| Project Name |
text |
20 |
|
Give a brief title. |
| Resident's Name |
textarea |
20 |
|
Give name and contact information for mentor. |
| Resident's Department |
checkbox |
5 |
Internal Medicine, Pediatrics, Ophthalmology, Anesthesiology & Pain, Infect Diseases, Hematology/ Oncology, Interns & Residents, NA, Joint Project |
| Mentor's Name |
textarea |
20 |
|
Give name and contact information for mentor. |
| Mentor's Department |
checkbox |
6 |
Internal Medicine, General Medicine, Pediatrics, FCM, Infect Diseases, Gastro/ Hepatology, Cardiology/ Cardiovascular, Hematology/ Oncology, Ophthamalogy, Anesthesiology & Pain, Endocrinology, Surgery, Pulm/CC, Nephrology, Dermatology, Biostatistics, Rehab, Patient Care, NA, Joint Mentors |
| Year 1 Section |
label |
|
Please complete the Year 1 Section during Year 1 of your Residency Project. |
| Abstract |
textarea |
100x10 |
|
Provide background information about your project. |
| Literature Review |
textarea |
100x10 |
|
Provide three papers you are referencing for your project. |
| Hypothesis |
textarea |
100x10 |
|
Briefly state hypothesis. |
| Type of Study |
radio |
4 |
Medical Records Review, Database Extraction, Other |
Check type of study. |
| Describe Other |
text |
25 |
|
Describe other type of study. |
| ResidencyYearOne |
label |
|
IRB Documents |
|
| IRB Submission |
date |
|
|
Check date that you are planning to submit your project to the IRB. |
| Study Classification |
radio |
5 |
case control, cohort, cross-sectional, NA |
Pick the epidemiology study classification. |
| Data Source |
radio |
6 |
EMR, Chart Review, EMR + Chart Review, Registry, Laboratory Data, Other |
Check all that apply. |
| Describe Other Source |
text |
25 |
|
Describe other source of data. |
| Type of Data |
radio |
3 |
nominal, ordinal, interval, ratio/continuous, categorical, qualitative |
Check type of data. |
| Study Preparation |
label |
|
Go to top of this page and complete the Year One: Study Preparation table. |
| Year 2 Section |
label |
|
Please complete the Year 2 Section during Year 2 of your Residency Project. |
| Data Collection |
textarea |
100X10 |
|
Describe your plans for data collection. |
| List Variables |
textarea |
100 x 10 |
|
List variables and coding for variables. |
| Data Information |
label |
|
Go to top of this page and complete the Year Two: Data Collection table. |
| ResidencyYearTwo |
label |
|
Residency Year Two Documents |
|
| Year 3 Section |
label |
|
Please complete the Year 3 Section during Year 3 of your Residency Project. |
| Type of Analysis |
checkbox |
5 |
Frequency, ANOVA, T-test, Correlation, Chi-square, Regression, Sensitivity, Specificity, NA |
Check type of analysis you are planning. |
| Project Keywords |
textarea |
100x10 |
|
Provide keywords for your project. |