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Episode 5 Getting into Research: The INSPIRE Pathway, with Dr. Akhilesh Jha
115 Plays14 days ago
In this episode we talk to Dr Akhilesh Jha, MRC Clinician Scientist at the University of Cambridge and Honorary Consultant in Respiratory Medicine at Cambridge University Hospitals, who leads INSPIRE - the Integrated Respiratory Research collaborative, the UK's research network for early career doctors and allied health professionals in respiratory medicine. Aki tells the story of how INSPIRE came about, how the network supports trainee-led research projects at regional and national scale, and how trainees and AHPs at any stage can join and get involved.
Links from this episode:
- INSPIRE website: https://www.inspirerespiratory.co.uk/
- Join the network: https://www.inspirerespiratory.co.uk/join-us/
- Resources for getting started in research: https://www.inspirerespiratory.co.uk/resources/
- INSPIRE at the British Thoracic Society (including the RESP webinars): https://www.brit-thoracic.org.uk/research-and-innovation/supporting-respiratory-research/integrated-respiratory-research-collaborative-inspire/
- INSPIRE on X: @INSPIREresp_UK
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Transcript
Introduction to the UKPS Podcast & Guest
00:00:02
Speaker
Hello, everyone. Welcome back to the UKPS podcast. Today, we will be talking Akhilaj Cha, who has been spearheading Spire Network, which a lot of you may have heard about. I'll ask Aki to introduce himself, if that's okay, and then we'll dive straight in. So over to you, Aki.
00:00:22
Speaker
Thank you so much for inviting me. I am an academic respiratory clinician in Cambridge, and I look forward to chatting more. Thank you, Eki, for joining us.
Inspiration Behind Inspire Network
00:00:34
Speaker
I just want to ask you what led to developing the Inspire Network? Because it's the first of its kind in respiratory medicine for trainees. ah So what was the thought behind it and aims and scopes, if you want to dig deep a bit about that?
00:00:51
Speaker
Yeah, it's a good question. You guys would have been practicing during COVID, right? So that was really the motivation. That was, I think, the first taste of research for a lot of um people, a lot of trainees in particular. And I remember I was finishing my training at that time and I built a rotor for people to get involved. People had never done research in their lives. They had only done clinical practice and they consented patients to take part in it.
00:01:18
Speaker
And Then what they did is they then saw how the recovery trial progressed to then publish their findings. Of course, we all know about the dexamethasone results, for example. And so they could see this direct link between their involvement, their consenting that patient in the side room with COVID to world-changing guideline practice. So there's probably not a more powerful way of linking how important it is for frontline clinical research to to provide the evidence base for what we do. So that really got me thinking about how can we build something like that within respiratory
Development and Support of Inspire Network
00:01:54
Speaker
medicine? How can we take inspiration and learn from that process to do that across multiple respiratory diseases? Because having been at that point, I'd already done a PhD and I'd done research and I was a clinical lecturer. And so I was excited about research and how we can really
00:02:11
Speaker
do that on a bigger scale than in our silos that we normally practice. And luckily at that time, NIHR were really enthusiastic about the idea as well. And Tony de Souza and Naj Rahman, who were leading the respiratory section at that time, were also really excited. So it it became a really great opportunity just to build something from there. So it started from scratch in that sense. And then the next steps, I guess, were trying to think of how we would do that.
00:02:41
Speaker
So the two main sources of the sort of foundations on which we built upon were the fact that there were already regional networks, research networks that happened that were in place in respiratory. So some of these were, for example, in the Southwest.
00:02:57
Speaker
And also the Midlands as well. There were training networks that were successfully doing regional projects but for a number of years. And the other aspect of this was thinking about specialties outside respiratory medicine. Actually, there were several specialties, particularly the surgeons who had done a really great job building things that Some of the surgeons, in fact, they're doing global trials now as trainees. It's incredible what they've achieved. And the neurosurgeons, for example, published something in the New England Journal. So you could really see how there there was a template already there for what we could do in respiratory medicine. So we borrowed some of the ideas and structures and processes that that were already in place and thought, let's try and do this within respiratory.
Goals and Project Proposals in Inspire
00:03:41
Speaker
Perfect. just to expand, INSPIRE, of course, is the Integrated Respiratory Research Collaborative. The primary aim, I imagine, would be that, of course, to support research projects, etc. So what kind of projects does INSPIRE support? And I know there have been a few that have been supported in the past, but what sort of things would would INSPIRE be looking to support?
00:04:05
Speaker
Yeah, so I mean, it's throughout the breadth of respiratory medicine. We initially did have quite a few plural research projects at the beginning. was I think because you guys have a really strong national infrastructure already in place, actually, so it' ah it's a great model to learn from, actually, I think, from for other conditions. But it's the general principle behind it is that I think...
