Getting Published in Medical Education: Overcoming Barriers to Scholarly Production

Getting Your First Publication in Medical Education-Why? What? Where? How?

The process of getting one's work published is a major milestone for many in their early academic and clinical careers. However, this process can be confusing and overwhelming for many who have yet to publish themselves. There are differing motivators for publishing work in our early career stages, alongside considerations, such as what we publish, where we decide to submit work, and how we logistically undertake the submission process. This commentary provides a holistic overview for the early career medical educator, empowering them to take the bold steps toward "getting published."

The Impact of Women's Agency on Accessing and Using Maternal Healthcare Services: A Systematic Review and Meta-Analysis

Agency, defined as the ability to identify one's goals and act upon them, has been recognized as a prominent strategy to access maternal healthcare services (MHS). The purpose of this study was to synthesize evidence of the association between women's agency and MHS utilization. A systematic review was performed on five academic databases, comprising Scopus, PubMed, Web of Science, Embase, and ProQuest. Meta-analysis was performed with a random-effects method using the STATA™ Version 17 software. A total of 82 studies were selected following the PRISMA guidelines. The meta-analysis demonstrated that an increase in women's agency was associated with a 34% increase in the odds of receiving skilled antenatal care (ANC) (OR = 1.34, 95% CI = 1.18-1.52); 7% increase in the odds of initiating the first ANC visit during the first trimester of pregnancy (OR = 1.07, 95% CI = 1.01-1.12); 20% increase in the odds of receiving at least one ANC visit (OR = 1.20, 95% CI = 1.04-1.4); 16% increase in the odds of receiving more than four ANC visits during pregnancy (OR = 1.16, 95% CI = 1.12-1.21); 17% increase in the odds of receiving more than eight ANC visits (OR = 1.17, 95% CI = 1.04-1.32); 13% increase in the odds of facility-based delivery (OR = 1.13, 95% CI = 1.09-1.17); 16% increase in the odds of using skilled birth attendants (OR = 1.16, 95% CI = 1.13-1.19); and 13% increase in the odds of receiving postnatal care (OR = 1.13, 95% CI = 1.08-1.19) compared to low level of agency. Any efforts to improve MHS utilization and reduce maternal morbidity and mortality should include the promotion of women's agency.

Leveraging existing education innovations to establish a community of practice to promote medical education scholar development

PROBLEM

While some academic health centers have organizational structures to support educational scholarship, such as Medical Education Research Units (MERU), many education scholars may lack access to such institutional resources to support their research agenda and professional growth.

APPROACH

In 2014, as part of an externally funded education grant, three faculty educators established a unique education data management system Research & Evaluation Data for Educational Improvement (REDEI). Lacking an institutional MERU, they established an educational research community of practice (CoP) using REDEI as the research dataset. The senior faculty member's effort to facilitate the group is funded by the Dean's Office.

OUTCOMES

The CoP meets every 2 weeks to generate research ideas, discuss analytic approach and strategy, review analyses designed to address or explore a research question, and plans for manuscript development. Our CoP has grown from 3 to 18 members representing faculty educators, administrators, and staff across many departments in the School of Medicine. As of 2021, the REDEI system contains performance data on 1,246 students across all years of undergraduate medical education. To date, we have published 11 peer-reviewed educational research manuscripts. Five learners have served as coauthors (three medical students and two residents), three of whom were first authors. Eleven additional papers are in process. This community of practice supports productivity, provides mentorship, overcomes barriers, and is flexible enough for people to join when they can or when an area of interest is actively under development.

NEXT STEPS

We are working on educational interdisciplinary research grant submission and creating collaborations with other institutions. Our focus remains on honing skills in grantsmanship, identification of impactful research questions, application of rigorous methods and instrumentation to address them, and refining process of budget development, timelines, and other planning strategies.

Elevating Radiology Education Research Through a Dedicated Research Fellowship: Adding Professional Identity as Essential for Success

RATIONALE AND OBJECTIVES

Education research has been undervalued in radiology, with few radiology journals having dedicated space for such research and barriers to production including dedicated time, resources, grant funding, and mentorship. As radiologists, we have an opportunity to study education in our unique learning environments and create more effective ways to teach that are grounded in established education theory, solid assessment methodologies, and a focus on merit as well as worth.

