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Research

Our Research Department is dedicated to advancing the knowledge base of our research fellows, faculty, and the hand surgery community in general. Clinical practice, health services, and basic science aspects of the musculoskeletal system have been more closely examined over the past several decades in formal research studies, making an understanding of scientific method, research practices, and data analysis critical skills for today's practitioner. Technical advances also require an ability to assimilate new information, and evaluate different surgical techniques, new prosthetic devices, new drug therapies, and biomaterials.

In addition to providing administrative and regulatory support for Fellow projects, the research department is actively involved in developing intramural studies and participating in externally funded studies.

Each Fellow at the CNHC is required to complete at least one research project, with a faculty member as sponsor/mentor, which will be suitable for presentation and/or publication before the end of their fellowship year.

Research projects may take the form of one or more options, including but not limited to retrospective or prospective clinical studies, large database and epidemiological studies, biomechanical and anatomical cadaver studies, and live animal studies.

The objectives of the research program are:

Objective 1: Conduct a literature search based on the selected research topic.  Critically read the literature to inform your understanding and design of the research project while realizing the difference between peer-reviewed and non peer-reviewed reports. 

Objective 2: Identify an appropriate research question with a clear and focused hypothesis with well-defined primary and secondary outcomes targets. Design the study to definitively answer these questions in as complete and non-biased a manner as possible. This process will typically involve collaboration with a biostatistician and other research personnel and should include understanding independent and dependent variables and potential sources of bias and error for the outcomes measured.

Objective 3: Evaluate facility and equipment needs including staffing, time frame, and budget for the study.

Objective 4: Develop specific objectives to address the hypothesis, understand the statistical tests necessary to analyze the data, and consult with biostatisticians early and often. The methodology to address each objective must be clear, and an understanding of basic technologies associated with the area of hand surgery being investigated must be established.

Objective 5: Use a well-crafted power analysis based on available literature to determine sample size, design questionnaires and/or data collection sheets, and conduct pilot studies (when applicable) to assess effectiveness of the procedures. In clinical trials, the Fellow/Resident will present themselves in a professional manner and show respect for the patients at all times. In laboratory trials, the Fellow/Resident will work methodically, practice safety, clean up, and use research etiquette. In both cases, the Fellow/Resident should work in a repeatable manner and understand the importance of handling all patients, specimens, and data collection consistently.

Objective 6: Develop a basic understanding of statistical tests and why they are appropriate, including the relevance of a p value, type I and type II errors, standard deviation, standard error of the mean, and confidence intervals.

Objective 7: Interpret the data and results, apply findings to the original questions, determine if the results have answered the basic research question, evaluate whether the objectives have been met, and accept or reject the hypothesis based on these findings.

Objective 8: Discuss the results and conclusions, compare the methodology and findings to other papers, and understand the contribution of the results to the general body of knowledge and their relationship to clinical applications and implications for future studies.

Objective 9: Present at the E.F. Shaw Wilgis CNHC Visiting Professor Lectureship.  Consider submitting to regional or national meetings via a poster or podium presentation. Discuss with faculty and research team advisors regarding ideal meeting targets and potential funding for presentation and travel costs.  For written publication, obtain the advice of the faculty advisor, research team, and CNHC medical editor in the selection of an appropriate journal based on the scope/results of the study and the journal audience.  Follow the journal format for submission of articles and gain an understanding of the publishing process including editing and creating effective figures and tables.

Timetable for Completion of Research Projects

August

Research Orientation: Introduction to key personnel involved in research and introduction to the research requirements. Start developing ideas for potential studies. Select and meet with faculty advisor to formulate question and discuss scope of project.

September

Begin developing study design, conduct literature search, meet with biostatistician, write protocol, calculate budget and complete IRB or IACUC forms. Complete submission for HCRC approval and funding request.  Design database to record data.

October

Submit completed IRB or IACUC application.

November

Revise protocol, budget or ICF in response to stipulations for IRB or IACUC approval. Obtain final approval.

December

Begin experiments/subject enrollment/data collection. Begin drafting abstract, introduction, background, and methods sections of manuscript. Discuss potential journals to submit to with editorial staff to determine manuscript requirements.  Make preliminary tables and figures.  Begin to frame the discussion section.

January - May

Complete experiments/subject follow-up/data collection. Meet with statistician for data analysis. Begin preparation for presentation (oral or poster). Continue work on manuscript, moving on to results, discussion, and conclusion.

June

Finalize presentation for E.F. Shaw Wilgis CNHC Visiting Professor Weekend. Submit manuscript to Faculty Advisor for review and comment. Turn manuscript in to editorial staff for final review and submission to target journal. Turn in raw data files to CNHC Research office.

July

Complete any manuscript revisions. File Study Termination forms with IRB or IACUC.

Salary & Benefits