Podcast | Episode 11: Clinical Research with Dr. Raine Osborne and Dr. Jason Beneciuk

Podcast Transcript

Tracy Davis: Welcome to the Brooks Rehabilitation Podcast, my name is Tracy Davis. This episode we are talking research. I think our guests today did a fantastic job of breaking down research, even for us nonclinical people like myself. So Dr. Jason Beneciuk is the Clinical Research Scientist for Brooks, and he’s also the Director of the Brooks Rehabilitation University of Florida, college of public health and health professions, research collaboration. We have a long history of collaborating with University of Florida, and a lot of amazing studies have come from from that. So Jason does a great job of explaining that for us. Then Dr. Raine Osborne is the Director of Research at Brooks. So we get into a whole lot of topics about how certain studies come about, how they conduct them, how they disseminate the information, so that, not just us here at Brooks benefit from the things that they learn, but also the whole world of rehabilitation.

Also we talk a little bit about why it’s so important and what Brooks does here about how we find research so valuable, and we want to be on that cutting edge of pushing the industry forward, and that’s why we invest so much into research. Before we get into the podcast, I just wanted to encourage you to consider sharing the podcast. I know that we have a lot of people listening that are employees of Brooks, or maybe you are just in the rehabilitation world of some sort. We would really appreciate you sharing the podcast, leaving a rating for us on whatever podcast platform that you listen on. We would really appreciate that. Also connect with us on social media. You can find us on Instagram, LinkedIn, Facebook, YouTube, all the major platforms. We’re not on TikTok, I don’t think. I don’t think we have a need to be on TikTok, but you can find us in all of those platforms at Brooks Rehab.

Again, I want to thank Dr. Jason Beneciuk and Dr. Raine Osborne for taking the time to be on the podcast. Let’s get right into it. Thanks for joining me guys. If you guys want to introduce yourself to everyone listening. Raine, you want to go and start.

Raine Osborne: Raine Osborne, I’m the Director of Research for Brooks Rehabilitation. A physical therapist by training and also have a doctorate in educational leadership.

Tracy Davis: Thank you, Jason.

Jason Beneciuk: Yeah, I’m Jason Beneciuk, I am part of the research collaboration that we have between Brooks Rehabilitation and University of Florida. I’m a Research Assistant Professor in the Department of Physical Therapy at the University of Florida and a Clinical Research Scientist at Brooks. Like Raine, I was also trained as a physical therapist

Tracy Davis: Let’s just start a little bit like what got you here? A little bit like going through some of your school and why did you want to become a physical therapist? Then maybe, how did that lead you into research?

Raine Osborne: Yeah, so as far as becoming a physical therapist, when I graduated undergrad I was really planning on going towards medicine, had a lot of interest there, but also had a lot of background in physical training and just working with changing the body through exercise and kind of rehabilitation model and really liked that. As I started shadowing a lot of different physicians and physical therapists and things, I just was really impressed by the field and the opportunities that I thought I’d had really for the future of societal needs and that rehabilitation model being something that I thought was sort of missing to a large extent, and a lot of opportunity to grow in that area, both personally and professionally.

Tracy Davis: Great. Then how did that lead you into research?

Raine Osborne: So, yes, number years I started out as a clinician, I was in clinical practice for about 10 years. About four years in, I did a residency here with Brooks in orthopedic physical therapy followed that up with a fellowship in orthopedic manual physical therapy, also here at Brooks through our Institute of Higher Learning. As I was in practice and really seeing the changes in myself as a clinician and the outcomes I was having on my patients, wanting to help spread that kind of that knowledge and help others be able to take better care of their patients, so I moved more into an education on sort of direction at that point.

For a number of years, I was the coordinator for the orthopedic residency program. Also started doing some teaching at the University of North Florida in their doctor physical therapy program. And really started valuing the education role and wanted to go further in that direction, which is why I pursued my doctorate in education. Through that, really started getting more involved in research and obviously being trained as a researcher. The opportunity came up here at Brooks. There was some transitions in the research program at the time and thought that there would be a really good opportunity to help further integrate our research program and clinical practice and bring those two things together, because I think that’s just a really good model for how we continue to advance in the field and have better outcomes for our patients. So took on that role in research, that was I guess in 2015 and then ever since, just continuing to try and build that program.

