Abstract

The Trainee Emergency Research Network (TERN), funded by the Royal College of Emergency Medicine (RCEM), is a new initiative that aims to demystify research and increase research engagement amongst Emergency Medicine (EM) clinicians. It was launched in 2018 and is ideally placed to improve how EM research is planned and conducted. Whilst the value of evidence-based medicine in Emergency Departments (EDs) is recognised, the unique pressures of the ED setting makes conducting research and disseminating good practice particularly challenging. TERN was designed to tackle these challenges with a focus on three important pillars to engage busy EM Clinicians: 1) Answer practice-changing questions 2) Robust and achievable data collection 3) Recognition Point 1, the research question has to be important and applicable to a trainees’ practice, both to encourage engagement and create impact. Point 2, the research has to be designed rigorously so that the data collection is clear and achievable within EDs and can be translated into clinical practice. Point 3, trainee contributions have to be recognised throughout. We will choose research questions that mirror the 2017 James-Lind/RCEM research priority setting partnership. This will allow TERN to frame its research questions around themes that have been recognised as vital in EM. TERN’s strength lies in accessing multiple ED sites for standardised data collection, ideally over short collection periods, to obtain nationally representative snapshots of patients and practice. This enables, for example, small pilot studies and subsequent multi-site prospective observational cohort studies to be conducted rapidly. We recognise that collecting data in multiple sites leads to potential issues surrounding data monitoring and governance. Simplifying the research design of studies by only collecting data that genuinely adds to the research question, will support the collection of accurate data. TERN will also harness the use of online data collection, which allows for live data monitoring and a clear audit trail of all data entered. This will allow busy ED clinicians to concentrate on data collection and allow the study team to have clear oversight of the project at local, regional and national levels. TERN is new but the response from the EM community, both academic and non-academic, has been very encouraging. Thanks to this support, within 8 months, we already have multiple successes, including our first primary research project, TIRED, which has 111 UK and Ireland sites signed up for data collection. We believe that by giving EM clinicians the opportunity to engage in high quality projects and contribute to a national data collection process, we can move away from the current model of EM evidence generation that typically relies on collections of small, often poorly-designed studies with limited compatibility. With our work, we aim to be transparent and seek guidance throughout our research designs, to ensure our projects stand up to the highest of research and statistical standards. Part of this process is opening dialogues and ‘EBM Live’ is the perfect forum to start this.