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    Index


    This year, several IMP students took the initiative to prepare posters for the annual CCME which was held in Quebec City on April 20 – 23, 2013.  Under the guidance of faculty supervisors, the posters were produced to illustrate projects that students had been involved in during the past year.  Details about two of these projects are provided below:

    Evidence Based Clinical Diagnosis: A Multimedia Summer Project
    A 2012 Student Summer Research Project (SSRP)

    Students: S. Campos (IMP 2015), J. Spencer (IMP 2015), A. Jeffery (IMP 2014), B. Buchan (IMP 2013), K. Sorenson (IMP 2014)
    Faculty Supervisors: L. Farrell, MD; A. Modi, MD; S. Martin, MD; S. Edwards, MD

    Video poster

    With the rapid advances in medical technology, conflict and competition has arisen between traditional physical diagnosis and more modern technologically based tests.  Evidence Based clinical education aims to bring clinicians and students alike to "a more appropriate middle ground" where physical diagnosis is used as a first-pass tool at the bedside and is valuable in undergraduate as well as continuing medical education.   In the summer of 2012, as part of a Student Summer Research Project (SSRP), five IMP students designed and helped produce three videos based on their research on evidence-based clinical examinations to introduce evidence-based clinical examinations to undergraduate medical students. The videos explained the rationale behind evidence-based physical examinations and depicted the application of evidence-based examinations in two clinical scenarios: suspected appendicitis and heart failure.

    Sarah Campos (IMP Class of 2015) in front of the poster "Evidence Based Clinical Diagnosis: A Multimedia Summer Project" at CCME 2013




     

     

     

    IMPart: The Therapeutic Waiting Room
    A 2012 DPAS Community Service Learning Option (CSLO) project

    Students: L. Huisman, K. Leech-Porter, J. Spencer, M. van Soeren, IMP Class of 2015
    Supervisor: M. Blouw, MD

    IMPart posterStudents from the IMP have been working in partnership with the Victoria Cool Aid Society's Access Health Community Health Centre to run a drop in art group, called IMPart.  Access Health offers primary health care for marginalized populations in Victoria.  IMPart was inspired by a need voiced by nursing staff at the Centre, with the aim of creating a calming and inclusive environment in the waiting room, providing a positive outlet for expression through writing, drawing, painting and knitting as well as a safe space for patients to talk, relax and eat healthy snacks.  The patients benefit from the therapeutic nature of art and are empowered to express their thoughts, feelings and frustrations.  The students learn about diverse social circumstances, barriers to health and experiences that they would otherwise not be exposed to, in the form of stories, narratives and artwork.  The "therapeutic waiting room" holds great promise for improving patient experience and nurturing and accepting patients from all walks of life.

    Melanie van Soeren and Lee-Anna Huisman (IMP Class of 2015) with the poster "IMPart: The Therapeutic Waiting Room" at CCME 2013


    2012 Summer Student Research Program (SSRP)

    Colin Lundeen (IMP Class of 2015)

    Colin spent two months working on a project with Dr. Gary Steinhoff of Pacific Urologic Research, investigating the safety and efficacy of a new drug in the treatment of non-muscle invasive bladder cancer.  This ongoing clinical trial involves patients with bladder cancer who failed Bacillus Calmette Guerin (BCG) treatment.  BCG is a live, diluted form of Mycobacterium bovis, better known for being used as a tuberculosis vaccine and which is now the most commonly used intravesical treatment for non-muscle invasive bladder cancer.

    Colin's role this summer was to work with patients, taking focused histories and vital signs along with assisting in the administration of the study drug.  He would meet with patients once per week during their induction phase and monthly thereafter, answering their questions and ensuring that all necessary paperwork was filled out and filed.  He also had the opportunity to perform chart reviews to determine patient eligibility for the clinical trial.

