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Me thesis

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Me thesis

  1. 1. Dr Md. Yunus Additional Professor & Coordinator, Medical Education Unit, NEIGRIHMS, Shillong PLANNING A THESIS FOR POSTGRADUATE MEDICAL STUDENT & HOW TO WRITE A DISSERTATION
  2. 2. A Dictionary meaning of a Thesis • The·sis (thss)n. pl. the·ses (-sz) • 1. A proposition that is maintained by argument • 2. A dissertation advancing an original point of view as a result of research, especially as a requirement for an academic degree • 3. A hypothetical proposition, especially one put forth without proof • 4. The first stage of the Hegelian dialectic process
  3. 3. “Thesis” & “Dissertation” • Words “Thesis” & “Dissertation” are used interchangeably • Thesis is much shorter than Dissertation (1 year versus 3-4 years) • Thesis & Doctoral Dissertation have different objectives • Objective of Thesis is to teach & train a PG student in Research Methodology & in Thesis process is more important than outcome • Whereas in Doctoral Dissertation (PhD) there is bound to be a new outcome & it reflects the critical thinking of the candidate on the research topic
  4. 4. What is Dissertation? • “A formal, often lengthy treatise or discourse, especially one written by a candidate for a doctoral degree” • “It is an exercise to train a PG student to plan, execute, evaluate, write & report a scientific project” • “It is an in depth study of a particular topic which contributes new information & knowledge in the field”
  5. 5. Why to do a Dissertation? AS FAR AS POST GRADUATE DEGREE COURSE IS CONCERNED THE TERM ‘DISSERTATION’ IS USED INSTEAD OF ‘THESIS’ As per the guidelines of MCI, many universities/Institute in India including NEIGRIHMS have made Dissertation a mandatory part of PG degree curriculum
  6. 6. Requirements for a PG dissertation • 1. Competent guide & • A determined student • 2. Adequate time • 3. Instrument, Equipments, Consumable & Drugs with technical know-how to use them
  7. 7. The Dissertation • 1. Teaches the fundamentals of Research Methodology & stimulates interest in research • 2. Helps to develop scientific attitude • 3. Teaches to probe in depth of a topic • 4. Teaches the critical appraisal of the medical literature • 5. Encourages to develop special technical skills
  8. 8. The Dissertation Cont.. • 6. Encourages the students to use library & electronic medical data bases • 7. Contributes new knowledge • 8. Teaches publishing of a scientific data • 9. Satisfies the academic /scientific instincts of PG students • 10. Brings about a behavioural change in a student
  9. 9. Role of Postgraduate Students • They must realize its importance • Get truly involved in their projects • Work sincerely & honestly to make use of this best opportunity of learning • Wrong notion amongst the students & inability to relate the need of dissertation with their clinical goal leads to malpractice like cooking the data, statistics, & copying from other sources
  10. 10. Role of Guides & Responsibility of Faculty Mentors • Supervision & guidance of the candidate at all stages of the dissertation • Helping from all angles to conduct a proper study • • The faculty mentor should make every effort to orient the student to a practical problem that can be addressed within the available time • 1. background of the problem being investigated • 2. hypothesis that will be examined • 3. specific aims of the study • 4. methods that will be used including details of the specific design of the study • 5. selected references
  11. 11. Submission of Dissertation Protocol • It should be submitted at the end of six months after admission in the course • Protocol in essence should consist of: • a. Introduction & objectives of the research project • b. Brief review of literature • c. Suggested materials and methods, & (scheme of work) • d. Statistician should be consulted at the time of selection of groups, number of cases & method of study • e. References
  12. 12. Where and How to Start? Selection of the topic • 1). Idea: Invariably comes from the guide • The guide is an experienced person with the knowledge of the research • The limitations of the facilities available in the institution • Moreover it is a maiden experience for the PG student
  13. 13. Guide for Dissertation • 1. Chief guide will be from the parent department • 2. Co-guide(s) will be from the parent department or from other disciplines related to
  14. 14. 2) Formulation of Hypothesis • Hypothesis is nothing but an idea, which is yet to be proved • example a Research hypothesis can be formulated • “Epidural Ketamine in sub-anaesthetic doses provides effective post operative pain relief following upper abdominal surgeries”
