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Journalof the Association of American Medical Colleges
Uncomposed, edited manuscript published online ahead of print.
This published ahead-of-print manuscript is not the final version of this article, but it may be cited and
shared publicly.
Author: Gisondi Michael A. MD; Michael Sarah DO, MS,; Li-Sauerwine Simiao MD, MSCR; Brazil Victoria
MD, MBA; Caretta-Weyer Holly A. MD, MHPE; Issenberg Barry MD; Giordano Jonathan DO, MEd;
Lineberry Matthew PhD; Olson Adriana Segura MD, MAEd; Burkhardt John C. MD, PhD; Chan
Teresa M. MD, MHPE
Title: The Purpose, Design, and Promise of Medical Education Research Labs
DOI: 10.1097/ACM.0000000000004746
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Academic Medicine
DOI: 10.1097/ACM.0000000000004746
The Purpose, Design, and Promise of Medical Education Research Labs
Michael A. Gisondi, MD, Sarah Michael, DO, MS, Simiao Li-Sauerwine, MD, MSCR, Victoria
Brazil, MD, MBA, Holly A. Caretta-Weyer, MD, MHPE, Barry Issenberg, MD, Jonathan
Giordano, DO, MEd, Matthew Lineberry, PhD, Adriana Segura Olson, MD, MAEd, John C.
Burkhardt, MD, PhD, and Teresa M. Chan, MD, MHPE
M.A. Gisondi is associate professor and vice chair for education, Department of Emergency
Medicine, and principal, Precision Education and Assessment Research Lab (PEARL), Stanford
University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0002-6800-
3932.
S. Michael is assistant professor, Department of Emergency Medicine, University of Colorado
Anschutz Medical Campus, Aurora, Colorado; ORCID: https://orcid.org/0000-0003-0077-6282.
S. Li-Sauerwine is assistant professor and assistant program director, Department of Emergency
Medicine, The Ohio State University, Columbus, Ohio, and chief academic officer, Academic
Life in Emergency Medicine Education Research Lab and Incubator; ORCID:
https://orcid.org/0000-0003-3445-6404.
V. Brazil is professor of emergency medicine and director, Translational Simulation
Collaborative, Bond University, Gold Coast, Queensland, Australia; ORCID:
https://orcid.org/0000-0001-9103-2507.
H.A. Caretta-Weyer is assistant professor and associate program director, Department of
Emergency Medicine, and senior scientist, PEARL, Stanford University School of Medicine,
Stanford, California; ORCID: https://orcid.org/0000-0002-9783-5797.
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B. Issenberg is professor of medicine, professor of medical education, the Michael S. Gordon
Chair of Medical Education, University of Miami Miller School of Medicine, and senior
associate dean for research in medical education and director, Gordon Center for Simulation and
Innovation in Medical Education, University of Miami Miller School of Medicine, Miami,
Florida; ORCID https://orcid.org/0000-0002-2524-4736.
J. Giordano is assistant professor, director of undergraduate medical education, codirector of
medical education fellowship, Department of Emergency Medicine, and lead, Texas Innovation
and Educational Research Lab, McGovern Medical School/ at University of Texas, Houston,
Texas.
M. Lineberry is director of simulation research, assessment, and outcomes, Zamierowski
Institute for Experiential Learning, and associate professor of population health, University of
Kansas Medical Center and Health System, Kansas City, Kansas; ORCID:
https://orcid.org/0000-0002-0177-5305.
A. Segura Olson is assistant professor and assistant program director, Section of Emergency
Medicine, Department of Medicine, University of Chicago, Chicago, Illinois; ORCID:
https://orcid.org/0000-0002-2585-0971.
J.C. Burkhardt is assistant professor, Departments of Emergency Medicine and Learning
Health Sciences, University of Michigan Medical School, and principal investigator, Policy
Analysis, Research, and Innovation in Medical Education Collective, University of Michigan,
Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-6273-8762.
T.M. Chan is associate dean for continuing professional development, Faculty of Health
Sciences, associate professor, Divisions of Emergency Medicine and of Education & Innovation,
Department of Medicine, clinician scientist, McMaster Education Research, Innovation, and
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Theory Program, McMaster University, Hamilton, Ontario, Canada, and founder, Technology,
Education and Collaboration in Healthcare Hub; ORCID: https://orcid.org/0000-0001-6104-
462X.
Correspondence should be addressed to Teresa M. Chan, Division of Emergency Medicine,
Department of Medicine, McMaster University, 237 Barton St. E, McMaster Clinics, Room 255,
Hamilton, Ontario, L8L 2X2, Canada; email: teresa.chan@medportal.ca; Twitter: @TChanMD.
