Category: Ryan

Everything was perfect. I was building the surveys, practicing the lattes, and preparing for clinical days. Then the house of cards that was my summer felt a light gust and fell apart. That is a wildly exaggerated metaphor but keep an open mind. I spent much of my summer dividing my time between the three jobs of being a barista, a student, and a biostatistics intern. Three jobs may sound like too much work… and it was.

Over the past two months I have been working with Dr. Jessica Keys to prepare a database for a clinical trial with the UNC Center For Aids Research. Much thought went into the structure of the electronic case report forms or eCRFs that we were creating. Aside from coding and translating forms, most of the meetings with my preceptor involved brainstorming rather than hands-on work to discuss the sequence in which the forms would be filled out and how that would influence the coding within each form. For example, many of the forms had redundant information such as date of birth or height. So, we used coding to fill in the redundant information automatically by transferring the data from one form to another. Overall, the practicum gave me my first experience with creating a database and my first practical experience in biostatistics. My preceptor stressed all the best practices that one can do to make the data analyst’s job more efficient. For instance, one should export the data early in the process to see how it looks and adjust the forms if needed. Other tips included keeping the number of variables small if possible and create self-explanatory variables to make the data analysis more user-friendly. More important than the lessons I learned, I am now able to use REDCap and plan to learn more biostatistics skills to explore other positions in the future.

What did I do when I wasn’t creating digital surveys? I finished training as a barista in March and will continue to work 20 hours a week indefinitely. Creating lattes is a nice break from academics and I enjoy learning about all the special types of coffee that exist. It’s crazy how many ways there are to make coffee. And something I have learned this summer is that it is essential to have something built into your schedule that allows you to relax.

Finally, I took an EMT course. The lectures were 16 hours a week at night and all-day Saturday, but I was glad to be busy this summer. Unfortunately, I failed one of the last exams in the course and had to stop two weeks before completing the class! But on the other hand, I worked one emergency department shift before failing and had the chance to practice a lot of what I learned during the semester.

I admit that I was greedy. I tried to work 40 hours a week while taking night classes rather than prioritizing the EMT course, but I still debate whether I should commit to studying or continue to serve coffee to relax. For now, I will be on the streets of Durham if anyone needs CPR, a latte, or a database.

Five years ago I could not have told you what “public health” was…because I had never even heard the term before. Also, I knew absolutely nothing about cervical cancer before this summer, but now I am working with the Center for AIDS Research (CFAR) on a clinical trial for a pre-cervical cancer treatment: “ACT II: Acceptability and Feasibility of Combination Treatment for Cervical Precancer among South African Women Living with HIV“.

The clinical trial is based in South Africa, but I am working in Chapel Hill with my preceptor (my direct superior/mentor), Dr. Jessica Keys, to build a database on a website called Research Electronic Data Capture (REDCap), a secure survey-building software. What is a secure survey-building software? It is difficult to explain why those adjectives are important and what they mean, but I can only give a brief explanation. REDCap is used to store information such as medication taken by trial participants, symptoms after taking the precancer treatment, and diagnostics/vitals recorded during the trial to monitor the health of the participants. And REDCap is one of many services that can create surveys (such as Qualtrics or SurveyMonkey), but it is one of the most useful because it provides many security measures to prevent breaches of sensitive medical information. Before I could even look at the surveys I had to complete a series of short online quizzes/readings to gain approval into the study. Since gaining approval, I have been translating surveys that were made beforehand into digital versions on REDCap. So, I am essentially taking surveys that are on paper and copying them so that the researchers in the clinical trial can store the information online.

My first expectation for the practicum is to learn biostatistics-related skills such as how to prepare for a clinical trial, how to properly create surveys or other methods of organizing patient information, and possibly learn more about how to analyze large data sets efficiently if time permits. An important thing to know about me is that I went straight from undergrad to this grad program, so my second expectation for this practicum is to develop the professional skills that most other students developed through full time jobs like clear communication in different mediums and maintaining punctuality of assignments and meetings. So far, the practicum has exceeded my expectations.

My first task was to gain IRB approval to join the study and that process was tedious, but necessary for the overall goal of making sure that research is ethical. For example, I had to read about the issues that could lead to unethical research such as conflicts of interest and insecure health records. Luckily, I won’t need to see any patient information during my practicum so there won’t be any worry about confidentiality or data security.

After gaining entry to the study, I have been learning how to use REDCap and gaining tips from my preceptor on the best methods of creating digital surveys to help the research team and analysts do their jobs. Honestly, using REDCap was simple after I watched a few training videos, but the difficult part of building surveys is completing all the behind-the-scenes brainstorming that is necessary to create a high-quality survey. The first objective for building a good survey is to anticipate all the possible answer choices that a participant could give. Related to that is the necessity of providing space to explain any answers that are not popular or anticipated (i.e. “Other, specify:”). Those two objectives may seem obvious but are easy to overlook in the process of creating a survey. The third objective is to raise questions about the quality of the surveys such as: “Are the electronic surveys intuitive for the investigators who are collecting data?” or “Are there any questions that are poorly worded or difficult to translate to the electronic format?” The final objective is to increase the efficiency of communication between the creation of the survey, to collection of the data, and finally to analysis of the survey answers after the participants terminate their participation. Given these four objectives, the summation of my job this summer is to accommodate the collection of information during the trial and prepare for the summation of that information after the trial is over.

Given the position of my work along the timeline of the clinical trial (between collection of the data and analysis of that information), it is important to think about all the ways that data analysis can be made easier for whoever is looking at the results of the surveys. All the coding within the electronic surveys must be intuitive and a spreadsheet should be provided that explains how the electronic versions of the surveys match the paper surveys that were given to me.

When I am not creating surveys on my laptop (usually at Open Eye Café or Weaver Street Market) I am engaged in two other “jobs”! First, I am working part time as a barista at Joe Van Gogh Cafe, which allows me to step away from my work and make some money on the side (around 18 hours a week). Second, I am taking night classes to become an Emergency Medical Technician (EMT) by the end of the summer (around 16 hours of lectures a week). Ultimately, my career goal is to become a nurse practitioner, so my experiences in public health and emergency medical services (EMS) will prepare me for my dream of practicing medicine while simultaneously building more equitable communities.

To recap, the practicum is showing me how clinical trials function internally and is indirectly teaching me about data collection. Also, my role in the clinical trial will give me the chance to meet the researchers who are leading the clinical trial in South Africa. On top of that, I will be busy with my other two jobs as a barista and an EMT. Yet, everything I am doing is leading to my goal of improving life for as many people as I can.

-Ryan