Family Medicine Research “Bright Spots” in Low-Resource Settings

We applaud the article, “Factors Associated With Successful Research Departments: A Qualitative Analysis of Family Medicine Research Bright Spots” by Dr Liaw and colleagues.1 It gives us great hope for what is possible in the field of family medicine research.

This study focuses on research bright spots within a well-developed infrastructure. The authors state “while intrinsic motivation was important, leaders also indicated that it was insufficient in isolation without resources.” This raises a common question: what about programs without resources?

We contend the principles—multidisciplinary collaboration, leadership support, mentorship, etc—are easily applicable in low-resource research settings. Grassroots development of successful research teams can grow up around physician innovators with “fire in [their] belly”1 as they utilize the principles of success presented in this paper. In so doing, research teams create their own research “microsystem,” not dissimilar to the infrastructure of these bright spots, though much smaller in size. This is especially pertinent to the residency environment, as scholarly activity is mandated by the Accreditation Council for Graduate Medical Education (ACGME).2

Take our experience for example. As a group of family medicine residents, we initiated a study to investigate the impact of group pregnancy care on maternal and fetal outcomes. Like many residents, we lacked time, funds, and practical research experience.3,4 Similar to these institutional bright spots, we built our own miniresearch network within the walls of our residency clinic, with medical technicians and clinical nurses quickly becoming our strongest research allies. The success or failure of this project relied on the trust shared within this multidisciplinary team. When faced with the barrier of time, we sought out leadership and worked to make the project relevant to their goals as well as ours, resulting in increased protected time for our team. When faced with a low return rate of our survey instruments, we identified strategic, real-time changes that resulted in significant benefits. When faced with minimal buy-in from other departments, we assembled an interdepartmental steering committee, facilitating interactions between stakeholders and growing a culture of collaboration.

The qualitative report of Liaw and colleagues is an important first step. Next, it is essential to perform a similar qualitative evaluation of research bright spots that are growing up amidst minimal resources. Their insight would be broadly applicable and may propel more research microsystems to become future bright spots.