Introduction
One of the challenges in developing a research project is where to start.
Objectives
The objectives of the module are:
- Critically appraise and synthesise the current evidence
- Identify a gap in practice or knowledge that can be addressed through research
- Develop focused, feasible, answerable research questions
- Communicate your synthesis of the evidence and focused research questions to a knowledgeable, non-expert audience
These notes focus on objectives 2–4.
Resources
See the Reading List for Module 1.
There are a lot of general resources for developing focused research questions.
I have used Ueda and Merabet (2018) as a resource for the notes ( unfortunately this resource is not available via the UQ Library).
Getting Started
Research is (arguably) a cluster concept. No single definition appears to be completely adequate because we use the concept in so many different ways.
UQ’s definition of research (developed for administrative purposes) seems as good as any:
Research and experimental development (R&D) comprise creative and systematic work undertaken in order to increase the stock of knowledge—including knowledge of humankind, culture and society—and to devise new applications of available knowledge.
More important than pinning down a definition that everyone will agree with is having an accurate picture of some of the features of research.
Research is:
Highly varied
There are many ways to identify and characterise problems or practice gaps that research can be conducted to address. There are just as many reliable and appropriate methods to address these problems. (And there are just as many, if not more, unreliable and inappropriate methods).
Not everything needs to be a randomized trial or DUE. There are a lot of questions, and a lot of different ways to answer these questions well.
Piecemeal
No one cures cancer. One large group of international researchers identifies a possible target on cancerous breast cancer cells. Another group confirms that the finding is reliable and rule out a host of viable alternative hypotheses. Another group discovers a compound that might interact with the target. Another group resolves formulation problems in getting the potential drug to the site of action at sufficient concentrations. Another group tests the drug in healthy volunteers to better understand the pharmacokinetic properties. Another group demonstrates that the drug is effective in breast cancer patients with poor prognosis. … And so on.
In case you are tempted to think that pharmacy practice research is different in this respect. It is not.
Moreover, research:
Involves making a decisions under uncertainty
Preparing to conduct research requires a lot of decisions. Guidance is available regarding how to plan for and conduct research that has rigour and provides reliable results. However, none of this guidance prevents the need to make a lot of decisions under uncertainty.
Research planning involves trade-offs. You are likely to be limited by time, resources and skills—how should you proceed given these limitations? Even if you are well-resourced, you still need to choose which specific research question you will focus your resources on. You are unable to simultaneously maximise the reliability of you methods for all the questions you would like to address in the study.
This means you need to make decisions, some of which don’t have a single right answer.
Makes contributions at different scales
Good research makes a contribution—it answers a question, it provides a new way to think about a topic, it raises new questions, etc.. It helps to think about the scale at which your research seeks to make a contribution: department, hospital, some aspect of practice, regional, state, national, international… It is often best to start local—what are the questions and gaps that you see in your day-to-day practice.
Often it is larger projects that seek to make a national or international contribution—but this is not always the case. You might have a small project targeted at an international problem.
Finally, research is:
Iterative
Very little about research is “set and forget”. Planning your project is an iterative process—e.g. you keep coming back to your aims and research questions as your methods develop. Conducting research project is often iterative—your previous project often serves as the starting point for your next project.
The overall process
The outcome we are working towards in this course is a comprehensive, well-argued research proposal/protocol. The steps in this process are provided in the diagram below.
Several example research proposals are provided on Blackboard. We are going to discuss Foot et al. (2017) and Krass et al. (2017) throughout the module. These are both comprehensive, well-funded, pharmacy practice research projects.1 I have also provided a proposal from a smaller-scale project for comparison. It is worth having a quick look at these documents to get an overall impression of the level of detail in a research proposal.In this module we are focused on the first three steps in this process:
- Identifying a need (reviewing and synthesising the existing literature)
- Formulating your overall aim
- Formulating a focused research question(s)
The first step is covered in the other component of the module. When you put these three together you have a Research Outline. This is an important early step in the development of the project. It is a pitch—to you and any potential collaborators and funders—for why the project is important (“So what”) and the contribution you intend to make.
It is often a living document that you refine over time until you have developed the full research proposal.
The key objective of the Research Outline is to clearly communicate the Research Question the project will address. We are going to spend most time unpacking how to develop a focused research question.
You won’t always start with a research question, you might start with a gap in the literature or practice or a more general aim. Moreover, the process in developing the research question is iterative—as you develop your methods and consider ethics, you will need to refine your research questions.
While the completed Research Proposal makes it look like the process is linear and obvious—it is anything but. The process of developing your aims, research questions and methods looks much more like the diagram below.
“I still don’t know where to start”
All of the above assumes you have an initial impression regarding a need, an overall aim or research question. What if you don’t?
The following prompts provide some suggestions if you are starting from a blank page.
Start local
What are you seeing day-to-day that doesn’t make sense, or you think could be improved?
What new thing is your pharmacy/department/hospital trying to do? How would you know if it worked?
Do GPs act on your medication review recommendations?
Do consumers accurately interpret the information you put on a dispensing label?
Is the electronic medication chart reducing medication errors?—which types?—are certain types of error becoming more frequent?
Why don’t junior medical officers conduct/document VTE risk assessments? Why don’t pharmacists undertake and document VTE risk assessments?
What drives you?
People do research for different reasons. You can usually infer what motivates researchers by the research they conduct.
What is your driver?
- Learning about a complex process
- Improving patient outcomes
- Improving practice
- Promoting the profession or your specific discipline
- Identifying and addressing inequities
What needs to be done?
Talk to experienced colleagues about what projects they think need to be conducted. Chances are some of them will have projects that they wish they had time for, but never get to.
What research is being done?
Read what your colleagues are publishing. Attend research meetings and conferences. Talk to people about their research.
Think critically about what is being presented.
If you think they are doing it wrong, come up with a project that is better.
If you think what they are doing is fantastic, consider getting involved, or doing research that would further support their research, or address the next set of questions along the line.
Once you turn on the tap, the supply of research questions is endless. Often the bigger challenge becomes identifying the questions that you want to, can, and should address.at.
References
Foot, Holly, Christopher Freeman, Karla Hemming, Ian Scott, Ian D. Coombes, Ian D. Williams, Luke Connelly, et al. 2017. “Reducing Medical Admissions into Hospital through Optimising Medicines (REMAIN HOME) Study: Protocol for a stepped-wedge, cluster-randomised trial.” BMJ Open 7 (4): 1–9. https://doi.org/10.1136/bmjopen-2016-015301.
Krass, Ines, Rob Carter, Bernadette Mitchell, Mohammadreza Mohebbi, Sophy T F Shih, Peta Trinder, Vincent L Versace, Frances Wilson, and Kevin Mc Namara. 2017. “Pharmacy Diabetes Screening Trial: protocol for a pragmatic cluster-randomised controlled trial to compare three screening methods for undiagnosed type 2 diabetes in Australian community pharmacy.” BMJ Open 7 (12): e017725. https://doi.org/10.1136/bmjopen-2017-017725.
Ueda, Keiko, and Lofti B. Merabet. 2018. “Selection of the research question.” In Critical Thinking in Clinical Research, edited by Felipe Fregni and Ben M. W. Illigens, 26–37. New York, NY: Oxford University Press.
Keep in mind that scale of these projects is quite a bit larger than a Masters project (and most PhD projects).↩︎