Archives of Medicine and Health Sciences

INVITED EDITORIAL
Year
: 2018  |  Volume : 6  |  Issue : 2  |  Page : 205--207

Medical education research: A “Maturing” component of scholarly practice


Douglas L Wooster 
 Professor of Surgery, Division of Vascular Surgery, University Health Network, Toronto West Vascular Lab, University of Toronto, Toronto, Canada

Correspondence Address:
Dr. Douglas L Wooster
Professor of Surgery, Division of Vascular Surgery, University Health Network, Toronto West Vascular Lab, University of Toronto, Toronto
Canada




How to cite this article:
Wooster DL. Medical education research: A “Maturing” component of scholarly practice.Arch Med Health Sci 2018;6:205-207


How to cite this URL:
Wooster DL. Medical education research: A “Maturing” component of scholarly practice. Arch Med Health Sci [serial online] 2018 [cited 2019 Jul 18 ];6:205-207
Available from: http://www.amhsjournal.org/text.asp?2018/6/2/205/248659


Full Text



 Introduction



Medical education research is a component of a scholarly approach to teaching, education, and the future directions of all aspects of learning and care. We are given the benefit of large amounts of data and information; we need to be contributing to converting this to knowledge and practice. Whereas data represent “raw material” and information can be collated by setting the data in an environment, it is the analysis and ascertaining the relevance of that information that leads to knowledge. Implementing this knowledge in practice and recycling it back through the study, data collection, information formulation, and knowledge development lead to future development and refinement in the educational milieu. The development of “best evidence in medical education-BEME”[1] and its application in What I will refer to as evidence-informed practice (“EIP”) in education suggests that research has refined our pursuit, but there is much still to do. Medical education research based on theoretical constructs, done with accepted methods and presented with rigor is essential to future direction. Medical education research may not be fully mature, but it is certainly maturing.

 Why, Who, What, How, When



Why do we do medical education research?

As professionals engaged in teaching, learning, developing, and expanding understanding, we find questions in daily practice. We recognize gaps or needs or simply want to know more about our work. The enquiring mind demands more depth to deal with what we do. This is a component of EIP and is “part of the job”. Many people, of course, need to satisfy job requirements or promotion strategies that require a research commitment and productivity. Some programs have a “built-in” research component, and as program director or faculty, individuals are assigned to work on that facet of the enterprise. As a professional obligation and societal expectation, a scholarly approach to teaching, learning and education in general is a component of all our work.[2]

Who should be doing medical education research?

All of us should be contributing to medical education research. We should be engaging a broad base of collaboration, support, mentoring, scope of enquiry, and range of impact. Although a study may appear to be “silo-based” and focused, the broader application should always be a goal. Although individuals in leadership positions may have more access to ideas, faculty, or financial support, they should not be the sole focus; similarly, such research is not the domain of the “educational scholars” who hold advanced degrees in medical education or social science. Anyone with the idea that can form a research question is in a position to initiate and conduct a research project. Some junior staff or clinical specialists or basic science researchers may not consider medical education research to be in their job description. They should, however, be resources for research or be engaged in some way, just as educators are engaged in knowledge translation or implementation of basic science or clinical outcome research in the larger medical spheres. Equally, other health professionals, administrators, and health policy specialists have a role in medical, or health, education research. Funding agencies may also have a role, but funding should not be the determinant of scholarly inquiry.

What is the activity of medical education research? What is the content?

Any idea that attracts attention or needs to be addressed can lead to an important project. Although broad, theory-based research will likely lead to further research and more general reach, even in-the-moment or focused issue research can lead to a stimulus for more in-depth study or formulation of strategies or theories that can be broadly applied. Although some scholars may ask for solely broad-based studies or research based on theory only,[3] any form of enquiry can contribute to our understanding and should be encouraged. The content areas can be defined by relationship to the teacher, the learner, the environment, society, applications of technology, health policy, curriculum, program evaluation, trainee assessment, and so on. The CanMEDS Scholar role identifies points of scholarly endeavor.[2] The Association of American Medical Colleges has identified 29 points of potential enquiry.[4] AMEE best evidence medical education guides have identified at least nine major domains, each with numerous sub-sections.[1] Others have shown the commonalities of learning, professional development, knowledge translation, and quality improvement.[5] The content can come from basic “nuts and bolts” of daily education practice, theories of pedagogy or sociological structures, learning, or anthropology. Topical issues may expand the potential content for study.[6] These may include stress management and burnout, social expectations and contracts or engagement of learners, administrators, patients or other health professionals, and so on.

 Where Do I Get Ideas for an Education Research Project? How Do I Develop an Idea?



