Research Highlights

The CFMS is launching its new research highlights campaign! We seek to elucidate the work that our peers perform across the country to connect like-minded individuals, inspire students around the country, and directly demonstrate the importance of research performed by health care professionals. Throughout the year, we will be focusing on various fields of research pertinent to the field of medicine.

If you would like to submit your research for highlighting, please use the linked form.

• Current Management and Healthcare Quality for Individuals with Knee and Hip Osteoarthritis in Nova Scotia

  

  Student Researcher: Clara Long
  School: Dalhousie University

  What is your research about?
  

  Knee and hip osteoarthritis are leading causes of pain, impaired mobility, and healthcare use for thousands of Nova Scotians, resulting in a substantial burden on the healthcare system. In light of long surgical wait times and risks for surgical and pharmacological treatment, there is increasing support for non-pharmacologic, non-surgical treatment methods, such as physical activity. Physical activity has been shown to improve quality of life and function and decrease pain and the need for medications. However, previous studies suggest that few individuals with osteoarthritis receive guideline recommended, non-pharmacologic interventions. My research is part of a larger project for which my co-supervisors, Drs Moyer and Hubley-Kozey, are principal investigators supported by the MSSU. The project uses the Atlantic Provinces Partnership for Tomorrow’s Health database to explore the relationship between physical activity and osteoarthritis management in Nova Scotia. In the second phase of this project funded by the Nova Scotia Health Research Foundation, we are exploring the quality of non-pharmacologic, non-surgical treatment strategies received by individuals from the Maritime provinces with osteoarthritis.

  Why did you choose this project?
  

  I chose this project as part of the Research in Medicine program at Dalhousie with the support of the DMRF Helen Watson Studentship and the Gladys Osman Estate Studentship. I am excited about this work because osteoarthritis is an important and increasingly prevalent health concern for Nova Scotians. Additionally, this project involves the application of research findings to inform local health policy. As someone who is training to enter the healthcare field, I am interested in working with researchers, government, and other stakeholders to create change within our health systems. Indeed, it is this collaborative and integrated approach to health that first attracted me to medicine.

  What are the implications of your research for clinical practice?
  

  The results of this project aim to identify gaps in the quality of care received by patients with knee and hip osteoarthritis and clarify how first line treatments like exercise are being used in osteoarthritis management. This data will also highlight patterns in how patients are triaged across health care pathways. Through close partnerships with the Nova Scotia government and Health Authority, the long-term goal of these results is to contribute to improved osteoarthritis guideline implementation in Nova Scotia.

  What activities do you do outside of research and medicine?
  

  I enjoy reading, and I just finished binging Schitt’s Creek. I am also part of a baking group!

  How do you see research playing a role in your future career?
  

  Research will be an integral part of my career by ensuring that the treatments I provide are evidence based or through my own research efforts. I hope to continue to develop my research skills now as a trainee and in the future as a practicing physician.

• HCV Elimination: Impact of HCV Point-of-Care Testing

  

  Student Researcher: Forrest Gallagher
  School: Dalhousie University

  What is your research about?
  

  Dr. Barrett’s team is looking at the impact of hepatitis C (Hep C) point of care (POC) testing on Hep C elimination. Our aim is to see if having a POC test works as a tool to engage people in Hep C treatment and care. My project is a branch of the larger project that is specifically looking at Hep C care in Nova Scotia provincial correctional populations.

  The major component of my project is a questionnaire that explores how people in correctional settings feel about their risk of contracting Hep C within the correctional setting. It also looks at how people feel about their ability to access ways to minimize their risk of contracting Hep C and their ability to access Hep C treatment within the correctional system. Last, it evaluates how people feel about general healthcare in provincial correctional settings.

  In the past few months we have been working to adapt this project to understand the same outcomes in regard to COVID-19 risk, prevention, and treatment in correctional facilities.

  Why did you choose this project?
  

  I chose this project because I feel the correctional population is a particularly marginalized group in general and especially when it comes to their healthcare.

