Open Mind Forum Basic Tenets Of Question Formulation

Peter K. Kitunguu BSc (Hons), MBChB

Objectives

• Be honest with yourself, not necessarily with everyone else

• What do you hope to achieve?• I’m a researcher….but do I say• Earn a living• Create a reputation in your specialty• Genuine curiosity about the research

question

Lower your head modestly while passing, and you will harvest bananas- Congolese proverb

Modes of Question Formulation

• Retrospective

• Prospective

• Case Reports

• Case Series

• Experimental Studies

Normal Ward round• Michael Wanjau• 35 yr old construction worker• Admitted 4 days ago with a history of

“assault” by a falling brick• Admitted in ED in unconscious state

with 1 episode of convulsion, vomiting• CT scan - right parietotemporal EDH

with midline shift and associated depressed skull fracture

• Neuro consult recommended evacuation

• Mary Kamulu• 21 year old para 4+0• Admitted 3 days ago with urinary

incontinence as a referral from…….• Hx of prolonged labour, 40 hours,

attempted forceps delivery at peripheral hospital and fetal demise

• Married off customarily at the age of 13, • Physical attributes: height 4’ 9”, weight

48 kg

• Not necessarily unique scenarios

• What are the possible reactions• Clerk, present and pull all stops to

impress consultants• Read around the topics “That could be

the compulsory essay!!”• How many others have similar

conditions?• How do we manage them in our

setup?• How does our outcome compare with

other centres?

No person is born great; great people become great when others are sleeping – Ashanti proverb

• Possibilities• Prospective• Retrospective• Case series

But where do I start?• Literature Review

• Google scholar • Blackwell synergy• Pubmed• Hinari• Research-Engine.com

• Most crucial in early phases of Research development

• May initially appear daunting- stick to principles

The cattle is as good as the pasture in which it grazes.- Ethiopian Proverb

Concentrate your efforts

• Success and intellect is more in the realm of intensity than extensity

• Create an objective, a single goal a single task and beat it to submission

• Proposal writing- your road map for the journey

How many ways to skin a Cat?

• Why would you want to do that?

• What about rare clinical conditions?

• Rachel Wefwewe• 11/2 year old• Admitted with history of multiple

fracture of long bones, allegedly following fall from her first attempted steps

• Previous history of fracture right radius ulnar

• Xray confirms Dx and demonstrates old fractures

• Examination shows poorly formed dental enamel and blue sclerae

• Angela Gathie• 46 year old RVD patient currently on

ARVs with a history of non compliance• Admitted with history of painless lump in

right breastx2/12• Lump hard, overlying skin tethered,

uneven surface• Ultrasound shows irregular mass,

patches of calcification and spiculated margins

• Biopsy results show areas of caseation necrosis, on AFB staining positive

• Ann Kinyau, 78 year old• Admitted with back pain was and left

leg radicular pain• Lower limb weakness, urinary

retention and bowel incontinence• On examination she had a superficial

cyst in the lower lumbar region• Plain x-ray showed spina bifida

occulta. • MRI scanning showed a cystic

intradural lesion compressing the conus medullaris

How to balance with academic work?

• The solution?• Create a retreat within

yourself• For more concentrated forms

of thought or action• Consistent effort• Goals with deadlines

So what?• Try it for your self

• Identify an area of interest

• Find someone with some experience and work with them

• Challenge yourself to do a study by year’s end

The sheep that wants to grow a long horn must have a strong skull- Ethiopian proverb

Asante