Aotearoa NZ Anaesthesia ASM – Feature speaker

Nicholas is a specialist anaesthetist working in Tāmaki Makaurau Auckland. His clinical interests centre around anaesthesia for orthopaedic and gynaecological surgical procedures, including the application of regional anaesthesia to optimise patient outcomes.

Along with his clinical work, Nicholas has an active interest in clinical research which he joins us to discuss ahead of the NZ ASM.

His clinical research endeavours across prospective and retrospective studies have led to more than 35 publications in the peer-reviewed anaesthesia and surgical literature, several local grants to further develop his projects, and collaboration with the ANZCA Clinical Trials Network. This interest in clinical research started while he was in medical school.

“Medical school is a long road, and I was filling my summers with jobs in retail and one year in construction. Then between my 4th and 5th years, I did a research summer studentship in Christchurch with Dr Peter Ganly in molecular haematology. This planted the seed. I really enjoyed being able to intensely research a particular area and try to come up with some conclusions. It also didn’t involve quite as much physical exertion.”

“I had vague aspirations of becoming a surgeon and did some surgical research which led to some of my first publications and presentations.”

“Later on, I became more involved in the data analysis side of research too. While preparing my formal project for submission, I found the statistician I was working with asked a lot of questions but wasn’t doing so much analysis. It felt like we were beating around the bush, and I just wanted a conclusion. So, I learnt how to conduct the statistical tests to reach those conclusions myself.”

“I find the analysis of data fascinating. You can get lost in a data set trying to work out conclusions. To a degree being involved in collecting the data can help with working out how you want to analyse it too.”

“That project led to other projects, some of which have taken multiple years.” Nicholas currently has a few projects on the go, alongside new opportunities in clinical governance while hoping to become an examiner for the ANZCA primary examination.

“During Covid, I was involved in the supervision of a medical student looking at the impact of acute pain on patient outcomes after multiple surgical procedures. This led to an association with a group of medical students and clinicians from across New Zealand and Australia – the TASMAN collaborative. They have conducted a larger project looking at the impact of opioid prescribing after surgery. There have been a few publications in the British Journal of Surgery and Anaesthesia related to the Collaborative’s projects. My involvement in this project was as a part of the scientific advisory committee to provide feedback to the data collection and how the data was later analysed.”

Nicholas has also mentored junior doctors and supported them in their research projects to help bolster their applications to the anaesthesia training programme.

“We need research to advance in medicine; to work out best practice. If something has become popular, we need the research to investigate what, if any, benefits it’s offering our patients. If we don’t foster junior doctors interested in research, then we won’t have anyone in New Zealand doing this work. That would put us behind on the world stage.”

“We also need research completed in New Zealand to determine best practices for our population. We need external validity. We have a unique population both culturally and socioeconomically so research from places like the United States and Europe may not be as applicable to our area of practice. This is a question I’ve attempted to answer in many of my projects.”

“Holding meetings like the NZ ASM allows us to discuss this research and to motivate people to do their own. I think it completes the circle. If we didn’t do this, we would stagnate as a specialty.”

“There are people who become interested in research at some point in their career. Attending these [research] sessions with people who are passionate about it and want to talk about it may provide the impudence they need to take additional steps and complete projects.”

“When you compare it to conferences in the USA or Europe that are attended in the tens of thousands the speaker-to-delegate ratio at the NZ ASM is in the delegates’ favour. You are much more likely to be able to engage with speakers.”

“I’m looking forward to that at the academic roundtable. We have speakers travelling from the UK and USA, alongside those from New Zealand, who will bring a range of perspectives. I’m looking forward to fleshing these out more. I’m interested to hear about their trials and tribulations, the struggles they face conducting research in other climates and how clinical research is viewed as part of contributing to their departments.”

“Please bring your questions to the session!”