Kerri LaRovere, MD | Master of Medical Sciences in Clinical Investigation
Kerri LaRovere, MD, loves helping others. As director of the Neurocritical Care Neurology Consult Service at Boston Children’s Hospital, she has dedicated her career to supporting critically ill pediatric patients and their families. She also recently completed Harvard Medical School’s Master of Medical Sciences in Clinical Investigation (MMSCI) degree program with new skills that she hopes will advance the field of pediatric neurology in exciting directions. “I applied to the MMSCI program for the personal challenge and professional growth and also to improve the care of my patients,” she says. “I was able to personalize my learning experience in this program by pursuing the comparative effectiveness pathway within the Clinical Investigation track. This will be particularly helpful for me moving forward,” she adds.
Sparking an Interest in Medicine
LaRovere’s interest in caring for the well-being of others began when she was in elementary school, and she witnessed two of her first cousins having seizures. After one of them was diagnosed with epilepsy, she got a first-hand view of how her daily life was affected. She also wondered how that cousin was feeling and wished she could help make the path easier for other children with such disorders. This desire to help sick children stuck with her over the years, ultimately leading her to medical school.
Then, during LaRovere’s pediatrics residency at The Floating Hospital for Children in Boston about two decades ago, her mother-in-law suffered a catastrophic neurological illness. This event sparked in LaRovere an even deeper interest in severe forms of neurologic illnesses. “This solidified my lifelong desire to learn about and care for individuals with neurological conditions,” she says. “My experiences not only helped me relate to my patients and their families on this service in an even deeper way but also made me realize that there were opportunities to improve the ways we care for children with severe neurologic conditions in the ICU,” she pointed out.
Caring for Critically Ill Pediatric Patients
Today, the goal of supporting children and families continues to drive LaRovere’s efforts. Through the Neurocritical Care Service at Boston Children’s Hospital, she leads a collaborative and cohesive team of 16 neurologists and advanced practice providers, delivering 24/7 consultative services supporting critically ill pediatric patients from infants to young adults. “These patients have severe conditions involving the nervous system and are admitted to neonatal, medical, cardiac, and surgical intensive care units, comprising a total of nearly 250 beds at Boston Children’s Hospital, Brigham and Women’s, and Beth Israel Deaconess,” she says.
Building on the Research
LaRovere is very active in clinical research. In fact, she explains that she is drawn to the clinical research arena because it enables her to bring a richer perspective to her clinical work that can help patients and their families better understand what they are going through and what treatments may work for them. “I am also uniquely situated to apply my patient experiences to the research,” she adds. In this way, everyone benefits.
In particular, she is fascinated by the intersection of neurology, neurosurgery, rehabilitation, and critical care medicine, and in the way that neurocritical care research involves a multidisciplinary collaboration among members of these disciplines; together, this enables them to accomplish more than any one of these specialties could do on its own.
Her many research efforts include collaborating with colleagues in pediatric neurocritical care through the Pediatric Neurocritical Care Research Group. She is particularly proud of the work she has done with this group, such as serving as site PI for multi-center NIH-funded clinical trials involving children with severe traumatic brain injury and those treated with extracorporeal membrane oxygenation. She has also worked with colleagues at Boston Children’s Hospital and the Massachusetts Institute of Technology to use continuous waveform and discrete physiologic data from bedside monitors in the ICU to better understand brain physiology during critical illness. Working alongside colleagues from the Neurocritical Care Society’s Curing Coma Campaign, she continues to focus on understanding long-term neurological outcomes in children with critical illnesses.
Using Clinical Research to Better Understand the Patient Population
Attending the Master of Medical Sciences in Clinical Investigation program has provided LaRovere with a great opportunity to continue building her expertise in these areas while also developing an advanced perspective in clinical investigation. “Some of the lessons I learned through the program that will now guide my work are how to conduct impactful research by formulating a good research question, using the right study design and data source for a particular research question, and being rigorous with data analyses and interpretation,” she stresses.
As part of the coursework, scholars are required to complete two clinical research projects in two years for their oral thesis defense and written dissertation. “My research focus for both of these projects was on the topic of catastrophic brain injury (CBI) in critically ill children. Our body of work defined a population of children with CBI at a single center, characterized their clinical characteristics and outcomes, and identified a potential screening tool using heart rate data available at the bedside for brain death in this population,” she says.
For the first research project, LaRovere and her colleagues analyzed exposures associated with outcomes and described long-term outcomes in a retrospective cohort of pediatric patients with CBI. “We found that death in children after CBI is common within one month of hospitalization. Furthermore, patients who were thought to be moribund on discharge can recover and regain consciousness and functional capacity,” she says. The second study “proposed a novel digital biomarker, which we termed heart rate change (HRC), for detecting brain death (BD) in the same CBI population from the first study,” she adds. “With further validation, HRC may be useful as a readily calculable biomarker to identify patients for formal BD testing.”
Benefits of the Master of Medical Sciences in Clinical Investigation Program
A key component of the program is that scholars are required to meet weekly with a mentor they can choose through the program. For LaRovere, having regular access to her Harvard mentor was so valuable. “This allowed me to apply theoretical concepts, research methodology, and code learned in class to actual clinical research projects in my area of interest, which helped strengthen my research skills,” she says.
Another one of her biggest takeaways from the two-year program was learning in a supportive and nurturing environment. “During this program, the faculty connected me with scholars at other hospitals who have similar research interests to mine, which then led to new research ideas and collaborations that have been ongoing. I also developed close relationships with the students in my class, who were from all over the world and came from diverse backgrounds in research and medicine,” LaRovere says.
“In fact, some of the other students from the program and I recently published one of our class projects, which was a systematic review and meta-analysis. This program helped me create a network of colleagues from all over the world, whom I connect with as needed and continue to learn from over time,” she adds. LaRovere admits that the biggest challenge she faced in completing the program was also working full-time as an Attending in the Department of Neurology at Boston Children’s at the same time. “I had to know when to prioritize being a student and when to prioritize my work responsibilities,” she says. It wasn’t always easy—especially since she was also balancing being a wife and mother of 3 school-age children during a pandemic. “I was also navigating the new technologies and processes that were rapidly introduced for learning in school (for both me and my children) and for seeing patients,” she adds.
However, LaRovere stresses that attending Harvard’s Master of Medical Sciences in Clinical Investigation was well worth the effort it entailed. “The Harvard program leadership, faculty, and students made this program doable, enjoyable, and memorable,” she points out. She advises other clinicians interested in strengthening their research skills and contributions to explore this option. She also stresses the importance of being prepared for the level of commitment the program requires so they can get the most out of the experience and use this experience as a stepping stone to propel their careers forward.
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Written by Lisa Ellis