  15. 15. Formulation of Hypothesis Cont.. • ‘Null Hypothesis’: also known as statistical hypothesis states exactly opposite of the research hypothesis • eg: “Epidural Ketamine in subanaestheic doses does not provide postoperative pain relief following upper abdominal surgeries” • Null hypothesis is the one that will be tested by the statistical significance tests & is either rejected or not rejected
  16. 16. Useful hints for the selection of a topic: • 1) Avoid topics on which dissertation has already been carried out in the previous 5 years, in the same institution • 2) As far as possible select a topic, which requires minimal help from other departments (equipments or personnel) • If unavoidable official appointment of a co-guide from the collaborating department will be useful
  17. 17. Objectives • These are more specific & relate directly to research question • They may be divided into two types: Primary objectives  (bound to be achieved) Secondary objectives  (by the way)
  18. 18. Defining an objective • The objectives have to be simple, clear, precise and should be only one or two • Please keep in mind the limitation of available time • At this stage only vague objective can be formed • To define a clear objective more information may be needed • Next thing is to search for available literature on the topic • A thorough reading of Anaesthesia/Pharmacology textbooks on Ketamine will be helpful • The cross reference from the original articles should be gathered
  19. 19. Defining an objective Cont.. • In our example the objective will be: • “To study the analgesic efficacy of sub- anaesthetic doses of epidural Ketamine for post operative pain relief in patients undergoing upper abdominal surgeries
  20. 20. SMART Objectives • S Specific • M Measurable • A Achievable • R Relevant • T Time-bound
  21. 21. Difference between Aims and Objectives • There is no real difference between an Aim (Goal) and an Objective • Aims point out the general purpose of the study, whereas Objectives spell out specifically what one intends to do in the study • eg: Aim is to study the analgesic efficacy of epidural Ketamine • Objective is to compare the duration of pain relief, pain score (VAS) in Ketamine group Vs. Saline (Placebo) group • In any study objectives must be justifiable & the PG student must be able to defend them
  22. 22. Doing a Literature Review
  23. 23. Review of Literature (ROL) • Sources: Books: * Textbooks & Reference books • * Journals Index Medicus • * Electronic Database: Medline
  24. 24. Literature Review as a Process
  25. 25. ROL reveals • One should also find out whether similar studies have been conducted or published elsewhere, to avoid duplication • Now the objective can be defined with precision • If the literature search reveals that the idea has already been tested by many, one has to drop that idea and go for another one • If it is found that the other studies have missed an important aspect, your study can be modified to explore that aspect
  26. 26. PROTOCOL - PROFORMA • A Proforma consisting of the details of the patient, details of the methodology, technical details, observations (in the convenient format for recording), complications & all the relevant details needed for the study have to be prepared by the students with, of course the help of guide/co-guide for approval by Dissertation committee
  27. 27. Approval by Ethical committee • Any scientific study epidemiological microbiological, pharmacological, pathological, clinical, nonclinical which involves human subjects, requires clearance from ethical committee • There is no clear line to demarcate what is ethical and what is non- ethical • A self-test such as asking oneself - Would I conduct this study on myself or my child (or parent) • This is one way of solving this dilemma • If the answer is ‘yes‘ go ahead & plan the study
  28. 28. Consent & Logbook • Consent of all Patients enrolled in the study is very essential • The Performa are to be Xeroxed and kept ready in the place of work and one copy is to be utilized for one patient • A separate logbook for all the cases of the dissertation has to be maintained by the students • A logbook is the only document, which can bailout a student if the credibility of his dissertation is challenged
  29. 29. PILOT STUDY Registration of the Dissertation • Once all the requirements for the study are satisfied, perform the pilot study always in the physical presence of the guide • Some or many of the unanticipated difficulties / problems/ complications may be encountered