Supplemental digital content for this article is available at
http://links.lww.com/ACADMED/B274.
Acknowledgments: The authors would like to thank all their research collaborators for the tireless
hours they work to support each of the authors. The authors thank you for your kindness,
compassion, and friendship.
Funding/Support: T.M. Chan reports an honorarium from McMaster University for her
education research work with the McMaster Education Research, Innovation and Theory
Program and an administrative stipend for her role of associate dean from the McMaster Faculty
of Health Sciences Office of Continuing Professional Development. She has also received
various unrelated research grants, teaching honoraria, and speakership fees from academic
institutions (Baylor University/Texas Children’s Hospital, Catholic University of Korea, Taiwan
Veterans General Hospital, Prince of Songkla University, Harvard Medical School, Northern
Ontario School of Medicine, University of British Columbia, University of Northern British
Columbia, Holland Bloorview Kids Rehabilitation Hospital), non-profit organizations (PSI
Foundation), physician organizations (Association of American Medical Colleges, Canadian
Association of Emergency Physicians, Society for Academic Emergency Medicine, Royal
College of Physicians and Surgeons of Canada, Medical Council of Canada, International
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Association of Medical Sciences Educators, Ontario College of Family Physicians), and
governmental sources (government of Ontario for the Virtual Learning Strategy eCampus
Ontario Program).
Other disclosures: The authors who have contributed descriptions of their research lab or
structures have listed their affiliations with their research entities in their biographies.
Ethical approval: Reported as not applicable.
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Abstract
Medical education researchers are often subject to challenges that include lack of funding,
collaborators, study subjects, and departmental support. The construct of a research lab provides
a framework that can be employed to overcome these challenges and effectively support the
work of medical education researchers; however, labs are relatively uncommon in the medical
education field. Using case examples, the authors describe the organization and mission of
medical education research labs contrasted with those of larger research team configurations,
such as research centers, collaboratives, and networks. They discuss several key elements of
education research labs: the importance of lab identity, the signaling effect of a lab designation,
required infrastructure, and the training mission of a lab. The need for medical education
researchers to be visionary and strategic when designing their labs is emphasized, start-up
considerations and the likelihood of support for medical education labs is considered, and the
degree to which department leaders should support such labs is questioned.
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Medical education researchers and clinician educators steer the future of health care through
scholarship, refinement of educational techniques, and direct teaching.1,2 However, academic
promotion has historically been tied to research productivity alone and not success in educating
learners. Though medical education researchers discover new knowledge and create meaningful
scholarship, it has been our experience that many in academia fail to recognize their work as
research. This bias negatively affects institutional support and the likelihood of promotion for
individuals pursuing medical education research careers.
In reality, education researchers employ distinct, well-established study methods that produce
bodies of work unlike those of bioscientists (e.g., an education researcher might study trainees’
abilities to advocate for vaccine uptake, while a bioscientist might study rates of vaccine
adoption by patients) but that are no less rigorous.3 Unfortunately, education research is
undervalued at schools where basic science and clinical investigators are often better funded,
resourced, and respected.4,5 In reviewing websites and grant outlines, we have found that
disparities in extramural funding, such as National Institutes of Health awards, greatly favor
bioscientists, and education research grants rarely cover indirect costs. In effect, we have found
find that medical education researchers are often left with inconsistent funding mechanisms and
few obvious mentors at their institutions.
Research labs provide a useful framework to support the careers of individual investigators, yet
we believe they are relatively rare in medical education. We define a lab as a distinct research
team within a department or institution that is led by a single or multiple principal investigators
(PIs) who study specific conditions or problems. They are smaller than research centers,
collaboratives, or networks, which often cross departments or schools and are comprised of
many investigators. Labs can be constructed to help a PI conduct their research, lead a robust
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supporting team, and train students. Medical education researchers have not broadly adopted the
lab model, instead arranging themselves in different kinds of collaborative configurations, such
as departments of medical education, health professions scholarship units, or other research
enterprises.6–9 In our opinion, this organizational spectrum results from cultural pressures at
certain institutions and common challenges in the field, such as a lack of funding, collaborators,
study subjects, and departmental support.10 We believe that education research labs can be
deliberately designed within departments by established investigators to overcome these barriers,
catalyze research, enhance training programs, and compete for extramural funding.