MATERIALS AND METHODS

The growth of education research in our field requires a two-pronged approach; We must cultivate leaders in education research from within our specialty, and continue to submit high quality work to radiology journals to increase exposure of the reviewers and readership to education methodologies.

RESULTS

We have created the first radiology education research fellowship to this end. This manuscript details the fellowship creation process, the first education research fellow experience, and in-depth analysis of the inaugural year via a qualitative program review.

CONCLUSION

We were successful in supporting an inaugural fellow in attaining the knowledge and skills to become a productive education researcher. Beyond this, the fellowship experience was a catalyst in developing her unique professional identity as an education master which will further raise the status of education research in pediatric radiology.

Writing Collaboratively in Medical Education

Scholarly writing and working in teams are vital skills for medical education faculty. Collaborative writing brings together team members from varying departments, professions, and universities and, as such, optimizes the resources and skill sets needed to develop high-quality projects and manuscripts. Previous literature discusses a broad perspective on collaborative writing, including writing surveys, submitting for institutional review board, and grant writing. We build on this work by providing detailed guidance for planning the writing process and then writing collaboratively towards a successful medical education submission.

Exploring the Attitudes and Perceptions of Master of Medical Education Graduates Towards Research Publication in Saudi Arabia

INTRODUCTION

Evidence is lacking to identify what encourages students to conduct research and publish. This study aimed to understand the barriers and facilitators of research and publications from Master of Medical Education student research projects as 15-20% have published their research while 75-80% did not.

METHODS

This study used qualitative in-depth interviews with 17 graduates from the previous 13 batches of the Master of Medical Education program, Saudi Arabia. In-depth interviews were conducted with participants by face to face and Zoom, using a semi-structured interview guide. The interviews were conducted in English, and the recordings were transcribed verbatim. Next, the interview text was read multiple times to familiarize with the data for thematic analysis, where the text was coded inductively. Themes were generated by identifying patterns in the data and merging similar codes. The data were interpreted within the themes and supported with the most relevant quotations.

RESULTS

We identified four distinct but interrelated themes and the first theme, the importance and advantages of conducting research and its publication, explains the participants need to conduct research and publish it to survive and progress in the academic environment. In the second theme, positive experiences of conducting research and its publication, we identify what participants' positive experiences of the research process entail. In the third theme, challenges to conducting research and its publication, we explore the participants' opinions on the barriers to their efforts to undertake and publish their research. In the last theme, facilitators for conducting research and its publication, we summarize various facilitating factors that participants described as necessary to complete the research process successfully to peer-reviewed publication.

CONCLUSION

Masters' student researchers, especially those with demanding projects, need to be supported by providing them with critical supervision, an enabling environment, technical support, and guidance at each step of the research process.

Dissemination of Quality Improvement Project Results After Local Presentation

Among quality improvement (QI) projects submitted for local presentation, the authors sought to understand how often project results were eventually disseminated through national/international presentation or peer-reviewed journal publication. Projects submitted for local presentation from 2016 to 2019 were linked to resulting publications or national/international conference presentations. Submitting authors were surveyed about their intentions, experience, and satisfaction with the process of disseminating their project results. Of 83 projects, 5 were published and another 10 were presented nationally/internationally. External dissemination was more likely with fewer project cycles and cost-focused outcomes. Survey responses indicated that most project leaders wanted to see their results published but held mixed opinions about resources and encouragement available to reach this goal. Few QI projects submitted for local presentation resulted in wider dissemination of project results. Sharing results and lessons learned beyond the local institution requires long-term planning, education, and support beginning early in the QI process.

Collaborative writing for clinical educators: recommendations from a community of scholars

Clinical educators who wish to engage in scholarship in health professions' education (HPE), are ideally poised at the intersection of educational theories and their application to educational practice. However, the burden of clinical practice does not often allow the time and space for scholarly writing. Being part of a collaborative writing team, incorporating members with varying levels of expertise, from different health care professions, and at different stages of their career, can provide valuable opportunities for clinicians to contribute to scholarship. Such collaborations can also bridge the gap between scholarship and educational practice in clinical settings. In this paper, we emphasise the benefits of collaborative writing, describe challenges for clinical educators in starting writing projects, and identify potential solutions. We outline a systematic approach to collaborative writing grounded in literature and our own experiences. Three key concepts underpin the provided recommendations: types and standards for scholarship, leadership and followership and communities of practice. Psychological safety, mentoring and a growth mindset are emphasised as integral to successful team projects. Finally, we argue that collaborative writing groups in clinical education can be powerful communities of practice where the overall contribution to the field can be greater than the sum of its parts.