Tracy Davis: Has it really been since 2015?

Raine Osborne: It has.

Tracy Davis: Wow. Wow. Can’t believe it’s been that long. Jason, what about you? What kind of got you on the path and landed you doing research and education?

Jason Beneciuk: So my initial plans were to be a relief pitcher for the New York Yankees.

Tracy Davis: Me too.

Jason Beneciuk: That didn’t work out. So what got me into physical therapy? Initially, I actually graduated with a biology degree and worked as a chemist for about three years and decided then that, I always had an interest in physical therapy. I submitted my applications and eventually got accepted into the University of St. Augustine. A lot of it probably came from either past experiences with family and physical therapy or high school or college sports as an athlete. After that, working as a clinician for about five years, I was really I guess you could say frustrated with a lot of the things that were going on in clinical practice and a lot of the confusion and kind of no clear direction in terms of some of the clinical decisions. I think that really interested me. So I then pursued a fellowship back at St. Augustine again, and I really wasn’t totally convinced that I wanted to go ahead and go get the PhD.

Jim … down at St. Augustine actually did a little help in convincing me that I could do something like that. So he introduced me to what would become my future doctoral mentor, Steve George. Be it after the fellowship, we started that program and five years later. One of my initial goals, I remember talking with Steve during the first year and he kind of asking me, where do I see myself when I’m done? I saw myself actually in this position with Brooks, but at the time, that position wasn’t there. We thought it might not be that realistic, but we kind of kept those discussions going over the years and the position was created. So it was actually a pretty neat experience along the way.

Tracy Davis: How many years have you been in your position?

Jason Beneciuk: So this’ll be year nine.

Tracy Davis: Oh, wow.

Jason Beneciuk: Yeah, 2020, this is year nine.

Tracy Davis: That’s awesome. It’s funny that you guys talk about your journey, because a lot of people talk about, when I’ve asked other physical therapist specifically, and it usually seems to be someone in the family had an injury and then they watched them go through and watched what the therapist did and the amazing recovery they made. Or some sort of a sports background, athletic training exercise kind of a background. So a lot of therapists seem to kind of go down that direction. It makes total sense.

So Raine, from my perspective, since you’ve been like you said, since 2015 research has really grown a ton and you guys have had a ton of recognition over the years, nationwide from all over the place. What’s the background of the research program and how has it changed and morphed and developed over time?

Raine Osborne: Yeah. I really came in at a good time. So yes, there’s been what seems to be a lot of growth, but really it’s just recognition of a lot of things that were already in the works when I came into that. Brooks really got started in research back in the late nineties and some of the faculty from the University of Florida would come and conduct research here. Then in 2010, Brooks started the Brooks Clinical Research Center. The effort there was to try to make Brooks a little bit more of an intellectual contributor to the research and sort of generator that as opposed to just a site where research was conducted.

Tracy Davis: Sure.

Raine Osborne: That, over time, morphed into what’s now the Brooks UFPHHP, which is the College of Public Health and Health Professions at University of Florida. So we now have a formal partnership that started in 2013 which Dr. Beneciuk here is a part of and he can speak more to that here in a moment. But that work that started in 2013 really laid the foundation for where we are today and the researchers that are a part of that collaboration, building a research agenda, building the program really from the ground up, because that took a number of years. Then when I came in in 2015, that was really one of the first things that was obvious, was that we have some really great work going on here. A lot of what’s needed on the front end is just helping people understand the great work that is going on and then build more support for that.

We’ve done that and then continued to expand from there and trying to reach out and have more collaboration with our local academic institutions, UNF, Jacksonville University and just really build a collaborative model of research. We were able to bring in the research expertise and match that with our clinical expertise here at Brooks. We think that’s a pretty good model.

