Like many of his colleagues at Mayo Clinic Health System in Eau Claire, Dr. Alex Beuning has all sorts of questions, theories and ideas about things that could potentially help him be even more successful in meeting the needs of his patients.
What the busy emergency medicine doctor doesn’t have is time to do the clinical research necessary to test his theories and find answers to his questions.
That’s why he was eager to be part of a Mayo Clinic summer program newly offered in Eau Claire that pairs Mayo Clinic Health System physicians with high-achieving undergraduate student researchers.
Last summer, three students from UW-Eau Claire and one student from UW-Stout worked alongside Eau Claire-based physicians — including Beuning — as part of Mayo Clinic’s Undergraduate Research Employment Program.
The UREP program, previously only available at Mayo Clinic in Rochester, Minnesota, gives students real-world research experience while working alongside physicians at the prestigious medical facility.
“When you work in a community hospital, you read journals to come up with ideas to change practices or you learn anecdotally,” Beuning says. “This program gives us the ability to expand into research and look at data more comprehensively.”
Though in its first year at the Eau Claire site, it’s already changing how physicians think about research, Beuning says.
“It’s a change in mindset,” Beuning says of working with undergraduate students on research. “We’re still developing a research mindset, but I know a lot of doctors who haven’t done research in the past but now are inspired to do projects of their own.”
Through UREP, students gain research skills and experience, but also professional connections and a sense of what it might be like to someday work in a medical setting.
Students apply for the paid UREP positions, and then are paired with physicians who have indicated that they are interested in working with students on research projects.
While the Blugolds work closely with their research partners, they have many opportunities — informal and formal — to interact with and learn from a variety of Mayo Clinic Health System personnel, helping them see the breadth of careers available within a medical center.
“This has been a very valuable experience,” says Ashley Walker, a UW-Eau Claire neuroscience major who has done summer research with a cardiologist and a general surgeon. “I’m more confident in what I will choose to go into in the future. Experience is the best thing anyone can have when making a decision about their future, and this program gives me that experience.”
Bringing UREP to Eau Claire is possible because of a recently established research collaboration between Mayo Clinic Health System and UW-Eau Claire, a collaboration that Beuning expects will benefit both institutions.
“I’ve been here in Eau Claire for 20 years and while I’ve spent some time on campus, I didn’t really engage with students,” Beuning says. “This gives students at UW-Eau Claire opportunities to experience our world and for us to have young, fresh minds to help us look at things differently, to question assumptions and to bring in a research mindset. It’s a great partnership.”
The first Blugolds to participate in the Eau Claire-based UREP and their physician research partners say the program already is exceeding their expectations.
Assessing emergency medicine procedures
When patients arrive at the emergency room complaining of chest pains, an assessment is done to help determine their heart attack risk. Through the assessment, the medical team determines a risk stratification score — known as the HEART score — that helps doctors determine next steps.
For example, someone with a high score may be immediately admitted to the hospital, a moderate score may indicate a need for more tests, and patients with a low score may be sent home for outpatient care.
While the assessment tool is used in emergency medical settings throughout the country, Beuning has long been curious about its impact on patients, especially those who have some chest discomfort but are deemed well enough to go home for outpatient care.
“Research is new here in emergency medicine,” Beuning says. “But we wanted to look at how to best care for patients with chest pain. We want to do appropriate testing versus excessive testing. We want to analyze data, but gathering data is difficult and analyzing data is challenging in a community hospital.
“Emergency medicine is not a big research department historically. Having a student interested in learning about the clinical side of research has been a great way for us to get this project started.”
While collecting data about patient outcomes is time-intensive, as is documenting and analyzing the data, it was exactly the kind of project Sierra Kleist, a UW-Eau Claire senior microbiology major, was looking for when she applied to the UREP program.
During the summer, Kleist was collecting and analyzing the data of patients who previously had come to the ER with chest pain. From that data, she helped to analyze what happens to patients with low-risk stratification scores.
The goal of the research project, she says, is to determine if it’s safe for patients who score 0-4 on the HEART score assessment to be sent home for outpatient care rather than hospital admission.
