Interview with a Researcher - Emma Charters, PhD, BSc

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

I work as the clinical lead of Speech Pathology services at Chris O’Brien Lifehouse, an oncology hospital in Sydney, Australia. I also work as the adult team leader at Hills District Speech Pathology, as a mentor for the adult team. I LOVE being a Speechie! I am particularly interested in head and neck cancer and specialized in this area, and am fascinated and frustrated by dysphagia and trismus following HNC treatment.

I have recently submitted my PhD thesis which looked at the impact of advances made in the treatment of head and neck cancer had on swallowing outcomes. I’m super lucky and have primarily a clinical role, but get to do a bit of research on the side because of the truly incredible MDT at Lifehouse.

**Update! Since this interview Dr. Charters officially has successfully defended her dissertation and now officially Phd🥳🥳**

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?!

My current dream project for when I get back from maternity leave is to prospectively look at the impact that an intensive, preventative swallowing rehabilitation program has on head and neck surgical and radiotherapy patients. Ideally, what I’d like to do is randomize people into standard care (where they get routine pre-treatment education and support) and the study arm. Get them doing an intensive swallow program before their surgery or radiotherapy begins, continue it during and then a minimum of 12 months after – then evaluate how preventative and intensive swallow therapy affects outcomes in those different treatment modalities.

I’d want to use instrumental assessment, we have access to both VFSS and FEES, but logistically FEES is usually easier to fit in due to availability in radiology, along with patient-reported outcome measures for baseline, end of treatment, 3, 6, and 12 months post.🤩😍

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

Different ethics submissions for different sites!! I would LOVE to be able to do one big magical ethics application which allowed for specified sites to opt to be included in a study, but not need to go under separate reviews. I think ethics can be such a daunting (but obviously necessary!!) process to undergo, that multi-site studies might be put off or put in the “too hard” basket. Where really it is such an incredible opportunity to work with other teams, clinicians, and get answers to your clinical questions which perhaps hold more weight than what you’d get in a single site study.

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

The focus on translational research and the role it plays bringing a very concrete, real-life conclusion to apply to clinical practice. It feels like there is a greater connection between the research and clinical world, giving clinicians more in their tool kit to their workplaces and to their patients.

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

That speech pathology clinicians are capable of change! I honestly feel that our profession is laden with this incredible evidence and skill-thirsty people who do have the ability and I guess humility to change what they’ve always done and try something different when new evidence comes to light.

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?

I must admit I used to skim the results and go straight to the discussion to get the author’s impression of what the results mean! But, if you’re keen on making your own mind up rather than take the author’s conclusion, I am a very visual learner and skip straight to the tables and figures. Once I’ve got a bit of an idea as to whether their patient demographics are close enough to the patients I see in my caseload (and therefore how appliable the conclusions are to my work😉) I make dot points about what I think was interesting in the results then compare those points to the main findings written in the discussion.🤯

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 points12)?

This is such a great question!!

So an ANOVA – is an Analysis of Variance which wants to know if there is a difference between the average scores of two groups. There are two types depending on how many variables you have; one-way is one variable, two-way is two variables! Love that simple logic! For it to work, you need a categorical independent (fixed) variable and quantitative dependent variable.

So a one-way ANOVA example would be if you were looking at wine preferences (ok I’m in😄) and had an independent variable which was red wine, white wine, and rose, then looking if the selection impacts how many scoops of ice cream you get at the end of the evening. [basically wondering if the type of wine has an impact on how much ice cream you/ll eat later–which is verry true!😅)

ANOVA assumes there is no association between wine choice and how much ice cream you eat (aka null hypothesis). But if there is a difference, then the ANOVA rejects the null hypothesis.

The term variance comes into play when you apply the F-test (which is the name of the test used for ANOVA analyses). It is looking for whether the responses are widely or closely spread. The variance of mean (average) ice cream scoops for each wine drinker group (red, white or rose) is compared to the mean-variance of ice cream scoops for anyone who drank wine that night. If the variance for the red wine drinkers is smaller than the variance for all the wine drinkers combined, the F-value will be high–which says that the finding is unlikely due to chance that red wine drinkers love having mountains of ice cream to finish their nights.🥴

**This sounds like the perfect reason to do my own ANOVA analyis this weekend!😅🍦🍷

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

That the order of research is not replicated in the chaos of clinical practice! It is almost impossible to replicate exactly a research scenario in real life BUT that doesn’t mean the principles and findings can’t be applied!🙃

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

Key points are king! Clinicians are SO busy (yes). Easily digestible content, with clear conclusions and written in emojis (kidding!) is appreciated. I love those journals which ask for 3-5 key points. Feels like a cheat sheet for if your brain fails halfway through reading something (I mean we’ve all been there😴)

**But for reason research with emojis would be amazing🤩🤩

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

Maybe invite clinicians to be part of their research? Evening seminars to chat through what they’re studying or recruiting for at the moment and seek clinician feedback and ideas? I think whenever there is the opportunity to collaborate and share ideas we’re heading in the right direction!🤝👍

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

I think there are probably two really important things, being fierce when information-seeking and generous when information sharing.

Information and experience seeking is our lifelong learning clinician responsibility. It’s this lovely thing that happens whenever we speak to our colleagues and friends or we absorb when reading a new article in the bath with a glass of wine🍷! Then, when we get fired up and a bit more curious, we start asking our own questions and dreaming up research studies and possibly enroll in a Ph.D…!!🤔

Information sharing I like to think is all about being generous with knowledge or ideas that we may have gained access to that might be beneficial to someone else. You don’t want to be that cranky kid in the corner who won’t share their toys. If you read something fascinating – tell the world! Incredible research findings otherwise run the risk of sitting on a virtual shelf and gathering cyber dust.