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EASD Robert Turner Clinical Research Course 2017 - Report

Upon Arrival in Oxford

Every year in early spring, a few privileged muggles unite in Oxford to learn about the secrets of research, a course organized since 2004 by the leading European authority on diabetes and named after the late Prof. Robert Turner, a pioneer in clinical research training.

They fly long hours from all over the world, park their broomsticks at the airport and proceed by train or bus to the centre of this magical city. Arrived on High Street, one must first find the Quod pub and turn left on a narrow paved street - normally invisible to millions of muggles passing near it every day; at the end of this street there is a street light that stands there crooked waiting for the newly arrived student to ring the bell at  Corpus Christi College. If you are lucky enough, the porter might tell you the short way to get to your dorm, for there are many ways to get lost inside Corpus.

Everything is so much clearer once they meet the loving Madam Mary Hata, the guardian of this course, always smiling, willing to help and organize.

Introductions being made, all students must gather in the main entrance and follow The Guide, a gentleman quick as a Quidditch snitch, guiding them around a maze of monuments and ancient Colleges of Oxford, so that by the end of the day, all enjoy the evening out, getting to know each other better, prepared for an adventure to remember for a lifetime.

Chapter I - Monday

Monday started off with a traditional English breakfast in the impressive dining hall of Corpus Christi, from where we were brought by bus through Oxford to OCDEM. There, we met Professor David Matthews, Dr. Anne Clark and Dr. Jonathan Levy and discovered what was ahead of us over the five days to come. After introductions, the day started off with a session on numbers, bringing us back to the basics of research and challenging us to explore the different meanings a single number can have. Continuing on from that, we had insightful sessions on physiological experiments, data collection, storage and verification. After lunch, armed with pipe, a scissor-jack, marbles of different sizes and probability paper we divided into groups and set about performing our first experiment of the week. The day finished off with a session on hypothesis testing and an overview of translational medical research. Dinner has held in the Corpus Christi dining hall and followed by the annual International Evening where, in the company of Professor David Matthews and Ms. Mary Hata, we were entertained into the night by Iraqi oud, enjoyed tales of New Zealand Maori folklore, all while sampling traditional foods from Romania, Greece, Serbia and Sri Lanka.

Chapter II- Tuesday

On Tuesday we were introduced to useful knowledge and new educational experiences in the wide field of clinical research in diabetes.

The day began with an interactive analysis of the role and skill requirements of the clinicians, clinical-scientists and scientists in the research setting from the perspective of three different groups of participants. At the end of this session, we had a constructive discussion with emphasis placed on the essential role that clinicians play as a “bridge” in the gap between the researcher’s bench and the bedside.

The second session included a detailed lecture on principles, methodology and outcomes of landmark clinical trials in diabetes research during the last decades. The United Kingdom Prospective Diabetes Study (UKPDS), which was a fundament of the RCT, featured prominently in this overview, highlighted the relation between glycaemia over time and the risk of macrovascular or microvascular complications in patients with type 2 diabetes.

The next lecture by Dr Clark provided considerable knowledge about the effective use of literature in view of applying evidence-based medicine principles to a patient case study and clinical research. Reading assignments from contemporary literature were given, aiming at evaluating research articles and illustrating flawed studies.

The following session integrated a wealth of information and tips for effective presentations, as well as ways of improving presentation skills. Using innovative lecture methods Professor Matthews provided advice for designing effective PowerPoint presentations in order to keep our audience captivated. An equally important part of the lecture was devoted to public speaking tips, especially to the ones dealing with difficult questions.

At the end of the day, we were divided into groups and assigned a task which included designing and conducting a research experiment. Trying to develop innovative ideas and implement them in the setting of a research protocol was a unique and challenging experience. The goal of the project was to answer a clinical question utilizing current research methods provided in CRU, thus requiring cooperative work from each group. Thus, we spent all afternoon brainstorming and designing the research protocol and dealing with the practical issues of each experiment in a collaborative atmosphere. In order to accomplish the goal of carrying out all the stages of a study, from innovative idea to presenting of outcomes, mental effort and a strong team spirit were required from each team.

Chapter III- Day of the Trials

The 3rd day of this scientific adventure was for us, simple novices in the field of research “The Big Day”. Why “The Big Day”? Because we had to put into practice the original research ideas from the previous day, to conduct our experiments, process the data and present the results at the end of the day using all our newly accomplished knowledge and skill set.

