Lessons Learnt from Operationalizing an International Collaborative Multi-Centre Study

Rhea Raj1, Catherine Dominic2, Suraj Gandhi3, Elliott H Taylor4, Marina Politis5, Syeda Namayah Fatima Hussain6, Divya Parwani1, Soham Bandyopadhyay4, Noel Peter4, Kokila Lakhoo4

doi: http://dx.doi.org/10.5195/ijms.2021.1029

Volume 9, Number 3: 242-244
Received 15 03 2021: Rev-request 09 06 2021: Rev-recd 14 06 2021: Accepted 18 08 2021: Publication 30 08 2021

The Experience

Clinician scientists are a varied group of healthcare professionals with roles in research and/or teaching alongside their clinic work.1 They play a key role in implementing research findings into clinical practice. Given their importance, there is growing concern regarding the decline in the number of healthcare professionals seeking to pursue a career as a clinical scientist.2 To tackle this issue, several initiatives to promote research activities among medical students have been launched to inspire the next generation of clinician scientists. They have ranged from incorporating publications and presentations into requirements when hiring for new positions3 to the creation of research mentoring schemes.4 Since active learning has long been known to be the optimum mechanism through which individuals learn,5 students have been enthusiastically encouraged to conduct their own research. Indeed, students have shown they can run national collaborative research studies effectively, with extensive protocols detailing how the studies were conducted.6 However, there is a lack of literature on how students can get involved in international research studies. To our knowledge, there is no published literature on students operationalizing an international collaborative multi-center cohort study. This article details the experience of a group of students who participated in leading roles in an international multi-center study run by the Global Health Research Group on Children's Non-Communicable Diseases (Global Children's NCDs) during the COVID-19 pandemic. Many lessons have been learnt from the successful operationalization of this study, which we hope to impart in this article.

Due to a lack of ability to travel or network in-person during the pandemic, to conduct this study effectively we had to mobilize attention and participation through effective use of online methods. We created a WhatsApp group for each operational team and its respective members. This allowed us to communicate the team goals and offer guidance and motivation. As operational team leaders, this method proved effective, as it allowed us to systematically organize and delegate tasks to group members. While an application tool such as Slack may have allowed for more streamlined communication, the use of WhatsApp reduced any barriers to inclusion for a global team. All members were familiar with WhatsApp; the same was not true for Slack. Creating an inclusive environment was felt to be imperative for the success of a global collaboration, and WhatsApp was pivotal to this. Additionally, having an instant messaging platform as our communication tool enabled us to solve problems and provide constructive feedback to team members in a timely fashion throughout the duration of the study. Social media was also found to be the optimal method for recruiting global collaborators in the circumstances of the pandemic. This involved creating a public-facing image and communicating ideas from our protocol using graphics. We designed graphics to promote the objectives of the study and raise awareness about the importance of pediatric cancer research. Our graphics proved incredibly successful in generating interest, with Twitter analytics revealing they had yielded 43,500 impressions and prompted 4,679 visits. Developing our graphic design skills was not only beneficial for the current project, but will likely become increasingly important in our globalized world as we become progressively reliant on using online platforms to communicate ideas and generate interest. Studies have already highlighted how important Twitter is in generating interest for academic articles,7 and the effect of social media in generating interest can be enhanced with the use of graphics, such as visual abstracts.

Once the collaborative network had been created, it was essential for us to maintain it and provide direction to over 1,000 interested researchers spread across 100 different countries. As a first step, we decided to designate one individual in each research center as the local study coordinator. Our next step involved connecting other collaborators with their respective local study coordinator. To ensure an effective workflow, a collaborator network database was created and organized by continent, country, and hospital. This structure also allowed for identification of regions where we had yet to generate interest, and therefore facilitated a targeted recruitment drive that aimed to maximize the number of countries captured within our collaborative network. Given the high volume of recruitment, multiple medical students needed to be involved in this part of the operational team to maintain the workflow. This posed an internal communication challenge to ensure that all members of the team were aware of the latest developments, and how to address and answer any questions or concerns. We employed two tools that were indispensable in meeting this challenge. First, a regularly updated online guide which contained algorithms for addressing common scenarios. Second, a series of template emails which could be edited to quickly address common scenarios in a standardized format. Whenever a new issue arose, it was escalated to a senior member of the team. Once we had a solution, the guide and template emails were updated to reflect this, and the solution was integrated into these to ensure the process was streamlined. Developing a team of medical students proficient in multiple languages also aided in the translation of documents and communication with collaborators who did not speak English.

