Write Choice: Determining the Strategies for “Determinants & Strategies Assignments”

By Rajesh Gururaghavendran

We were told it was coming. We had to be prepared, we had to be ready. We need to get oriented. We had to get sensitized. We had to get primed. In a course without the final crescendo of the quintessential “final exam”, a lot was riding on it. This was our writing project. We had to choose a topic, collect published articles, convert data into information, information into knowledge and finally transform knowledge into wisdom. Piece of cake!! Or so I thought.

As students, we are always looking for something that is unique, different, groundbreaking, mind-blowing and earth-shattering. There is that urge to explore the horizons of knowledge, to push the boundaries of human understanding. Naive and bordering on the insane.

I thought about non-communicable diseases and had an informal chat with the Teaching Assistant (TA). “Its way too broad, what non-communicable disease will you focus on?” was the feedback. Okay. Cancers?

“Its way too broad, what type of cancers?” was the response. Head and neck cancers?

“Its way too broad, which head and neck cancer?”. “Oral cancer” I replied.

“Its way too broad, what about oral cancers?” “Habits” I retorted.

“Its way too broad, which habit that is known to cause oral cancers?” Wow wow wow “Lets just wait!!”

I was looking for other “newer” risk factors and from the depths of my fading labyrinthine memory cells sprang the word “Vaping”.

So, vaping it was. The TA nodded with optimism. Guarded optimism. “Just confirm with the professor once” was the standard generic instructions. “Sure” was my standard generic response. I emailed my professor and had a brief chat before the start of a class. I got the informal approval and was ready to go!! It did seem to be the “write choice”.

Phase 1: Enthusiastic exploration

The first part of the assignment was to write a brief statement about the current status of the issue at hand. I pieced together some information from various “sources” and tried my best to convince the huge audience (read: TA and Professor) that vaping is (the only) problem that we should all concentrate on. I was instructed to include some relevant numbers in the form of statistics in the introduction, to make my paper more relatable. I could relate well with this suggestion, and I obediently complied. My next agenda was to identify determinants for the problem. I got back to my sources and again managed to outline the factors influencing vaping. My second part of the assignment went through with minor edits and suggestions.

Phase 2: Marooned

The last portion of the assignment consisted of identifying interventions suggested or reported on vaping. I checked with my “sources”, and they were all commentaries, surveys, reports, editorials. The gold standard of all research endeavors of Homo Sapiens: “Randomized Controlled Trials” was conspicuous by its absence. I now remembered the faint smile my professor offered after I decided on vaping as the topic of choice for my D&S assignment. Things were clearly getting out of control.

I renewed my search for all sources on vaping. It was like restarting the laptop when it gets hung. Still no progress. I needed 9 interventions and I had one, which was “arguably an intervention” and not “definitely an intervention”.

This clearly called for TA’s intervention. “Just confirm with the professor once” was the standard response and “Sure” was my standard reply.

I launched a detailed explanation/emotional plea to my professor, which was liberally interspersed with words and expressions clearly indicative of my pain and agony. My Professor just replied “There are always articles”. I could see a sly smile behind the weil of the Professor’s personal protective equipment used to restrict the entry of all harmful substances, including the dreaded coronavirus, that is globally popular as the “mouth mask”.

I cursed the idiot (read: me) who first thought of this topic in the first place.

I was marooned.

Phase 3: Light at the end of the tunnel

I cannot recollect who suggested that I can and I should consult “Peer coach”. I liked both the words. Peer: I needed someone to vent all my agony and frustration; coach: I needed a lot of coaching to get this assignment done. I had to wake up the geek within me to book an appointment with the peer coach. My nerves weren’t very conducive to facing the new technological assignment, but I finally managed to get myself an appointment.

The student lounge was bustling with students and teeming with activity. The sunlight gently beaming through the glass windows on a busy afternoon during the fall in New England brightly illuminated the premises. The fresh aroma of coffee wafting through the glass doors of the student lounge hit my already heightened/tensed senses. “Not now” I told myself as I stomped away from the coffee outlet. The small passage led to a broader waiting room which houses the consultation/conference rooms. I meekly peeped into one and announced my name. The peer coach was ready to coach me.

I briefly explained my present precarious position to the peer coach, who just asked for the document. Whoops!! I had not shared the document.

I then took upon the task of sending my document to my peer coach seated right next to me. My laptop would burst out signals containing the encrypted version of my document to a signal tower located somewhere near our premises, which would then throw them to a satellite located millions of miles above us. The same satellite would then beam them back to the earth to the signal tower, which would duly pass them on to my peer coach’s laptop seated just a couple of feet away. Technology: Check. Social distancing: double check.

A fresh pair of eyes is always welcome, and the peer coach was calm and collected. We just had to collect the relevant literature and sort them out. Simple. And so started the humongous process of sorting out the literature. The peer coach immediately inserted a table for the entire assignment. This was specific for interventions and was not the same as the table included in the earlier parts of the assignment. One by one, we started to fill in the cells of the table. We had to enter, check, delete and then reassess our entries. There were many blanks.

We then resorted to the help of Mr/Ms. Google to fill in the empty spaces in our table. The articles looked all too familiar. We had to wade through them and slowly, but surely, we had filled up most of the cells in our table. There were a few empty cells, but I was feeling a lot more confident. I could now breathe.

We found a case study, which fit wonderfully into the individual level of the SEM model. We found a trial conducted among teens that considered age, gender and background variables. My peer coach suggested to consider if this fits into the individual level. And it did!! The most challenging part of the paper was the interpersonal/relationship determinants. There were 2 papers conducted in school and college campuses, which might consider interpersonal/relationship factors, but I was not very sure. Peer coach was kind enough to sift through this article with me and it was a very nuanced, very subtle consideration. At the end of the deliberations, both of us concurred that it does consider the relevant factors. So, in it went!!

Slowly, but surely, we started to fill-in the details for my paper. My peers and peer coach suggested me to visit the librarian for further help. I now had enough material and content to work with a librarian. My one-hour appointment just flew by. My muddled brain managed to blurt out a “thank you so much”. I boarded the shuttle bus still reeling with the flood of information. I managed to reach home and I just slept. System down!!

At the end of the day:

I ended up choosing a topic with very little prior information for a critical assignment. Naive enthusiasm has to be tempered with practical feasibility. During the last phase of my assignment, I realized that there were not many articles on interventions related to the topic. I was marooned in a no-man’s land.

Science progresses by identifying knowledge gaps and identifying strategies to address these gaps. Having considered this fact, we will find ourselves in situations where we have to work with the resources we have, with the literature that is out there, whatever the numbers of published articles are. More often than not, we will hit a dead end, a cul-de-sac. It is important to keep nudging, keep probing, keep nibbling, keep working and just keep at it!!

Appointment with the peer coach gave me the clarity of thought that was so critical for my assignment. The practical approach adopted by the peer coach went a long way in my successful completion of the assignment. Fresh perspective helps.

“There is always the professor” the TA quipped.

“There are always articles” the professor remarked.

“There are always possibilities” the peer coach suggested.

Invaluable lessons!!

Email Rajesh at: rajeshg@bu.edu