  People within the correctional system represent a different demographic than those found in the general population. There are differences in race, ethnicity, age, and disease risk in correctional populations. Additionally, due to a multitude of factors, there are higher rates of certain diseases such as Hep C within the correctional population.

  Overall, what this means is that people within a correctional population have unique healthcare needs and I believe as healthcare professionals we have to be responsive to those needs and ensure that people (regardless of where they live) have proper access to healthcare.

  There is also an advocacy role for healthcare professionals to improve the care for people who are marginalized. I see this as an opportunity to help those within the correctional setting.

  What are the implications of your research for clinical practice?
  

  My goal is that this research impacts the way healthcare professionals think about the care people in correctional settings receive. I hope that the system as a whole is more responsive to the needs of people in this group; not just from the Hep C risk/treatment prospective, however; from a general healthcare prospective.

  I also hope that this project helps raise awareness about Hep C and improves the way we are able to engage people in care. Hep C is a curable disease if people have access to proper testing and treatment. It is important for health professionals to realize this and help people overcome/breakdown the barriers to accessing care. My goal would be that the implication of this work was the improvement of this in even the smallest degree.

  What activities do you do outside of research and medicine?
  

  Outside of research and medicine, I enjoy playing sports such as hockey and baseball. During my undergrad, I was actively involved in coaching minor hockey and working with minor baseball. I hope to get back to this after my education is complete.

  Currently, I enjoy reading and getting back to my hometown of Springhill, NS to visit family and friends.

  How do you see research playing a role in your future career?
  

  I hope to work as an emergency room physician in the future. The ER is a place that I would argue sees the highest number of people who are marginalized in one way or another. Certain people have a tendency of not getting the healthcare they deserve whether it is due to stigma, social circumstances, or a system that is not flexible enough to meet the needs of people who are different in one way or another.

  A person’s emergency room experience can be the reason they continue to access healthcare or choose not to in the future, which overall affects their health outcomes. The ER is a place where people can be connected with the care they need whether it be disease testing/treatment (such as Hep C), housing, addiction services, social services, spiritual support, etc.

  My goal is to help people achieve the best health outcomes they can by working with them to identify their unique needs and connect them with the services they require. This project and the opportunity to learn from Dr. Lisa Barrett and her team has taught me to approach medicine differently and I hope to use that approach to help my future patients.

• Endoscopic Resection & Adjuvant Therapy vs. Esophagectomy for Early Stage Esophageal Cancer: A Comparison of Patient Outcomes

  

  Student Researcher: Madeline Robinson
  School: University of Manitoba

  What is your research about?
  - The current standard of care for esophageal cancer is esophagectomy, a procedure carrying high risk of morbidity and mortality that significantly impairs patient health-related quality of life.
  - The minimally invasive and organ-preserving techniques of endoscopic resection has been approved for T1aN0 esophageal cancer, but is not currently accepted in T1bN0 or T2 cancers.
  - I hope to assess the safety and feasibility of treating T1bN0 and T2 esophageal cancers with organ-preserving endoscopic resection and adjuvant chemoradiotherapy in patients who cannot tolerate or do not wish to have an esophagectomy
  - The project consists of a systematic review of existing literature and a single-center cohort study, the results of which are being used to establish a run-in feasibility Phase 2 clinical trial
  

  Why did you choose this project?
  

  My research background prior to medical school was largely in basic science; I chose this project because I was interested in learning more about clinical research. I was particularly interested in minimally invasive surgery, the progress of which has drastically improved surgical outcomes for many patients, and offers an exciting area of research that is still growing.

  What are the implications of your research for clinical practice?
  

  This research will inform future clinical trials for non-invasive endoscopic resection procedures vs. more invasive esophagectomy in the treatment of early stage T1bN0/T2N0) esophageal cancer; it will hopefully offer a safe quality- of-life and organ-preserving alternative to patients with early stage esophageal cancer.

  What activities do you do outside of research and medicine?
  

