On paper, my plan for data collection is very streamlined and very direct- after all, I had to justify my process to my committee and get it approved. I am recruiting patients for my data collection from my own clinical practice, since this is what inspired my interest in my dissertation project to begin with. I have packets made up, I have duplicates of the consent form, I have adjusted my clinic schedule, I have a locked cabinet for signed consents, I have well-thought-out inclusion and exclusion criteria for my study. I have a plan for beginning to discuss my data. On paper, I have everything I need.
I have everything I need except actual study participants. Unfortunately it took me over two months last summer to figure out something was wrong. My data collection at this point is way behind where I imagined it would be at this point. I had been warned that data collection can be very frustrating, but of course I figured that I had worked out all the details on paper, and that this could not possibly happen to me. But it did and it has, and I wish I could point to exactly where it went wrong, to help anyone in a similar situation to mine.
So what did happen? There are a lot of moving parts in order to have potential candidates for my study scheduled into my clinic. I needed input from my collaborating physician, I needed input from our clinic coordinator, I needed input from our scheduling call center, I needed to develop brand-new clinic referral criteria. And I needed it all to happen in the right sequence at the right time. Unfortunately, many of these moving parts were not working together in the right way at the right time. It took some significant investigation on my part to figure out where the problems could be. I had to add meetings into my schedule to review my plan for recruitment, and to review the inclusion criteria with some of my clinical staff.
But I also asked myself: was this infrastructure failure in anyway useful to me? It demanded some introspection, to make sure that I wasn’t so “close” to the project that I was missing a huge communication point from my end. It did make me review my planned process for recruitment, and during that process I received much reinforcement from urology providers about how they appreciate the goal of this project, and are willing to help.
It also highlights the difference between “work” and “schoolwork.” It is frustrating, but ok that my data collection is slower than anticipated- it may just take me longer to graduate. But if my regular clinic was this slow and poorly scheduled, there would have been some bigger investigations on a faster time scale, since they are employing me to evaluate and manage patients…Which I was still doing all along, just not the ones that might have been candidates for my study.
I’d like to tell you I have the secret to success in spite of a huge initial infrastructure fail. But I don’t. For me the secret was just to keep moving ahead; because my study draws from my clinical population, each clinic then became a potential time to recruit, and each time I am surprised when I find a candidate. So it has put a new face on my regular clinic time.
Make no mistake- it's been a challenge for me to continue to blend an active clinical practice with my role as a Ph.D. candidate. But the highlight in this process has been that the men that I have approached about participating in my project have been very gracious with their time, and very willing to participate. But I am now becoming jealous of people who do secondary data analysis… The data that I do have so far is very interesting, and has reenergized me because I am creating a very robust database on a poorly-studied clinical population- the benefit of a project directly inspired by clinical practice.
School can be isolating in this way; the projects that we are required to create and the criteria that we have to meet as Ph.D. students and Ph.D. candidates sometimes don't play well with the real world. But I'm trying to spin this experience in a positive way. I intend to pursue a career that continues to blend clinical practice and research, and these sort of infrastructure issues are ones that I will continue to have. I know everyone entered into helping me with this project with the best of intentions. This is a good reminder, and good experience, of how it can be challenging to focus the talents and roles of so many individuals toward a specific change in how any clinic works. And my New Year's resolution continues to be graduation in 2016, so onward-