Case study: Medical students take their first steps in research during the COVID-19 pandemic
Evidence-based medicine is paramount and reinforced throughout medical student training, however as many medical students graduate from their medical schools, their exposure to clinical research delivery in NHS settings can be limited. The COVID-19 pandemic provided an opportunity for the NIHR to kickstart the ‘Volunteers in Research’ programme, which aims to encourage bio-medical students to volunteer their time to gain greater knowledge of healthcare research delivery.
Workforce challenges provides new opportunities
As the COVID-19 pandemic took hold in the UK in March 2020, and the NHS became under increasing pressure to care for the rapidly growing numbers of patients who were becoming ill with the disease. The world was looking towards science and healthcare research as the way out of this challenging situation.
Through the National Institute for Health Research (NIHR), the UK is uniquely positioned with a research-ready workforce at its disposal already working in the NHS and they were ready to respond to the rapidly growing number of new studies that were coming down the pipeline in response to the COVID-19 crisis. However with frontline care under increasing pressure, a large number of this research-active NHS workforce were being re-deployed to provide essential clinical care to patients on the wards.
Evidence-based medicine is paramount and reinforced throughout medical training, however as medical students graduate from their medical school, their exposure to clinical research being delivered in NHS settings can be limited, making it difficult to contextualise research delivery in the NHS. It also means a reduced number of graduates, or those early in their careers, consider research as a career option alongside their specialism.
The COVID-19 pandemic inadvertently provided an opportunity for the NIHR to kickstart the ‘Volunteers in Research’ programme, which aims to encourage bio-medical students to volunteer their time to support healthcare research. The programme provides students with real experience and knowledge of research being conducted in the NHS and in this case, provided much-needed reinforcements for support to study teams delivering the Urgent Public Health (UPH) COVID-19 research in hospitals across England.
Volunteers in Research programme
Led by Professor Eric Alton, one of the NIHR Clinical Research Network (CRN) Cluster Leads, and Professor Matthew Brookes, Clinical Director within NIHR CRN West Midlands, the programme got underway in mid-March 2020, following discussion with Health Education England. Regional medical schools across England subsequently distributed an invitation letter to undergraduate students asking them to contact their Local Clinical Research Network (LCRN).
We were delighted by the response we received to the letter, with 224 students registering their interest in the programme over the six months to September 2020. This was more than we had expected given the lockdown restrictions; and uncertainty being felt across the country at that time.
Professor Brookes, Volunteers in Research Lead.
For various reasons including students returning home, conflicts with another NHS role, or exams, there were 103 volunteers who participated in NIHR Good Clinical Practice training, which is the international ethical, scientific and practical standard to which all clinical research is conducted. Subsequently, 55 volunteers were briefed on their role and then allocated to hospitals assigned based on their postcodes.
Making a difference
The chance to see research making a difference in the real world prompted one medical student to get involved in supporting a COVID-19 vaccine trial at a CRN North Thames NHS trust.
Jayden Patel, who is studying Medicine at UCL and lives in south London, was one of a number of UCL students who gave their time as a volunteer helping to deliver the Novavax vaccine trial at the Royal Free London NHS Trust. The trial is supported by CRN North Thames.
“The chance to be a part of something as exciting as the COVID-19 studies was really exciting to me.” explained Jayden. “You learn something about clinical trials when you study medicine, but the chance to see one being delivered first-hand, making a real difference during a pandemic, was fascinating.”
During his time volunteering, Jayden's main involvement was contacting potential participants, and taking blood samples to the lab for processing. Jayden added: “I was very well supported by the dedicated research team at the Royal Free, and it was really interesting to meet so many different doctors who were involved in delivering the trial. What really stood out to me; was how everyone on the research team had very defined, specific roles.
I had some understanding of research through lectures but here it was making a real difference to people in a pandemic. I remember, later, seeing the news that the interim results from the trial had been released and thinking that it was pretty cool to be part of something which helped make that happen.
Jayden was part of a group of students who worked with Nargis Hemat, the trust's Lead Research Manager, to deliver the Novavax trial. Hemat said that the academic background of the students, as well as their desire to get involved in research, meant that the training they needed was minimal with great attention to detail.
“They all wanted to get research experience on their CVs, so it was easy to train them,” she said. “They were always approachable and working with them was a really pleasant experience. It would have been a huge challenge to meet our targets for the trial without their help.”
The student group was responsible for pre-screening and booking more than 600 participants to the Novavax trial at the trust, and the ease of working with them meant there were fewer hiccups for the research team. Hemat added:
“It was hugely beneficial for us to have the students working with us and I would certainly work with them again. I think any clinical trial would benefit from having a group like the one we had working with our researchers.”
Not only did the volunteer programme support the study team and medical students themselves it was also beneficial to the Local Clinical Research Networks (LCRN). Julie Davis, Deputy Chief Operating Officer at NIHR CRN: West Midlands said:
The medical student volunteers were quick to respond to our call to help research teams in the West Midlands deliver the most urgent COVID-19 studies. We have a high number of ICU trained staff, so during a time when many research staff were deployed to the frontline; these volunteers stepped up and helped with the regional response to the pandemic.
There is no doubt that every person who volunteered to help deliver a research project, has played their part in saving lives through the development of new treatments or vaccines.
Creating an enthusiasm for research
As a result of this encouraging pilot, the NIHR CRN is currently auditing the UK numbers of students who were involved in the scheme and assessing how valuable their volunteer experience was to them, along with the LCRNs learnings. Subsequently, the intention is to consider how this can be developed to be part of the NIHR CRNs standard offer, with students (medical, biomedical, postgraduate) involved in CRN Portfolio study delivery.
Volunteering in this way has had mutual benefit in terms of accelerating the delivery of CRN Portfolio studies and enabling medical students to experience research in a real-world setting. We hope that by having a positive experience of research this early in their careers, the students will be encouraged to develop an enthusiasm for research and embed this into their routine clinical practice.
Professor Eric Alton, Volunteers in Research Lead.