An idea for a project may arise from daily educational practice, teaching, or reading. Whatever the source, the key next step is to identify any background information regarding the topic. A literature search, which is usually done electronically online, can reveal what has been what, what is known, approaches to the topic, theories relevant to it and provide direction for the study. Even if there is considerable literature on the subject, a “twist” or insight based on your local environment or specific aspects of the situation may lead to a meaningful study. Insights from colleagues or other health professionals can provide input. Frameworks, such as the population, intervention, conditions, outcomes, and timing, are available to help convert an idea into a researchable question.[7] Systematic application of such frameworks can structure a study and make it easier to execute. The “research question” should be specific enough to serve as a basis for the investigation. The idea and research question may lead to other approaches which can be incorporated or serve as grounds for future work. These considerations should lead to the development of a research proposal that includes theory, research methods and a sense of the direction of the analysis of the findings.[3] Finding a champion and a mentor may help to maintain the momentum of the work going forward. Regardless, it is essential to engage in a subject that is important to you and will serve to be a focus and an encouragement to continue with the research.

 How Do We Apply Appropriate Research Methods to the Research?



In general, medical education research may follow the usual tenets of “scientific” research including case reports, case series, observational studies, case–control, cohort, controlled trials, and randomized controlled trials. These are usually quantitative and test an hypothesis with numeric data and analysis. The conclusions are usually stated as “how many”. In education research, tenets of social science are often applied. These are qualitative studies that seek to answer the questions “what, how or why”. Mixed methods studies may incorporate elements of both approaches.

If possible, a theoretical foundation for the study should be identified and should guide the process.[3],[5] A variety of learning theories have been promulgated. These include behavorialist, cognitivist, humanist, social learning and constructivist approaches.[7] Each can be assessed to identify its implications to the study. Different approaches may focus on the learner, the environment, behaviors, impact, critical thinking, concept maps, technology, evaluation, self-awareness, social impact, future learning and so on. Conceptual models can be used to model, predict, justify or implement education research. This has been characterized as ‘the research compass’.[3]

The choice of approach will feedback on refining the research question and guide the study and its analysis. Strategies such as the cohort approach may be helpful in further defining this. Once the data or qualitative information has been gathered, analysis of its meaning and how it fits with the theory and the practice environment is needed to develop cogent conclusions supported by the study. Additional research ideas may be suggested by the study as well.

 How Do I Present or Publish the Material?



Ideally, being able to give a poster or oral presentation at an appropriate meeting is the goal. As a preliminary step to help define the analysis and conclusions, local presentation to collaborators or other colleagues interested in the research is a good strategy. This may be an informal meeting or a more formal presentation and discussion. It is essential to be ready to respond to questions and incorporate suggestions into future presentations. Once the material has been vetted in this way, a carefully written abstract and submission for presentation is needed. The abstract must follow the exact requirements; incomplete proposals or submissions that do not follow the rules will not be considered. During the work, attention should be given to preparing a paper for publication. Choice of an appropriate journal can be a challenge; regardless, the paper must be clear and defensible and follow the outline required by the journal.

For material to be published, consideration of research ethics board approval is required. Local requirements will dictate which studies require approval and at what level. This must be done before starting the study.

 What Challenges Await Medical Education Research?



Ideally, medical education research should be the domain of all of us who consider a scholarly approach to medical education. It is a component of EIP. Although high-level work may require multiple centres' input, detailed statistical and theoretic bases and potential cost challenges, we can prepare meaningful contributions by addressing important issues and evolving problems at any and all levels. This scholarly mandate should be our mandate.

References

1AMEE. Best Evidence in Medical Education (BEME) 2018. Available from: https://www.bemecollaboration.org/. [Last accessed on 2018 Dec 24].
2Sherbino J. CanMEDS Framework 2015. Available from: http://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e. [Last accessed on 2018 Dec 24].
3Ringsted Charlotte, Hodges Brain, Scherbier Albert. ‘The research compass’: An Introduction to research in medical education: AMEE Guide No. 56. Medical Teacher 2011;33:695-709.
4Association of American Medical Colleges. About Medical Research 2018. Available from: https://www.aamc.org/initiatives/research/about/.[Last accessed on 2018 Dec 24].
5Riva John J. Keshena MP Malik, Burnie Stephen J, Endicott Andrea R, Busse Jason W. What is your research question? An introduction to the PICOT format for clinicians. J Can Chiropr Assoc 2012;56:167-71.
6Maniate JM. Trends and opportunities in medical education: Aligning societal needs and expectations. Arch Med Health Sci 2017;5:154-6.
7Daley Barbara J, Durning Steven J, Torre Dairo M. Using Concept maps to create meaningful learning in medical education. MedEdPublish 2016. Doi: doi.org/10.15694/mep.2016.000019.