Tracy Davis: Sure. Zooming in a little bit on what you said is, I know this was a little bit before you were in research, but is there any anything that you know of that kind of triggered Brooks to say, “Hey, we don’t want to just be recipients of the research being done, but we want to actually be on the leading edge of the research and moving the research,” the pre rehabilitation industry forward through research at Brooks?

Raine Osborne: Yeah. I mean, I think it just goes back to the overall mission of Brooks and really trying to do the best for our patients and provide the patients that we care for with the latest best care that’s possible in rehabilitation.

Tracy Davis: Sure.

Raine Osborne: Obviously, you can wait around for the research to catch up with the clinical practice, or you can be a part of that process. I think the leadership of Brooks wisely said, “Yeah, let’s be on the front edge of that and contribute.”

Tracy Davis: Yeah. I mean, it makes total sense. Like you said, it fits totally in with our mission, vision and values. I’ve never known Brooks to not be on where we are with research, trying to push the industry forward. So that’s very interesting to hear that, your side of the story of that. Jason, you’re the Interim Director of the Brooks UFPHHP collaboration and Raine had mentioned that a little bit ago. Can you tell me more about the collaboration and why the collaboration was formed? Because Brooks has all kinds of UF employees here that graduated from UF. Do either of you go to UF? No?

Jason Beneciuk: I did.

Tracy Davis: You did go to UF? There’s like a million employees here that graduated UF, so we seem to have a lot of connections there in multiple ways. But tell us a little bit more about that collaboration.

Jason Beneciuk: Sure. Yeah. When the collaboration was initially developed, there were some really key players that were involved with the development. Michael Spiegel, who’s no longer with Brooks, obviously Doug Baer was involved on the Brooks side. Dr. Michael Perry, who’s the Dean of the College of Public Health and Health Professions at the University of Florida and the physical therapy chair Dr. Krista Vandenborne. Those were really the four key players in terms of developing the program. I think when the program was developed, the collaboration was developed, the key thing was that we were able to link Brooks and what Brooks has to offer, their sophisticated way of delivering care with their patients. But also with the resources that we have at the University of Florida in terms of researchers resources and also the doctoral students that were training to either be clinicians. Like you said, Tracy, a lot of them are actually in our system right now as clinicians, but also future researchers. A lot of those future researchers are involved in the collaboration.

One of them actually just defended her dissertation and a lot of her work was done here at Brooks. So it was real important to us that it was a true collaboration. It wasn’t where a academic research institution is coming into a health system and “using them for their patient data and their clinicians in terms of collecting the data.” I think a lot of what we do, the investigators that are part of the collaboration is we really try to include Brooks’ clinicians, some very early in the research development process for their intellectual contributions. That’s, I think important to all of us, really in developing research, conducting the research and then also disseminating the research. That’s a lot different than just having clinicians collect data. So that’s one thing that we’re kind of proud about, and that was, I think, the thought about the collaboration going into it.

Tracy Davis: That’s great. I mean, it seems like a fantastic partnership. I’ve been at some of the events that you guys have where people are talking about things that they learned during their research that they’ve been doing at Brooks for whatever period of time it was. Usually, it’s pretty long research studies, right? Some of them are years long or something like that. How does that happen? How did they determine the length that maybe a research study needs to be done?

Jason Beneciuk: Yeah. I think all studies are really different depending on what type of study it is and what type of question it is. But you can even expand it out even a little broader than that. When the actual study starts and then completes, a lot also happens before that and after that. For example, we actually just completed a project that was funded by the Patient Centered Outcomes Research Institute, PCORI. Where we really kind of developed infrastructure and capacity to include stakeholders in terms of just developing research questions. Those stakeholders included patients, included clinicians from the Brook system, as well as other stakeholders. That was before we even started a study. We still haven’t started that study, we’re still trying to seek funding for that, but the study would then be conducted.

Then what happens after I think is really probably the most important part related to the collaboration, because that’s really what it’s all about. I know this is really important to Doug. When we have our conversations with him is, we do some really good work in terms of research at Brooks, but how is it impacting clinical practice? So really taking the next step in terms of how our research findings can impact clinical practice. I think sometimes folks need to be a little patient in terms of, that often doesn’t happen right after the completion of a study. It often takes time to integrate things into clinical practice. That’s really a different line of research if you will.