00:04:28
Speaker
ah out On the front line, people who practice on the front line, whether it's clinicians, nurses, allied health professionals, are often the best people who can see what the clinical need is or where the problem is. And that's what you've always got to think about is that's where the research should be directed, right? You're meeting a need, whether that's from a from a clinical practice point of view or whether it's from the patient's perspective.
00:04:54
Speaker
So in that sense, that's what the driving thing is. And that can be anything within respiratory medicine. As a template, we've used the trainee curriculum as a kind of idea as to covering all those conditions is what we'd like to cover.
00:05:07
Speaker
So when we started, what we wanted to do is build a... a kind of platform and people come to the network with their ideas rather than prescribing you must do know this disease or you must do this condition because that's i think often there's how i see it is there's lots of very well-meaning initiatives from top level funders be they the big institutions and nihr or mrc and they want people to get involved but actually on the grassroots if you're
00:05:38
Speaker
If you've never had that research experience, then actually, how do you go about doing that? And so this is a kind of way of trying to link that grassroots movement to these opportunities and the initiatives that are there.
00:05:50
Speaker
So the idea would be, you would come with an idea and we initially did this by a couple of sandpit events. So these were online sandpit events where people would come along. Initially there was an application process and it was scored. And the first one we had the top five projects that were scored that were then presented. And the idea is it it was presented in front of people, an audience of multidisciplinary team audience, but also with a few experts who had already established it so they could ask questions and probe a little bit further about the methods, the analysis, et cetera. So that was how it started. And from that was born a couple of different projects. Steve Walker led a project from Bristol on secondary pneumothoraces, which was popular. And then the second project that was supported was a project from Newcastle with Ruth Sabala and Joe Kibler on thrombolysis and how we use it in treating pomemboli.
00:06:46
Speaker
And they were quite different across the respiratory diseases. So in terms of the breadth there, but also in terms of experience, I think it's important to mention. So Steve, I believe it was a clinical lecturer at the time, so had already done a PhD with some experience. Whereas Ruth, on the other hand, had never done research in her life. And so this was one way of learning how to do this with the support, of course, of a senior PI in that case, Tony DeSoyza.
00:07:10
Speaker
So that's how the first project started. And then from there, we've moved on to more plural projects as well. And Binnish has done a great job advancing her project with Plum. But we've also covered other conditions as well. There's one that's currently in process on exacerbations of interstitial lung disease, for example, progressive fibrosis.
00:07:33
Speaker
There'll also be one happening, what's happened already in bronchiectasis as well. So the idea is we'd cover any respiratory disease as long as the people come up with an ideas and an approach that will help to deliver a specific research question using the resources and platform that we can provide.
00:07:52
Speaker
That's really helpful. If, for example, I say i have a project and I've never done research before and I'm not affiliated with a research institute, what is the way to contact the Inspire Network? but Secondly, if we get in touch, what support I would have in shaping that into a project that is deliverable?
00:08:14
Speaker
Yeah, it's a great question, Vinish. Initially, our approach had been to do these sound pit events, which would be like an annual thing, and people then pitch as part of that. And we may come back to that, but at the moment, we're accepting rolling calls so people can just get in touch. So the Inspire website is probably the easiest way to do this, and all the contact details and email addresses are all on there.
00:08:38
Speaker
Just send an email, essentially. I'm also happy to be contacted directly as well. And I guess the first steps, if you've got an idea, is to think about, if you've never done research and you're thinking about an idea, is really read around it. How has that research question been addressed before? Is it truly novel?
00:08:57
Speaker
Try and chat to experts in that particular area as well. try and chat to colleagues as well. These collaborative projects are not one person sort of events. You build a coalition of people. Are there other people that would be interested? What their thoughts on it? So I'd say that would be the very first steps you should consider doing. You should also try and think of reading some guidelines as well on that particular area. So often the BTS guidelines, as an example, at the end of the guidelines, there's a recommendations for research section as well, which I'd encourage people to read because that's often ah You've already got your rationale, everything already laid out there. But yeah, in terms of the practical steps, if you've done all of those things, and then actually this is really a great question that we could address with all of us banding together, then do send an email. And then the idea would be you would...
