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Research at Basic and

Clinical Levels an
Islamic Framework

Role of Research in
Undergraduate Medical
Training
Traditional views

Research at the undergraduate level


is a nice to know but not a must
know

Training in research is not critical in


the training of a good doctor

Why is the traditional view


outdated?

Medical

science is constantly evolving


Modern doctors are expected to
exercise the highest level of Blooms
Taxonomy evaluation of knowledge
Modern doctors are expected to
practice Evidence Based Medicine
Modern doctors are expected to be
Life Long Learners

Why is Research important in


Islamic Medical Curriculum?
Reminds

us how little we know about


the truth of our own self

Brings

Creator

Helps

the individual closer to his

to Relive the Glorious Past of Islam

The Motivation

We will show them Our Signs in the


universe and in their own selves ,
until it becomes manifest to them
that this is the truth ( Fussilat :53)

Then look again and yet again your


sight will return to you in a state of
humiliation and worn out ( Al Mulk: 4 )

The Motivation
Do they not look at the camels how they are
created?
And at the heaven, how it is raised?
And at the mountains, how they are mooted and
fived firm?
And at the earth , how it is spread out?
So remind them , you are only a one who
reminds ( Al Ghashiya 17-21)

Then look again and yet again your sight will


return to you in a state of humiliation and worn
out ( Al Mulk: 4 )

Research in Medicine was a


Muslim Contribution

. was of investigation, the


accumulation of positive knowledge
and minute methods of science ,
detailed and prolonged observation
and experimental inquiry were
altogether alien to the Greek
temperament
( Briffault 1948 )

Research in Medicine is a Muslim


Contribution
precise

, scientific, rational and


sound in their approach.
( Sarton 1992 )

Ar

Razi ( 865-925 M) established the


most up to date laboratory of his
era and carried out relevant
research to understand and
diagnosed diseases

And we must further remember that the Arab


translators, who were at work nearly 1200 years
ago, were in contact with a living tradition which
went back from Baghdd to Jundi-Shpur, thence to
Edessa and Antioch, and thence to Alexandria; and
that this tradition may well serve to elucidate many
obscure points in the Greek texts still preserved to
us. Finally the clinical observations

(embodied especially in the works of Rzi)


have an intrinsic value of their own which
would undoubtedly repay investigation. On
all these grounds, then, even if we rate the
originality of Arabian Medicine at the lowest, I
venture to think that it well deserves more careful
and systematic study.
Arabian Medicine Edward G. Browne
Fitzpatrick Lectures, College of
Physicians
November 1919 and November 1920

It has therefore been asked whether the


Arabs showed any originality.
He repeats the thoughts of the Greeks
and collects and amasses what has been
handed down.
.. What they offer is not factual material
extracted through observation, or through
systemic research and experiments, but a
construction based on theories.
Manfred Ullmann
Islamic Medicine 1978
Edinburgh University Press

Avicenna (980-1037) - Canon of Medicine; seven rules to evaluate


the effects of drugs in disease - time of action and reproducibility.
Arabic Ibn Sina, 9801037,
Islamic philosopher and
physician, of Persian origin, b.
near Bukhara. He was the most
renowned philosopher of
medieval Islam and the most
influential name in medicine from
1100 to 1500. His medical
masterpiece was the Canon of
Medicine. His other masterpiece,
the Book of Healing

Research in Medicine is a Muslim


Contribution

Ibn Sina
Father of Modern Clinical Trials
( Lancet December 1999 )

Evolution of EBM
900 M Ar Razi : carried out relevant clinical research
1000M Ibn Sina : laid down the principals of clinical
trials
1747 M
: Linds Experiment
1840s
Louis Bichat : call for external evidence in
treating illness
1960s Sackett
: realised the role of epidemiology in
clinical medicine
1980s Sackett : form department of clinical
epidemiology and biostatistics
Early 90s Sackett : convince others on the need for
EBM
1996
: NHS R&D Center for EBM

Az Zahrawi
Lived 500 years before Pare
Pioneered the use of fine sutures in
ligating arteries
Perfected the science of suture made
from animal intestines ( catgut)
Pioneered the design and creation of
many surgical instruments
Work and invention based on careful
observation and experimentation

Abul Qasim
al Zahrawi
Surgeon
extra
ordinaire
Al Tasrif
used as
reference for
500 years

Az Zahrawi Father of Rational


Surgery

Refined and scholarly

Utilizes practical experience with


careful observations to innovate
progress

Muslims Contribution Now

That

was the past

What

about the present ?

