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December 15, 2008
ER course puts students on front lines

By Carol Clark

It’s one thing to watch an episode of “ER” on television. It’s another thing to help clear a spot in the hallway for a gurney, as wailing ambulances pull up at Grady Memorial Hospital.

“I’m surprised by the volume of patients and the variety of problems you see on any given day,” says Hannah Kinkel, a senior enrolled in a new Clinical Research Practicum in Emergency Medicine offered by the Neuroscience and Behavioral Biology (NBB) Program.

“It’s amazing the amount of people required to make a system like Grady work. When a trauma case comes in, a team of 10 to 15 people goes into action,” adds Kinkel, a pre-med student who plans to specialize in neurology.

The 32 NBB undergraduates who enrolled in the new elective studied the fundamentals of clinical research — both in the classroom and at Grady.

David Wright, assistant professor of emergency medicine in the School of Medicine and a practicing ER doctor, developed the practicum and teaches it along with Paul Lennard, director of the NBB program.

Wright is involved in cutting-edge, clinical studies of traumatic brain injury, and trains the students in clinical research methods. The students then pull “shifts” at Grady, observing physicians and nurses at work and interviewing patients to determine if they are eligible for actual clinical trials, covering everything from strokes to seizures and heart disease.

Only two or three other hospitals in the country receive the same volume and acuity of cases as Grady — a Level 1 trauma center covering a region of about 4.1 million people. “It’s a busy hospital and it serves the underserved. You see a huge amount of disease and pathology,” Wright says.

“I enjoyed getting to spend so much time with patients and really talking with them,” says Taslima Choudury, a junior who plans to be a pediatric surgeon. She says that she learned the value of listening carefully when she interviewed people with a history of congestive heart failure, to determine their eligibility for a quality-of-life study.

Choudury was surprised that one woman who had recently been diagnosed with CHF did not know some of the basic things she could do to alleviate her symptoms. “She was clearly intelligent, but no one had told her these things before,” Choudury says. “I realized that I take information for granted. That woman lives by herself, doesn’t have much money, and doesn’t have a primary care physician or health insurance. You can’t just tell her, ‘Go look up this stuff on WebMD.’”

Senior Stacey Elkhatib agreed that a major benefit of the practicum was learning to communicate well with patients. “Some people would tell me their life stories,” she says. “You really have to be understanding and listen closely. Sometimes people will dance around what they are really trying to say.”

The practicum is open to all undergraduates, but it filled up quickly with NBB pre-med students when it debuted this fall. It offers a rare chance for undergraduates to get first-hand experience conducting clinical research.

“Even many doctors don’t have a solid grounding in clinical research, which is important for evaluating the studies that they read about,” Lennard says. “The course helps students develop critical thinking skills, while also exposing them to the joys and heartaches of being on the front lines of medicine. They are witnessing very traumatic situations — even death.”

The practicum may convince some students that medicine is not for them. Others, including Elkhatib, gain a stronger commitment to becoming a doctor. “I realized how stressful and hard [being a doctor] can be,” she says. “But when you see how much people need health care, and what a difference a physician can make for people, that’s really powerful.”