    Colin had three reasons for wanting to take part in this project: to gain exposure to a surgical field of medicine; to develop an understanding of clinical research and to engage in patient-based research.  One important thing he learned from his experience was how detailed and lengthy the clinical trial process can be.  Colin gained a better understanding about why drugs take so long to be approved for the market and why drug costs are so high.

    When asked how his experience with the project might help in his medical studies and future career in medicine, Colin replied "I had many interactions with patients as well as time to look up medical information I was unsure of.  The experience satisfied all three of my goals and helped prepare me for future clinical practice".

    Katrina Genuis (IMP Class of 2015)

    Katrina GenuisKatrina worked at the BC Cancer Agency Deeley Research Centre in Victoria this past summer.  Below is her response to questions about her project and what she learned from the experience.

    Project title: Proliferating Killer T Cells and Survival in Ovarian Cancer
    Supervisor: Dr. Brad Nelson, founding director of the Deeley Research Centre

    Can you describe your project? Ovarian cancer is the most lethal gynaecological cancer.  After initial chemotherapy treatment serous ovarian cancer, the most deadly ovarian cancer subtype, has a 5-year survival rate as low as 20- 30% due to persistent cancer recurrence. My summer project at the BC Cancer Agency's Deeley Research Center (DRC) in Victoria focused on the body's immune response to serous ovarian cancer. Previous research at the DRC has demonstrated that serous ovarian cancer patients with tumour-infiltrating Killer T white blood cells have higher survival rates. In fact, researchers at the Centre discovered that by transferring a targeted Killer T Cells line into mice, ovarian cancer tumours completely regressed within 10 days. Despite these intriguing results, much is still unknown about the action of Killer T cells within tumours.

    My project sought to explore these Killer T cells by answering three questions:

    Are Killer T cells actively proliferating in ovarian tumor tissue?

    Where, and to what extent, are the Killer T cells proliferating?

    Is Killer T cell proliferation within serous ovarian cancer related to patient survival?

    1.  

      Why were you interested in working on this project? One of the central pillars of being a physician is practicing evidence-based medicine. This evidence basis stems from the ever-expanding world of medical research, an area which I had very little knowledge of prior to this summer. I believe that it is extremely important for physicians to learn and be confident about the prognosis they make and treatments they prescribe. How else to learn where the science comes from, than to directly immerse myself in research?  This project was a perfect fit for me, allowing me to both experience the world of research and to contribute to an area of personal and academic interest- cancer research.

      What is one important thing that you learned? How will this research experience help you in your medical studies in the future? Being a part of a research community has taught me so much about the importance of a cohesive and supportive team in the process of scientific discovery. Whether creatively developing new ideas at a small meeting with just a few researchers or discussing recent publications alongside the entire research team at lunchtime presentations, I have been struck by the way that a diverse team is so much more effective than just a few individuals. This is incredibly relevant to my future in medicine, a field where I will be learning from and working together with medical and research colleagues on a daily basis.  I have also learned a significant amount regarding research statistics and methods of ensuring that data and results are valid. When I now read about new treatment guidelines or medical discoveries, I have a much better idea of where this knowledge comes from and how to critically read the medical papers which publish these new discoveries.

      Anything else you would like to add? I am extraordinarily grateful to my supervisor, Dr. Brad Nelson, and the entire DRC for their teaching and guidance this summer. I have been incredibly encouraged in spending my summer with so many brilliant and motivated researchers who devote their time to studying the workings of the human body.  I will continue working at DRC on occasion throughout the school year and plan to write up the results from my research for publication in the coming year!tumour cell

       

       

      Tumour sample stained for certain cell markers and then changed to fluorescent colors. Those cells with purple coloration are CD8+ Killer T Cells; those with green coloring are proliferating (Ki-67+) cells. Those cells with both (‘double positives) are proliferating Killer T cells

    2. To answer these questions, I first worked in the lab toperform colored antibody stains on microscope slides containing hundred of ovarian tumour tissue samples. This cell staining allowed me to visualize, count, and analyze proliferating Killer T cells in over 200 serous ovarian cancer tumour cores.