We also recognized that several of our collaborators had never navigated the process of gaining ethical approval locally. As such we set up a research support team. Our aim here was to ensure that collaborators felt supported in their efforts to gain the necessary approvals to participate at their institution as per their local ethical regulations. The novelty of our research support team was that it was composed of medical students, albeit supported by academics and clinicians. Previous research has highlighted that near-peer teaching benefits students by increases understanding as well as by fostering more comfortable learning and interpersonal connection.8,9 In conducting this approach, we hoped collaborators would develop transferable skills and the confidence to use what they gained from this study in their own future work. The skillset and awareness developed from this experience will allow us to feel more comfortable in leading our own studies in the future and supporting future generations of medical students.

In summary, being involved in running an international, multi-center cohort study provided an invaluable learning opportunity. Developing our ability to communicate scientific knowledge and the importance of a study through online channels will be useful in our future academic careers. Similarly, logistical management is important in any large-scale study, and developing an awareness of how to do this effectively at an early stage is valuable. The decline in interest in clinical academics is an international problem and there is a need for international mentorship to address this problem. Students can define the future of global research. Thus, it is imperative that they have the opportunity to develop skills at an early stage and learn from their mistakes We actively encourage senior academics and policymakers to recognize the value of having medical students involved in leading international studies in order to facilitate the development of future clinician scientists.


Thank you to all our collaborators from our country leads to the members of our local teams for driving this study forward. Thank you to the members of the operational team of the Global Health Research Group on Children's Non-Communicable Disease.

Conflict of Interest Statement & Funding

The Authors have no funding, financial relationships or conflicts of interest to disclose.

Author Contributions

Conceptualization: RR, CD, and SB. Methodology: RR, CD, and SB. Validation: SB. Data Curation: RR, CD, and SB. Resources: SB. Writing – Original Draft: RR, CD, SG, EHT, MP, SNFH, DP, and SB. Writing – Review & Editing: RR, CD, SG, EHT, MP, SNFH, DP, SB, NP, and KL. Visualization: RR, CD, and SB. Supervision: SB, NP, and KL. Project Administration: RR, CD, and SB.


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Rhea Raj, 1 Medical student. St. George's University School of Medicine, Grenada, West Indies

Catherine Dominic, 2 Medical student. Barts and the London School of Medicine, Queen Mary University of London, United Kingdom

Suraj Gandhi, 3 BSc (Hons). Leicester Medical School, University of Leicester, United Kingdom

Elliott H Taylor, 4 BSc (Hons). Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom

Marina Politis, 5 Medical student. School of Medicine, University of Glasgow, United Kingdom

Syeda Namayah Fatima Hussain, 6 Medical student. Liaquat National Hospital and Medical College, Pakistan.

Divya Parwani, 1 Medical student. St. George's University School of Medicine, Grenada, West Indies

Soham Bandyopadhyay, 4 BSc (Hons). Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom

Noel Peter, 4 BSc (Hons). Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom

Kokila Lakhoo, 4 BSc (Hons). Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom

About the Author: Rhea Raj is currently a second-year medical student at St. George's University School of Medicine, Grenada, West Indies of a 4-year program.

Correspondence: Rhea Raj. Address: St. George's University School of Medicine, Grenada, West Indies. Email: aaravpaul3422@gmail.com

Editor: Francisco J. Bonilla-Escobar Student Editors: Najdat Bazarbashi & Diego Carrion Alvarez Copyeditor: Adam Urback Proofreader: Ciara Egan Layout Editor: Anna-Maria Chantaliyska Process: Peer-reviewed

Cite as: Raj R, Dominic C, Gandhi S, Taylor EH, Politis M, Hussain SNF, et al. Lessons Learnt from Operationalizing an International Collaborative Multi-Centre Study. Int J Med Students. 2021 Jul-Sep;9(3):242-4.

Copyright © 2021 Rhea Raj, Catherine Dominic, Suraj Gandhi, Elliott H. Taylor, Marina Politis, Syeda Namayah Fatima Hussain, Divya Parwani, Soham Bandyopadhyay, Noel Peter, Kokila L

This work is licensed under a Creative Commons Attribution 4.0 International License.

International Journal of Medical Students, VOLUME 9, NUMBER 3, September 2021