Week 1:
A Fledgling and Adventurer

Dimensions Fellow in Orthopedic Research

Children's Hospital Colorado | Aurora, Colorado

June 15, 2019

Children’s Hospital Colorado (CHCO) is located in the Anschutz Medical Campus of the University of Colorado. The Musculoskeletal Research Center (MRC) at CHCO studies medical and surgical interventions for patients with musculoskeletal and neuromuscular disorders, collaborating with the Center for Gait and Movement Analysis and the university hospital. The findings are translated into improved treatments for patients with muscular disorders and largely improve their life quality.

I am interested in this position through Cornell Fellows because I am planning to complete a doctor of physical therapy program and a Ph.D. program in rehabilitation science. I would like to work in inpatient rehab and serve post-surgical patients in the future. While physical therapy and rehabilitation science have been developed for years in some western countries, the importance of rehabilitation and the treatments are underestimated in many Asian countries, such as China. However, the literature suggests that clinical medicine, rehabilitation are very important in the quality of a patient’s life. Many patients who do not have rehabilitation treatment after surgeries have physical dysfunction and are not able to live on their own. I am interested in arousing the awareness and importance of rehabilitation to health care workers and the public in China. I expect that this research experience will provide me with the opportunity to work with clinicians, physical therapists, and other related health practitioners. It is important for me to experience what physical therapists do and what my future job may look like. The opportunity to shadow surgeries and attend relevant lectures will also help me in exploring the different careers pathways in health care and make a difference in China.

The adventure began earlier than I thought.

I arrived in Colorado two weeks before the internship and stayed with my friend Chandra’s family in Broomfield. I was amazed by the magnificence of the mountains when we went to the Rocky Mountain National Park. Colorado has the most number of “fourteeners” (mountains higher than fourteen thousand feet) in the world! That’s why everybody here loves outdoor activities and they are experts in hiking. We also went for a hike at Chautauqua in Boulder. We picked a moderate trail since I am such tyros in hiking compared to Colorado residence. It was a “real hike” having a lot of big rocks without any easy stair. We need to grasp the tree trucks using our upper extremities to keep balance. When I finally made it to the top, I immersed myself in nature and realized that “THIS IS A REAL ADVENTURE!”

Hiking in Chautauqua with my friend Chandra.

However, my biggest adventure this summer is doing orthopedics research at Children’s Hospital Colorado. I moved into the house in Stapleton with Alicia this Sunday, which is a 15-minute drive to my workplace. Alicia is also a Cornell Fellow working at the same site but on a different project.

On the first day, eight of us met some of our research assistants Patrick, Eun Bi, Wade, and Kaley. They led a tour around the hospital and the medical campus. The hospital is comprised of two parts–the main hospital side and the administrative pavilion, linked by a short corridor on each floor. However, just like other orientation tours, I remembered nothing in five minutes. I am overwhelmed by how big the hospital is and don’t feel ashamed at all when I get lost.

Alicia and I at the atrium of the Hospital.

The atmosphere is very flexible that we are free to arrange our schedule as long as we work 40 hours a week. We will have more than 10 lectures and 20 shadowing hours throughout the summer. I will meet with my PI (principal investigator) Dr. Jason Stoneback every Wednesday, have lecture series on Thursday, and interns’ meeting on Friday to discuss the progress we make and any questions we have from the previous week.

The first week was mostly finishing all the training on research compliance and the software including Epic (patients’ database) and Redcap which is a widely used software for designing clinical research databases. Even though we had already finished tons of training on good clinical practice before we came in, there is still a lot to learn and to be quizzed since it is very important to protect the participants and ensure data safety.

This type of sign is everywhere in the hospital. I am so proud to be a part of it!

Unlike other interns, Patrick told me that I will be working with my RAs (research assistant) Anastasiya Trizno and Colin Reisenauer in the university (the adult site), where Dr. Stoneback’s office is located.

I will work on two different projects throughout the summer and focus on Anastasiya’s first. I will be looking at adult patients with tibial shaft fractures treated with intramedullary nails (IM nails), which is a metal rod implanted into the medullary cavity of a bone. While most fractures heal by making new bones without any complications, some fractures do not heal properly which are called “nonunion”. Tibial shafts fractures are complicated because they are covered with very little muscle while bone healing requires blood supply and muscle attachment. In those cases, exchange nailing will be performed to replace the current IM nails with a larger one to better facilitate healing. In this project, we investigate the risk factors that cause nonunion and to see if the nail fit predicts the need for exchange nailing.

I met Dr. Stoneback on Wednesday. He is the Director of Orthopedic Trauma and Fracture Surgery at the University of Colorado Hospital. He is also the physician of the school’s sports team. Dr. Stoneback is a very energetic and interesting person. I am looking forward to working with him this summer!

Another big mission of the week is studying the research protocol and performing the literature review. Thanks to the anatomy and physiology class I took at Cornell with professor Barbara Christie-Pope, the musculoskeletal system is still fresh in my mind. In addition to lectures, histology, and cadaver lab, we were assigned a case each week given the demographics, symptoms and relevant test results. We had to come up with a diagnosis and figure out the mechanisms of the disease by doing a large amount of literature search. At the end of each week, we gave a presentation to the whole class under Barbara’s critiques, which put me into struggles and pressure. However, this experience well prepared for what I am doing since research requires some of the most important skills, trying to answer questions on our own and presenting results to the public. While reading the articles, I followed Cornell’s pre-health advisor, Mark Kendall’s advice on highlighting and writing notes on Adobe Acrobat as well as printed copies. I am very grateful that I have received guidance from these great people at Cornell and developed useful skills that I can carry on.

Me doing the literature review at Children’s Hospital. I will move to the university office next week.

The program also facilitates me in the literature review. My RAs gave me an Excel template to take notes and summarize articles which I found to be very helpful. From the first lecture, we learned how to do a thorough literature search on PubMed. Ben the librarian recommended “PICO” (patients/problems, interventions, comparisons, and outcomes) to summarize the keywords of a project. He also introduced Mesh (Medical Subject Headings) which is used for indexing articles for PubMed database. For example, if we just type in “cancer”, we will miss a lot of articles using other words having the same meaning, such as a “tumor” and “neoplasm”. Mesh allows us to obtain all the relevant articles applying different terms and have more confidence in our search. This life-changing method is going to play an important role in my research as well as my coursework when I get back to Cornell.

I went to the Wednesday food truck during the lunch break. There are many people and I waited for 30 minutes to finally get a bacon cheddar hot dog. It is a great event to get good food, talk to people and take a break from work.

Life is an adventure, and so is research. I am very excited to go on a new adventure and looking forward to diving deeper into my project next week!

Penny (Yin) Peng '21

Penny is a biochemistry and molecular biology major with minors in chemistry and psychology from Guangzhou, China.