“It’s really exciting to know that work I did there could be implemented in hospitals all over the world in the future,” Kleist says of possible revisions to ER protocols that could result from the research findings. “My work directly impacted the lives of patients and that’s an amazing feeling.”
Already, Beuning says, Kleist found interesting and sometimes surprising information through her research.
“It’s amazing when I look at the data she collected because some things I was correct in my assumptions and then I wasn’t right in some of them,” Beuning says. “The data Sierra brought back was very interesting and helpful to us.”
The Portage native came to UW-Eau Claire because of its reputation for offering undergraduate students meaningful research opportunities.
However, while Kleist has been active in lab research on campus throughout her undergraduate years, she also was anxious to gain clinical research experience as well given her plans to go to graduate school for biomedical research.
“I wanted to get some experience and figure out if I like it before I apply to grad school,” Kleist says of clinical work in a medical setting.
She’s confident that she’s on the right career path given her research experiences at Mayo Clinic Health System, Kleist says.
“I liked the research and the people I worked with,” Kleist says. “It’s awesome to have had this experience at Mayo Clinic of all places. I’m used to lab research, but there I was doing clinical research. The patient contact was especially important to me because it will help me to not lose sight of what I’m working toward in the future even when I’m working in a lab.”
Interacting with and observing physicians and other medical staff as they went about their work also helped shape her thinking about her future career, she says.
“I saw a different side of the physicians and of health care,” Kleist says. “It may not be the field I’m going into, but it will help me be better at my future job because I will have the bigger picture in mind.”
Knowing that her work is shaping how Eau Claire-based physicians might think about research also is rewarding, she says.
“I know my research affected those around me,” Kleist says. “I worked in the ER physician office. A lot of the doctors were quiet around me at first, but then they started reaching out to me and asking why I was there, what I was working on.
“I told them about the research and then every day they asked me questions about it. I think that my being around the physicians opened their minds to research. Research is not yet huge here at Mayo Clinic Health System, but they’re working toward it. My being here inspired them to think about and do research of their own.”
Beuning agrees, noting that his colleagues took note of the quality of Kleist’s work and started thinking more seriously about how they might partner with undergraduate researchers in the future.
Beuning says he is among those who likely will be thinking about new ways to partner with more undergraduate students in the future.
“Sierra was great,” Beuning says. “She was very interested, very bright and worked hard. I hope we can create more interesting projects so we find other interesting students. We want to enrich their experiences while also benefiting us.”
Monitoring heart patients
During the summer, Walker, an Eau Claire native, worked with a cardiologist, Dr. Richard Hanna, on research that aims to better monitor patients on the heart drug Amiodarone, an often-prescribed medication with side effects that make it critical for doctors to closely monitor patients taking it.
Monitoring is challenging for patients and physicians, Hanna says of the heart medication. With that in mind, the cardiology team wants to create a new monitoring system, but there is a lot of manual chart review and other labor-intensive work to be done before changes can be made, he says.
“We have had projects for years that have been difficult to get going because of time not being available for people to do them,” says Hanna. “This year, through our collaboration with UW-Eau Claire, we can involve students and get some of these projects going, including this one, which we’ve been trying to get going for a couple of years.
“During the summer, with Ashley’s help, we were able to start it and it will be successful now. Now this is going to happen and it’s going to really be beneficial to a lot of people.”
Walker has long been interested in the medical field and in research, so UREP was a perfect fit since is allowed her to combine her two interests.
The experience, she says, will help her decide on a future career path.
“I’ve been trying to decide if I should do an M.D. or M.D-Ph.D. program,” says Walker, an active undergraduate researcher at UW-Eau Claire who will graduate in spring 2020. “This will help me decide if I want to go the medical research route.”
Engaging in clinical research at a medical center as prestigious as Mayo Clinic Health System is an incredible opportunity, Walker says.
During the first weeks of the program, she shadowed a cardiologist, visiting patients, observing surgeries and learning about the field of cardiology.
Once she had a basic understanding of the unit, she began reviewing patient data with Hanna, deciding which patients to include in the research project.
“I read scientific papers to learn about a drug named Amiodarone,” Walker says. “It has not so great side effects, so you need to monitor patients on it closely. I learned about the drug and then analyzed patients to begin building a better program for monitoring patients who are on it.”