00:09:47
Speaker
flesh out a proposal. so you'd flesh out an idea, a proposal. so it could be something simple, even a one, two page Word document would be the first step. and There's no strict formatting in terms of how you should do this. but A guide might be to use the PICO guidance. So the NIHR have PICO guidance. And again, if you wanted more research, you can obviously have more information. You can obviously read it online, but we also on the Inspire website have specific webinars dedicated to things like developing a research question like PICO, for example, the whole session on PICO and how to do it specific for respiratory. And then there's other stuff around ethics committees and funding, things like that as well, which hopefully people find helpful. The idea is you would pitch a proposal and then we would
00:10:31
Speaker
try and think about it as a committee as to what we could do, what we think, is there any feedback we can give? Try and link you up. If you don't know anybody, then try and link you up with some specialty experts who, you know, who may have some expertise in the area to think about how we can take that forward. I think it is important that you do have some kind of mentor or a more senior PI that and support you because these things do take time and having people with credibility in that area can help with that. And that's one of the things we would really like to do to try and link up because that's often the thing that's hard if you don't know anybody or never done research before.
00:11:08
Speaker
After that point, if it's something that we can support, so we try and use REDCap as our primary research data collection tool because it's a academic friendly research tool that's GDPR compliant and it's used increasingly commonly across the NHS. And it's just a way of either most commonly collecting anonymized data from sites, multiple different centers that can then input data remotely. even through a mobile phone app or via laptop. So we try and support the development of the database for that.
00:11:44
Speaker
In terms of actual funding, if it's required, we're not a funding organization that would, here's £10,000 finished for your project. It's not working like that way, but people are interested in this and the project needs that kind of money. Then we would definitely support applications for grants, for example, et cetera, small grants initially, but we People have got an ambitious idea that's worth doing. We could support that as well. And there's plenty of professors, for example, who have supported Inspire, who have been successful in getting lots of funding, for example, via NIHR.
00:12:18
Speaker
So that would be another way to support Inspire. I guess beyond that, the those are the kind of initial bits about starting a project and moving your idea forward.
Support for Novice Researchers
00:12:28
Speaker
Once you do get moving forward with the project, but that there is obviously lots more support we can then give during that period and afterwards as well.
00:12:37
Speaker
So once a project has taken off, what other things would inspire, be able to offer to make sure the project is seen through till the end, so to speak?
00:12:49
Speaker
Yeah, I'm glad you asked that, Malvika, because I think that's really important. One of the things I've noticed in the past when we do our research or you see the abstracts or posters is often you see single center studies, don't we? And they're really important in terms of locally developing people. But I often think to myself, that that's a really good question, but it's a shame it's an only an N of eight in one center. Wouldn't it be great if we could do that same question, but just do it across different the whole of the UK. So that's where I think we can try and help by sharing that opportunity and advertising it. So via the newsletter that we'd encourage people to subscribe to via the website. We did do the tweeting it out in X, but there's a bit of a transition there with X at the moment. I know BTS have moved to LinkedIn, so that's something we could move to as well. But the idea is generally with social media and any other communication channels that we can access. And some of it may be bespoke to your project, depending on What it is, say for example, the UK plural society, I'm sure plural products is a great opportunity, but it may be something else depending on say bronchiectasis, maybe a different network, et cetera. And often with access to this specialty expertise that can also facilitate that as well. Beyond that, there is also the, if people haven't heard of it, the NIHR Associate PI scheme as well, which some of our projects have been badged with. and So the idea is you can have that extra, more formal recognition of your efforts at your centre when you're recruiting people with that process.
00:14:22
Speaker
And then during the conduct of the study, if you need extra advertising to get more people, more sites involved, we'd do that. When we have VTS meetings, we've had various formats, either at the the stall or at presentations that we've done, both across winter and summer meetings. We try our best to advertise any projects that might be active or need further sites. And so with, I think we've had quite good success actually so far with that approach.
00:14:51
Speaker
And then the idea is after you've done the data collection, then of course, it's about writing it up and staff support and publications. And we can also support with that as well.
00:15:02
Speaker
The other thing that just to mention before I forget is that the NIHR also have a, it was called the Research Design Service before, but it's now called the Research Support Service. This is for any NHS staff member who has an idea for research, but they don't know where to begin or where to get support. And they can help with that as well, it's worth looking at.
00:15:21
Speaker
That's great, Eki. That was really well-rounded answer to how a journey would look like for a new idea all the way to the completion. And I can actually vouch for it because I also started off, and I still remember, we had a Teams meeting to talk through Plum and then how Plum developed and from a very... simple idea to something a bit more complex ended up going up to 18 centres across the UK. So it was an all by trainees with no funding attached to it. so I think that's something that I have lived through it and it's been a great journey. And I would like you to expand a little bit on the webinars that you mentioned and I really find them quite fascinating. And I just want to see what's the thought process behind it. And also, i correct me if I'm wrong, that you've now done two sessions
00:16:09
Speaker
for to inspire more research and respiratory trainees in collaboration with the BTS. So tell us a bit more about the webinars and also the thought behind these sessions.
