Research
The Medical Student Summer Research Program (MSSRP) provides rising second-year UNMC medical students with the opportunity to deepen their research expertise. This eight-week program encourages students to develop research skills, engage full time, and present their findings. Students develop their research skills by working closely with faculty mentors to create and execute a research project, earning information, analyzing data, and applying solutions to defined problems. They engage in full time work as participants are expected to dedicate themselves fully to their research projects, enduring a comprehensive learning experience. Finally, upon completion, students are encouraged to present their research at the Midwest Student Biomedical Research Forum (MSBRF), further honing their communication skills and contributing to the scientific community.
Research spotlights
Morgan Baker Korthals
Project Title: Validating Published Trial of Labor After Cesarean Prediction Models in a Midwest Cohort
Mentor: Rebecca Rimsza MD, Division of Maternal and Fetal Medicine, Olson Center for Women’s Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
Research Overview: Trial of labor after cesarean (TOLAC) is an option for women with one or two prior cesarean deliveries who wish to avoid risks of repeat surgery. The American Congress of Obstetrics and Gynecology published guidelines stating that patients with less than 60% predicted vaginal birth after cesarean (VBAC) success may experience higher morbidity. The most widely used predication tool is the Grobman nomogram published in 2021. This study sought to compare the Grobman model to an optimized institutional nomogram in a Midwest cohort.
Methods: A retrospective analysis was performed of all eligible patients undergoing TOLAC with a singleton term pregnancy over a five-year period from 2020 to 2025. Eligibility criteria included one or two prior cesarean deliveries and a desire to undergo a TOLAC. The Grobman vmodel was first applied to the cohort and predictive performance was evaluated. Subsequently, a personalized logistic regression model was developed using additional clinical variables with stepwise selection to retain the most significant predictors.
Objectives:
- To compare the predictive accuracy of the Grobman VBAC prediction model in a Midwest cohort.
- To develop a new predictive model that better aligns with the trends observed in the Midwest cohort.
Results: Preliminary results from the cohort of 427 TOLAC attempts show 318 successful VBAC deliveries (74.5%) and 109 repeat cesarean deliveries (25.5%). Early model comparisons suggest that the Grobman model produced an area under the curve (AUC) of 0.709, while the new logistic regression model achieved a value of 0.774. This reflects nearly a 7% improvement in the ability to distinguish VBAC successes from failures. DeLong’s test confirmed that this difference was statistically significant (p = 0.027).
Student Involvement: Morgan was involved in the IRB application and coordinating the READiCore data pull. She used her background in mathematics and computer science to conduct and interpret all data analyses for the study. Throughout the project, she was communicating regularly with her research mentor to discuss process and statistical approach.
Significance: The use of VBAC prediction tools can help guide decision-making for women pursuing TOLAC. Early findings suggest that incorporating additional clinical factors, such as asthma history or epidural use, into prediction models could improve predictive performance in Midwest populations. Future plans include model refinement, manuscript publication, and development of a UNMC-specific online VBAC prediction tool for both physicians and patients.
Joshua Oarhe
Project Title: Context Matters: Overcoming Surgical Safety Concerns of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy through Comparative Analysis
Mentor: Jason Foster MD, FACS, Division of Surgical Oncology, Department of Surgery
Research Overview: Peritoneal metastasis of various abdominal cancers carries a poor prognosis. Cytoreductive surgery (CRS) performed in conjunction with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival but was initially associated with high morbidity and mortality. With better patient selection and training, the risk of this procedure now approaches that of other complex oncologic procedure. This study compares the surgical safety of CRS/HIPEC to CRS alone and other complex operations using the ACS National Surgical Quality Improvement Program’s (NSQIP) variables.
Methods: This study employs a retrospective cohort design, analyzing CRS cases with and without HIPEC performed at UNMC from 2020 – 2025 using case logs, EMRs, and the “Surgical Outcomes for Cytoreductive Surgery” (SOCS) database. Demographics, surgical profile, operative details, preoperative risk factors, and postoperative outcomes were all abstracted. Complications were graded using the Clavien-Dindo system.