So I know we are really interested in trying to move forward with some of those types of studies in the future as well.

Tracy Davis: Great.

Raine Osborne: Just to add onto that, I mean, I think that’s a great example. Really the integrative model that we’re talking about and some of that impact on clinical practice. Like Jason said, we had a number of clinicians who were in those meetings and just being a part of the discussions and what you hear from them is, really it starts to change the way they just even think about practicing what they ask. And so, some of those are kind of intangible and they’re difficult to measure the impact, but even those interactions really influenced how our system thinks about what we’re doing.

Tracy Davis: Right. How would you describe the focus areas for Brooks research and what are some of the examples of the projects that you guys have been working on from long ago to now currently, maybe something coming up?

Raine Osborne: I mean, I think the two big buckets that we would look at is our core programmatic research. That’s the research that’s being done by our Brooks investigators that are part of the collaboration, myself, others that are truly part of the Brook system. Then we have what we would consider our aligned partnership in the research. That’s where we work with other researchers that share interests. And they have research that either maybe the ideas are generated from Brooks or maybe the ideas are generated from the researcher, but ultimately there’s an alignment and true partnership like that intellectual contribution that Jason referred to earlier. So those would be really our two main buckets of research.

Then within those core programs, currently, we kind of have three core programs. One is the musculoskeletal program, which Jason leads. The other is the neuromuscular program, which is led by another of the collaboration investigators, Dr. Emily Fox. Then the learning and development which is the program I kind of oversee. We can talk a little bit more about some of those studies. I’ll just mention some of the neuromuscular right now since Dr. Fox isn’t here, but then I’ll let Jason talk about his studies.

I think one of the more recent, but interesting studies that’s going on, we’re working with Cyberdyne, which is a organization that has developed, I’m going to call it an exoskeleton just so you can have a picture in your head, but it’s really much more than just an exoskeleton system.

Tracy Davis: We’ve had them on the podcast, they talked about it before.

Raine Osborne: Oh, great. Okay.

Tracy Davis: They kind of talk about the whole origin story of how we got the … and all that kind of thing.

Raine Osborne: Oh, Oh, good. Okay. So you’ve heard that?

Tracy Davis: Yeah.

Raine Osborne: So, yes, we’ve had some of that research.

Tracy Davis: We didn’t talk about the research too specifically, but we just had them on to kind of talk about what it is and what they do.

Raine Osborne: Perfect. Yeah, that’s interesting. That’s certainly something cutting edge that is really unique to our research program here. They’re also doing some work on backwards walking, which is something that’s relatively novel in rehabilitation and looking at studies on how does training backwards walking reduce fall risk and things like that after a stroke? That’s something that’s relatively new and has the potential to really take therapists down maybe a different avenue of rehab than they’ve thought about before.

Some of the other stuff that’s going on is, Dr. Fox has a large grant from the Department of Defense that’s related to hypoxia training, which is a short burst of low oxygen training. The idea is that, it’s kind of similar to people go and ride bikes in the mountains or things like that, in low oxygen environments. Well, there’s some basic science research that has shown that that’s really helpful in priming the system for making changes and recovery after things like a stroke or spinal cord injury, those types of conditions. Our group is working hard at now translating some of that basic science into clinical practice with actual patients and seeing in the research environment, in the laboratory environment, does this actually make a difference in the recovery with patients? So that’s really exciting.

Tracy Davis: Yeah.

Raine Osborne: We also have some work going on around what happens after care? So we have a stroke wellness program here at Brooks and looking at intensity training and how do we really effectively continue patients after they’ve received their formal therapies. Now they’re in more of a community wellness type program. What type of exercises and intensity of exercises do they need to be doing in order to really get the optimal benefits out of those things?

Tracy Davis: Even after their therapy?

Raine Osborne: Yeah.

Tracy Davis: So this is kind of on their own or they go to the gym or whatever, like stuff they need to just continue to do to keep the recovery.

