2014 graduate sees significant opportunity for two-way partnership between clinicians and researchers

The relationship between the MGH Institute and the physical therapy department at Massachusetts General Hospital has always been robust and constructive, with students benefitting from clinical rotations, then often landing jobs at the hospital after earning their degree.  Now, the Institute – the only degree-granting affiliate of Mass General Brigham - and hospital are building on an already successful partnership by increasing their collaboration. And Noam Segal is at the center of it all. 

Segal, clinical specialist in the physical therapy outpatient clinic at Massachusetts General Hospital (MGH), already works with MGH Institute students and mentors its graduates and knows how the clinical education program has thrived. But he also knows the ability to collaborate around research initiatives with MGH Institute faculty has been challenging. 

“This is an opportunity for us to explore what a more vigorous collaboration would look like,” said Segal, a 2014 MSc in Physical Therapy graduate of the Institute. “So far, there's been naturally occurring collaboration, but both the hospital and Institute would like to see a more structured approach.” 

The way Segal sees it, there’s an opportunity to create a research panel for Massachusetts General Hospital clinicians interested in research or in asking clinical questions. On the other side would be the MGH Institute researchers who either have the answers or can conduct research to find them. 

“So, you have a little bit of that academia and clinical mesh up together,” notes Segal. “This type of partnership can create a translational effort to bring evidence-based care to the clinic faster to further elevate our practice, while guiding research and generating new or follow-up clinical questions.”

Segal, and the leadership of his department, had discussions with Physical Therapy Chair, Dr. Keshrie Naidoo, and director of orthopedic clinical residency Dr. Benjamin Adams on this partnership. They are well aware that the time and resources within the clinical environment are the limiting factors in research production rather than the collaborative relationship with Institute faculty. But if a more structured relationship can be developed, Segal says it would be a two-way street for both the hospital and the Institute. Based on the needs, clinicians can pursue any type of novel approach they’ve learned of and want to implement. However, many approaches and interventions still require further study and supporting evidence in the discipline; that’s where the MGH Institute researchers come in. 

“A clinician who works with a patient might identify some type of anecdotally occurring event, something that they keep seeing, and they're wondering, ‘Is this something that I'm just seeing because of my biases? Is this a generalizable phenomenon? Or is this an issue we need to study?’” noted Segal. “They might then wish to bring that idea or insight to an academic environment where they can receive help with the design, and methods part of it, with creating that framework of asking the right question of what we’re trying to identify, or what we’re trying to answer. This is a win-win situation where we can deal with clinical questions in a very methodical, scientific way, with the help of the MGH Institute knowledge.”

Segal was a senior physical therapist at the MGH Chelsea Health Center for 10 years and recently took a new position at MGH main campus as a clinical specialist. Here, he spends half his time treating patients with complex presentations, while the other half is geared toward mentoring clinicians with myriad experience levels. MGH Institute students and recent graduates are in that mentoring mix, a responsibility Segal says is crucial to the mission of Mass General Brigham. 

“We want to make sure that we're able to provide quality care for our patients because this is what they're coming from all over the country and the world to receive,” reminds Segal. “We reach out to students coming into the clinic to understand their program, what kind of language, concepts, and frameworks they're coming in with. We want to speak a similar language and also know some of the gaps that they might be coming in with because you just can't do it at all in a program. So, we need to understand that; we need to make sure that the people coming to work with us find a home here for their knowledge and for their practice.”

Segal says the IHP students typically have a seamless transition in becoming effective clinicians because of their strong basic knowledge, holistic approach to treatment, and awareness of social determinants of health. 

“It's easier as a student to be more focused on things that were learned in the classroom with a kind of ‘This is how it needs to be’ mindset. When they hit the clinic, or are in the field, they might be a little bit overwhelmed with how things are not black and white,” observed Segal “So I think the IHP is exceptionally good at giving students a wider range of practice. It’s not just our specific clinical skills which need to be top notch, we need to make sure that when we treat, we apply our knowledge, and it’s professional and evidence based as well as employing a holistic approach. I think the IHP is successfully integrating that into its syllabus.”

As Segal adjusts to his new role, he looks forward to making an impact through a role as a facilitator between MGH and the Institute. 

“This is how I see it - if I form good relationships with the leadership at the IHP, I can bring them over and start the conversation. Since I recognize I might not possess all the skills a certain project requires, the collaborative work and discussion can cover that gap,” assured Segal. “Seeds grow. Being able to cultivate something and have the MGH physical therapy team develop in that way professionally and have the IHP faculty reaching out and teaching us some new things to improve the quality of care, improve our environment, or improve the knowledge of our discipline, will be a great. This is something that I look forward to, for sure.”

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