Application to undertake intercalated year of study for BSc degree - Scheme B
1. Title of project
Injury prevention and control - identification of modifiable risk factors for traumatic injuries
2. Proposed supervisor
Dr Roderick Mackenzie, Senior Lecturer in Emergency Medicine, Emergency Medicine Academic Group, Department of Cardiovascular Sciences.
E-mail: Tel (Office): 0116 258 7274.
3. Head of Department Hosting the Project
Professor NJ Samani, Head of Department of Cardiovascular Sciences. Tel: 0116 256 3021, E-mail:
4. Student
Ms Sonal Tripathi (year of entry to medical school: 2005)
5. Background to the project
The Emergency Medicine Academic Group is developing an injury research programme which focuses on injury epidemiology and the evaluation of novel techniques for identifying modifiable risk factors across the spectrum of primary, secondary and tertiary prevention. Although many institutions and agencies collect information on injury incidents, physical injuries, interventions and outcomes, the existing information sources are fragmented across a range of agencies each focusing on different details and using different definitions. As a result, there is very limited useable epidemiological data regarding fatal and serious injury in the population. Trials of injury prevention and control strategies have therefore been difficult to develop and manage. To address these issues, the Group's injury research programme has focused to date on developing methodology to collect, match and analyse injury data across NHS and non-NHS agencies whilst complying with regulatory, ethical and legal requirements. Having established this methodology, the Group is now developing projects to identify modifiable risk factors for specific injury problems with a view to developing targeted prevention strategies and evaluating these in ecologic studies (studies of groups rather than individuals).
6. Purpose of the Project
Within the context of the injury research programme, the purpose of this project is to describe the epidemiology of a specific injury problem (e.g. forearm fractures in pre-school children, severe burn injuries or types of road traffic related injury), apply established and novel analytical tools to identify modifiable risk factors and develop proposals for a targeted prevention and control strategy specific to that population. The specific injury problem has not been determined in advance and will be selected by the BSc student based on their area of interest and the patterns of injury presentation at Leicester Royal Infirmary - one of the busiest Emergency Departments in the UK.
7. Programme of Research
The programme of supervised research within the BSc year will include the following.
(1) Identification of a specific injury problem within the community - based on a review of common attendances at Leicester Royal Infirmary.
(2) Development of a literature search strategy and critical appraisal of the relevant literature related to the epidemiology of the chosen problem and any existing evidence for prevention strategies.
(3) Mapping of data available in relation to this injury problem. This may include data from a range of sources including the local government and police road accident data sets, the ambulance service, the coroners and other agencies directly involved in collecting data related to the injury problem.
(4) Derivation of a minimum data set and collection of a retrospective pilot sample of patients from the Emergency Department in order to determine prevalence and support sample size calculation.
(5) Analysis of this retrospective sample using descriptive epidemiology and conventional statistical analysis (regression analysis) to identify contributory factors (related to the host, agent and environment in the pre-event, event and post-event phases), culpability and geo-demographic factors as relevant.
(6) Undertake prospective population based case-control study of the injury problem to test the hypothesis that certain identified factors increase (or decrease) the incidence of the specified injury problem. The population for this study will be the resident population of Leicestershire County and/or Leicestershire City (depending on injury prevalence) over a specified time period and possibly restricted to a specified activity (determined by the sample size required). Cases are persons presenting to the Emergency Department who are members of the study population and have the specified injury problem (e.g. persons sustaining head injuries in bicycle accidents). Controls are persons presenting to the Emergency Department who are also members of the study population but do not have the specified injury problem (e.g. persons involved in bicycle accidents who do not sustain head injuries). Results will be expressed as odds ratios and relative risk estimates.
(7) Having identified and confirmed the key contributory (or risk) factors, articulate countermeasures for the major contributory factors.
(8) Propose an intervention strategy for the injury problem (which may subsequently form the basis of a pragmatic intervention trial).
8. Summary of the Techniques to be Used
Generic Research skills:
Formulating and articulating research questions
Developing and applying literature search strategies
Research methodology (and study designs)
Critical appraisal
Statistical techniques including sample size determination
Use of word processing, spreadsheet, database and presentation software
Medical writing
Applied descriptive and analytical epidemiology
Project management
Time management
Presentation skills
Specific skills related to this project:
Utilising electronic hospital information systems
Injury epidemiology methodology
Developing and maintaining information sharing protocols
9. Timetabling of the Project
Weeks 1-4: Commence literature review related to chosen injury problem; map data sources related to that problem within Leicestershire and initiate case finding for retrospective sample. Learn literature search techniquesand undergo training in relevant computer systems and software.
