The goal of this proposal is to collect, catalog, and disseminate the intellectual investments medical students and residents make to explain how research pioneers care for patients. During the course of almost any clinical encounter, a question will arise whose answer requires the physician to synthesize different domains of knowledge. In some cases, the answer might take on added dimensions with incorporation of how basic, clinical, or translational research contribute to or will someday affect our understanding of diseases and treatments. The people who first encounter these questions are our trainees: medical students doing an initial history and physical or residents who check in on their patients multiple times a day. The questions that emerge from interactions with patients are opportunities to educate physician and patient alike. They are the foundation of Daily Attending or Team Rounds and it is common for medical students and residents to invest significant time researching answers, exploring unfamiliar topics, and building connections between basic and clinical science. Ideally, this intellectual investment is translated to the patient so as to improve understanding, trust, and satisfaction of care.
Example: A third year medical student is asked by a patient, “What causes melanoma to develop?” In researching this question, student discovers the article published in this week’s (11/12/15) New England Journal of Medicine, “The Genetic Evolution of Melanoma from Precursor Lesions” with UCSF’s Boris Bastian as senior author. By reading the article (and perhaps others), student learns about the biology and use of sequencing to study carcinogenesis through successive genetic alterations, implication of UV radiation in initiation and progression, and impact on natural history of disease. Student teaches residents, Attending, and other team members during rounds. Student teaches patient. Student deposits question and brief summary of his/her understanding to repository. Curator of repository reviews, formats, and seeks expert opinion as needed. Feedback provided to student. Entry becomes available to others.
Tech innovation/needs: Searchable, curated, and accessible (mobile-compatible) repository of clinical questions that have summaries/answers that connect basic, translational, and/or clinical research to clinical care.
Collateral benefits: 1) Codifies an important component of the Bridges curriculum—bringing basic sciences into the clinical rotations. 2) Increases awareness of research happening at UCSF and provides new opportunities for mentorship between esearchers and trainees. 3) Increases patient awareness of research endeavors at UCSF.
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