Raine Osborne: That’s right. That’s right. So those are some of the projects. There’s a number of others. I mean, that’s really highlighting kind of the tip of the iceberg with those projects, but that’s some of the ones that are going on in the neuromuscular. Jason, I don’t know if you want to talk a little bit about the musculoskeletal?

Jason Beneciuk: Before we moved to the musculoskeletal, I just wanted to make sure we acknowledge Dr. Dorian Rose as well. She’s part of the most neuromuscular team. I think one of the examples I like to use in terms of the impact of the collaboration and how it’s really impacted on what we’re doing here at Brooks is, I kind of think about Lou Demark. When Lou Demark was going through his residency program here at Brooks, he had a case report of a patient and he used backwards walking, right? He didn’t develop the technique, but he published a case report on it. He then eventually collaborated with Dr. Dorian Rose, who’s one of the collaboration investigators and kind of related to one of the studies Raine was talking about before they actually went on and received some small initial funding. Now we’re in, I think they kind of, we’re at the next level where they got some more funding. So a lot of this started off with lose single patient case report during the residency program.

So that’s where I’d like to use as an example in terms of how we actually truly do collaborate with our clinicians here.

Tracy Davis: I remember walking down the hallway one time and Lou was having someone walk backwards and I was like, that’s interesting. I have never seen that before, and then I found out what he was doing.

Jason Beneciuk: Yeah. So in terms of what we’re really focusing on in the musculoskeletal arm and the musculoskeletal investigators really consists of myself, Dr. Joel Bialosky and Dr. Meryl Alappattu. We’re doing several different studies, I will really just focus on a couple of them. One of the studies that I think could potentially have a significant impact on clinical practice, if I kind of think about similar studies that we’ve done in the past is, the StarT Back screening tool when it was developed from the folks, Jonathan Hill and the folks at Keele University, and the impact that using the StarT Back tool has on patients with low back pain. We have an ongoing study now that’s funded by the Foundation of Physical Therapy Research, and we’re collaborating with the University of Southern California. We’re looking at a new tool that the folks from Keele to be used for a wider spectrum of musculoskeletal pain.

That’s always one of the big questions from clinicians is, can I use the StarT Back tool for my patients with neck pain or shoulder pain? The true answer is no, because that’s not how it was developed and we haven’t tested it. We’re testing that new tool now through Brooks with our orthopedic resonance and then with the University of Southern California’s orthopedic residents. So hopefully that can be another opportunity to really have a significant impact on clinical practice.

The other one that we can touch on that I kind of mentioned earlier was our study that involved the multiple stakeholders, where the patients played a vital role in really kind of, coming to the final product and identifying areas that we should maybe think about focusing on with future musculoskeletal related studies. That was something that I think we will be able to use for future grants and developing future research questions.

Then I guess the final study that we really just recently completed was an implementation study, where we implemented clinical practice guidelines for the neck and low back with physical therapists. That study was funded by the Center on Health Services Training, and Research or CoHSTR. We also had a clinician, Brian Hagist play a vital role in that in terms of training the clinicians, Raine was also involved with that study, Implementation science, implementation studies are a different beast if you will, because what we’re ultimately doing is really trying to change behaviors of clinicians. It’s challenging, but in my weird mind, it’s also very exciting.

So we learned a lot from the clinicians in that study in terms of behaviors and really identified a few more barriers that we maybe not have thought about in the past. So we’re kind of in the process of getting ready to submit that for peer review publication as well.

Tracy Davis: That’s great. I’m just curious, whenever you guys, since these are such amazing studies and things like that, I know some of these are expensive to do, especially over time. How does research go about trying to get grants for things or what’s the interest in whatever the organization is and saying, we will give you money to research this thing. How does that work?

Raine Osborne: Yeah, so there’s a couple of levels of that. One, Brooks has definitely invested a number of dollars and continues to invest dollars every year in what we would consider sort of pilot funding. These big grants, like we’re talking about in these big studies, often in order to be successful, for the researchers to be successful in being awarded those grants, there needs to be some preliminary work that shows that, yes, this can be done and we’re seeing some trends here. We supply some of that funding to support our researchers. Then from there, that’s really one of the important pieces of the partnership is, because of their expertise and knowledge and training in that area, they’re able to then go on and submit for additional funding through more external agencies.

