RIV spotlights HM-focused research in real-time


– Masih Shinwa, MD, stood beside a half-circle of judges at SHM’s annual Research, Innovations, and Clinical Vignettes poster competition and argued why his entry, already a finalist, should win.

To think, his work, “Please ‘THINK’ Before You Order: A Multidisciplinary Approach to Decreasing Overutilization of Daily Labs,” was borne simply of a group of medical students who incredulously said that they were amazed patients would be woken up in the night for tests.

Masih Shinwa, MD, explains his abstract, “Please ‘THINK’ Before You Order: A Multidisciplinary Approach to Decreasing Overutilization of Daily Labs,” to inquiring passersby during Tuesday evening's RIV poster session.

Dr. Benji Mathews (left) explains his poster on point of care ultrasound to the judges during the Tuesday evening RIV poster session at HM17.

Now it was a poster at RIV, one of the biggest highlights of SHM’s annual meeting. The Scientific Abstracts Competition – the event’s formal name – has exploded in popularity over the past few years. Submissions for posters rose from 634 in 2010 to 1,712 this year, and presenters ranged from first-year residents to a former SHM president.

Dr. Shinwa’s project shows just how an idea can blossom into a recognized poster.

Some 18 months ago, the students he works with at Mount Sinai Hospital in New York just couldn’t understand why so many tests had to be done overnight while a patient slept. So, Dr. Shinwa and his colleagues looked at ways to reduce unnecessary lab tests and chemistry testing.

Now, Dr. Shinwa was humbled to think his work and that of his colleagues could be a pathway to eliminating tests that don’t need to happen across the country, a focal point of SHM and the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign.

“This is a way to make it national,” he said. “You may have affected the lives of the patients in your hospital, but, unless you attend these types of national meetings, it’s hard to get that perspective across (the country).”

That level of personal and professional collaboration is the purpose of the RIV, said Margaret Fang, MD, MPH, FHM, program chair for the HM17 competition.

“One of the amazing things is, everyone has their own poster. They’re doing their work,” she added. “But then they start up conversations with the people next to them. ... Seeing the organic networking and discussion that arise from that is really exciting. RIV serves as a way of connecting people who might not have know the other person was doing that kind of work.”

Dr. Fang said that the intergenerational aspect of the RIV, where early-career hospitalists mingle with the field’s founders and leaders, creates an environment where research is encouraged.

“Just seeing the intense interest that more senior hospitalists have in mentoring and guiding the next generation is delightful,” she added.

Dr. Shinwa said that the specialty’s focus on both clinical research and systems-level change is important, as the work positions the field to be leaders not just in patient care but for hospitals as a whole.

“We are physicians,” he said. “Our role is taking care of patients. Knowing that there are people who are not just focusing on taking care of specific patients but are actually there to improve the entire system and the process – that’s really gratifying.”

That’s the word that Merideth Prevost, MD, of New Mexico VA Health Care System, Albuquerque also used to describe presenting her poster, “Improving Accuracy in Measuring Fluid Balance on a General Medicine Ward.”

“If we can improve our little microcosm, then spread it to other folks, then patients all over the country can be helped by what we do,” she said. “And that’s a really cool thought.”

The RIV also has the unique advantage of letting people have immediate and direct access to lead researchers at the exact moment of reading their research. HM17 attendees had conversations that usually went beyond just the results, which can be downloaded at

Dr. Prevost believes that the chats can helpfully highlight the behind-the-scenes pitfalls and mistakes of research that can sometimes be just as valuable as the published results.

“The things that don’t make it to the posters are all the challenges that people experienced on the way to get to this particular work,” she added. “Like ‘Oh, well, I’ve tried this before, and it didn’t work at all.’ Or, ‘Oh yeah we tried this and it didn’t work at all, but we tried this other thing that worked really great.’ Or, ‘This was the key to our success.’ You can brainstorm with every poster that you’re interested in, which is really exciting.”

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