The Day of the Trials started with a traditional English breakfast at Corpus Christi College. Well, at least for some of us, who were lucky not to be the souls of our little experiments. When we say the soul we really mean the guinea pig role. With the precision of a Swiss Watch, at 8.00 o’clock we arrived at OCDEM (the English Heaven of the Diabetes Research). We were welcomed by the very kind and supportive team of the CRU and then we entered the unit, where magic of research happens daily. We received our last safety and practical instructions on our experiments and the work began. Those instructions where like “golden rules” for a successful trial. 

Our interesting ideas were put into practice and we were so captured in the work that the morning flew without us noticing. Once we gathered our biochemical samples, the team kindly processed them in a timely matter.

While anxiously waiting for the results we had a very inspirational lecture by Dr Peter Scanlon regarding diabetic retinopathy screening in England. Through his presentation he motivated us to work hard, to never give up on our dreams no matter what other people say so that we  manage to make a difference to our patients.

After receiving the results we spent our assigned time processing the data and preparing our abstract and power point presentation in order to impress the honorary jury represented by Prof. Mathews, Dr Clark, Dr Levy and Pam Dyson. Each team struggled to finish the task in time. In those moments we really felt on our own skin how time can be “the worst enemy”. With inspiration and definitely more perspiration we managed to deliver our tasks. The stress reached the critical point during presentations as each team tried to demonstrate in front of some world leading experts in the field of diabetes that its study was the best. The previous exams and presentations seemed nothing compared to this moment. But, as great teachers and mentors the members of the jury listened, made suggestions and then gave us precious pieces of advice regarding further presentations.

As a reward for our efforts, the day concluded in the Corpus Christy College exquisite dining manner.

Chapter IV

The fourth day of the Robert Turner course saw a change of scenery. We were based at Harris Manchester College – the newest College at the University.  The grounds and buildings were stunning and it was lovely to feel like we were having the real ‘Oxford academic’ experience. 

Dr. House used to say in the famous TV show:’ Tests take time. Treatment’s quicker.’, but everything that we learned on Thursday proved that the Oxford-born actor is completely wrong.

We received a whirlwind tour through all aspects of Good Clinical Practice, from the history of developing GCP guidelines worldwide, to ethics guidance and an update on current European and other international regulatory guidelines. Furthermore, we got the chance to test our knowledge through pub quizzes and clinical scenarios to get us thinking. So at the end of the day, we could honestly advocate that treatment without following the international guidelines and standards is a risk no doctor should take.

After the course, we had a small amount of free time to explore Oxford. Many of us made a beeline for the expansive medical books section at Blackwells – the largest academic and specialist bookstore in the United Kingdom. 

Thursday’s dinner was a formal occasion at Corpus Christi College.  We were privileged to meet Dr Jennie Turner, the widow of the late Professor Robert Turner.  It was wonderful to have dinner with all of the lecturers and organisers who made the week run like clockwork for us, and a fantastic opportunity to give our thanks.  Over dinner, Professor David Matthews gave a wonderful speech, reminding us of the true reasons we choose medicine. The winners of the clinical experiment day were announced, with congratulations to Ljubica, Stella and Abhinav for their experiment on the changes in metabolic profile by combining physical exercise with intake of food. 

Final Chapter

All good things must come to an end, so our last breakfast in the elegant Dining Hall at Corpus Christi came round all-too-soon. Having all things packed we proceeded to OCDEM on a gloomy morning prepared for a new challenge. This was the time to review studies, organize as new teams, pro and con discussions, all coordinated by our Professors. Ethics had an important part during this day followed by a feedback session.

Just to give us a glimpse of what OCDEM is, and to make us dream about coming back one day, the staff organized a tour of the most important parts of the Centre.

After tearful goodbyes were said, we slowly departed some going back home, others to more adventures, all with unforgettable memories, willing to and knowing better how to start new researches and a great desire to meet again.

Hussam Alaissi, Lia Anguelova, Daniel-Tudor Cosma, Aoife Garrahy, Abhinav Gupta, Cosmin Iancu, Guranda Maisuradze, Daniela Moteli, Stella Proikaki, Udari Samarasiri, Ljubica Stosic, Veronica Tudor, Patricia Whitfield and Amila Ruwan Wickramasinghe