Jason and you’ve had a lot of experience with that, I don’t know if you want to talk about that end of…

Jason Beneciuk: Yeah, I can talk about some of the external mechanisms that we’ve pursued in the past. Before we go there though, I want to really reinforce the point that Raine made about Brooks and the opportunities they provide. A lot of people might not know this, but when I was doing my PhD, my dissertation was funded by Brooks. I’m always grateful to Brooks and Doug Baer and his support that he provided me. Without that work, I probably wouldn’t have the position that I have now. So yeah, definitely very supportive of us. That’s not common with a lot of health systems in terms of how many opportunities they provide in terms of funding, internal funding. Because let’s face it, research requires dollars for a lot of things that some people might not really recognize the need for those dollars. So extremely important, especially for those pilot studies.

When you submit grants for the larger funding, external agencies like NIH or PCORI, you need those pilot studies. You need that pilot data, or you probably won’t be very successful in your grant.

Tracy Davis: Because it’s kind of showing that there’s something here. We need more money in order to see this out further.

Jason Beneciuk: Yeah. Yeah. And even to conduct those pilot studies, even if it is 10 participants. Money’s needed for time, for the staff, for the clinicians and maybe to reimburse the study participants. So definitely needed. But part of our role in the collaboration is really kind of what I like to say, and I’ve been reminded, this is really what I should be after is really going for the bigger prizes. Right? So really submitting those grants that are, let’s face it, they’re difficult to be awarded those there’s really large grants, but we often have multiple times a year to kind of submit those grants. A lot of times, it’s three times a year to submit grants. Possibly resubmit them.

There’s other smaller foundational grants that we have opportunities for too, but one of our challenges, and I think one of the things that all of the investigators really try to do is kind of diversify our portfolios a little bit. So we don’t just isolate ourselves to one specific area. We can kind of branch out. I think that’s the great thing about working with a system like this is, is you have clinicians that have other interests. So, you kind of have multiple research teams. We all share one common goal, but we also have our specific interests. So yeah, it’s been a great experience.

Tracy Davis: How does some of the ideas come about? I mean, I would imagine you have to stay pretty curious about how we’re currently doing things and maybe let’s this, let’s try that. Or maybe a certain patient comes in with something very unique. How does some of the ideas come up, I know you said Lou didn’t come up with the actual technique, but how does that come out? Hey, let’s have the stroke, patients start walking backwards. Is it just kind of like, let’s try this and then maybe it kind of slowly grows from there, or do you guys maybe have meetings on things of, let’s try this study out or? I’m just curious, from the infancy of some of these ideas, how does that start?

Jason Beneciuk: I think some of the work that Dr. Emily Fox is doing now with one of the studies that Raine talked about related to breathing was something that really probably had a lot of the previous work was done with animals. Now we’re trying to kind of translate that to some humans. So, that would be one example. That’s definitely not my area of expertise, so I’m going to kind of stop talking about that now. But the example that I like to kind of share based on the work that we do is, the idea that came from our stakeholder group, right? So shared decision-making is a concept that’s been around for a while, right? Our patients didn’t come up with this, I didn’t come up with this, but it’s really been studied and looked at for higher risk conditions, such as cancer or cardiovascular disease.

It’s not really something that’s common for looking at with musculoskeletal pain, but our patients told us. I at least obviously had an interest in it, but our patients told us that, this is something that we should probably be doing because in their view, not mine, their perceptions about healthcare decisions a lot of times are “ignored” and really not considered. I think that’s an example of how we kind of start someplace and then kind of develop. Like I said, from that we submitted grants and we continued to submit grants to kind of attract other external agencies. That’s always the challenge, attracting them to the idea.

