This view point describes the experience of introducing research at an undergraduate level during clinical rotation in psychiatry. Objective of this initiative was to encourage critical thinking, self directed learning and sensitization to mental health issues. This contributed to student learning besides galvanizing their interest in the subject. The opinion piece aims to expose various issues to students’ research in the context of medical education in Pakistan

Naqvi, Haider A

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eCommons@AKUDepartment of Psychiatry Medical College, PakistanOctober 2010Students’ Research: Tradition Ahead of Its TimeHaider A NaqviAga Khan UniversityFollow this and additional works at: http://ecommons.aku.edu/pakistan_fhs_mc_psychiatryPart of the Medical Education Commons, Psychiatric and Mental Health Commons, and thePsychiatry CommonsRecommended CitationNaqvi, H. (2010). Students’ Research: Tradition Ahead of Its Time. Journal of the College of Physicians and Surgeons Pakistan, 20(10),701-702.Available at: http://ecommons.aku.edu/pakistan_fhs_mc_psychiatry/1Journal of the College of Physicians and Surgeons Pakistan  2010, Vol. 20 (10): 701-702 701Universities are not places where knowledge is justtransferred from the teacher to a student. Knowledgehas to be generated at a University, through researchand inquiry. Research is central to teaching. We teachwhat has been established through research - either byus or others. Local research, when carried out in thecontext of the global issues, ends up having more utilityin terms of application. It is one thing to teach research,while quite another to carry-out one. In the domain ofeducation, in research-methods boundaries areindefinite. Critical distinction between doing-researchand ‘teaching’ research-methods is that research has tobe an action. Teaching in research methods isinsignificant until and unless it translates into an actualresearch inquiry. There is some evidence to suggest thatstudents in Problem Based Learning (PBL) system aremore receptive to research than traditional lecture-based system. However, this claim needs to be validatedwith a larger sample size and representative samplingframe.1,2Students do conduct research at an undergraduate aswell as postgraduate level. An important question inmedical education is when they should be exposed toresearch. There is some evidence to suggest that theearlier the students are exposed to research, better theoutcome is.3 The desirable effect may be in terms ofresearch initiatives and publications, academic pursuit inpublic health and actual evidence-based practice inclinical years.  Learning to think divergently about anidea, to develop it systematically through discourse andexecute a research plan is a composite skill, that needsto be mastered through practice. The conventionalsystem in undergraduate education focuses onimparting knowledge from an experienced teacher to areceptive student. It however, does not promote criticalthinking or questioning existing paradigms of medicine.There are various issues related to students’ research,which will be highlighted in this opinion piece.  The department took an initiative in which students wereguided to do a research project on issues concerningmental health. This was during their 4th yearundergraduate clerkship rotation in psychiatry. Theobjectives of this initiative were to imbine criticalthinking, self directed learning and sensitization tomental health issues. Students were encouraged tochoose from the broad theme of topics, under theguidance of a supervisor who acted as their facilitator. Team of seven medical students took the responsibilityof designing and conducting the research project, onsuccessive rotations through psychiatry. They wereexpected to present the findings of their research projectat the end of every rotation.  An important outcome ofthis pilot project was that students carried out researchinquiries on culturally pertinent issues and addressedproblems unique to the context of health care scenarioin Pakistan. This contributed to their learning inpsychiatry besides galvanizing their interest in thesubject. It also promoted critical thinking and evidence-based learning, which is a critical pre-requisite to anyunder-graduate teaching. Research publication by students could be divided infollowing four broad groups of; psychiatric epidemiology,Knowledge, Attitude and Practice (KAP) studies, opinionsurveys and health service audits. While few have beenpublished, others are under peer-review process ofevaluation.Generally, courses pertaining to research methods aredistributed over the course of five years of medicalcurriculum of the Medical Colleges in Pakistan. Electiveresearch rotations are expected to provide theopportunity to pursue research during the medicaleducation. These are generally graded in terms ofperformance outcome. The real challenge, in terms ofteaching, is to inculcate research mindedness amongthe students. This may require ongoing research pursuits.Some quarters have expressed their reservation regardingABSTRACTThis view point describes the experience of introducing research at an undergraduate level during clinical rotation inpsychiatry. Objective of this initiative was to encourage critical thinking, self directed learning and sensitization to mentalhealth issues. This contributed to student learning besides galvanizing their interest in the subject. The opinion piece aimsto expose various issues to students’ research in the context of medical education in Pakistan.Key words: Students’ research.   