00:16:20
Speaker
Yeah, of course.
Webinars and Networking Importance
00:16:21
Speaker
And thank you for the compliment, Ganesh. It's great to see how much we can get by with threadbare funding as well. So that's great. I think that is important to to know as well, that collaboration can achieve impact.
00:16:32
Speaker
So basically the webinars that we have, we are collaborating with British Thoracic Society via their, one of the arms of BTS is called Respiratory Futures. And if you haven't been there, I'd encourage you to go to their website. And the program of webinars that we've done there is to really make that link to people clear in their minds as to when we practice our clinical medicine, when we practice using whatever drugs we're using, which we're so commonly prescribing, be it, I don't know, steroids for airway disease or carbocysteine for bronchiectasis or whatever. whatever it is, or when to stick a chest strain in or when not to with pneumothorax, is to really make that link between what we are doing with the fact that was based on some kind of evidence or some kind of research or some kind of trial that has been done. Because often we just go through on kind of autopilot. Because this is how we learn things as we move from center to center and we complete our training and then we're just still prescribing whatever dose. But actually, what why is it that we're doing that? What is it that we're doing? What's it based on? And so that's the aim of those webinars is to make that link really explicit, because I think that will encourage people and make people understand actually how important and critical
00:17:52
Speaker
research in clinical practice. And so it's linking it with the practice, the drugs that we're already prescribing or the procedures we're already doing and giving a glimpse of the future, the landscape of trials that we ought to be keeping an eye out for what's new, what's coming up. And these are really delivered by world leading topic experts in terms of the management of these conditions.
00:18:14
Speaker
We're running them since around April, May last year. but um the the idea is this is ongoing. And it's also, CP accredited as well for CPD points if people need them. Yeah. And just as a sprunk, just ideas that we've had a Mona Baffidol, for example, for COPD management, we've had Sam Jaynes for lung cancer. Steve has been on as well for pneumothorax. We've had Liz's below looking at breathing pattern disorders most recently. And the idea is it covers the the breadth of respiratory medicine. Yeah, but strongly encourage people to try and dial in. And they're also available online to watch on the Respiratory Futures website as well. And as for the collaboration that's happening with the BTS, so the BTS have had a real drive and a push towards trying to support research and really encouraging uptake amongst trainees. So last year, there was an inaugural event held in Birmingham for 14 years.
00:19:10
Speaker
trainees ranging from IMT through through to ST level. People have never done research before, and it was an entire day of really introducing them to the idea of research, why we do it, some journeys around for listening to how other people have made those journeys, and workshops, really working with people about introducing different things. for example, the second one is happening Next week, but this will, the idea is hopefully it'll be a regular thing and also plans for the AHP separate AHP event potentially as well. But there's one for translational science.
00:19:46
Speaker
There's one for epidemiology. There's one for clinical trials. So the idea is there are workshops there that you can really gain some specific skills from. And also network, you're meeting other trainees, but you're also meeting people leading in their fields as well. It's fully funded attendance as well. So it is something that if you haven't been on and you'd like to, then it's likely to hold it next year. So it's worth watching out for that.
00:20:12
Speaker
Brilliant. That's great, Aki. Thank you. So I think just before we close up, I think we usually like to ask this, what's sort of the one piece, or it could be more than one piece of advice for early career researchers that you've got?
00:20:28
Speaker
Yep. Thank you, Melvie. Because I remember when I was doing my PhD, I got a book out of the library and it had a picture of two coffee cups on the front of it.
00:20:39
Speaker
And the point of, had lots of other information, of course, in the book. But the point of what they were encouraging the authors of that is talk to people, really talk to people who have the knowledge and skill. I think in respiratory medicine, we are a really friendly bunch in general. It's one of the reasons I wanted to go into the specialties. I would strongly ask and encourage people. Most people want to help and support, and it can feel a little bit lonely if you're just somewhere thinking about something. But actually, there's often a community of people that might be thinking the same thing or may be able to
00:21:14
Speaker
help advise further.
Conclusion and Call to Action
00:21:16
Speaker
Great. Thank you so much, Aki. That was really insightful and well done for initiating this whole process. And you must be very proud of yourself seeing it that is blossoming into something really interesting, helpful for the trainees.
00:21:31
Speaker
And thank you for your time today to talk about it. And I hope you would be expecting a flurry of emails. after people listening to our podcast but i can tell from my experience that he's very approachable helpful and guys through and through so please get in touch with the inspire team if you have ideas that you think can develop into a research project thank you very much