Raine Osborne: I think going back to your example from Lou Demark and the backward walking, to the point being that there are multiple ways that those kind of ideas come in and not every idea that might come from a clinical setting can take the same path that this one has, but I think that’s the point of having those researchers that you can kind of bring the ideas to, and then they can link that idea to say, “Hey, this really is a gap in the literature.” And know the science behind that a little bit better, and then take the ideas and form them into something that can really be a good research.

Then, the only thing I want to point out when we’re talking about funding in research, you obviously spend a lot of time talking about that topic. But I want to make sure that people understand that getting that funding and being successful in obtaining the funding, that’s a really a measure of the quality and importance of the work that you’re doing as a research program. When you look at our collaboration team and the funding that they’ve been able to obtain over the years, as really four now, five investigators, the amount of funding that they’ve been awarded is just phenomenal. It’s not that the dollars makes it phenomenal, it’s that it’s valued by the scientific community and the rehab community to say, “Hey, this work is important and it needs to be supported further.”

Tracy Davis: Sure. I think it’s really awesome what you were saying, Jason, about just that Brooks sees itself as not just a, we do rehab, here we are come to us. We know things, how to help you, but where you actually are wanting to invest in the future of the industry of rehabilitation and helping. The things we do as general practice now, were probably not done maybe 10 years ago or more. The research you guys are doing now, I mean, who knows how it could change the game in a year to 50 years from now? So that’s really cool to think about that we’re pushing the front edge forward. It’s good that Brooks invests in that.

Since we have so many therapists and employees at Brooks, and they’re seeing tens of thousands of patients a year, how do you stay connected with some of our employees? Maybe they have ideas on certain things, because they get maybe a patient in that could be something that could be a part of a research study, how does that work as far as like, just kind of working internally with our own employees?

Raine Osborne: I mean, the short of it is it comes down to relationship building. Jason and Emily and Dorian, and all the investigators, they spend time outside of their individual research studies, working with our residents that our residency programs or being in the clinic and working with our different divisions and forming those relationships. I think that’s really the core of it. Then it’s just creating opportunities for people again, to think differently and to bring ideas to the table. The PCORI example that Jason gave earlier is a great example of that, that sort of stimulated research ideas. Then we also have had brought together groups of therapists with shared interest in outpatient orthopedic therapy to come together and just talk about what are some ideas that might be beneficial to clinical practice and also make useful research questions.

We see those same examples with Meryl Alapatu, and she’s working with our women’s health program and really developing. She’s the newest member of the collaboration, but is also really working hard to develop sort of a line of research that aligns with the clinical practice that we’re doing here and gets out and works with the clinicians that practice in that area and gets to know them.

Tracy Davis: Obviously this year has been different for obvious reasons, but as far as going to conferences and things like that, do you guys normally go to a lot of conferences and kind of get connected with other areas of the country or the world as far as rehabilitation goes? I’m sure you go and speak at places all the time. Let’s say this year it didn’t happen, what normally do you guys do to kind of stay connected to the research rehabilitation community?

Raine Osborne: I mean, getting out the word on the research that’s going on and disseminating that work, that’s really one of the core functions of research. It doesn’t do anyone any good to just do the projects and then move on, you have to share that gained knowledge. So yes, I mean, that’s a core piece of what we do is, go to conferences and present, publish the work that’s done. Hold events here at Brooks, normally we hold those five events a year but like you said, we haven’t been able to this year. But that’s certainly a core function.

I think one of the challenges with COVID has been, obviously not being able to hold some of the events and the live things that we do, but it’s also stimulated us to think a little bit differently about how might we do that dissemination next year. And so, we’re having discussions on how do we create more of a virtual platform where we can reach a broader audience than even just our internal folks here at Brooks or our local community, but how can we really reach out much broader than that nationally and invite others to hear about the work that’s being done here?

Jason Beneciuk: Yeah, I think COVID has kind of opened my eyes up a little bit in terms of how some of this work is being disseminated primarily based on experiences with conferences. But then also a lot of the internal education let’s say, that we would provide as part of the IHO, usually that would be done in person, but now obviously a lot of it’s done remotely. I think having that platform and being able to communicate with folks on a more regular routine basis is something that a lot of times is a challenge, right? Raine talked before about the importance of relationship building with research related projects and kind of developing your team. It’s very important, but it’s also, let’s face it, it’s very time-consuming. But it’s important.