  When I have free time, I really love being outside; I am an avid rower (though I’ve retired from competing) and enjoy walking my dog Izzy during study breaks.

  How do you see research playing a role in your future career?
  

  I hope to pursue a master’s of science during or after my residency, and aspire to continue incorporating research into my future career and clinical practice.

• Postoperative Delirium and Subsyndromal Delirium in Older Adults Undergoing Elective Thoracic Surgery: A Prospective Cohort Study

  

  Student Researcher: Kaleigh Ducas-Mowchun
  School: University of Manitoba

  What is your research about?
  - Delirium is one of the most common post-operative complications in older surgical patients and is associated with poor clinical outcomes.
  - Subsyndromal delirium (SSD- features of delirium that never progress to meet delirium criteria) has also been shown to be associated with poor clinical outcomes, including cognitive and functional decline, increased length of stay and increased rate of institutionalization.
  - The primary objective of this study is to clarify the incidence of delirium and subsyndromal delirium in this patient population using prospective data accounting for both surgical and age-related factors.
  - Secondary objectives are to explore the predictors of delirium and subsyndromal delirium in this population and their relation to long term outcomes including cognitive and functional decline.

  Why did you choose this project?
  Throughout my studies in medical school and from volunteer experience beforehand, I have been increasingly interested in the complexity inherent to the field of geriatrics and physiological changes associated with aging. Thoracic surgery is also unique in its physiological demands both intraoperatively (e.g. duration of hypoxia endured, stress of surgical approach) and postoperatively (postoperative pain, loss of respiratory units, etc.), adding yet another layer of physiological complexity to this patient population. Carrying out research in the context of a complex patient population is a fun challenge, and it’s very motivating working towards improving care for a population with such complex needs.

  What are the implications of your research for clinical practice?
  We are hopeful that completion of this study will provide important baseline information on postoperative delirium and subsyndromal delirium in this patient population in order to guide larger prospective studies, improve risk assessment for patients undergoing elective surgery and allow for evaluation of prevention strategies.

  What activities do you do outside of research and medicine?
  Outside of medicine and research, I like to hang out with my friends, family and dogs, spend time outdoors, practice yoga, dance and travel!

  How do you see research playing a role in your future career?
  I can definitely see myself incorporating clinical research into my future career as a physician. I’m excited to see be able to use my experience from the bedside to guide future research questions and be able to translate it back to improve patient care.

• Investigating LAG-3-associated dysfunction of iNKT cells in HIV infection

  

  Student Researcher: Alli Balasko
  School: University of Manitoba

  What is your research about?
  - I work in Dr. Keith Fowke's Viral Immunology lab focused on HIV treatment
  - My project is focused on chronic HIV infection, because even though there are great HIV treatments available, they are not a cure, and HIV can still cause multiple clinical symptoms, including "exhausting" your immune system and causing immune dysfunction
  - We're looking at developing some therapeutic options to address this immune exhaustion, so people living with HIV can better fight off infections that they might encounter during their lifetime and live longer.
  - Specifically, I am investigating immune exhaustion in the context of chronic HIV infection, and how to reverse this exhaustion and dysfunction using antibody therapeutic blockades binding specific immune targets, known as "exhaustion" or "checkpoint" markers, such as LAG-3 and PD-1.
  

  Why did you choose this project?
  

  The reason why I wanted to focus on HIV research is just the sheer abundance and the damage that the HIV epidemic has had on everyone around the world for the past 40 years.

  Worldwide, there are currently almost 40 million people living with HIV and even though there are some treatments available there’s still a lot of clinical symptoms and negative impacts of having HIV.

  There are also tons of ways my project will impact other fields and not just HIV. You can relate it to a lot of different fields like cancer immunotherapy for example. My project has a broader scope than just HIV. In general, the potential of immune therapeutics can impact millions of lives and has been a hot topic in the cancer field.

  What are the implications of your research for clinical practice?
  

  I find there are the silos of research and clinical work, but to be able to bridge those two together so when you meet with a patient you see the direct effects. It helps you move your research forward and gives you that drive to want to help that person.

