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Medical Scholars: William Quach explores a different approach

Posted by on Tuesday, September 28, 2021 in Research .

by Lexie Little

William Quach

When William Quach (MD ’23) arrived at Vanderbilt University School of Medicine after studying biology at the University of California San Diego, he brought research experience with him.

Quach, an aspiring anesthesiologist, examined how a specific protein traditionally known to play a role in the death of cells actually helped ovarian and breast cancer cells to survive and spread. Spending five years at Moores Cancer Center from 2013 to 2018, he applied his academic study to laboratory research. But, as he later realized, labs only reveal part of a medical story.

At Vanderbilt, faculty and researchers expose medical students to a broad range of research – everything from exploratory lab experiments based in basic sciences to qualitative and quantitative studies of patient ethics in a social science tradition.

At a research fair session, a poster about black box systems in operating rooms caught Quach’s attention. Sometimes, black box systems record audio, visual, and other data to help medical teams review and improve their quality and efficiency of care. As Quach viewed the work by Associate Professor Alexander Langerman, a practicing head and neck surgeon, he learned to think more broadly about what questions physician researchers – and practicing physicians – need to address.

Langerman, now Quach’s mentor and research principal investigator, approached him with a project that would change the course of his studies.

“I started working with him looking at overlapping surgeries, and then that project kind of got scooped [and became less relevant],” Quach said. “But he also does a lot of research in ethics, so he said, ‘William, this is something I wanted to do for a really long time, and I just never had the bandwidth to do it. So, would you be interested in [working with me], or do you want to jump ship to someone else?’”

He decided to anchor down.

That something – ethics of surgical consent – piqued Quach’s interest enough that he decided to dedicate a year of his time at Vanderbilt to research through the Medical Scholars Program. Medical Scholars receive a $30,000 stipend in addition to a $1,500 conference allowance to conduct 12 continuous months of research on any topic in medicine.

Though the program would delay his graduation by one year, Quach wanted to explore the consent process for surgeries where residents will practice and learn. When patients learn about what will happen during surgery, attending physicians often simply mention a resident will be present without explaining their role. This brief mention meets the standard for many surgeons in obtaining consent to operate, glossing over residents’ roles amid other important information.

However, Quach felt that patients, perhaps too anxious to make an informed decision, deserve more information in the moment. His motivation impressed his mentor.

“William’s study is really important work, because it addresses something we as surgeons do every single day at academic institutions across the country,” Langerman said. “What I was most impressed with, is that William scoured through hundreds of pages of past interviews with surgeons and patients that my prior students and I conducted in order to identify the key topics regarding residents that we might discuss with patients. He’s a seriously motivated student.”

Through a triangulated study including patient interviews and representative surveys, Quach now hopes to find better methods to fully and ethically explain resident roles to patients, ensuring full consent.

“This was a 180 from the research I had been doing. I had absolutely no background in social sciences,” Quach said. “I really want to take a year to spend the time learning how to interview patients, learning how to do surveys and analytics, and trying to make sure it’s all done correctly – not just cramming it through before I graduate.”

Feeling a responsibility to his future patients, Quach decided to go directly to the source to uncover potential concerns. With his undergraduate minor in theatre perhaps playing a role, he ventured to the One Hundred Oaks (OHO) to see the consent process from a patient perspective.

“I interviewed 20 to 30 patients in the pre-surgical clinic at OHO, then we refined the questions to make them sound more realistic. Like how the patient would actually ask this question during an office visit,” Quach said.

Based on these questions, he and his team designed a survey currently in review for field testing. He hopes to reach a diverse population of around 1000 people to gauge each question’s importance to potential patients. Attending surgeons and other practicing physicians might then use the results to refine how they explain procedures and personnel based on what patients would want to know.

So far, Quach has most enjoyed conversations with diverse people.

“Some patients have like amazing insight into residents, like, ‘You know, if I wrote this survey, I’d change this question. I’d write it like this. I’d add this,’ and there are other people who are like, ‘All these questions are irrelevant because I trust my doctor. I would just go in there,’” Quach said. “It was so interesting because across three or four days, I got such a wide array of responses to validate in the survey.

“It supports the fact that we’re doing good research because it’s so varied.”

Sometimes, difference makes the difference.