2. National Alliance of Research Associates Programs (NARAP) Keith Bradley, MD Stephanie Carro-Kowalcyk, BA Ryan King, BSEE William Keefe, BS

3. Process n Pre-Orientation –Lectures via NARAP website (www.theNARAP.org) –NARAP hospitals around the country –NARAP Director and NARAP Chief RAs n Orientation –meet Program Directors and Chief RAs –practice how to enroll participants in the study(ies) –get > 500 RAs around the country to enroll study participants the same way, every time over the course of the study

4. Pre-Orientation Lectures NARAP n Overview of the RA Program and NARAP n Primary Health Care Screening n Facilitating Primary Health Care Screening through the Emergency Department

5. Pre-Orientation Lectures This Semester n Research: Cervical and Breast Cancer –Didactics –Pilot studies on RAs facilitating cervical and breast cancer screening among ED patients and visitors → current NARAP national, multi-center study n Service: Tobacco Cessation –Didactics –Results of NARAP’s first national, multi-center study

6. Pre-Orientation Lectures Practicals n REDCap n Demonstration n Best Practices and Pitfalls of being an RA

7. Pre-Orientation Lectures Site Specific n Day in the Life n Ethics of Research: –Confidentiality –Informed Consent n Safety

8. Goals Fired Up! Fired Up! n Being an RA –Discernment –Qualification –Development

9. Goals Goals Fired Up! n NARAP –Clinical research that efficiently enrolls unprecedented numbers of participants in short time frames –New way to facilitate primary health care for a large percentage of the US population –Evaluated, significant clinical experience as one of the determining factors for health professional school admission

10. Goals Goals Fired Up! You are each an essential part of this new, exciting national effort!

11. Research Associates (RAs) RA’s are pre-health professional students who volunteer in the emergency department (ED) as participant identifiers and data collectors in clinical research.

12. RAs: An Answer for an EM Research Need

13. n bright, motivated individuals

14. RAs: An Answer for an EM Research Need n bright, motivated individuals n primary responsibility = research

15. RAs: An Answer for an EM Research Need n bright, motivated individuals n primary responsibility = research n focused experts on the details of the research

16. RAs: An Answer for an EM Research Need n bright, motivated individuals n primary responsibility = research n focused experts on the details of the research n on-site, 24/7, in the ED

17. RAs: An Answer for an EM Research Need n bright, motivated individuals n primary responsibility = research n focused experts on the details of the research n on-site, 24/7, in the ED n available in large numbers

18. RAs: An Answer for an EM Research Need n bright, motivated individuals n primary responsibility = research n focused experts on the details of the research n on-site, 24/7, in the ED n available in large numbers n “free” = willing to be paid in a commodity not money

19. RAs: An Answer for an EM Research Need n bright, motivated individuals n primary responsibility = research n focused experts on the details of the research n on-site, 24/7, in the ED n available in large numbers n “free” = willing to be paid in a commodity not money Traditionally, = Medical Students!

20. Difference between MS1 and Pre-Med?

21. n 1 st year of medical school: –anatomy, physiology, biochemistry, neuroscience

22. Difference between MS1 and Pre-Med? n 1 st year of medical school: –anatomy, physiology, biochemistry, neuroscience –clinical skills?

23. Difference between MS1 and Pre-Med? n 1 st year of medical school: –anatomy, physiology, biochemistry, neuroscience –clinical skills? Not so much until MS 3,4

24. Difference between MS1 and Pre-Med? n 1 st year of medical school: –anatomy, physiology, biochemistry, neuroscience –clinical skills? Not so much until MS 3,4 n So … why not ? –applicants/seniors

25. Difference between MS1 and Pre-Med? n 1 st year of medical school: –anatomy, physiology, biochemistry, neuroscience –clinical skills? Not so much until MS 3,4 n So … why not ? –applicants/seniors –juniors, sophomores, 2 nd semester first years

26. Research Associates Pre-health professional students who want:

27. Research Associates Pre-health professional students who want: n significant clinical exposure

28. Research Associates Pre-health professional students who want: n significant clinical exposure n significant research experience

29. Research Associates Pre-health professional students who want: n significant clinical exposure n significant research experience n a specific role in the ED

30. Research Associates Pre-health professional students who want: n significant clinical exposure n significant research experience n a specific role in the ED (vs. just shadowing)

31. Research Associates Pre-health professional students who want: n significant clinical exposure n significant research experience n a specific role in the ED (vs. just shadowing) n work with a diverse patient population

32. Research Associates Pre-health professional students who want: n significant clinical exposure n significant research experience n a specific role in the ED (vs. just shadowing) n work with a diverse patient population n an evaluated patient-care experience

34. Research Associates Responsibilities

35. Responsibilities n participate in training and orientation

36. Research Associates Responsibilities n participate in training and orientation n volunteer one 4-hour shift / week / semester

37. Research Associates Responsibilities n participate in training and orientation n volunteer one 4-hour shift / week / semester n receive evaluations by RA Program staff

38. Research Associates Responsibilities n participate in training and orientation n volunteer one 4-hour shift / week / semester n receive evaluations by RA Program staff –patient interaction skills

39. Research Associates Responsibilities n participate in training and orientation n volunteer one 4-hour shift / week / semester n receive evaluations by RA Program staff –patient interaction skills –follow research protocol

