Advanced Research Program – Australian National University

Advanced Research Program – Australian National University

ANU Medical School’s Advanced Research Project addresses the need for greater research readiness by offering a research skills pipeline prior to commencement of PhD studies. 

Why was the program undertaken? 

The ANU MChD degree is a post-graduate medical program with a particular focus on research. All students complete an independent research project within their two pre-clinical years: the requirement is to submit a report in the form of a scientific manuscript by the end of Year 2, based on approximately 120 hours of research in a field of the student’s choice.

Starting from its establishment in 2004, the ANU Medical School offered its students the MBBS/PhD Conjoint Program. This was a unique opportunity for medical students interested in becoming clinician researchers to graduate from medical school with a PhD. Interested students applied concurrently for a school-funded PhD scholarship and medical school entry. If successful, the candidates commenced full-time research in Year 1, deferring their medical studies for two years. After two years, according to the plan, the students commenced full-time medical school, completing their higher degree part-time while studying medicine (Table 1, Original Model).

By 2015, it became clear that there were problems with this program. Students were unable to complete sufficient research in the first two years and required extensions, delaying the commencement of the MChD and extended scholarship support. More concerning was that students felt the promises to integrate the two aspects of the program and support them in gaining transferable research skills and clinical research experience were not being met.

To address these concerns, a different model was designed whereby students could commence their research in years 2 and 3 (Table 1, Revised Model). However, this model did not produce the desired outcomes either, with supervisor/student relationship issues and a continued lack of research readiness on the part of those entering the program.

Table 1. Organisation of Original Conjoint MChD/PhD model and Revised Advanced Research Project (ARP) model.

In 2017, the HDR team devised the Advanced Research Project (ARP) program to address the need for greater research readiness by offering a research skills pipeline prior to commencement of PhD studies. This program leverages the MChD research project by allowing students to use it as part of their PhD if they meet the prerequisites required to enter the program. These prerequisites include: having H1 honours or equivalent, a willing supervisor, achieving a higher-level pass on their research project, being awarded a PhD scholarship based on merit, and having approval from the director. In this way the ARP acts as a filter, optimising admission to the conjoint program by testing students’ ability and resolve prior to their commencing.

Although the ARP was primarily designed for prospective conjoint MChD/PhD students, all MChD students are eligible to enrol. All projects must relate to the practice of medicine, while prospective conjoint MChD/PhD candidates and their supervisors are advised that their projects should be able to be extended to a PhD program.

The objectives of the ARP are to:

• Provide students with research knowledge required for undertaking useful health and medical research
• Provide opportunities for developing and applying research knowledge and skills
• Support students to undertake excellent research during their research project course.
• Provide an instrument to accurately assess MChD student’s suitability for undertaking a conjoint MChD/PhD.

How was the program implemented?

The ARP is led by a team of active researchers, experienced in undergraduate and higher degree research supervision. The team is experienced in systematic review, and qualitative and quantitative methods to conduct social science, laboratory science and translational and clinical research, and the course leverages this combined knowledge and experience to deliver research-led education. This cross-disciplinary, mixed-methods team also serves to prepare students for the interdisciplinary nature of both medical practice and clinical research. In addition, the students themselves bring a rich array of experience; many have prior research experience including PhDs. Therefore, the peer to peer experience is crucial in promoting energy, enquiry and adaptation.

A critical element of the ARP is exposure to a broad range of approaches, not just the narrower range relevant to the student’s own project. Students are actively encouraged to experiment in their interpretation of the content and to discuss their research successes and dilemmas. In this way, a student completing, for example, a lab-based biomedical project, will gain understanding and insight into qualitative patient experience research from peers and through the taught content.

The specific course learning outcomes are to:

1. Identify research questions, and design and implement a research plan
2. Perform sophisticated, critical analysis of the literature
3. Analyse and summarise research data sets
4. Synthesise meaning from data and observations and present coherent arguments
5. Produce written research outputs (grant applications, reports, publications) to publication standards
6. Develop project management skills commensurate with the planning and undertaking of an extended research plan, including setting goals, meeting deadlines and communicating progress against agreed milestones
7. Develop persuasive written communication skills based on the judicious use of evidence to support a comprehensive research plan, as outlined in a grant proposal sufficient to cover the minimum requirements to successfully undertake the research
8. Develop capacity to provide constructive feedback through peer review of the work of others, and to respond to constructive feedback form peers, supervisor and research mentor.

The program is project-based and students complete the course in parallel with their core medical studies during the pre-clinical phase of the MChD. All students enrolled in the ANU MChD must complete a research project but the ARP differs in four ways:

• The scale of the project is larger. Typically, we expect about twice the time commitment of a regular Research Project.
• ARP students must complete a series of online lessons (KuraCloud, Lt Lifescience eLearning Platform, ADInstrument) and face-to-face tutorials (via Zoom during COVID), introducing them to key research concepts, skills and processes.
• A focus on peer review, peer mentoring and collaborative engagement with fellow students.
• It includes a critical mentorship model, wherein the students have access to advice, support and facilitation from established researchers in medical science, clinical science and social science.

The curriculum for the ARP is a live document which has evolved over several years in response to student needs, student feedback and our review of the final submissions. In 2021, the materials covered nine key areas in Year 1 and four areas in Year 2. These are summarized in the Appendix.

There are also two formative assessment items that students complete in the planning phases of their project: a critical presentation of three key papers from their literature review and how the review has informed their design; a draft introduction. These formative assessment items are useful, both in terms of the substantive task but also as vectors for peer review and collaboration. Each of these submissions receives feedback from both staff and students. Completion of these formative assessment tasks, as well as 80 percent attendance and completion of live and online lessons, is required to maintain enrolment. Students who do not meet this expectation for engagement are transferred to the regular research project stream, where they can continue the same project at a smaller scale.

