Introduction:

For my Community and Global Health concentration project, I completed a summer clinical research internship at Gillette Children’s Hospital in St. Paul, Minnesota. In addition to working on various clinical research studies, I also had the opportunity to shadow doctors, physicians' assistants, and nurse practitioners in both the clinic and operating room as well as learn about the latest treatments and therapies being implemented at Gillette and other medical institutions. There was also a poster session at the end of the summer for all the interns (pictured below) to present our work. It was such an invaluable experience and I encourage anyone who’s interested in medicine or clinical research to apply!

Projects I Worked on and My role

I had the opportunity to assist in a variety of capacities with several clinical studies being conducted that summer. I worked primarily on Dr. Barney’s pain registry study, which aimed to assess the efficacy of a pain coping questionnaire called the Child Self Efficacy Scale (CSES) in predicting patients’ postsurgical opioid usage. The CSES is a survey that measures patients’ ability to cope with pain and is filled out by the parents. We wanted to assess whether this survey had any merit in predicting the type, amount, and frequency of administration of opioids patients recovering from a major orthopedic surgery received during the course of their hospitalization. My work included collecting patient data related to their demographics, health history and orthopedic surgery from a variety of patient databases.

The second study I helped out with was Dr. Georgiadis’s virtual reality study, which assessed whether virtual reality headsets could be used to ease the discomfort, anxiety, and fear associated with cast removal in young children. With this study, I was involved in screening for eligible patients, administering informed consent, setting up the technology during the visit and recording heart rate data.

I also assisted in another virtual reality study led by Dr. Barney that looked at whether virtual reality could be used to manage postoperative pain in patients who received a spinal fusion operation, a long and painful operation used to realign severely curved spines. With this study, I assisted with setting up the technology (camera, VR headset, heart rate monitor) and collecting heart rate data during the visit. These last two studies provided me the unique opportunity to interact with patients with their families which was very exciting to get to do as an undergraduate intern.

MY RESULts

The initial goal of my primary project was to assess whether there was a correlation between opioid usage after a major orthopedic surgery and patients' CSES score. However, we weren’t able to obtain all the data we needed for that analysis by the poster session, so I instead looked at whether there was an association between patients’ CSES score and various patient-level factors, such as age and length of hospital stay, for which I did have data. While I did not find statistical significance for any of the associations, this is what I expected. Dr. Barney hopes to find statistical significance once she is able to collect all the relevant opioid usage data.

Here is a link to the poster I presented if you are interested in learning more about the CSES pain survey, the methods, and my results.

WHY THIS WORK IS IMPORTANT TO CGH

This project, and much of Dr. Barney’s other pain-related studies, aim to better understand how pain can affect the postsurgical outcomes and health of patients. It is generally accepted in the medical community that there are four vital signs, including body temperature, blood pressure, pulse, and respiratory rate. However, many clinicians argue for a fifth vital sign that includes pain. Pain and patients' ability to cope with it plays a tremendous role in the speed and length of their recovery. Many of Gillette Children’s patients suffer from severe cerebral palsy and are non-verbal, meaning they are unable to verbally express their pain, so it is essential that there are effective measures in place to understand these patients’ pain, such as through the CSES questionnaire, to ensure the quality of their care. Dr. Barney hopes to improve life for people who have disabilities and complex conditions through her research by better understanding pain and finding innovative ways to reduce it and improve patients’ comfort.