  30. 30. EXECUTION - Useful hints • * Be meticulous in recording the data • * Interact with the guide/co guide as frequently as possible (at least once a month) • * The dissertation team (candidate, guide and co-guide) should meet at least once in 3 months & quarterly report should be submitted to the Departmental Dissertation Committee • * Collection of data should be complete in one year • * Consult a statistician for scientific analysis of the study including for calculation of sample size at the beginning of the study itself • * Six months would sufficient for writing the dissertation • * Dissertation should be submitted six months prior to the examination as per University
  31. 31. Details to be worked out before execution • 1) Study design & methods of elimination of errors, in the study • 2) Sample size & number of groups • 3) Inclusion/Exclusion criteria • 4) Technical details • 5) Parameters to be measured • 6) Data collection, organization & analysis • 7) Statistical methods
  32. 32. Strategies to Eliminate Errors • Errors may creep into a study at any time, even during interpretation of results • They can be: • * Random or Systematic • * Due to bias or oversight • Error elimination can be done by: • * Controls • * Randomization • * Cross over designs • * Placebo • * Blinding
  33. 33. STUDY DESIGNS • i) Prospective: - Data collected from the follow up of patients/ volunteers over a period of time. Look forward after the exposure (drug /intervention) to observe the outcome • ii) Retrospective: Data collected from past records. Look back with the aim of finding a cause. • i) Descriptive: - Describe the characteristics of a disease in relation to a person, place or time. They are mainly epidemiological studies necessary for planning of preventive/ control /eradication programs • Three sub types viz. Correlational, Case studies, Cross sectional surveys. • ii) Analytical: - A hypothesis is tested • Two sub types –i) Observational (Case Control & Cohort) • ii) Interventional (Experimental) Clinical trials
  34. 34. SAMPLE SIZE ( SS) • Denotes the number of subjects to be used in the study • A correct sample/size is the real strength of a study, the results of which can be applied to a population • Incorrect sample size will lead to • i) Wrong Conclusion • ii) Poor quality research • iii) Wastage of resources & invite • iv) Ethical problem • Factors affecting sample size • 1) Prevalence rate of the factor • 2) Degree of difference expected • 3) Degree of variation among subjects • 4) Desired level of significances • 5) Power of the study • 6) Drop out cases • 7) Non compliance to treatment • 8) Resources available
  35. 35. SAMPLE SIZE ( SS) Cont.. • The correct method to calculate the sample size of a study is to use one of formulae depending upon type of a study and study design • One of the commonest formula often used. • n= 4pq/ d² {n= Sample size, p= Prevalence of a factor in the population, q= (1-p) / (100-p), d= error allowed}
  36. 36. ANATOMY OF A DISSERTATION • * Title • * Introduction including aims & objectives • * Review of the literature • * Material and methods • * Results • * Discussion • * Summary & conclusion • * References • * Acknowledgement • * Certificate
  37. 37. The Title • It should be concise • but informative • short • active • & brisk • No abbreviations are to be used • The title must indicate in fewest possible words the • i) objective of the study • ii) the type of study • iii) the place where the study was conducted & the duration of the study
  38. 38. Introduction • Avoid Long preambles in the introduction • Should answer why did you start? • The introduction should include (in 200-500 words) the purpose of the study, the hypothesis being tested & the methods employed for the study • Need for the study has to funneled down • What is known of a topic through What‘s not known to identify the unexplored aspect of a topic
  39. 39. Review Of Literature • Strictly pertinent references are to be written • Critical approach to the reliability of previous work has to be performed • A retrospective ramble is boring & so – use your discrimination in including various studies • Evolve a consistent theme in the narration • Avoid data / conclusion from the work being reported, in the review
  40. 40. Material & Methods • It should contain that much information (& no more) for a competent worker to repeat your work • It should contain sample size, sampling procedure selection criteria, randomization, blinding if any, data collection procedure, instrument, & investigation
  41. 41. Results • This is usually the shortest part of the dissertation & should precisely state your findings, analysis plan, statistical measures employed, confidence interval, level of significance etc • Present the data wherever possible in the form of • a) Graphics, histogram, bar diagram, pie chart, frequency polygon • b) Illustrations • c) Photographs