In this article, we describe the organization and missions of medical education research labs as
compared to other larger structures, such as research centers, collaboratives, and networks. We
also discuss several key elements of education research labs. Given its relative novelty in
medical education, we highlight the research lab construct for consideration by other education
researchers who may be contemplating starting up labs of their own.
Case Examples
Our author group is comprised of medical education researchers who lead teams that differ in
organization, size, and/or purpose. We were conveniently and informally assembled through
existing professional relationships. To compare the differences among them, we each provided
detailed case examples of our team structures. We described the defining characteristics of our
teams including the organizational structure, primary research emphasis, funding mechanisms,
institutional supports, trainee impacts, and/or barriers to success. A few of us (M.A.G., S.M.,
J.C.B., T.M.C.) then reviewed the descriptions, grouped the teams based on common
characteristics, and created 5 common typologies of research team structures: single PI labs (labs
with a single PI lead), multiple PI labs (labs led by small groups of PIs, who are generally within
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the same department), research centers (large, single-institution entities that cross departments
but aggregate multiple investigators at the institution; these may also be called research
institutes), research collaboratives (large, non-institutional groups of investigators who come
from many institutions and may also come from many departments), and research networks
(loose associations of investigators across many institutions). Our nomenclature is that the term
labs refers to single PI or multiple PI labs, distinct from larger research centers, collaboratives,
and networks. Chart 1 and Figure 1 provide an overview of these medical education research
structures. We describe the different structures below with brief examples and provide complete
case descriptions for each research team structure in Supplemental Digital Appendix 1 (at
http://links.lww.com/ACADMED/B274).
Single PI labs
Similar to traditional basic science labs, these units rely on a single PI who maintains the
infrastructure to conduct research and support trainees. Benefits of a successful single PI model
generally include a clear research agenda and sustained grant funding. Challenges include the
pressure on that individual PI to continue self-funding and a likelihood that the lab would close if
they left the institution. The Burkhardt Policy Analysis, Research, and Innovation in Medical
Education (PRIME) Collective at the University of Michigan is an example of a single PI lab. It
stemmed from a desire to align the PI’s research activities with his overall goals to study policy
analysis, research, and innovation in medical education and to increase his visibility to potential
mentees and collaborators. Its research agenda is “to leverage the power of medical and
professional education for the greater public good.”11
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Multiple PI labs
These labs are led by a small group of PIs with a common research agenda at the same institution
and generally within the same department. They have shared accountability and increased
financial resilience, since each PI within the lab can initiate and hold grants. Challenges include
the potential for group conflict surrounding research initiatives and selecting projects. The
Precision Education and Assessment Research Lab (PEARL) at Stanford University and the
Texas Emergency Medicine Research Center at the University of Texas Health Science Center at
Houston are 2 examples of multiple PI labs.12,13 PEARL is directed by 3 researchers with unique
skills and backgrounds that complement one another and allow for the mentorship of trainees
with diverse interests. Its mission is to “define precision in medical education by studying the
best ways to individualize training for physicians [… to] optimize assessment methods to
promote learning and [to] leverage technology to reimagine health professions education.”12 The
Texas Emergency Medicine Research Center was created by 2 PIs who share a similar passion
for the application of technology to educate learners. Its research goals are to develop,
implement, and measure the impact of innovative medical education tools.13
Research centers
Sometimes called research institutes, these groups are usually institution-wide enterprises that
support multiple investigators across multiple departments who share a common research
agenda. The establishment of a research center is generally a very formal institutional endeavor
with specific organizational requirements. They are usually either donor-funded or centrally
funded to ensure a smooth start-up but require significant support to sustain long-term. Some
have the capacity to grant degrees or have their own internal hierarchy or promotion process. We
offer 3 examples of this research team design. The Gordon Center for Simulation and Innovation
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in Medical Education was established as a University of Miami Center of Excellence to study the
development and evaluation of innovative technologies for learning and assessment.14 The
Gordon Center is self-funded through a combination of federal and non-federal grants and has 4
full-time PIs who dedicate a minimum of 50% of their efforts to research. Next, the McMaster
Education Research, Innovation and Theory (MERIT) Program15 was originally a multiple PI lab
that supported McMaster University in designing problem-based learning curricula.16,17
Recently, MERIT evolved into a research center that also supports apprenticeships in medical
education research.2,18–20 Finally, the CoLab within the Zamierowski Institute for Experiential
Learning at the University of Kansas Medical Center examines individual provider and team
performance.21 The creation of CoLab was initiated by institutional leadership and benefactors
who recognized the need for social and behavioral science expertise.
