• Audits: Are a way at ensuring that practice is following guidelines
  • Research: Evaluates practice or compares alternative practice with the purpose of contributing to a body of knowledge. 

Research is the use of materials and methods in order to test a hypothesis. It is the means by which we obtain evidence to determine best practice.

National Institute for Health Research

Provides a health research system in which the NHS supports outstanding individuals in world class facilities.

Medical research council. The MRC funds research at the forefront of science to prevent illness, develop therapies and improve human health.

The use of high quality research along with clinical experience to aid clinical decision making whilst taking into account patient values.

Research can be classified as interventional or observations.

  • Interventional studies include: Crossover study design, nonrandomised controlled trials, randomised control styles.
  • Observational studies include: Cohort, Case-control and Cross-sectional studies.

I understand that some individuals do not like research and am against research becoming a tick box exercise. However, I think that all trainees should at least understand research principles in order to practice evidence based medicine. In addition, as part of my research work (X grants, X presentations and X papers). I have had the opportunity to work as a team, develop my written and oral communication skills, and attend multiple orthopaedic conferences. Which have not only been educational but have also allowed me to make contacts who provide me with careers advice.

  • Identify a question
  • Perform a literature search
  • Formulate a hypothesis
  • Obtain ethical approval/funding
  • Collect data
  • Statistical analysis 
  • Write up/disseminate

I am extremely interested in research. I have completed formal research training as part of my Orthopaedic BSc/MSc/PHD. I have completed X papers and presented X pieces of work. I have also achieved X prizes/grant applications for this work.

During this work I have not only learnt how to formulate a research question, apply for ethical approval, apply for grants, perform statistical analysis. But have also improved my organisational and team-working skills and have developed my written and oral communication skills.

Variety of methods:

  • Discussion/teaching with senior colleagues e.g. in trauma meetings
  • Read journals
  • Listen to podcasts
  • Watch webinars
  • Attend courses and conferences e.g. AO, ATLS, BOA
  • Consolidate through own work e.g. papers, presentations

This will be specific to you. Examples of how research may change practice:

  • Teaching methodology
  • Improved team-working/communication skills
  • Directly: Results may influence/change management

Duckworth 2017

Paper mentioned in a trauma meeting which I went away and read
Randomised control trail of 19 patients >75YO
Compared non operative vs operative fixation in Mayo 2A and B fractures
DASH, ROM at 6-52 weeks. No significant differnce.
Trial stopped early due to complications in the operative group.
Changed my practice important to select the right treatment for the patient. Important to always have a conversation with patients and understand their functional requirement as some patients may tolerate lower functional outcomes and avoid operative complications.
Other papers:
  • Khan RJ, Fick D, Yao F, Tang K, Hurworth M, Nivbrant B, Wood D. A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br. 2006 Feb;88(2):238-42. doi: 10.1302/0301-620X.88B2.16923. PMID: 16434531.
  • Oakley BNightingale JMoran C, et al
    Does achieving the best practice tariff improve outcomes in hip fracture patients? An observational cohort study
  1. Meta-analysis and randomised control trials
  2. Cohort studies
  3. Case control studies
  4. Case series
  5. Expert opinion