Mentorship.   Medical education.   Problem based learning.   Mental health.Department of Psychiatry, The Aga Khan University, Karachi.Correspondence: Dr. Haider A. Naqvi, D-215/1, KDA SchemeNo. 1-A, Stadium Road, Karachi.E-mail: haider.naqvi@aku.eduReceived  October 15, 2009; accepted August 12, 2010.Students’ Research: Tradition Ahead of Its TimeHaider A. NaqviVIEW POINT students doing research outside their elective time.Declining grades are often cited as a reason behind astudent’s underperformance. Some students are alsounable to keep a balance between their scheduledactivities and social hours. Imperatively students haveother distractions – competing social and relationshipcommitments – which could also lead to decliningperformance. A long standing, trusted mentor-menteerelationship can help them reel out of such tail spins.Research supervisor can provide such an avenue forprofessional growth and development. However, notevery interaction is based on integrity; students can, anddo end up data-mining for faculty. Student research projects are mostly time bound andsubjected to the dynamics of rotations in medical schoolcurricula. Ethical review of such projects is one of themajor issues. In places where there are ethics reviewcommittees (ERC)/ethics review boards (ERB), approvalof such projects is of paramount importance; however,committees meet periodically, application and reviewprocess is also very tedious and time consuming,making it difficult to do research under the umbrella ofethics. In such circumstances, review process needs tobe fast-tracked for students’ research projects. In placeswhere there are no ERC’s it is judicious to discuss theethical issues pertaining to human subject research withthe students, in order to make the study compliant withethical standards outlined in the Helsinki Declaration onHuman Subject Research.4When research is relegated to postgraduate medicaleducation alone then students do research just for thesake of it. They see it as a requirement which needs tobe fulfilled for a degree. Research is considered animpediment between successful completion of a fellow-ship and bounties of rich private practice.  Needless tosay, such clinicians, lacking sound understanding ofevidence-based practice, do not necessarily do well inthe domain of practice. Mentorship is also an important issue during the post-graduate training years. The slipshod approach bysupervisors, when research is relegated as a mereformality, does not impart enthusiasm to trainees. Oneway in which students’ research can be improved is byhaving a mandatory thesis committee.  Committee couldhave a mix of field experts (supervisor) and other areaspecialists relevant to the topic of inquiry. One of thebenefit of having a mandatory thesis committee is thatvarious facet of research and medical-writing can beaddressed more formally. This could also providestudents with an opportunity to interact and learn frompeople with various backgrounds, thereby buildingresearch capacity. In the context of Pakistan, adeveloping country with dearth of resources, research istoo important to be taken dismissively.  A teacher can only teach the ‘how-to-do-it’ part ofresearch, the spirit of inquiry can only be inculcatedthrough mentorship. In teaching, supervisors worksclosely with a trainees, giving him critical feedback onthought-process apart from challenging mental blocksand limitations. In the words of illumed Khalil Gibran(1883-1931) “The teacher who is indeed wise does notbid you to enter the house of his wisdom but rather leadsyou to the threshold of your mind for the vision of oneman lends not its wings to another”.5 Through suchwisdom a teacher encourages pupil to start a journey ofhis own inquiry – a lifelong pursuit of search and re-search.REFERENCES1. Donner RS, Bickley H. Problem-based learning in Americanmedical education: an overview. Bull Med Libr Assoc 1993; 81:294-8.2. Khan H, Taqui AM, Khawaja MR, Fatmi Z. Problem-basedversus conventional curricula: influence on knowledge andattitudes of medical students towards health research. PLoS One2007; 2:e632.3. Segal S, Lloyd T, Houts PS, Stillman PL, Jungas RL, Greer RB3rd. The association between students' research involvement inmedical school and their postgraduate medical activities. AcadMed 1990; 65:530-3.4. Council for International Organizations of Medical Sciences(CIOMS) in collaboration with the World Health Organization(WHO). International ethical guidelines for biomedical researchinvolving human subjects. Geneva: The Organization; 1993.5. Teaching [Internet]. [cited 2009 Oct 14]. Available from:http://leb.net/~mira/works/prophet/prophet18.html702 Journal of the College of Physicians and Surgeons Pakistan  2010, Vol. 20 (10): 701-702Haider A. Naqvil l l l lOl l l l l

Students’ Research: Tradition Ahead of Its Time

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Students’ Research: Tradition Ahead of Its Time

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