  That really helps to shape your research into what people need in the clinic right in that moment. It’s invaluable to have those connections between clinical work and research.

  As I am a basic scientist, I am focused on bench work to show proof-of-concept of reversing immune exhaustion in chronic HIV infection using anti-LAG-3 and anti-PD-1 therapeutic antibodies, by working with cryopreserved blood samples of HIV-positive donors. I hope this work will result in compelling evidence, and eventually lead to a clinical trial.

  What activities do you do outside of research and medicine?
  

  I love the outdoors – hiking, biking and hanging out at Falcon Lake are some of my favorite memories.

  I also love to travel – I was recently on a safari in South Africa, and I would go back in a second!

  How do you see research playing a role in your future career?
  Infectious Diseases is an extremely interesting field that is quickly and continuously changing, where we have to adapt and fight off new and evolving pathogens. I love the challenge that poses. Further, being in both the MD and PhD streams, you truly realize how dependent medicine and research are on each other. Aside from carrying out my own research in the future, I also aspire to play a critical role in this knowledge translation and communication between research and medicine, and potentially taking on a public health role as well.

• Analysis of Enterovirus Evolution in Canada Over a 23-Year Period

  

  Student Researcher: Andrew McDermid
  School: University of Manitoba

  What is your research about?
  - My research career started in characterizing Rotavirus samples in Canada in the wake of Rotavirus vaccine licensure.
  - The project also included evaluating the genetic variation of Rotavirus strains over time with some focus on antigenic regions.
  - My next project applied concepts and skills drawn from the genetics component of my Rotavirus project to analyze more than 20 years of Enterovirus clinical isolates from across Canada.
  - Genetic variation of the strains from common serotypes were compared with incidence rates of those serotypes to assess the effects of genetic shift on incidence.

  Why did you choose this project?
  In a way I chose this field of research because I have a keen curiosity in infectious diseases and virology. This role also provided me with an opportunity to do research in the National Microbiology Laboratory.

  What are the implications of your research for clinical practice?
  Both of my research projects contribute to the understanding of viral evolution, both are valuable for the present understanding of viral circulation in Canada, and I hope for both to contribute to the future use or implementation of vaccines in the future.

  What activities do you do outside of research and medicine?
  Outside of school I spend much of my time with my partner and 2-year-old son, cook, and try to get out for a game of golf on occasion.

  How do you see research playing a role in your future career?
  I plan to incorporate research into my future career.

• Optimizing the Pedagogical Benefits of Testing in University for Improved Academic Outcomes

  Student Researcher: Vivian Tsang

  Describe your research in up to five bullet points.
  - Assessment driven learning has recently been revived as an important topic within education
  -One might expect the effects of rehearsal to generalize to conceptually related, but distinct information
  -This testing effect is transferable to related material that was not directly studied or studied but not tested (transfer)
  -In a pilot study simulated to emulate real classroom scenarios, it was demonstrated that testing supports transfer of learning to new material but that the results varied depending on the organ system tested
  -Secondary studies are currently being done to further understand this phenomenon
  -Results of the studies will contribute to curriculum development through restructuring of lecture order and content
  

  In-Brief Explanation
  The notion that assessment can drive learning has recently been revived as an important topic within education. The very act of sitting a test can increase the memorability of the information being tested relative to repeated study of that information. What is not known is the mechanism through which testing creates this benefit and the extent to which the benefits gained generalize to other related material. This research tested the extent to which test enhanced learning benefits transfer to concepts that are related but not formally tested.
  
  Results demonstrated that testing supports transfer of learning to new material but that the results varied depending on the organ system tested. Further analysis is currently being conducted to better understand our preliminary results. Conclusions of these studies will translate to improved restructuring of courses and ultimately towards academic success for medical students.