Will I publish this abstract? Determining the characteristics of medical education oral abstracts linked to publication

BACKGROUND

Prior studies have shown that most conference submissions fail to be published. Understanding factors that facilitate publication may be of benefit to authors. Using data from the Canadian Conference on Medical Education (CCME), our goal was to identify characteristics of conference submissions that predict the likelihood of publication with a specific focus on the utility of peer-review ratings.

METHODS

Study characteristics (scholarship type, methodology, population, sites, institutions) from all oral abstracts from 2011-2015 and peer-review ratings for 2014-2015 were extracted by two raters. Publication data was obtained using online database searches. The impact of variables on publication success was analyzed using logistic regressions.

RESULTS

In total, 953 oral abstracts were reviewed from 2011 to 2015. Overall, the publication rate was 30.5% (291/953). Of 531 abstracts with peer-review ratings, between 2014 and 2015, 162 (31%) were published. Of the nine analyzed variables, those associated with a greater odds of publication were: multiple vs. single institutions (odds ratio (OR) = 1.72), post-graduate research vs. others (OR=1.81) and peer-review ratings (OR=1.60). Factors with decreased odds of publication were curriculum development (OR=0.17) and innovation vs. others (OR=0.22).

CONCLUSION

Similar to other studies, the publication rate of CCME presentations is low. However, peer ratings were predictive of publication success suggesting that ratings could be a useful form of feedback to authors.

Diversity in health professional education scholarship: a document analysis of international author representation in leading journals

OBJECTIVES

The global distribution of health professionals and associated training programmes is wide but prior study has demonstrated reported scholarship of teaching and learning arises from predominantly Western perspectives.

DESIGN

We conducted a document analysis to examine authorship of recent publications to explore current international representation.

DATA SOURCES

The table of contents of seven high-impact English-language health professional education journals between 2008 and 2018 was extracted from Embase.

ELIGIBILITY CRITERIA

The journals were selected according to highest aggregate ranking across specific scientific impact indices and stating health professional education in scope; only original research and review articles from these publications were included for analysis.

DATA EXTRACTION AND SYNTHESIS

The table of contents was extracted and eligible publications screened by independent reviewers who further characterised the geographic affiliations of the publishing research teams and study settings (if applicable).

RESULTS

A total 12 018 titles were screened and 7793 (64.8%) articles included. Most were collaborations (7048, 90.4%) conducted by authors from single geographic regions (5851, 86%). Single-region teams were most often formed from countries in North America (56%), Northern Europe (14%) or Western Europe (10%). Overall lead authorship from Asian, African or South American regions was less than 15%, 5% and 1%, respectively. Geographic representation varied somewhat by journal, but not across time.

CONCLUSIONS

Diversity in health professional education scholarship, as marked by nation of authors' professional affiliations, remains low. Under-representation of published research outside Global North regions limits dissemination of novel ideas resulting in unidirectional flow of experiences and a concentrated worldview of teaching and learning.

Role of graduate courses in promoting educational scholarship of health care professionals

PROBLEM ADDRESSED

Many courses are offered to health care professionals to improve educational scholarship and scholarly teaching. The literature on the effect of such courses on promoting educational scholarship and scholarly teaching is currently suboptimal.

OBJECTIVE OF PROGRAM

To evaluate scholarly productivity of health care professional learners participating in 2 graduate courses in which curricula and assignments facilitated experiential learning.

