PEDIATRICS Vol. 91 No. 3 March 1993, pp. 628-631
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From the Bedside to the Public Policy Arena: The Role of General Pediatric Research

Frederick P. Rivara MD, MPH1

1 From The Harborview Injury Prevention and Research Center and the Departments of Pediatrics and Epidemiology, University of Washington, Seattle

The Ambulatory Pediatric Association is an organization dedicated to improving teaching, patient care, and research in general pediatrics. This paper addresses the task of conducting successful research in general pediatrics, often a challenging task for fellows and junior faculty beginning their careers. However, I believe general academic pediatrics has almost a unique opportunity to translate what is seen at the bedside into a research question and from there to try to use the results to affect the health of children. There are three steps in this process: finding a good idea, conducting rigorous research, and doing something with the results.

PATIENT CARE AS A SOURCE OF RESEARCH IDEAS

How does one come up with the "right" research idea? Fellows and graduate students find this a difficult process. I believe the best way to select a research topic is from one's patient care experience. By listening to and learning from our patients, the most important research questions become obvious. Nearly all of us started our careers as pediatricians and most of us remain practicing physicians. This means seeing patients each week, listening to the concerns of their parents, dealing with the thorny issues that arise, and scratching our heads about the unknowns and the uncertainties we face as clinicians. From this constant experience, we learn what is important. We learn which are the problems most in need of prevention, which problems need further study of their etiology and which problems are the most vexing to manage because of our inadequate knowledge.

Submitted on July 20, 1992
Accepted on October 6, 1992