Cited Research Papers from the


Muslim World ( 2005 & 2009 )
Egypt
Malaysia
Pakistan
Indonesia
Saudi
Iran

Total
Turkey

8,229
6,607
5,850

21,786
13,466
12,453

5,493
5,257
3,995

7,932
17,144
21,253

35,431

94,034
91,829

Cited Research Papers from the


Non Muslim World ( 2005 & 2009 )
USA

1,529,164
UK
331,621
Germany
97,148
Japan
84,286
Netherlands
35,027
Israel
18,217

3,687,524
372,243
514,070
721,026
220,123
111,842

Why ?

Symptomatic of general malaise to


afflict ummah

Inferiority complex and defeatist


mentality

Suspicious

of anything Western

Reliving Past Glory

Do we want to ?
Why should we do it ?
How do we do it ?

Lessons from the Past


Important Characteristics to Emulate
Experimental inquiry
Attention to Minute details
Prolonged observation
Accumulation of positive knowledge
Precise
Scientific
Rational
Sound approach
Refine
Exact
Relevant

Research at the Pre Clinical


Phase

Inculcate research culture by


nurturing the following attributes
Self directed learner
Pro active learner
Team Based learner
Inquisitive mind
Criticality in retrieving information

Research in the Pre Clinical


Years

Incorporate research into learning


process

Assignments are done with relevant


references cited
Student presentation adjudicated
and assessed

Research in the Pre Clinical


Years

Incorporate research or research


related topics
Course / module on scientific English
Course/module on practical biostatistics
Introduction to observational research
in Public Health modules/ courses
Encourage research based electives at
the end of the preclinical years

Research at the Clinical Phase


Inculcate research culture by nurturing the
following attributes

Self directed Learning


Student centered learning
Team Based Learning
Inquisitive mind
Criticality in retrieving information

Research in the Clinical Years


Incorporate research into learning
process
Evidence Based student
Presentation eg OSLER
Evidence Based Case Write ups
Evidence Based Clinical Practice
Guidelines Presentations
Student Journal Clubs

Research in the Clinical Years


Incorporate research or research
related topics
Research and Evidence Based
Modules
Strongly encouraged ResearchBased Elective/ Selective

Research and Evidence Based


Modules
Aim(s):

To introduce students on Evidence Based Medicine


and its role in clinical decision making
To train critical appraisal know -how to students which
will enable them to apply it during their clinical
rotation.
To formally train and certified students on the
elements of Good Clinical Practice in the conduct of
Clinical Research using standard international
benchmarking
To give exposure to students on the essentials of
scientific writing

Research and Evidence Based


Modules Learning Outcome
At the end of the course, students should be able to:
Define Evidence Based Medicine and how it relates
to clinical care
Perform critical appraisal of selected
clinical
literature in conjunction with their clinical rotation
Elaborate on generic techniques on keeping up to
date with medical progress.
Apply the techniques learned above in their
respective clinical posting to better understand
clinical decision making

Research and Evidence Based


Modules Course Contents

Introduction and Overview of the Research and EBM


Introduction to thinking and thought processes
Essentials of the various thinking processes
Introduction and Overview of Research Methodologies
Techniques in experimental research
Essentials of Biostatistics
Introduction to Medical Informatics
Understanding and Critical Appraisal Medical Literature
Good Clinical Practice in Medical Research
Scientific Writing with emphasis on proposal writing

The Essentials to a Successful Training


in Research at Undergraduate Levels

Must be formally incorporated in the curriculum in


tandem with the philosophy, vision and mission of the
university.
Must have critical mass of enthusiastic and trained
staff.
Must have the necessary infrastructural facilities.
Must have the necessary mechanism in place to
facilitate research ( eg funds, Research and Ethics
Committee )
Must provide incentives to students for their future
professional development ( opportunity to
presentation and published , criteria for post graduate
training )

Lessons from the Past


Characteristics to avoid
o
Western phobia
o
Western bashing
o
Arm chair critic
o
Closed mind
o
Fear of innovation and change

Begins with the End in Mind


Why do we do research

Personal glory
-publish papers
-get recognition
-promotion
Have no choice
Publish or Perish
Contribute to health care
Evidence Based Health Care
Please Allah

Why We Have To Inculcate


Research Culture
Very unlike the European Renaissance
researchers, knowledge was pursued with
vigour not to disprove that God (aka the
Church) was wrong. On the contrary the
more they discovered, the closer the
Muslim scientists and researchers
were to the Creator.
( FIMA Year Book 2010)

ALLAH KNOWS BEST , WE


HUMAN HAVE TO STRIVE
O MY LORD INCREASE FOR US
KNOWLEDGE AND GRANT US ( THE
RIGHT ) UNDERSTANDING

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