Research collaboratives
In contrast to formal research centers, collaboratives are informal and more amorphous, arising
more organically between like-minded researchers across departments or schools within a
university, and possibly also between institutions. In contrast with research centers, they are not
formal institutional structures. Collaboratives have multiple PIs and form project-specific teams
but may change their membership with each new venture. This contrasts them from research
networks, which sponsor different projects but within the same member group. Challenges for
collaboratives include reliable funding streams and dependence on technology for
communications. We highlight 4 examples of collaboratives here. First, the Medical Education
Translational Resources: Impact and Quality (METRIQ) Study Collaborative is a partnership of
investigators at multiple institutions who study how educational and translational online
resources can be developed, measured, and evaluated for quality.22 METRIQ has no physical
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home, rather it consists of collaborators that span multiple continents and have completed dozens
of projects together. Second, the Translational Simulation Collaborative (TSC) at Bond
University is a nexus for researchers working to improve health care through simulation.23 The
focus of the research collaborative is translational simulation practice; thus, it aims to explore
health services challenges, test potential improvements, and embed better health care practices
into clinical operations through diverse simulation techniques.24 TSC serves as an umbrella
organization for multiple research partners from different institutions with complex financial
arrangements, intellectual property issues, and potential conflicts of interest.25 Third, the
Academic Life in Emergency Medicine (ALiEM) Education Research Lab and Incubator (ERLI)
is a research collaborative within a non-profit, health professions education organization that
focuses on social media technologies and education researcher mentorship.26 ERLI is not
affiliated with a university and therefore does not qualify for most traditional funding
mechanisms; its funding has been largely philanthropic. Finally, the Technology, Education, and
Collaboration in Healthcare (TEaCH) Hub is an international collaborative coordinated by 6 PIs
interested in technology, education, and digital networks. There is a shared academic and
professionalism code of conduct, as one of the core principles of the hub is to encourage
transparency and sharing, rather than competition, among investigators.
Research networks
In contrast to less formal research collaboratives, research networks tend to be highly structured
and aim to increase the number of study subjects and participating institutions in research
projects. Multicenter clinical trials are often conducted within a research network. Members are
loosely affiliated with one another through participation in these trials and may communicate
infrequently. Funding is complex, and site leads may have little agency within the overall
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network. We profile 2 examples here. The Emergency Medicine Education Research Alliance
(EMERA) was established by a group of Northwestern University emergency medicine
residency graduates with an interest in medical education research.27 Members have a breadth of
formal research training and diverse administrative roles. The mission of EMERA is to conduct
multi-institutional research aimed at developing educational best practices in emergency
medicine. Second, the Canadian Data Research for Evaluation and Analytics in Medicine
(CanDREAM) Team was established 1 year before the Royal College of Physicians and
Surgeons of Canada implemented a nationwide competency-based medical education assessment
framework.28 Three education researchers started CanDREAM to study this implementation and
quickly recruited a wide network of educators from nearly all physician training programs in
Canada. Four investigators lead this large team to develop new tools, develop machine learning
innovations, and validate assessment rubrics.
Key Elements of Labs
In our experience, we have found that the establishment of a lab is a strategic attempt at
overcoming the well-recognized institutional challenges experienced by medical education
researchers. Launching the lab can itself be a hurdle at institutions that have strict requirements
for extramural funding and PI eligibility based on professoriate line, rank, and narrative of
research. We have found that lab success is often predicated on the vision, passion, and political
will of the investigators and rarely results from the nascent efforts of the sponsoring institution.
In our review of the case examples presented above, we identified several key elements for
medical education research labs: the importance of lab identity, the signaling effect of a lab
designation, required infrastructure, and the training mission of a lab. These elements appear to
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differentiate research labs from other team configurations (i.e., research centers, collaboratives,
and networks).
Importance of lab identity
Medical education research labs share a phenotype: the lab is directed by a single PI or small
group of senior researchers and PIs, who have a focused line of research and whose mission is
research rather than teaching. We believe that the last characteristic is a critical difference that
distinguishes research labs from educational centers or teaching collaboratives. For example, a
simulation center that primarily provides clinical training is inherently different from a
simulation research lab that has a scholarly focus to its work.8 A medical education research lab
can also validate the career path of the PI and clarify their research focus. In our experience, the
self-concept of investigator is important to education researchers, as it aligns their intrinsic
motivations and approach to discovery with that of their bioscience colleagues. Identifiers such
as PI, faculty collaborator, and research trainee define relationships and clarify mentor/mentee
roles.29
Signaling effect of a lab designation
Since scientists often have a lab, the creation of a medical education lab can act as a signal to
hospital and decanal leaders that an individual should be seen as a scientist. The brand image of a
lab is further crafted through the experiences of having “consumers” (i.e., those who attend
scientific presentations and department meetings), fundraising, and having lab websites.