      In response to my 3 research questions, I discovered that:

      Yes! Although cancer is often considered an immuno-suppressive environment, actively proliferating Killer T cells are present inside the majority of serous ovarian tumors.

      In varying ovarian tumour samples, anywhere from 0% to approximately 80% of Killer T cells may be proliferating in either the tissue surrounding the tumor or directly within the tumor. 

      We still are working on analyzing the data related to survival, but initially there does not look to be a statistically significant relationship between the percentage of Killer T cell proliferation and patient survival. This analysis is still in progress, so keep your eyes out for the results in the future!



    Andrew JefferyAndrew Jeffery (IMP 2014) – Year 2
    Andrew worked on a project with Dr. Craig Brown (Division of Medical Sciences) titled “The role of vascular endothelial growth factor (VEGF) signaling in diabetic encephalopathy”  in which he completed a research review on the molecular mechanisms that worsen the prognosis for individuals who suffer a stroke and also have diabetes.   Andrew had previously worked as a summer student with Dr. Jim Rush in the Integrative Vascular Biology Lab at the University of Waterloo, and he wanted to be able to use his previous knowledge of the molecular mechanisms regulating vascular tone to help Dr. Brown's lab with their goal to examine the intricate relationship between the brain’s neural networks and vasculature.  

    Asked about what he learned from this research experience, and how it could help in his medical studies and future medical career, Andrew replied: “I learned a lot about the importance of basic science progression to clinical science and the importance of basic science in directing decisions and research in clinical settings.  It helped me develop excellent search strategies for finding good quality research, as well as being able to thoroughly understand a topic and communicate it to the scientific community”.


    Geoffrey McKeeGeoffrey McKee (IMP 2013) – Year 3
    Geoff worked in the Neuroscience Research Lab of the Division of Medical Sciences under the supervision of Dr. Patrick hippocampusNahirney on a project titled “Ultrastructure of synapses in the dentate gyrus of the mouse model of Fragile X Syndrome”.   Geoff developed new skills in the microscopic analysis of brain tissue and learned methods to quantify cells in the memory region, or hippocampus, of mice that lack the protein FMRP, which is also absent in humans with Fragile X Mental Retardation Syndrome.  The main focus of Geoff’s research was to elucidate how the memory center (hippocampus) is affected in mice that lack the FMRP protein.   It is expected that data from Geoff’s research will form an integral component of a manuscript that will be submitted for publication.  


    By broadening his understanding of the research process involved in exploring the pathogenesis of neurological disease, Geoff believes he was able to gain better insight into the literature used in his medical education.  “The laboratory skills developed throughout the project will be highly useful in pursuing medical research as an aspect of my medical career, regardless of which medical specialty I pursue” said Geoff. 


    Ben Martens

    Ben Martens, IMP Class of 2011, was given a self-described “amazing” opportunity to work with the BC Cancer Agency Vancouver Island Centre (BCCAVIC) in Victoria during the summer of 2008. A generous donation by local Victoria rugby and fire communities to the BC Cancer Foundation (in support of a firefighting colleague who is battling stomach cancer) made it possible for Ben to spend close to 3 months in a summer studentship with Agency clinicians, patients and researchers.

    While at BCCAVIC, Ben spent about half of his time observing and participating in all aspects of cancer patient care. Sometimes he would observe one patient as they met with a variety of health care professionals or went through various treatment regimes, while at other times he would shadow a single professional (eg. oncologist, radiologist or radiology technician, nurse) as they worked with many cancer patients.He also spent time learning how to read X-Rays, CT scans, MRI scans, ultrasounds and pathology slides and samples.These patient-interaction experiences gave Ben a greater understanding of the cancer care process and communication issues involved in dealing with cancer patients and their families. “I’ll take away from this a better understanding of how to be better attuned to the patient and how to adjust my communication style to best suit the individual ”.

