A medical student's experience of research at Florey Stroke

Every year in the last week of June, medical students from the University of Melbourne escape the routine of ward rounds and study for an annual conference. Held 'by students, for students', the MD Student Conference brings together 1400 students at the Melbourne Convention and Exhibition Centre for a week of inspiring speakers and big issues.

But while other students are returning from their holidays, the final year students are busy adding the finishing touches to their MD Research Project (MDRP). UniMelb students undertake an MDRP in the third and fourth year of their degree, at institutions across Australia.

This year, two students joined Florey Stroke for their MDRP. Both Caitlin Kennedy and Blake Nielsen presented their work at the UniMelb MD Student Conference. 

We caught up with Caitlin and Blake at the conference to find out what it was like to do a research project with Florey Stroke.

Caitlin Kennedy completed her research project on walking after stroke under Dr Kate Hayward and Prof Julie Bernhardt, as part of the AVERT Early Rehabilitation Group.

Blake Nielsen's research on dolichoectasia was under the supervision of Prof Vincent Thijs in the Stroke Research Unit.

Blake Nielsen with his MDRP poster

Caitlin Kennedy with her MDRP poster

 What was your research project about?

Caitlin:

We were investigating the relationship between pre-stroke factors and factors collected within 24 hours of stroke with number of days to walking 50 metres independently, using data from A Very Early Rehabilitation Trial (AVERT).

Blake:

I looked at a poorly understood arterial abnormality called dolichoectasia, which refers to an abnormally dilated and elongated vessel. This condition mostly affects the basilar artery of the brain and its most common complication is stroke.

We had the opportunity to use MRI data from the MRI-GENIE repository, which is a large international database of acute ischemic stroke patients. With clinical, imaging and genomic information available, ongoing research in this cohort may help to unravel some of the mechanisms underlying dolichoectasia.

What inspired you to pursue this research project?

Caitlin:

The topic was fascinating, and I thought the findings would be of interest to many people with stroke as well as clinicians. The project was very well supported with fantastic supervisors.

Blake:

I am constantly excited by the potential that large datasets offer for clinical research. We have also had only small amounts of exposure to radiology throughout our course, so I thought it would be really interesting to take on a neuroimaging project! Finally, I really enjoy clinical medicine, and this project allowed me to be involved with the Austin Health stroke unit.

What were the main findings and why is this important?

Caitlin:

The primary findings were that earlier return to independent walking post stroke was associated with younger age, less severe stroke, ischaemic stroke, absence of diabetes, and left hemisphere stroke.

Caitlin presenting her MDRP at the MD Student Conference

Blake:

Firstly, after some trial and error, we developed a scale to evaluate dolichoectasia in the MRI-GENIE database. We evaluated 513 of the 3,301 patients available and had a good interrater agreement, meaning that the scale performed well.

We also did an exploratory study on this subset and found that the three diagnostic components of dolichoectasia (dilation, deviation and elevation) had unique clinical risk factor profiles – this suggests it may be important to consider these components separately in future investigations.

What was the best thing about this project?

Caitlin:

Learning how research works. This was my first introduction to research and it was a really rewarding experience! I am looking forward to expanding on these new skills with other research projects in the future.

Blake:

Throughout my MDRP, I had the opportunity to hear lots of people discuss their research. I really enjoyed this opportunity to learn about how evidence translates into a clinical setting. It made me really think about the decisions that clinicians make, including the strengths and limitations of certain evidence.

What was the most challenging thing about this project?

Caitlin:

Learning how to code and manipulate data in STATA was a fairly steep learning curve but manageable with the expert assistance of Professor Leonid Churilov, YouTube and Dr Google.

Blake:

There was definitely a learning curve involved with reading MRI images. However, the statistical aspect of my study was probably the most challenging. There is a massive amount of information out there on biostatistical methods. Luckily, the Florey has the talented Prof Leonid Churilov, who was able to guide me in the right direction.

What is your favourite thing about the Florey?

Caitlin:

The people I have worked with. Everyone was willing to help and provide advice, so it was a great learning environment.

Blake:

The Florey is a pretty amazing facility with lots of driven, but friendly staff. I was part of the stroke research unit and was always greeted with smiles and hellos. This collegiality is definitely one of the Florey’s major assets.

Any tips for future MDRP students?

Caitlin:

You should definitely consider undertaking your MDRP at the Florey! I think the most important aspects were being interested in the project and having supportive supervisors.

Blake:

I would recommend any future MDRP student to think through their entire project from research question, to data collection and statistical methods from a very early stage. Having a grand plan in mind will make the whole process much easier. Also, make sure you break up your time by spending time on the wards, as well as outside the hospital. Good luck!