Medical knowledge is acquired slowly and almost always with difficulty, for, in the process of discovery, one ventures into the unknown with only a vague idea of the destination and precious little insight about how to get there. Generation of ideas and theories, the first phase of research, has throughout medical history begun at the bedside, where the identification of clinical problems and the development of solutions have come from clinical observations made by astute and intellectually curious physicians. More recently, biomedical scientists have initiated studies based on observations that they have made about problems, inconsistencies, and knowledge gaps either from the laboratory or from within the body of medical knowledge.
However, no matter how ideas develop, they must be refined into specific hypotheses and tested experimentally in the laboratory—the second phase. The bulk of the ongoing biomedical research effort is concentrated in this stage of information gathering, documentation, testing,
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