40. Research Associates Responsibilities n participate in training and orientation n volunteer one 4-hour shift / week / semester n receive evaluations by RA Program staff –patient interaction skills –follow research protocol –accurate data collection

41. Do RA Programs Work?

42. Since 1994,

43. Do RA Programs Work? Since 1994, n > 50,000 participants enrolled

44. Do RA Programs Work? Since 1994, n > 50,000 participants enrolled n by over 1000 RAs

45. Do RA Programs Work? Since 1994, n > 50,000 participants enrolled n by over 1000 RAs n in 23 clinical research studies

46. Do RA Programs Work? Since 1994, n > 50,000 participants enrolled n by over 1000 RAs n in 23 clinical research studies –traditional, e.g., ankle injuries, trauma, CQI

47. Do RA Programs Work? Since 1994, n > 50,000 participants enrolled n by over 1000 RAs n in 23 clinical research studies –traditional, e.g., ankle injuries, trauma, CQI –screening, e.g., domestic violence, firearms risk,

48. Do RA Programs Work? Since 1994, n ≈ 40,000 participants enrolled n by over 1000 RAs n in 22 clinical research studies –traditional, e.g., ankle injuries, trauma, CQI –screening, e.g., domestic violence, firearms risk, Pap, mammogram, PSA, colon-rectal Pap, mammogram, PSA, colon-rectal

49. Do RA Programs Work? Since 1994, n > 50,000 participants enrolled n by over 1000 RAs n in 23 clinical research studies –traditional, e.g., ankle injuries, trauma, CQI –screening, e.g., domestic violence, firearms risk, Pap, mammogram, PSA, colon-rectal Pap, mammogram, PSA, colon-rectal tobacco cessation tobacco cessation

50. Think of These Numbers

51. n > 1/2

52. Think of These Numbers n > 1/2 –more than half the U.S. population goes to ED every year as a patient or visitor

53. Think of These Numbers n > 1/2 –more than half the U.S. population goes to ED every year as a patient or visitor n 4

54. Think of These Numbers n > 1/2 –more than half the U.S. population goes to ED every year as a patient or visitor n 4 -average number of hours for an ED visit

55. Think of These Numbers n > 1/2 –more than half the U.S. population goes to ED every year as a patient or visitor n 4 -average number of hours for an ED visit n  500,000

56. Think of These Numbers n > 1/2 –more than half the U.S. population goes to ED every year as a patient or visitor n 4 -average number of hours for an ED visit n  500,000 –college students and post-bacs consider medical school

57. Think of These Numbers What would a Fortune 500 company pay to have half the U.S. population sit in a room for 3 ½ hours once a year with half a million college-educated people poised and motivated to ask them questions about their use of the company’s products and to encourage them to buy the products they weren’t using?

58. RA Programs Benefits

59. Benefits

60. Benefits

61. Benefits n Research is done effectively

62. RA Programs Benefits n Research is done effectively, efficiently,

63. RA Programs Benefits n Research is done effectively, efficiently, while minimizing impact on clinical care

64. RA Programs Benefits n Research is done effectively, efficiently, while minimizing impact on clinical care n RAs get clinical exposure and research experience

65. RA Programs Benefits n Research is done effectively, efficiently, while minimizing impact on clinical care n RAs get clinical exposure and research experience n Advisers have a guaranteed evaluated clinical experience for their students

66. RA Programs Benefits n Research is done effectively, efficiently, while minimizing impact on clinical care n RAs get clinical exposure and research experience n Advisers have a guaranteed evaluated clinical experience for their students n Participants and future patients benefit most

67. RA Programs Benefits n Research is done effectively, efficiently, while minimizing impact on clinical care n RAs get clinical exposure and research experience n Advisers have a guaranteed evaluated clinical experience for their students n Participants and future patients benefit most Win-Win-Win-Win

68. Chief RAs Responsibilities n Program Director's assistants n develop their RA Program’s –recruiting, personnel management, scheduling, website, database management scheduling, website, database management n “first port of call” for line-RAs' on-shift issues

69. National Alliance of Research Associates Programs (NARAP)

70. n RA programs in multiple hospitals around the U.S.

71. National Alliance of Research Associates Programs (NARAP) n RA programs in multiple hospitals around the U.S. n clinical research consortium with a focus on the ED as a site to facilitate primary care

72. National Alliance of Research Associates Programs (NARAP) n RA programs in multiple hospitals around the U.S. n clinical research consortium with a focus on the ED as a site to facilitate primary care n tens of thousands of participants enrolled in clinical studies over short time periods

73. NARAP Member Institutions CT Hartford Hospital/UConn Lawrence & Memorial Lawrence & Memorial St. Vincent’s / Quinnipiac St. Vincent’s / Quinnipiac DC Georgetown MA UMass MO St. Louis University NJ Hackensack University Medical Center NY University of Rochester NV University of Nevada PA Jefferson TX Seton / U Texas, Austin VT UVM WA Pullman Regional

74. Watch “ER” on TV and guess what it’s like; Be a Research Associate in the Emergency Department and know.

75. Quiz n complete the RA Program Overview quiz found on the www.theNARAP.org website www.theNARAP.org n save as YourLastName,YourFirstName-RAProgramOverview n send to your Chief RA for Recruiting