So I think moving forward with the conferences, I think we’re going to probably see a lot more of those remote options in terms of dissemination. I think if you look back 15 years ago and you would go to your typical rehabilitation conference, again, I go to a lot of physical therapy conferences. 15 years ago, you might’ve been lucky if you saw one or two posters from Brooks. You go to those conferences now, and it’s not uncommon to see maybe 10, 15 or 20 posters from Brooks folks. Brooks folks are giving platform presentations, educational sessions and that’s really a short period of time. 10, 15 years ago that wasn’t common, but now it’s kind of the norm. So that’s something that I’m very proud of.

I used to talk with Michael Spiegel about the culture, which is another part of the collaboration, right? One of the metrics, if you will. How do you measure the culture and if we’re going to change it, how are we going to measure that? That was one of the metrics that we talked about was really just our folks here at Brooks and their ability to kind of engage in conferences or other other events like that. So, yup.

Tracy Davis: Yeah. I mean, that’s great. Well as we’re wrapping up here, where do you guys see the future of research and then research at Brooks? Where do you see it going?

Raine Osborne: Yeah, I mean, I think from my perspective, one is continuing to strengthen the collaboration. Where in the, what’s that? Seventh, eighth year of the PHHP collaboration now, it’s been super successful up to this point and I think it’s one of the things that were success begets success and I just expect that to continuing to grow and that we would continue to support that. Then building those additional relationships with other researchers in the community. I think those are two really important things for us as an institution.

Then increasingly finding opportunities to integrate that research into the system kind of like you were talking about earlier and the changing practice. It takes time for that to happen. Just because one study has a positive result, doesn’t mean that all of a sudden, yes, we need to put this into clinical practice across the board. It builds over time. A a lot of the work that’s been done, as that continues to grow, when it’s ready, now’s the time to then start putting it into clinical practice and testing and making sure that yes, we’re seeing the effects. I think that’s a really exciting opportunity for us as these programs continue to grow.

And really building on the relationships like we were just talking about with the clinicians and and looking for more opportunities for those clinicians to be contributors to the research that’s going on. Again, the thinking of practice elevates the quality of practice. It just raises the bar for what we’re doing here. I think as our activity continues to grow, those opportunities will as well. Then like we were just talking about with the dissemination, that finding more ways to really let others know locally, nationally, what’s going on here and how Brooks and the investment that we’re making in research, how that’s progressing and really contributing to the field.

Jason Beneciuk: Yeah, I think obviously one of the most important things from my perspective is being more successful with the external research funding. Because a lot of times, that’s the way us as investigators are often judged critique, if you will, at the end of the year. So, we are successful, but continuing to be successful and even more successful than we are now. The other thing that was kind of related to one of Raine’s comments was I think we need to be innovative and strategic in terms of how we involve the clinicians in future projects. That in itself sometimes is the challenge. How do you do that in terms of time, who pays for the time?

I think there are ways that we can involve our clinical people in the Brooks system to be involved in projects on multiple levels, like I said, we have to be innovative in how we do go about that process. Because I will tell you there’s a lot of clinicians that are interested in participating, we just have to provide them with those opportunities.

Tracy Davis: Well, I think this has been great. Thank you guys for your time. I really appreciate it. I think this is going to help people really understand a whole lot more about not just what you guys do, but what the role of rehabilitation research is and how it benefits our patients, because we keep having more and more patients to see. I know this year has been a little bit different, but we’ve still seen a ton of patients. Like what you guys are doing, it’s going to be interesting to see even years to come, how it’s kind of shaping the world of rehabilitation.

Jason Beneciuk: Yeah. Thanks, Tracy, for giving us this opportunity. Just this in itself is really disseminating the research we do here. I think is an important message that sometimes is hidden. So I think anytime we can kind of talk about what we do, is a good thing. So I think we both kind of thank you for that.

Tracy Davis: Yeah, absolutely. Well, thanks for coming on, appreciate it.