  42. 42. Discussion • The discussion should contain • i) Present principles, relationships & generalizations shown by the results • ii) Point out exceptions or lack of correction • iii) Indicate agreement or contrast with previously published work • iv) State the implications of your results • v) Give reasons for your conclusions • vi).Mention limitation of your work • vii).Indicate the scope for further work
  43. 43. The Summary & conclusion • The summary should concisely describe, (within 150-200 words) • i) the problem • ii) the solution • iii) the principle conclusion • In the summary, avoid all experimental details & references to previous work
  44. 44. References: References should be written in the Vancouver style • Vancouver Style: • References are numbered according to their appearance in the text • The first author cited in the text is reference number 1 the second author cited is reference number 2 and so on • These numbers are written as Superscripts in the text at their relevant places and enlisted at the end serially
  45. 45. Certificate • Certificate from • 1) Self (declaration) • 2) Guide & Co-guide • 3) Head of the department must be included in the dissertation • The head of the institution must countersign the dissertation
  46. 46. Submission of thesis • The thesis shall relate to the candidate own work on a specific research problem or a series of clinical case studies in accordance with the approved plan
  47. 47. Evaluation of thesis • The thesis shall be referred by the University evaluation to the Examiners appointed by the University • The examiners will report independently to the Controller of Examinations and recommend whether the Dissertation is: • a) approved • b) returned for improvements as suggested or • c) rejected ( reasons for rejection should be detailed) • The thesis shall be deemed to have been accepted when it has been approved by a minimum of three examiners; one internal and two external examiners, who shall not be the examiners for theory and clinical examinations
  48. 48. Evaluation of thesis Cont.. • The thesis shall be deemed to have been accepted when it has been approved by at least two examiners • Where improvements have been suggested by two or more of the examiners, the candidate shall be required to re-submit the thesis, after making the requisite improvements for evaluation • When a thesis is rejected by the examiners, it shall be returned to the candidate who shall have to write it again • The second thesis, as and when submitted shall be treated as a fresh thesis and processed • Acceptance of thesis submitted by the candidate shall be a pre- condition for his/her admission to the written, oral and practical/clinical part of the examination
  49. 49. Acknowledgement • Acknowledge without fail • 1) all persons who have helped directly or indirectly • 2) source of funds if any
  50. 50. Time management • Phase—I (0-6 Months) • •Problem identification • •Review of Literature • •Proforma • •Pilot study • •Synopsis • Phase II --- (7-18 Months) • Data Collection • Phase III – (19-24 Months) • Analysis • Discussion • Publication
  51. 51. • The thesis or dissertation certainly has an impact on that future • Trying to figure out how your topic will help or hurt is the most time- consuming part of narrowing down the choices Has thesis has any impact on your future ???
  52. 52. • Some guides / mentors are too adamant, stick to their outdated knowledge creating conflicts in selecting the topics and completing the thesis. • Choose modern topics which can serve your progress in your career • Best option remains with guides, advisers & mentors, every research is a progress in Science • By repeating a grand old ideas will stagnate departments • Go forward with research – be a master of future rather than creating conflicts
  53. 53. Do not get disappointed if your thesis cannot meet the academic standards
  54. 54. Our research in medicine is uncertain do not plan thesis for explosive ideas
  55. 55. Books for Further Readings • A practical approach to PG dissertation by R. Raveendran. Jay pee Publishers, 1997. • WHO Health Research Methodology ; A guide for training in Research Methods. • Oxford University press 1993. • International committee of Medical Journal Editors. Uniform requirements for • Manuscripts submitted to biomedical journals. N.Eng. J Med; 324: 424-8‖ 22 • An Epidemiologic Approach to Reproductive Health. CDC Atlanta, Georgia, • USA World Health Organization Geneva, Switawrland. Editor Phyllis. A Wingo • & others. 1994.
  56. 56. Created by Dr Md. Yunus for Learning & Development of Post Graduate Medical Student Email: drmdyunus@hotmail.com Web: www.neigrihms.nic.in