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Session 2 of the Open Mind Initiative by AMSUN. Peter Kitunguu takes us through the initial thought process that goes into developing a question from near nothing :) Peter Kitunguu holds First Class Honors in Anatomy and graduated valedictorian of the University of Nairobi in 2006. He has research and clinical interest in Neurosurgery. He is currently based at the Kenyatta National Teaching and Referral Hospital.
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Open Mind Forum Basic Tenets Of Question Formulation
Peter K. Kitunguu BSc (Hons), MBChB
Objectives
• Be honest with yourself, not necessarily with everyone else
• What do you hope to achieve?• I’m a researcher….but do I say• Earn a living• Create a reputation in your specialty• Genuine curiosity about the research
question
Lower your head modestly while passing, and you will harvest bananas- Congolese proverb
Modes of Question Formulation
• Retrospective
• Prospective
• Case Reports
• Case Series
• Experimental Studies
Normal Ward round• Michael Wanjau• 35 yr old construction worker• Admitted 4 days ago with a history of
“assault” by a falling brick• Admitted in ED in unconscious state
with 1 episode of convulsion, vomiting• CT scan - right parietotemporal EDH
with midline shift and associated depressed skull fracture
• Neuro consult recommended evacuation
• Mary Kamulu• 21 year old para 4+0• Admitted 3 days ago with urinary
incontinence as a referral from…….• Hx of prolonged labour, 40 hours,
attempted forceps delivery at peripheral hospital and fetal demise
• Married off customarily at the age of 13, • Physical attributes: height 4’ 9”, weight
48 kg
• Not necessarily unique scenarios
• What are the possible reactions• Clerk, present and pull all stops to
impress consultants• Read around the topics “That could be
the compulsory essay!!”• How many others have similar
conditions?• How do we manage them in our
setup?• How does our outcome compare with
other centres?
No person is born great; great people become great when others are sleeping – Ashanti proverb
• Possibilities• Prospective• Retrospective• Case series
But where do I start?• Literature Review
• Google scholar • Blackwell synergy• Pubmed• Hinari• Research-Engine.com
• Most crucial in early phases of Research development
• May initially appear daunting- stick to principles
The cattle is as good as the pasture in which it grazes.- Ethiopian Proverb
Concentrate your efforts
• Success and intellect is more in the realm of intensity than extensity
• Create an objective, a single goal a single task and beat it to submission
• Proposal writing- your road map for the journey
How many ways to skin a Cat?
• Why would you want to do that?
• What about rare clinical conditions?
• Rachel Wefwewe• 11/2 year old• Admitted with history of multiple
fracture of long bones, allegedly following fall from her first attempted steps
• Previous history of fracture right radius ulnar
• Xray confirms Dx and demonstrates old fractures
• Examination shows poorly formed dental enamel and blue sclerae
• Angela Gathie• 46 year old RVD patient currently on
ARVs with a history of non compliance• Admitted with history of painless lump in
right breastx2/12• Lump hard, overlying skin tethered,
uneven surface• Ultrasound shows irregular mass,
patches of calcification and spiculated margins
• Biopsy results show areas of caseation necrosis, on AFB staining positive
• Ann Kinyau, 78 year old• Admitted with back pain was and left
leg radicular pain• Lower limb weakness, urinary
retention and bowel incontinence• On examination she had a superficial
cyst in the lower lumbar region• Plain x-ray showed spina bifida
occulta. • MRI scanning showed a cystic
intradural lesion compressing the conus medullaris
How to balance with academic work?
• The solution?• Create a retreat within
yourself• For more concentrated forms
of thought or action• Consistent effort• Goals with deadlines
So what?• Try it for your self
• Identify an area of interest
• Find someone with some experience and work with them
• Challenge yourself to do a study by year’s end
The sheep that wants to grow a long horn must have a strong skull- Ethiopian proverb
Asante