ใช้ประกอบการบรรยาย แนะนำการวิจัยสำหรับแพทย์ประจำบ้านสาขาเวชศาสตร์ฉุกเฉิน 19 กันยายน 2008

1. Research in Emergency Medicine
Medical School Aspect
Boriboon Chenthanakij MD.
Family Medicine Department
Faculty of Medicine Chiangmai University
1

2. Why Research?
2

3. Why Research?
• to improve QUALITY of our mission.
2

4. Why Research?
• to improve QUALITY of our mission.
2

5. Why Research?
• to improve QUALITY of our mission.
• Our Mission
2

6. Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
2

7. Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
2

8. Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
• Undergraduate program
2

9. Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
• Undergraduate program
• Postgraduate program
2

10. Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
• Undergraduate program
• Postgraduate program
–Research 2

11. From Mission
3

12. From Mission
• We have many PLANs
3

13. From Mission
• We have many PLANs
3

14. From Mission
• We have many PLANs
• How can we know that our plans are good ?
3

15. From Mission
• We have many PLANs
• How can we know that our plans are good ?
3

16. From Mission
• We have many PLANs
• How can we know that our plans are good ?
• We run Deming Cycle
3

17. From Mission
• We have many PLANs
• How can we know that our plans are good ?
• We run Deming Cycle
–Plan Do Check Act
3

18. 4

19. 4

20. 4

21. Check
5

22. Check
• To ensure that things are in the way we would like to see.
5

23. Check
• To ensure that things are in the way we would like to see.
5

24. Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
5

25. Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
5

26. Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
• Can help us find the way to improve our process.
5

27. Research
6

28. Research
• can come from any plan check or any
question to improve our quality.
6

29. Patient Care
7

30. Patient Care
• We have STEMI fast tract, Stroke fast tract.
7

31. Patient Care
• We have STEMI fast tract, Stroke fast tract.
7

32. Patient Care
• We have STEMI fast tract, Stroke fast tract.
• Many resources were use in fast tract policies.
7

33. Patient Care
• We have STEMI fast tract, Stroke fast tract.
• Many resources were use in fast tract policies.
7

34. Patient Care
• We have STEMI fast tract, Stroke fast tract.
• Many resources were use in fast tract policies.
• Were these policies really improve quality of life for our
patient?
7

35. Patient care
8

36. Patient care
• We have 5 triage level for patient in Emergency
Department.
8

37. Patient care
• We have 5 triage level for patient in Emergency
Department.
8

38. Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
8

39. Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
8

40. Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
• Is 5 level triage improve quality of care compare to
3 level triage ?
8

41. Teaching
9

42. Teaching
• Undergraduate
9

43. Teaching
• Undergraduate
–In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
9

44. Teaching
• Undergraduate
–In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
–we now have 2 weeks selective program about
disaster medicine for medical student in 4th year.
9

45. Teaching
• Undergraduate
–In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
–we now have 2 weeks selective program about
disaster medicine for medical student in 4th year.
9

46. Teaching
• Undergraduate
–In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
–we now have 2 weeks selective program about
disaster medicine for medical student in 4th year.
–Is our selective program can actually improve our
medical student performance when disaster occur?
9

47. Teaching
10

48. Teaching
• Postgraduate
10

49. Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
10

50. Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
–The price of manikin is around 1 or more million B.
10

51. Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
–The price of manikin is around 1 or more million B.
10

52. Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
–The price of manikin is around 1 or more million B.
–Is advance life support manikin can actually improve our
resident’s skill?
10

53. POLICY
11

54. POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
11

55. POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
• We should know how much energy we use and how
much plastic garbage we produce.
11

56. POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
• We should know how much energy we use and how
much plastic garbage we produce.
• And how much we can reduce them.
11

57. Interest
12

58. Interest
• Some questions come from ourself.
12

59. Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
12

60. Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
12

61. Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
• We know that IV beta blockers is very helpful to control
heart rate in AF patients, but we don’t have this
medication form in ED.
12

62. Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
• We know that IV beta blockers is very helpful to control
heart rate in AF patients, but we don’t have this
medication form in ED.
• So, which medication can be used when we don’t have
this medication. 12

63. Question
13

64. Question
• Many questions occur in our daily life practice.
13

65. Question
• Many questions occur in our daily life practice.
13

66. Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
13

67. Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
13

68. Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
• Some questions can be answered easily, but many are not.
13

69. Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
• Some questions can be answered easily, but many are not.
13

70. Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
• Some questions can be answered easily, but many are not.
• We need evidences before we can do evidence
based ............
13

71. How strong is our evidence?
14

72. How strong is our evidence?
• We must have good methodology while looking for evidence.
14

73. How strong is our evidence?
• We must have good methodology while looking for evidence.
14

74. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
14

75. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
– Descriptive study
14

76. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
– Descriptive study
– Experimental study
14

77. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
– Descriptive study
– Experimental study
– Clinical trial
14

78. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
– Descriptive study
– Experimental study
– Clinical trial
• Which statistics is/are appropriate for our data?
14

79. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
– Descriptive study
– Experimental study
– Clinical trial
• Which statistics is/are appropriate for our data?
14

80. How strong is our evidence?
• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
– Descriptive study
– Experimental study
– Clinical trial
• Which statistics is/are appropriate for our data?
• Epidemiologist is our good friend in this situation.
14

81. When we have subjects
15

82. When we have subjects
• We should learn about ICH/GCP
15

83. When we have subjects
• We should learn about ICH/GCP
15

84. When we have subjects
• We should learn about ICH/GCP
• International Conference on Harmonization
15

85. When we have subjects
• We should learn about ICH/GCP
• International Conference on Harmonization
• Good Clinical Practices
15

86. ICH GCP
16

87. ICH GCP
• An international ethical and scientific quality
standard in
–Designing
–Conducting
–Recording
–Reporting
16

88. ICH GCP
• An international ethical and scientific quality
standard in
–Designing
–Conducting
–Recording
–Reporting
trials that involve human subjects.
16