PROGRAM DESCRIPTION

A retrospective analysis of course assignments and publications of learners from 2007 to 2014 was conducted. Learners' current positions were identified through Google Scholar searches, and publication of course work was identified through PubMed or EMBASE author searches. There were 137 learners, with a male to female ratio of 3:7, consisting of physicians (73%) and other health care professionals (27%). During the 7 years, 50% completed both courses, 42% only the first course, and 8% only the second course. Of the learners whose current positions could be identified, 66% worked at academic centres, 20% at community hospitals or office practices, and 5% were in senior leadership positions. Current positions were unidentifiable through public records for 9% of learners. Sixty-eight percent of learners (93 of 137) published 1050 articles in peer-reviewed journals. Twenty-six percent of learners (35 of 137) published 1 or more articles based on their course assignments, for a total of 49 peer-reviewed articles; 80% of articles were published within 3 years of completing the course.

CONCLUSION

Experiential learning facilitated by curricular design and assignments coupled with mentorship stimulated scholarly publications. Educational courses should design curricula to promote scholarship in learners and evaluate their effect.

Twelve tips for conducting educational design research in medical education

Despite a steady growth in educational innovations and studies investigating the acceptance and effectiveness of these innovations, medical education has not realized sufficient improvement in practice and outcomes from these investments. In light of this lack of impact, there has been a growing call for studies that more effectively bridge the gap between research and practice. This paper introduces Educational Design Research (EDR) as a promising approach to address this challenge. Twelve tips are provided to inspire and guide medical educators to conduct EDR to achieve the dual goals of tackling a significant educational problem in a specific context while at the same time advancing the theoretical knowledge that may be used to improve practice elsewhere.

Publishing ethics in medical education: guidance for authors and reviewers in a changing world

This article was migrated. The article was marked as recommended. Medical education publishing is growing rapidly, with both increasing demand for publication space and increasing space availability. The increasing speed of publication, variable degrees of manuscript checking and increasing accessibility pose some challenges to compliance with ethical guidelines for academic publication. In this paper we review the literature and the websites of journals that publish medical education content and present a contemporary view on issues that should be considered by authors, reviewers, editors and readers of medical education publications. Based on this analysis, we present guidance on how to meet desired ethical standards when writing particular categories of manuscripts. Relying on self-judgement of the ethical status by authors may no longer be acceptable. The need to meet ethical guidelines in publishing must be balanced with the desire for freedom of speech and avoidance of editorial bias. Our intention is to provoke discussion and learning within the medical education community of practice.

Emergency Medicine Education Research Since the 2012 Consensus Conference: How Far Have We Come and What's Next?

In 2012, the Society for Academic Emergency Medicine convened a consensus conference on the state of medical education research with goals of defining and advancing a future research agenda. Since that time, emergency medicine (EM) education research has grown significantly. A task force of EM education experts was assembled and sought to understand the current state of EM education research and future directions. Among the advances are increases in medical education fellowships, advanced degree and certification programs, faculty development programs, publication venues, and funding. These findings are discussed in light of the prior objectives from the 2012 consensus conference, and recommendations for future directions are provided.

Use of the "Step-back" Method for Education Research Consultation at the National Level: A Pilot Study

BACKGROUND

There are a limited number of emergency medicine (EM) physicians with expertise in education research. The Harvard Macy "step-back" method is an emerging model utilized to gather group feedback. Despite its use in multiple educational settings, there are little published data demonstrating effectiveness.

OBJECTIVES

Our objective was to create and evaluate a national faculty development session providing consultation in education research utilizing the step-back method.

METHODS

This was a pilot study. EM experts in education research from across the country served as facilitators for a faculty development session held at the 2018 Council of Emergency Medicine Residency Directors Academic Assembly. Small groups consisting of two or three facilitators and one or two participants were formed and each participant underwent a step-back consultation for their education research study. Participants wrote their study question before and after the session. After the session, facilitators and participants completed an evaluative survey consisting of multiple-choice, Likert-type, and free-response items. Descriptive statistics were reported. Qualitative analysis using a thematic approach was performed on free-response data. Participant study questions were assessed by the PICO (population, intervention, comparison, outcome) and FINER (feasible, interesting, novel, ethical, relevant) criteria. Both scales were evaluated using a two-way random-consistency intraclass correlation. Before and after scores were evaluated with a paired t-test.

