Interview with a Researcher - Charissa Zaga – BSpPath, MPH, PhD Candidate

Please give a brief background: (Employment, interests of study, special honors/certifications etc.)

I have been working as a Speech Pathologist in the acute hospital setting for over 10 years. During this time, I have worked clinically across a wide variety of medical and surgical acute inpatient units and spent some time in outpatient clinics and working with patients in the community. My specific clinical interests relate to critical care, upper airway, and respiratory care, including invasive mechanical ventilation and weaning from ventilation. I am working part-time in a joint clinical and managerial role as a stream leader for the Ventilation Weaning Unit, Victorian Respiratory Support Service, ICU, Respiratory, Cardiothoracic, and Spinal units at the Austin Hospital, Melbourne, Australia. I am also currently undertaking a PhD part-time, focused on communication interventions for mechanically ventilated patients in the ICU.

I have worked with the Tracheostomy Review and Management Service (TRAMS) at Austin Health since 2012 and have been involved in the Global Tracheostomy Collaborative since 2016. I’m also the Co-Convenor for the Victorian Critical Care and Tracheostomy Interest Group.

I completed a Master of Public Health in 2016, where my minor thesis examined consumer participation in the Quality of Care reports produced by Victorian hospitals. Besides clinical care and research, I am passionate about quality improvement in the healthcare setting. I think that the overlap between quality improvement, evidence-based practice, and research is really interesting – it doesn’t matter where you look, there are always questions to ask, information to seek, and ways to improve care and outcomes for our patients!

(Following this interview, she was also the first author on this most recent COVID19 publication on managing tracheostomies!🤩)

If you could conduct any research study on any topic/issue (meaning money/funding, time, subjects, IRB, etc. are NOT a problem!), what would it be? In other words, what’s your dream study?!

I think my dream study would be something along the lines of demonstrating that speech pathology intervention improves delirium. That’s a big topic to unpack but I guess that’s why it’s the dream study!

If you could change one thing about having to do research, what would it be?

The time-consuming process of referencing in an article! EndNote has made this infinitely easier than when it was entirely a manual process but still, the re-formatting of references is my least favorite part of the process.😩

What’s one thing you think clinicians should be excited about in our field regarding research?

I think our profession is becoming far more confident about engaging in research. We are increasingly looking for the evidence-base to underpin our clinical practice and therefore, identifying the gaps that exist. That means that more of us are undertaking research and working on translating the evidence into clinical practice – that’s the ultimate recipe for improving outcomes and quality of life for patients.

muah

What’s one thing you think researchers should be excited about in our field regarding clinical practice?

Similarly, more clinicians are seeking evidence to support their clinical practice, whether it be to inform patients about their likely outcomes, guide workforce decisions about staffing profiles, or ensure high-quality care is being provided. I think that being a clinical-researcher who wears two hats (and sometimes more than two!🎓🧢⛑), it is exciting to think about how hopefully, the research you’re producing is going to add value to the clinicians on the ground who are reviewing the literature.

(And equally, as clinicians, we are excited to find that research as well!!!😊🙌)

I feel the Results section of studies can be the most misunderstood or difficult to navigate through, what tidbits or tips/tricks can you share to help clinicians process these sections?

Tips for processing the results sections of studies can include taking note of the sample size of the included study population, understanding what the p-value, the odds ratio, the hazards ratio and other statistical values mean – at least in a basic sense🤓 [heckout Dr. Krekeler’s interview that even mentions Google!)] To put those results in context and understand the study as a whole, it is important to have a really basic understanding of the methodology and the research question, too.

Could you pick one technical jargon (e.g. “linear regression” “ANOVA” “two-tailed test” etc.) to explain in a relatable and easily understandable way (real-life, simple examples get bonus points)?

I think that understanding the purpose of confidence intervals and how to interpret these is quite important. The confidence interval represents the upper limit and lower limit of a range of values produced from a study population. The most common confidence level that is calculated is 95%, which means that we are 95% confident that the results truly lie between the lower and upper limit, leaving a 5% chance that the population mean giphy lies outside of this range. Confidence intervals provide a measurement of how confident we are that the sample population studied really represents the population studied overall.

With larger samples in a study, you can estimate the population mean with more precision than you can with smaller samples, so the confidence interval is quite narrow when computed from a large sample. The narrower the interval, the more precise the estimate is. For clinicians, looking at the confidence intervals can be one of the tools you use when interpreting the clinical significance of studies, the generalizability, and applicability to clinical practice.😯😮🤯

What’s the one thing you think is important for practicing clinicians to know/understand when reading research?

Not all studies are robust or demonstrate clinically or statistically significant results. Some studies advance the knowledge on a given topic, but do not immediately allow for change to practice. Understanding key factors, such as different study designs, sample sizes, p-values, as well as of course the setting and population studied will make a big difference in how you interpret the research.

What’s one thing you think is important for researchers to know/understand about clinical practice?

Not all clinicians are able to easily extrapolate the “so what?” from research articles. It is helpful to consider your target audience and describe the clinical relevance of the study and the limitations of the study. 👏👏👏👏

What is something you believe researchers could do better to #bridgethegap?

Keep your foot in the clinical space – whether it be the maintenance of a small clinical load, mentoring clinicians and discussing cases, or something else. The clinical space can change over time, particularly items such as the culture within teams and units, and the enablers and barriers that impact our patients and our clinical practice. Keeping abreast of what is staying the same and what is changing ensures that the research is relevant and valuable.

What is something you believe clinicians could do better to #bridgethegap?

Develop critical appraisal skills so you are better equipped to understand published research and determine the clinical relevance, applicability and/or limitations of the studies.

(Check out some free Resources for this!!!)