By Cindy Foster

For Elisabeth Burton, Her First ‘Research Marathon’ Results in International Publication

The idea was always to knock it out of the park.

As a high school student, recent UNM College of Nursing graduate Elisabeth Burton made it to the Intel International Science Fair (ISEF) with her first two high school projects. She knew those wins would help with college applications and she had found the level of sophistication of her competitor's projects "awe-inspiring."

"She decided going into her senior year, that she wanted to move things to the next level," remembers her mother, Laura Burton, PhD, associate director of Business Operations at the UNM Health Sciences Rio Rancho Campus.

"It was never a question of tagging along on someone else's project. She wanted her own original research. I was willing to help - but medical research is written very differently from social research," she says.

Horses had always been part of the backdrop for her family and Elisabeth was working at an equine therapy site in Corrales called Four Point Therapy.

"My brother had just returned from Afghanistan and was processing the experience and it was just a two plus two moment for me. One day I wondered if there was any research specific to veterans on the benefits of equine therapy," Elisabeth says.

She found that not only was there no quantitative research on equine therapy specific to veterans, but the VA was not funding these types of complementary therapies.

So, with a good topic as a starting point, the questions began to change. What would be markers of success in designing such a research project? One of the things Elisabeth looked at was cortisol levels, "but I had no idea where to start in designing a project that used them," she says.

"It seemed like everyone who won big at ISEF had mentors," remembers her mother.The cortisol problem would require finding an expert to help her, so Elisabeth went looking for one.

Turns out, finding a cortisol level researcher close to home was not as difficult as either had feared it might be.

Mark Burge, MD, deputy director of the UNM Clinical & Translational Science Center, had investigated cortisol levels in a study evaluating the effects of a mindfulness practice on Emergency Room nurses.

"I thought, hey I will send him an email. The worst he can say is 'no,' right? So, I contacted him, explained my research, my history and interests and asked, 'Would you be interested in helping me or guiding me to a place that can help me?'"

At any given time, Burge finds he usually is mentoring two to five medical students and several residents.

"She is the only high school student I ever took on," he says. "She was motivated and I told her it would be a lot of work and she said she knew it and was willing to do it," Burge says.

In addition, she took the writing pledge.

"That is the worst - when someone says they will do the work but then they graduate or disappear and things are only half done," he says.

The writing is the hardest part. I always make them promise to finish," he says.

"The goal is always to end up with a project that can be published," Burge continues.

It quickly turned into a much more complex project than anyone had thought it would be.

"It was much harder than any of us had expected. There were these massive obstacles in winning the trust of prospective participants," says Laura.

Combat veterans were at first less than enamored with the idea. The VA did not recognize any benefit to using horses as therapy animals and did not help with enrollment. Elisabeth ended up going to veterans groups herself. Slowly, she found 20 participants.

Rather than several months, the journey turned into a six-year odyssey. Elisabeth actually never had a project ready in time for the senior year competition.

But she was committed to finishing the research.

Like eating an elephant, Burge would cut the next steps into bite-sized chucks. First came the protocol, then receiving approval.

"He would push her at times," Laura said.

It wasn't all work.

"It is really extraordinary what he did for her. He stuck with her, guided her, and truly mentored her for years. He submitted her for a Sigma Chi Award for Science and we all went to the banquet when she won," Laura says.

Burge says he was impressed with her dedication. Elisabeth credits a lot of that to her experience with the vets in the project.

"I kept telling them that when the research was finished it might help others. I didn't want to let them down," she says.

In 2015, Burton presented her work in Carmel, California, at the Western Medical Research Conference.

"She did great," Burge says. "I proofed everything she wrote. She was presenting with a lot of fellows, junior faculty members, and medical students and she completely held her own."

The last hurdle was publication. It was when the two approached the journal that an editor asked that they add a statistician to the team. Once that happened, "Efficacy of Equine-Assisted Psychotherapy in Veterans with Posttraumatic Stress Disorder," appeared in the international journal, Integrative Medicine last winter.

These days, Burge takes delight in queries from medical journal editors seeking his expertise in equine therapy training.

"That interest is a testament to how well-written the article is as well as the scope of her research," he says, as he pulls up an academic journal screen query asking if he would like to edit a special edition of a journal issue on the topic.

"It garnered a lot of attention because there is not much data in the literature. Now I am invited to come and give talks about animal therapy, which is not my thing," he says with a grin.

"The key is to have a good, scientifically sound idea so that once the project is finished, it is publishable. And, that is where they often need help. They have to have a faculty member sponsor them, they can't just do research without that," he adds.

After six years, "I sort of freaked out" when she saw her name in print Elisabeth says.

She graduated with her nursing degree this spring and snagged a well-regarded nursing position in the Trauma ICU at University Hospital and plans on obtaining a PhD.

Burge is not surprised by her plans.

"Having your research project published in a prestigious medical journal can be a chance to write your own ticket for an advanced degree but it seldom happens," Burge says.

"Writing for publication in the midst of getting your degree is a marathon," he continues.

"You have to be truly motivated in order to take on such a project in addition to all your studies and all your exams and all your spring breaks. It has to be topic you are passionate about in order to follow through on it. For someone to spend that kind of time on research while in high school and college the way Elisabeth did is truly remarkable," he says.