�������ϲʿ����ֳ�

Sometimes it takes a long time to figure out what you are really interested in and want to research. For Vanessa Silva, however, this happened as love at first sight.

“When I did my undergrad at Federal University of Sao Paulo in Brazil, my sister was a part of a research group in organ donation and transplantation. Once she said, ‘Hey, you should come and see how great it is.’ I went there and fell in love with this area. I have studied organ donation ever since. It is a long-term relationship for me.”

Statistics show that one organ donor can save up to 8 lives and a tissue donor can benefit up to 75 individuals. However, hundreds of people worldwide die each year waiting for an organ that never comes, and over 1,600 Canadians are added to organ transplant waiting lists annually. “There are never enough donors,” agrees Vanessa. The shortage of most organs needed for lifesaving transplants is chronic. Yet, the success of any organ donation program depends not only on the availability of organs and tissues. This is a complex, multi-component process that evolves through the collaborative effort of organizations and individuals.

As an internationally-trained researcher, Vanessa has always strived to investigate quality improvement initiatives in organ donation programs implemented in different parts of the world. “When I moved to Canada, I had this huge idea of analyzing the organ donation program worldwide based along policies and legislation. Yet, after researching the current quality initiatives worldwide, some questions popped up.”

Why do similar projects often have different results? “There are hospitals in Ontario that have a high number of organ donations and others with a lower number, but they are the similar hospitals with the same resources and support available,” says Vanessa. “They may have the same quantity of Organ and Tissue Donation Coordinators and identical equipment, but different outcomes. I want to understand why that happens. Such complexity intrigues me a lot”.

To address this question, Vanessa will collect, consolidate and analyze a broad range of data as she needs to identify what piece makes that difference at the end. “Is this collaboration? Is this communication? Is this having a policy in place at the hospital? There are many various aspects that might influence the outcomes in organ donation, so I can’t rely on just one research method and will run a multimethod study.”

To start, Vanessa will perform a scoping review study, which is the broad and inclusive review of scientific and non-scientific documents, to analyze the international organ donation programs. “I have to conceptualize the meaning of ‘success’ is in organ donation programs, because we do not have this definition on the scientific literature. There has been research done on quality improvement, but they analyze numbers. For example: This organization has, say, 70% effective donation, with the number of donors divided by the number of the possible donors. We do have this number, but there is no consensus on what a good organ donation program is.”

A second study in her doctoral dissertation will then reunite different methods. Vanessa is going to employ a social network analysis, a multiple case-study and a network comparison: she will look at the relationships and how the strength of the relationships correlates with communication and collaboration. As Vanessa explains, in her field there is a tendency to favor quantitative findings. “All those numbers and statistical indicators are definitely important and solid, but sometimes it is pretty unclear why we have such data and how the relationships in the field can impact those numbers.”

Finding a balance between diverse approaches in such a sensitive area is a hard task. Undeterred, Vanessa recently immersed herself in studying research methodology and how to do social network analysis. “I tried to learn how the flow of communication happens, how to measure the relationships and how to map the network.”

As part of the research process, Vanessa will also collect organizational materials such as meeting minutes, institutional policies and procedures on organ donation, as well as information about email exchanges and communication flows. “To provide just one example, I will count the times that people talk with each other, and this number will say how strong the relationship is.”

Vanessa has been a trainee at the Canadian National Research Transplant Program since 2017. In addition, she has been working closely with the Trillium Gift of Life Network (TGLN) – Ontario’s not-for-profit organ and tissue donation agency – to design the research. Recently Vanessa has obtained the KRESCENT Allied Health Doctoral Fellowship from The Kidney Foundation of Canada to complete her work.

When asked what she loves more – working with people or documents – Vanessa ponders for a second and responds, “I see many fascinating aspects in both, but I personally love being with people. Talking to them, knowing their work and how they do things and solve problems is an exciting experience. Communication is key in my field, I believe.”