Clinical Epidemiology: Evidence Based Clinical Care in Acute Medicine

Unit Code

02048

Department/Institution Offering Unit

Monash-Cabrini Department of Medicine
Cabrini Institute
Cabrini Health
183 Wattletree Road
Malvern Victoria 3144

http://www.cabrini.com.au

Unit Points

Research Points: 87.5

Coursework Points: 12.5

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Contacts

Unit Coordinator/s:

Assoc Prof Michele Levinson
Monash-Cabrini Department of Medicine
Cabrini Institute
Cabrini Health
183 Wattletree Road
Malvern Victoria 3144

tel: +03 9508-1454
fax: + 03 9508 1368
email: mlevinson@cabrini.com.au

Alternative Contact:

Fiona Clay
Monash-Cabrini Department of Medicine
Cabrini Institute
Cabrini Health
183 Wattletree Road
Malvern Victoria 3144

tel: +03 9508-1416
fax: + 03 9508 1368
email: fclay@cabrini.com.au

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Overall Objectives

Cabrini Hospital is a Catholic tertiary teaching hospital committed to providing ongoing high quality health care through a partnership of excellence in clinical practice, education, ongoing research and the latest technology. Cabrini Institute encompasses a range of activities including high quality academic research, undergraduate and postgraduate teaching, and education with a clinical focus.

The Monash-Cabrini Department of Medicine is focused on the use of evidence based research for the improvement of patient care at all levels- from patient contacts with the Emergency Department, during the in-hospital experience, through to discharge back home. The focus of the department is around acute common medical problems principally affecting older persons.

The overall objectives of the unit is to:

• To provide basic training in clinical research methods through coursework in epidemiology and biostatistics and then to apply these tools to a research project
• To develop experience in moving a clinical research project through the phases of project design, data collection, database entry, statistical analysis and report writing
• To provide an opportunity for regular patient and clinician contact in a private tertiary teaching hospital
• To provide training and assistance in critical review of literature

This unit is appropriate for a student who:

• Has an interest in evidence based clinical practice and an awareness of the gaps between evidence in the research literature and in-hospital clinical practice
• Wishes to research a common acute condition.

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Content

Coursework: Intermediate Epidemiology and Biostatistics

Research: The major research components to be offered include:

• Clinical research activities in the Monash-Cabrini Department of Medicine. Major interests include secondary prevention of osteoporosis, health literacy in the elderly, current management of stroke patients, effective management of community-acquired pneumonia and the diagnosis of older persons presenting to the Emergency Department with collapse.
• Participation in the design, conduct, analysis and writing up of a well-defined fully mentored clinical research project
• Ongoing one on one interaction with clinical/research mentors with opportunities for discussion on all aspects of the research project.
• Consultation with relevant stakeholders as required.
• Continued development of student clinical skills through participation in ward rounds associated with the Cabrini Clinical School

Sample Research Topics:

Implementing strategies for improved outcomes in minimal trauma fracture

We will develop and test targeted approaches to improve the in hospital use of evidence-based treatments in the management of minimal trauma fracture.

Assessing health literacy and health knowledge in an elderly population

An observational study will be carried out to assess the levels of health literacy and health knowledge in an elderly population who have sustained a minimal trauma fracture in order to inform the development of education based approaches designed to improve health knowledge, medication compliance and health behaviours.

Evidence in clinical practice: Acute Coronary Syndromes study

The importance of the translation of clinical research evidence into practice has been a major thrust by medical professional bodies. There is a large body of evidence informing the care of patients with acute coronary syndromes (ACS). However, there is a lack of data that informs us how widespread is the application of ACS research evidence in routine clinical practice. A study will be carried out to inform the e fficacy of evidence-based pharmacotherapies in the elderly.

Cardiology research group

A trial of two regimens for the treatment of high blood cholesterol is in progress to look at relative efficacy. The trial is part of a multi-centre cooperative study.

Evaluation of older persons presenting to the Emergency Department with collapse

Collapse is a common reason for the presentation of older persons to the emergency department, however, little is known about the frequency with which a diagnosis can be made or which patients actually require admission to hospital. To better understand the needs of this group of patients, data will be collected relating to the need for admission, length of stay, risks related to admission and diagnosis at separation.

Management of community acquired pneumonia by Hospital in the home

There is a lack of evidence regarding the place of home management in the care of patients with community-acquired pneumonia. In a randomized controlled trial, we will compare the use of oral vs intravenous antibiotics in two matched groups of patients with community acquired pneumonia referred to hospital in the home.

Survey of the beliefs and attitudes of clinical staff to stroke management.

Evidence indicates that optimal outcomes are achieved for patients when a stroke team manages patient care following diagnosis of a stroke. In order to inform the development of stroke care pathways, we will survey clinical staff on their beliefs and attitudes in relation to stroke care.

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Assessment Breakdown

Research Component: 87.5 points
Research Plan (1,000 words): 10% to be evaluated by supervisor and independent academic assessor

Research Report: 80% (up to 9,000 words)

Oral Presentation: 10%


Coursework Component: 12.5 points
Intermediate Epidemiology and Biostatistics will be assessed as per the subject descriptions.

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Student Numbers

Number of places available:
2