Hanna says he built 30 minutes a week into his schedule to work with Walker on the project, but they have had constant interactions outside the appointed times.
“We set it up so she was just down the hall,” Hanna says. “That way if something came up or she ran into a road block, she wouldn’t be stuck. We spent a fair amount of time together each week to make sure the project was moving along and that she was prepared to summarize it well in presentations when we met with the rest of the team.”
While the research itself was interesting, Walker says a huge benefit of UREP was spending time observing physicians as they went about their daily work.
“I loved the research, but it was nice to see how everyone’s day works and what it’s like to be a physician and how valuable their time is,” Walker says.
UW-Eau Claire prepared her well for her work at Mayo Clinic, Walker says, noting that in classes and through faculty-student collaborative research projects she’s had experience collecting and analyzing data as well as presenting her findings.
While she spent the first part of her summer working in cardiology, Walker then partnered with doctors in general surgery.
Walker says she appreciates the variety of experiences she had through UREP.
“They placed us in departments, which is good because I’m not sure I would have picked cardiology or general surgery,” Walker says of her summer research projects. “This way, I stepped out of my comfort zone. If I’d chosen, I probably would have stuck to neurosurgery, but it’s nice to learn about other specialties.”
A bonus, Walker says, is that she feels like maybe she has a foot in the door at Mayo Clinic for when she someday begins her professional career.
“It would be a dream to work here one day,” Walker says.
Hanna is equally enthusiastic about the UREP experience.
Given the quality of Walker’s work, Hanna says he’s already thinking about new ways to involve undergraduate students in his work in the future.
“It really helped us understand what’s possible at the undergraduate level,” Hanna says of including UW-Eau Claire students in research. “We now have a better idea about what we can involve them in that will be beneficial for them and for us. It’s a great collaboration.”
Walker’s contributions to the research project also has him about thinking about what else might be possible given the UW-Eau Claire and Mayo Clinic Health System collaboration.
“I’m still learning about the partnership and I’m excited about it,” Hanna says. “The many opportunities to capitalize on the strengths of both organizations are clear.
“I’m certain that undergraduate students being exposed to clinical work is a big advantage over being in a classroom all the time. For us, having these young people bring energy to projects that need help is a huge benefit. The whole idea of collaboration is a good one. I really think this is going to very good for both institutions.”
Better communicating with cancer patients
Shanzay Suhail, a senior biochemistry/molecular biology major from Eleva, worked in the Mayo Clinic Health System Cancer Center during the summer on a project that will help providers better communicate important information to cancer patients and their loved ones.
The goal of her project was to gather and analyze data that will help the multiperson health care team determine when and who should share information about everything from goals to logistics to side effects.
Suhail, who plans to pursue a career in medicine, says the UREP project was a great opportunity to be involved in clinical research, which will be valuable as she pursues a career in medicine.
Among the lessons she gained from the project was a better understanding of the many people who are involved in the care of a patient.
“I learned so much about how many people are on a care team besides the physicians and nurses,” Suhail says. “It’s interesting to see the roles of the social workers, pharmacists and others. I got a better understanding of the bigger picture, which is going to benefit me in the future.”
It’s also satisfying, she says, to know that her research project will have an impact on patients and their loved ones.
“I was able to see the end goal,” Suhail says of the project. “I’ve done other research in labs and it's really easy to lose focus on the big picture there, but this project was different. It was exciting because I could see the big idea and how it would make a difference for people.”
Having Mayo Clinic Health System physicians serve as mentors added even more to her already exceptional undergraduate experience at UW-Eau Claire, she says.
“Just having the opportunity to talk with the physicians is something that would be really hard to do otherwise,” Suhail says. “There it was easy to talk about the research but other things as well. It was nice to see that not everyone took the same path to get there. It made me feel like I could do what I like to do and still get there.”
She also made connections between lessons learned in her classes and how they can be applied within a health care setting.
Those connections are inspiring her to think about continuing to be involved in research regardless of her future career path.
“I saw real-life applications of things we’ve talked about on campus,” Suhail says. “It’s convinced me that I would like to continue to do some type of research in the future even if I don’t pursue a Ph.D. along with my M.D.”