What is the program achieving? 

Outcomes and Evaluation

Since its inception, two cohorts of students have completed the ARP. The outcomes have been surprising, with effects beyond the original purpose.

Enrolment: The course has been steadily gaining enrolments as it has settled into the course landscape. A quarter of the yearly cohort are now enrolled in the advanced stream.

Conference Presentations and publications: Currently, we don’t have reliable data for these outcomes but are developing strategies to capture this data more rigorously. We would normally have five or six students from the entire year applying for support to attend and present at conferences, but the disruption caused by the pandemic has prevented our cohorts from participating.

Conversion to MChD/PhD: The program has not yet converted a student to the conjoint program. However, perhaps counter-intuitively, we consider this a success. Part of the reason this program was instituted was to ensure that the students who enrolled were able to meet the expectations of the PhD program and produce high-quality research in a timely manner. Allowing the students to engage with publishable research at an earlier stage in their studies, in a lower-stakes environment, has facilitated reflection by the students on their capacity and time commitments, and shown them not to start something that they can’t finish. Having this research experience (and possible associated publication) has given many of our students the knowledge and confidence to know whether a higher degree is something they want to aspire to in the future, as well as insights into when might be appropriate for them.

Student evaluation: The most exciting outcome of this program has been the enthusiasm shown by emerging clinician researchers eager for the challenges of research and excited to be part of it (feedback from students sent without request is included in the Appendix). The following quote is a great accolade and strengthens our belief in the value of the ARP: “Inclusion in the MChD’s Advanced Research stream has been a highlight of my medical education so far.”

Reflections and goals for the future

There is no doubt that this program provides a rich, student-centred experience for medical students with aspirations to become clinician researchers. Increased cohort size has necessitated more peer-to-peer feedback, prompting more debates and discussions, which we regard as a very valuable development. We envisage future development will involve structuring the course to facilitate even more peer-to-peer engagement, development of our online resources based on student feedback, and mechanisms to ensure a higher percentage of publications per student in the program.

The cost of the program has been minimal. Members of the team which teaches into the course contribute approximately 30 hours each in face-to-face teaching time, facilitation, assessment/feedback and one-to-one interviews.

Adjusting to online teaching during the Covid19 pandemic has been a reality for all medical schools. In Canberra, we have enjoyed a hiatus where we have been face-to-face for a short period in 2021. It is clear from this experience that face-to-face is preferable because it facilitates easier communication, however, the online environment has had advantages, such as easier inclusion of students with childcare responsibilities and the opportunity to record sessions for review.

Summary

The ARP has fulfilled its role as a filtering program to ensure that only research-ready students enter the conjoint MChD/PhD stream. However, it has also filled an important gap in medical education for students who want to be active researchers in their medical career, regardless of whether they undertake the conjoint program.

APPENDIX

1. Taught Curriculum (2021)

2. Student Feedback

The feedback below was sent to us without request (unsolicited comments) It is arguably the most powerful evidence of the success of this initiative.

2019 – “Just wanted to send a belated message of appreciation for your work with the advanced research program and the mentorship you provided. Despite the challenges associated with research, I learnt an incredible amount over the past 18 months and couldn’t have done it without help.”

2020 – “The 2020 ARP students just wanted to send through a big thank you for all your hard work helping us in 2019 and 2020. It was a crazy year and we appreciate you still making the time for us. We all learnt a lot about our individual research topics and also learnt a lot about ourselves as researchers. We’ve put together a list of “what I learnt doing a research project” tips and tricks for future ARP students. The list is quite long – a testament to our revelations! I hope it’s helpful for future students, or even just helpful for you both to have a giggle!”

2021 – “The Advanced Research Project run by the ANU Medical School was an exciting and innovative program that allowed me to not only retain but continue developing myself as a young researcher. Through dedicated teaching staff, additional classes, extra support and a collaborative environment, we have all been supported to produce creative and high-quality research. It also fostered an environment where students, passionate about research, could come together to collaborate, share ideas and support each other through the trials and tribulations of biomedical research. It is exciting for me to look at my colleagues and wonder what wonderful contributions they will make to their chosen fields.

While uncertain about whether I wanted to pursue a pathway as a clinician scientist, I knew that I had a passion for research and after a successful honours project, I was dismayed to realise that medical school would see me lose many of the research skills I had worked hard to develop. However, the Advanced Research Program has given me the opportunity to form research networks, begin to publish my work and speak at conferences. More than this, it has equipped me with the confidence and enthusiasm to pursue a PhD. While challenging to fit in a busy medical curriculum, the program has cemented my intention to become a clinician scientist, with feet in both the clinical and research world. It compels young doctors to meet a high standard and has given us skills that will undoubtedly help with our clinical training. The program gives students the opportunity to uphold the highest traditions of scientific endeavour, of which medicine rest upon. It is also humbling and a privilege to be mentored by senior researchers that have distinguished themselves and generously share their insights with us.”

“Inclusion in the MChD’s Advanced Research stream has been a highlight of my medical education so far. It’s allowed me access to a small community of student researchers who have helped me navigate this element of the course, an opportunity that was especially welcome in 2020 during lockdown, when interaction amongst our cohort was minimal. It has also elevated the quality of my research, providing guidance in developing a project, connecting me with great supervisors and prompting me to submit work ahead of deadline.”

PDF of case studies available here: Research in the Medical Curriculum, Volume 1 – A window on innovation and good practice 2022