    In addition to clinical learning, Ben was involved in several cancer research studies at BCCAVIC.These included a short-term study designed to gain evidence on the best way to treat Cardiac Sarcomas (a rare cancer of the heart muscle); piloting a patient history questionnaire for GI complaints (which could prove beneficial to patients and clinicians in preparing for consultations); and an extensive literature review looking at the occupational risks for cancer in firefighters.

    Will medical practice specializing in cancer diagnosis and treatment be something Ben considers as a career?"Initially I thought it would be difficult to stay upbeat while working in the cancer field…but I realized that despite possible outcomes for patients, [as a physician] you are always able to provide some assistance that will help to improve quality of life…so, yes, it certainly is a possibility"


    Winning Research TeamIn the summer of 2007, between first and second year of medical school, Carola Behrens (IMP Class of 2010) thought she might like to spend her few months off learning more about the field of radiology. She began work on a CT Colonography research project with Dr. Giles Stevenson and the VIHA Medical Imaging Department. In May 2008 Carola had the opportunity to attend the Canadian Association of Radiologists Annual Scientific Meeting in Ottawa and present the research...and came home with a first place award for the research team!

    CT Colonography uses CAT scanning to obtain an interior view of the colon (the large intestine) that is ordinarily only seen with an endoscope during an optical colonoscopy. It is becoming an important tool in colon cancer screening. Carola’s has been involved in many facets of the research currently being conducted by Dr. Stevenson and his team including planning the study, logging data from clinical cases and quality control analysis of the CT colonography procedure. The research is ongoing, and Carola plans to continue her involvement in data analysis and writing up results as well as planning future projects…all while balancing the demands of medical school!

    Carola feels that she has really benefited from her experience in this project. Not only has she learned a great deal about colon disease and medical imaging but there have been fringe benefits. “Radiologists I’ve worked with have been very generous with their time and eager to teach me about the imaging and pathology of other body systems too” Will this experience have any influence on future medical career choices? “Yes, I am fairly sure I want to be a radiologist!”


    David KimDavid Kim, IMP Class of 2016, spent two months this summer working on a research project at the BC Cancer Agency's Deeley Research Center (DRC) in Victoria, under the supervision of the DRC Director, Dr. Brad Nelson.  The project was entitled, "Personalized therapeutic vaccines for ovarian cancer".  Like other cancers, ovarian cancer is caused by mutations that allow cells to divide uncontrollably, eventually forming tumours. New DNA sequencing technologies have allowed researchers to identify every mutation in individual tumours.  This has revealed that the average ovarian tumor contains tens to hundreds of mutations, the vast majority of which are unique to each patient.

    The goal of the project David was involved in was to develop a new form of cancer treatment involving personalized vaccines that specifically target the unique mutations found in individual tumours.  To investigate this concept in a mouse model of ovarian cancer, David used a recently sequenced mouse ovarian cancer line (called ID8) that identified over 100 tumor-specific mutations.  David's task was to help assess and validate these mutations for recognition by T-cells (cells that help to control and regulate the immune system) from genetically matched mice.  Those mutations that are found to be recognized by T-cells will be incorporated into therapeutic vaccines.  Mice bearing established ovarian tumors will be treated with these vaccines with the goal of triggering potent T-cell responses that induce tumor regression.  By exploring this technique of cancer immunotherapy, Dr. Nelson and his team are laying the groundwork for future clinical trials of personalized vaccines in human ovarian cancer patients with the goal of preventing recurrence after completion of standard treatments.

    When asked how this experience will help his medical studies and future career as a clinician David said, "This experience working in a laboratory enabled me to see a different perspective of medicine.  While working in the front lines of a cancer research laboratory I was able to draw the dots of how research can translate to clinical care to improve patient outcomes.  Basic science research builds the foundation of good clinical practice and this experience allowed me to understand the importance of the intricate relationship between scientific research and clinical medicine".