RESULTS

Twenty-four facilitators and 13 participants completed the step-back session. Evaluations from 20 facilitators and nine participants were submitted and analyzed. Sixteen of 20 facilitators felt that the step-back method "greatly facilitated" their ability to share their education research expertise. All facilitators and participants recommended that the session be provided at a future academic assembly. Regarding suggestions for improvement, qualitative analysis revealed three major themes: praise for the session, desire for additional time, and a room set up more conducive to small group work. Seven of nine responding participants felt that the session was "very valuable" for improving the strength of their study methods. Qualitative analysis regarding change in study as a result of the step-back session yielded four major themes: refinement of study question, more specific outcomes and measurements, improvement in study design, and greater understanding of study limitations. Both FINER and PICO scale comparisons showed improvement pre- and postintervention (PICO 60% relative increase; FINER 16% relative increase). Neither achieved statistical significance (PICO t(5) = -1.835, p = 0.126; and FINER t(5) = -1.305, p = 0.249).

CONCLUSION

A national-level education research consultation utilizing the step-back method was feasible to implement and highly valued by facilitators and participants. Potential positive outcomes include refinement of study question, more specific outcomes and measurements, improvement in study design, and greater understanding of limitations. These results may inform others who want to utilize this method.

A Guide for Increasing Scholarship for Medical Educators

Disseminating scholarly work as a clinician educator is critical to furthering new knowledge in medical education, creating an evidence base for new practices, and increasing the likelihood of promotion. Knowing how to initiate scholarship and develop habits to support it, however, may not be clear. This perspective is designed to help readers choose and narrow their focus of scholarly interest, garner mentors, find potential project funding, and identify outside support through involvement with national organizations, collaborators, and faculty development programs. By incorporating these suggestions into their daily work, educators can find ways to connect their clinical and educational interests and make their daily work count toward scholarship.

Show Me the Money: Successfully Obtaining Grant Funding in Medical Education

Obtaining grant funding is a fundamental component to achieving a successful research career. A successful grant application needs to meet specific mechanistic expectations of reviewers and funders. This paper provides an overview of the importance of grant funding within medical education, followed by a stepwise discussion of strategies for creating a successful grant application for medical education-based proposals. The last section includes a list of available medical education research grants.

Research Pioneers in Emergency Medicine-Reflections on Their Paths to Success and Advice to Aspiring Researchers: A Qualitative Study

STUDY OBJECTIVE

Research in basic, translational, and clinical emergency medicine has made great strides since the formalization of emergency medicine as a specialty. Our objective is to identify and analyze strategies used by emergency medicine research pioneers to inform further advancement of research in emergency medicine, particularly for aspiring researchers and those in emerging areas, using emergency medicine medical education as one example.

METHODS

This was a prospective, grounded-theory, qualitative study, using a constructivist/interpretivist paradigm. Leading basic science, translational, and clinical emergency medicine researchers who completed residency before 1995 were eligible for structured interviews. Thematic coding followed an iterative process until saturation was reached. A theoretic model was developed and analyzed.

RESULTS

Research pioneers valued advanced methodological training and mentorship. Barriers to funding were lack of recognition of emergency medicine as a specialty, absence of a research history, and lack of training and funding resources. Deliberate interventions to improve emergency medicine research included educational sessions at national meetings, external (to emergency medicine) mentor pairings, targeted funding by emergency medicine organizations, and involvement with funding agencies. Pioneers facilitate research excellence by serving as mentors and allocating funds or protected time to develop researchers. To advance emerging subfields of research in emergency medicine, pioneers recommend advanced methodological training that is specific to the area, deliberate mentorship, and the formation of research consortia to conduct generalizable outcomes-based studies.

CONCLUSION

Research pioneers in emergency medicine cite mentorship, advanced skills obtained through fellowship or graduate degrees, deliberate collaboration with experienced researchers, support from emergency medicine organizations, and forming networks as the cornerstones of success.

Advice for authors from the editors of Perspectives on Medical Education : Getting your research published

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Scholarship in Emergency Medicine: A Primer for Junior Academics Part I: Writing and Publishing

The landscape of scholarly writing, publishing, and university promotion can be complex and challenging. Mentorship may be limited. To be successful it is important to understand the key components of writing and publishing. In this article, we provide expert consensus recommendations on four key challenges faced by junior faculty: writing the paper; selecting contributors and the importance of authorship order; journal selection and indexing; and responding to critiques. After reviewing this paper, the reader should have an enhanced understanding of these challenges and strategies to successfully address them.