Objectives:
- To evaluate the quality data fidelity collected from Jan 2022-2024 and ensure all events have been identified and captured accurately
- To retrospectively collect the historic data between January 2020-December 2021 to expand the database to include all variables for the entire time period.
- To use NSQIP variables which are collected as part of the SOCS database to perform a comparative surgical safety analysis of CRS/HIPEC versus other oncologic procedures.
Results: When comparing CRS/HIPEC to other oncologic procedures, such as esophagectomy, hepatectomy, and pancreatectomy, superficial/deep SSI rates were similar as were 30-day readmission rates. CRS/HIPEC had significantly lower organ/space SSI, RTOR, and 30-day mortality. Overall, this analysis demonstrates that CRS/HIPEC had lower mortality and fewer serious complications than similar risk GI oncologic procedures.
Student Involvement: Joshua was involved with data abstraction and collection, analysis, and interpretation of research findings. He utilized UNMC’s EMR to collect information, such as demographics, pre-operative risk factors, and post-operative outcomes, and perform preliminary data analysis to identify important trends. He also attended multiple cases of CRS with HIPEC to gain a real-world understanding of its diagnostic process, operative technique, and clinical management.
Significance: This research hopes to challenge the misconception of the surgical toxicity of CRS/HIPEC. By revealing similar risk profiles, the team anticipates a change in the perception of the procedure and an improvement in the presentation of surgical safety and support to the level comparable to other oncologic procedures of similar risk profiles. Josh plans to further develop the study to isolate specific perioperative factors that contribute to successful CRS/HIPEC to help standardize management techniques and improve outcomes across other institutions.
Scott Scholars Summer Research Program
The Scott Scholars Research Program builds on the foundation laid by the Medical Student Summer Research Program (MSSRP) by offering even broader and more diverse research opportunities tailored to the ambition student eager to make significant contributions to global medical research. The program features national research mentorship, access to UNMC research cores, certification and badging system, and career pathway exposure. Unlike the MSSRP, which limits mentors within UNMC, Scott Scholars Summer Research Program encourages students to seek out research mentors from any national or global research university, diversifying the educational experience and enhancing the breadth and depth of research opportunities available to our students. Students also have access to UNMC research core facilities which provide hands-on training in state-of-the-art research techniques. Upon completing these research technique courses, students earn badges that certify their proficiency in these advanced technologies. Additionally, the program is designed to build skills and expose students to various career paths within the scientific community.
Research spotlight - Heather Richard
Project Title: Palliative Care Intervention (POISE) in Metastatic Non-small Cell Lung Cancer
Mentor: Dr. Petrillo, Massachusetts General Hospital
Project Overview: This project focused on a clinical trial designed to enhance the quality of life for patients with metastatic non-small cell lung cancer through a targeted palliative care intervention. Heather was tasked with analyzing qualitative data from the trial's early stages, specifically examining patient feedback and outcomes.
Research Activities: Data Analysis: Heather reviewed and analyzed interviews and questionnaires from the stakeholder and pilot phases to identify themes and evaluate the intervention’s effectiveness.
Manuscript Preparation: Heather contributed to a manuscript that outlined the analytical findings, aiming for publication.
Timeline and Location:
Purpose and Importance: Educational Enhancement: Integrated Heather’s interests in oncology and medical humanities, offering insights into palliative care’s role in patient management.
Professional Development: Provided valuable learning experience at prestigious institutions, supplemented by shadowing and seminar participation.
Career Aspiration: Supported Heather’s residency ambitions in Boston, with the ultimate goal of enhancing healthcare in Nebraska.
Ongoing Research Projects: Involvement in genetics, public health, and gastrointestinal research, enriching her research portfolio and medical knowledge.