• Canadian Neurosurgery Educators' Views on Stereotactic Radiosurgery in Residency Training

  Student Researcher: Justine Philteos

  Describe your research in up to five bullet points.
  -There is an increasing need and use of Stereotactic Radiosurgery (SRS) in treating intracranial and spinal pathologies.
  -Despite this, there is limited exposure to this modality in neurosurgical residency. For the field of neurosurgery to sustain its involvement in the provision of SRS planning and delivery, adequate training of neurosurgery residents in SRS is needed.
  -This study was aimed to assess neurosurgery educators’ views regarding the current state of Stereotactic Radiosurgery exposure, and to identify potential approaches to improve residency education in this domain.
  - Of the 34 eligible participants, the overall response rate was 41.1% (14/34). This represents 9 of the 12 Canadian institutions surveyed - the majority of participants being current program directors. Most respondents (9/12) view an increasing role for SRS training in neurosurgery residency.
  -This analysis is timely as residency training is at a crossroads with the development of competency-based medical education.
  

  In-Brief Explanation
  Stereotactic radiosurgery (SRS) is an integral component of neurosurgical practice. The indications for SRS as a minimally invasive tool in the treatment for neurosurgical pathologies continue to expand. Previous reports have emphasized that loss of neurosurgery leadership in SRS could jeopardize the field and compromise patient care. This study employed qualitative thematic analysis and constructivist grounded theory methodology in semi-structured phone interviews with current residency directors, past residency directors and departmental chairs across neurosurgical departments in Canada to assess their views regarding the current state of SRS training and exposure in residency. Unanimously, respondents endorse greater exposure to SRS during residency through formal residency rotations and engagement in interdisciplinary tumor boards to facilitate involvement in clinical decision-making. This analysis is timely as residency training is at a crossroads with the development of competency-based medical education.

• Implementing Peer-Led Teaching in Medicine: an Impactful Stress-Reduction and Learning Strategy

  Student Researcher: Tia Karass-Rohan

  Describe your research in up to five bullet points.
  -Ambassadors for Comprehensive Education(A.C.E.) Program: student-led leadership initiative at McGill
  -Aims to improve medical student education via peer-teaching activities and educational resources
  -Our study demonstrates significant stress reduction and improved academic preparation
  -Improving medical education through peer-teaching is beneficial to both students and tutors
  -Thus, we encourage the presence of peer-led teaching as a learning method in the medical curriculum From: Brault C, Souza G, Doucet A, Karass-Rohan T, Long J, Hennegan K, Heron J. Poster presented at: 2018 Canadian Conference on Medical Education (CCME). 2018 Apr 28-May 1; Halifax, NS.
  

  In-Brief Explanation
  The Ambassadors for Comprehensive Education (A.C.E.) Program is a student-led leadership initiative at McGill University. It is a committee aimed at improving education for medical students at all levels through peer-teaching activities and educational resources. Students relay their knowledge to their peers, while reinforcing their own understanding, promoting active rather than didactic learning. Our survey results reveal that our program is beneficial for academic preparation, stress reduction and bolstering students’ interest in peer-teaching activities. In light of the results this innovative strategy has yielded, we promote the presence of peer-led teaching as a learning method in the medical curriculum.

• Is there enough about ME in Canadian Medical School Curriculums?

  Student Researcher: Perneet Sekhon

  Describe your research in up to five bullet points.
  -ME is a problem with the nervous system involving inflammation or a neuroinflammatory disorder.
  -In conducting a survey of 811 general practitioners, 48% were not confident in making a diagnosis of ME and 41% did not feel confident in providing treatment
  -In a 2013 study by Peterson et al., it was found that there were significant gaps in ME coverage within medical schools in the US.
  -Leonard et al. reviewed 119 medical textbooks and found that only 0.09% of the pages had ME content.
  -This article highlights the current gap in medical school curriculum content concerning Myalgic Encephalomyelitis (ME).
  

  In-Brief Explanation
  This article will highlight the current gap in medical school curriculum content concerning Myalgic Encephalomyelitis (ME) and why it’s a major issue. There is a need for advancing research about ME pathophysiology and treatment. This need must go hand in hand with educating students and healthcare professionals about ME.