits will be an improved ability to assess and utilise the research findings of others.
Choosing a research question
During the course of your clinical practice, you will come across questions that are not answered by a review of the scientific literature. Maybe no one has done research in the area you are considering, or maybe research has been done in other countries or settings but none has been done that is applicable to your area. For instance, what is the association between cannabis use and development of schizophrenia?
Once you have a research question, you need to operationalise it. This means that you need to change your question into something that is answerable by a research study. One way of doing this is through the PECOT formula (population, exposure, control, outcome, time) described at the University of Auckland’s EPIQ website. Framing your question in this way gives you some idea of what type of study would be the best way to answer it.
Choosing a supervisor
Once you have chosen your research question, you need to find a supervisor. Ask your local senior colleagues, university department or Director of Training for advice. Bear in mind that your supervisor may be your clinical supervisor, or can be someone without a direct clinical load. Depending on the type of research you want to do, perhaps a career researcher might be a better option than someone with a busy clinical practice. If you have a researcher as a primary supervisor, remember that the Scholarly Project guidelines require you to seek a local Fellow to co-supervise.
Meet with the potential supervisor to see if there are mutual interests in research and to gauge if you have compatible working styles. If this is your first piece of research, make sure the supervisor is willing to help you through some of the basics, such as looking over and correcting your proposal and ethics application, helping you with basic questions around methodology, and giving you feedback on your write-up. Some supervisors are interested in the end product – the published paper – but aren’t very hands-on when it comes to the process of producing it. Putting together a written supervision agreement is often a good idea to clarify the supervisory relationship.
Ask if you can speak to previous students of the supervisor, particularly those who have finished their research and moved elsewhere – they are more likely to give you an honest opinion.
Planning and developing a research project proposal
In consultation with your supervisor, the next step is to decide what the appropriate methodology for your research should be. A guide to different types of research can be found via the below links:
Qualitative research should involve consultation with a research expert in the particular methodology of research in which you are interested. There is sometimes a perception that qualitative research is easier than quantitative; this is not the case, and you will need to plan your methods carefully. Some issues to think about are outlined in these articles:
If you are undertaking quantitative research, this should involve consultation with a person with statistical experience. If your local health board or university has a statistical consulting unit, you should make it a priority to talk to them. Your supervisor may be able to arrange for someone to work with you and help with statistical analysis (supervisors may have a research assistant able to help or funding to pay for someone to help). Other options include collaborating with a researcher experienced in statistical analysis. It may be beneficial to undertake a short course in statistics. Often universities will offer short courses in basic statistics for social sciences. If your supervisor is unaware of available courses, contact local universities for further information about the courses they offer. There are some free online guides to basic statistics, such as Statistics at Square One, hosted by the British Medical Journal, and the more detailed Introduction to Biostatistics online lecture course, offered by the Yale Center for Clinical Investigation.
If you are considering a clinical audit, you need to have a good idea about what information you need and what clinical practice improvement you are aiming for.
Spend some time putting together a complete study proposal with your supervisor. This should include aims, hypotheses, methods, analysis, power calculation, timeline, information and consent forms, and proposed outcomes.
- Aims should be a simple, clear explanation of the objectives.
- State hypotheses based on a literature review and/or preliminary research.
- Methodological detail includes: population, sampling, measurements, measurement instruments (surveys/scales/investigations).
- Power calculations should be based on the measures you intend to use and refer to prior studies for estimations of differences in measures to calculate effect size. Consider using a free power calculation program such as G-Power. In the case of qualitative research consider the number needed for saturation of themes.
- Analysis should include detail on appropriate statistical methods, based upon statistical advice from an expert and supervisor, including the software etc. with which the statistical analysis will be conducted.
- Plan a reasonable timeline for your project with your supervisor based on your commitments.
- Outcomes are what you believe your research will contribute to the scientific literature and the proposed significance.
Taking the time to put together a detailed study proposal is time well-spent. It gives you a number of advantages:
- It allows you to put together your literature review in one place, and this part can be recycled for the introduction in your write-up.
- By setting out the methods clearly, you know what you are doing beforehand and have made sure the study is appropriately designed and powered. Again, this section can be tweaked to go into your write-up.
- A clear proposal will help you with the ethics and funding applications, discussed below.
Ethics applications should be considered for all studies and should be discussed with your supervisor.
The exception is clinical audits for quality assurance, but it may still be worthwhile to obtain a ruling from the relevant ethics committee that specific approval is not required.
A complete study proposal as outlined above is needed for submission for ethical approval.
Information and consent forms may need to be prepared for recruitment and consent for participants.
Ethics approval can be obtained from the appropriate jurisdiction:
- university ethics committee (one of the investigators will need to be affiliated with the University)
- hospital or local health service ethics committee (public or private)
- multiple approvals may be required in joint health service and University research and are best obtained with one committee, with the approval attached to the other relevant committee
Useful guidelines on human research ethics can be found on the NHMRC website. Some additional guidelines are available for considering ethical issues while working with indigenous communities, both in Australia and New Zealand. The College also publishes guidelines for working with Indigenous communities.
Once you have put together your research proposal and received ethical approval, you can use it to apply for grants to aid you in completing the study. Your supervisor will have ideas about where to apply. The College awards a limited number of New Investigator Grants of up to $6000 each year, and encourages applications from trainees in any year of training, College Fellows in the first 2 years after Fellowship or medical students who are conducting research supervised by a Fellow of the College. Other external funding sources useful for psychiatry include the MIGA Doctors in Training (DIT) Grants Program.