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. Author manuscript; available in PMC: 2014 Sep 1.
Published in final edited form as: J Clin Anesth. 2013 Aug 17;25(6):10.1016/j.jclinane.2013.04.008. doi: 10.1016/j.jclinane.2013.04.008
1. Which aspects of research represent a barrier to you and to what extent?
 a) Regulatory (IRB approval, Fiscal Review, Clinical Trials Office, FDA, independent data safety monitoring)
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · · complete barrier (5)
 b) Specific aims/hypothesis
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · · complete barrier (5)
 c) Study design
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · · complete barrier (5)
 d) Grants
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · · complete barrier (5)
 e) Statistics/data analysis
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · · complete barrier (5)
 f) Study conduction/implementation (consenting procedure, data collection, organization, security)
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · · complete barrier (5)
 g) Manuscript preparation/publication
 no barrier (1) · · · (2) · · · moderate barrier (3) · · · (4) · · ·complete barrier (5)
2. Do you plan to do research during residency?
 Yes or No
2. Resident level (select one)
 PGY1 (CBY) PGY2 (CA1) PGY3 (CA2) PGY4 (CA3)