What’s in a Question?

This content is part of an ongoing collaboration between EMS World and the Prehospital Care Research Forum at UCLA. The PCRF is dedicated to the promotion, education, and dissemination of prehospital research; for more see https://www.cpc.mednet.ucla.edu/pcrf. 

The basis for any research undertaking is a robust question. It is illogical to search for an answer to a question one has yet to ask. Thus, the question must precede the answer. But as you peruse the journals and scour the library, you might be struck by your own question: How did they think to study that? The answer, conveniently for researchers everywhere, is simpler than you might expect. 

It is human nature to explore and observe the world in which we live. Thus, every one of us possesses the intellectual curiosity and ability to craft a meaningful research question. The simplest of observations have led to world-changing questions (why does the apple fall to the ground?), and no individual thought is too trivial to explore to its fullest. 

What do you find interesting? You may be drawn toward hiring practices or clinical protocols or even ambulance design. This is the time to delve into your curiosities and explore the profession you love. Start by identifying problems or issues you feel need to be addressed. For example, the matter of sleep deprivation and EMS fatigue has yielded a wealth of research questions. 

Think Big

Think big, think broad, and don’t limit yourself. This stage is meant for romanticism. Keep a running list of ideas. Channel your own interests to drive your research agenda. Use a “who, what, where, when, why, how?” method of question genesis. 

• Who becomes a paramedic?
• What motivates students to complete paramedic studies?
• Where are the most effective places to place paramedics during mass gatherings?
• When is the most effective time of day to hold continuing education classes?
• Why do EMTs/paramedics leave the profession? 
• How can we reduce worker stress?

Your research question is meant to start a dialogue. Great research questions are born of individual passions; yet the question should identify a problem that is relevant to your intended audience—that is, the question should be important to the EMS community. You may be intensely interested in the quality of shoelace materials and which is best for your boots, but this question may not be imperative to the greater community. 

Your question should also contribute to the body of academic literature. An integral step in this process is to stay current on others’ research. You certainly don’t want to delve into a project that has already been explored. You can, however, improve upon existing literature or replicate older studies. 

Read existing literature! Ideas often come from reading others’ work. As you generate ideas do some initial background research of your own. Has this idea been explored before? If so, what were the outcomes, and is there an opportunity to improve on a portion of the study? 

Refine and Hypothesize

Hypotheses and questions go hand in hand. We are hardwired to draw quick conclusions about our everyday observations. Your first inclination might be to think, Lights and sirens cause drivers to behave oddly. We can easily convert that hypothesis into a research question: Does the use of audible/visual emergency warnings affect driver behavior?

Additionally, your original thought should be refined into a practicable and achievable project. We must define certain aspects of the question. In the above example, driver behavior is vague and broad, lacking a measurable definition. This question can be refined to read, Does the use of audible/visual emergency warnings create a greater likelihood of motor vehicle collision? Through this we can measure the use of emergency signals, ambulance paths, and locations of motor vehicle collisions. 

By perusing the latest issue of the journal Prehospital Emergency Care, we can extract great examples of poignant research questions. Each of these questions is succinct, measurable, and important: 

• Does end-tidal carbon dioxide measurement predict traumatic mortality?
• Can paramedics accurately obtain lung ultrasound in the presence of respiratory distress?
• Is EMT/paramedic burnout associated with employee turnover? 

Finally, don’t be afraid to abandon an idea if you find it to be unfeasible. Often a great idea proves too broad or cumbersome to explore to its fullest. In the case of the former, continue to refine the question into smaller parts. Moreover, keep a list of your ideas. Whenever an idea strikes be ready to write it down (I suggest having a readily available online document). If you remain in a constant state of observation, your research questions will become increasingly relevant and substantial. 

References

Becker TK, Martin-Gill C, Callaway CW, Guyette FX, Schott C. Feasibility of paramedic performed prehospital lung ultrasound in medical patients with respiratory distress. Prehosp Emerg Care, 2018 Mar–Apr; 22(2): 175–9. 

Childress K, Arnold K, Hunter C, Ralls G, Papa L, Silvestri S. Prehosital end-tidal carbon dioxide predicts mortality in trauma patients. Prehosp Emerg Care, 2018 Mar–Apr; 22(2): 170–4. 

Crowe RP, Bower JK, Cash RE, Panchal AR, Rodriguez SA, Olivo-Marston SE. Association of burnout with workforce-reducing factors among EMS professionals. Prehosp Emerg Care, 2018 Mar–Apr; 22(2): 229–36. 

King G, Keohane R, Verba S. Designing Social Inquiry: Scientific Inference in Qualitative Research. Princeton, N.J.: Princeton University Press, 1994. 

Patterson PD, Weaver MD, Frank RC, et al. Association between poor sleep, fatigue, and safety outcomes in emergency medical services providers. Prehosp Emerg Care, 2012 Mar–Apr; 16(1): 86–97. 

Stock JH, Watson MW. Introduction to Econometrics, 3rd ed. Pearson, 2015. 

Jackson D. Déziel, PhD, MPA, NRP, is an assistant professor with the emergency medical care program at Western Carolina University. He holds a PhD in public policy from the University of North Carolina-Charlotte and a Master of Public Administration from North Carolina State University. His research interests embrace the intersection of EMS, health economics, and subsequent public policy.