Weeks 3-6: Define minimum data set for injury problem, complete collection of retrospective sample and secure relevant permissions and approvals to access and share additional (non-NHS) data. Develop further skills in descriptive epidemiology.
Weeks 5-10: Complete initial analysis of retrospective sample and plan case-control study.
Weeks 10-20: Undertake case-control study. Consolidate literature review and skills development.
Weeks 20-30: Complete case-control study, commence writing dissertation.
Weeks 30-36: Complete analysis, write and submit dissertation, prepare for examination
10. Resources
The student will require office and computer facilities, both of which can be provided from within the Emergency Medicine Academic Group.
11. Need for increased word count
There is no anticipated need for an increased word count for this project.
12. Ethics Committee Approval
Ethics Committee approval will be required for this project. In addition, information sharing protocols will need to be agreed with relevant data partners.
13. Supervision
Proposed supervisor
Dr Roderick Mackenzie, Senior Lecturer in Emergency Medicine and Honorary NHS Consultant in Emergency Medicine - substantive contract.
Previous supervisory responsibilities:
Elective and Special Study Module medical student supervision within Leicester and Cambridge
Clinical Research Fellow supervision (Cambridgeshire Trauma Audit and Research Project)
Clinical supervisor role for training grade doctors.
Only one student will be supervised
Details of relevant experience.
Dr Mackenzie is the principle investigator in the Department of Health funded Cambridgeshire Trauma Audit and Research Project (CTARP). This was a population based epidemiological study of major trauma over a five year period. CTARP is now completed and the results are being written up for conference presentations and publication this year.
Relevant conference posters
Development and implementation of a multi-agency population based injury research register (poster). Annual Trauma Audit and Research Network Conference, Manchester, February 2004.
Creation of a multi-agency population based trauma register (poster). Faculty of Accident and Emergency Medicine Annual Scientific Meeting, Leeds, November 2004.
14. Co–supervisors and other sources of supervision
There are no planned co-supervisors.
Additional support will be available within the Emergency Medicine Academic Group (members include Academic Clinical Fellows, Research Nurses and supporting NHS staff) in addition to the wider support available within the Emergency Department and the Department of Cardiovascular Sciences.
15. Mentor
Professor T Coats, Professor of Emergency Medicine, Emergency Medicine Academic Group, Department of Cardiovascular Sciences.
E-mail: Tel (Office): 0116 258 7274
16. Summary of student’s academic performance
I amcurrently in 4th year of medicine at Leicester Medical School.I have successfully completed all academic modules within the pre-clinical phase of my course at the first attempt.
I achieved an ‘excellent’ in the following modules:
Tissues of the body
Respiratory medicine
Head and neck
1st year OSCE
Throughout this phase of teaching, I have studied physiology, anatomy and pathophysiology. Having understood the theory, I have endeavoured to utilise this knowledge within the clinical aspects of the course.
Currently, I am completing the clinical stages of the degree. I have passed all my rotations with ‘excellent’ portfolios during my respiratory and peri-operative rotations. I am often credited by consultants with being enthusiastic, diligent and aspiring to learn.
In addition, I also undertook an innovative SSC, entitled 'Infection and public health' which provided me with a unique insight into teamwork, leadership and project management. Working within a team, I co-presented our findings regarding public health to the chairman of a community group. Our conclusions were presented as a poster designed to assess levels of depression in the Somali community and ways of tackling it. Our ideas for the issue along with the presentation itself were highly commended by the chairman.
I am highly motivated and have a strong desire to undertake this BSc project. It will allow me to acquire new skills, utilities my attributes and further develop abilities which I can employ in future research projects.
17. Signatures
By signing the application it is assumed that the supervisor and Head of Department have read the notes about the intercalated BSc scheme and are willing to supervise the student and the project detailed above. In the case of the Head of Department, s/he must be satisfied with the supervisory provision in this application.
Signed ……..……………..……………Date…………
(Student – Ms S Tripathi)
Signed ……..……………..……………Date…………
(Proposed Supervisor – Dr R Mackenzie)
Signed ……..……………..……………Date…………
(Head of Department – Prof N Samani)