Websites are particularly important signals of legitimacy to those external to an institution.
Furthermore, we find that in our experience the lab structure is generally well understood within
the halls of medicine, adding credibility to the work of the researchers who direct or are
members of them. We have seen a powerful signaling difference between the phrases “I study X
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condition” (signaling the work and capacity of an individual researcher) and “My lab studies X
condition” (signaling the work and scalability of a research team). Such signaling may lead to
collaborations or mentoring relationships with others in the institution, who are more likely to
find established labs than a single investigator.
Required infrastructure
Lab activities and personnel require financial support, and the lab model may provide resources
that are not available to individual investigators. Funding for lab personnel and other needs are
sought through combinations of extramural grants, philanthropic gifts, consultancy work, and
institutional support in the forms of direct stipends, seed funding, grants, and faculty salaries.
Sponsoring institutions commonly provide salary support for lab managers and administrative
staff but are less likely to do so for other full-time personnel, such as statisticians or data
scientists. Lab personnel comprise the research team of a PI and help to catalyze a research
program. Office space and equipment needs vary based on the type of research and
organizational approach. Smart design and strategic funding of an education research lab can
directly overcome common barriers, such as inadequate or sporadic extramural funding and
difficulty recruiting study subjects. These initial investments can ensure the success of a PI who
might otherwise struggle without such formal departmental support. Moreover, a robust
infrastructure improves the credibility of programmatic researchers and their ability to compete
for extramural funding.
Training mission of a lab
We believe that there are many advantages for labs with research trainees. The next generation of
education research scholars are developed in such labs, and we have found that established labs
can make it easier for junior scholars to gain access to the mentorship and infrastructure that they
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need to become successful. Though labs are not mandated to teach, many sponsor trainees who
learn to conduct education research from their PIs. These trainees can include students, residents,
fellows, and junior faculty. The positive engagement and influence of PI mentors can enhance
trainee’s training programs. Importantly, the focus for trainees in a medical education lab is
education research methods and scholarship, not simply clinical teaching or learning theory as is
seen with other postgraduate medical education training programs. In some cases, these trainees
have affiliations outside the sponsoring department, which can lead to additional collaborations
that reciprocally enrich the lab. Additionally, learners attract more learners; that is, a track record
of successful research mentorship acts as a recruiting device for other trainees and faculty
collaborators with similar interests.
Start-Up Considerations and Likelihood of Support
We have observed a recent proliferation of investigators developing innovative organizational
approaches to support their medical education research careers. The question arises: Why? Why
are labs or larger research structures necessary for their success? There is certainly a wide array
of education research entities and many ways to calculate return on investment (e.g., grant
monies received, papers published, presentations delivered). The single PI lab is uncommon but
remains a classic unit of analysis, with clear advantages that stem from lab infrastructure and
funding that are often difficult to marshal in the medical education field. However, we observed
in this recent proliferation the use of other constructs of various scales and scopes that bring
value as well.19 For the burgeoning researcher contemplating whether to establish a lab of their
own, the question arises “Which strategy is best?” Should medical education researchers mirror
the single PI lab used by their bioscience colleagues? Or must medical education researchers
identify a better approach for the field? (See Figure 2 for a lab start up guide.) The current
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scarcity of the lab model concerns us, as a single individual conducting research on their own
yields no trainees, no mentoring, and no pipeline for future education scientists. Without these
opportunities, there may be no one able to lead medical education labs in the future because of
insufficient training.
Efforts to best position an education researcher within an organization have implications for the
investigator and their home department. In our experience, researchers who align themselves
with research collaboratives and networks tend to do so because they have exhausted the local
resources necessary to start a single PI lab, they never had such resources to begin with, or they
never thought to ask for them. We view the various labs and larger research structures reviewed
in this paper as measured responses to the realities of local research environments. The paths
chosen for each case example may have been the only one available at that specific time and
place. It is unclear from our case examples whether the various configurations occurred in
response to decisions by department leaders or because the investigators themselves worked
around the decision makers. Another theory is that these arrangements are often made of
convenience rather than necessity. Perhaps low-cost, external collaborations more easily allow
departments to abdicate their responsibilities to support medical education researchers. Why
should they support, how much should they support, in what ways should they support, and to
what end should they support? It is easy for a department to avoid answering these questions if
no one is asking them but instead looking externally for medical education research support. In
our experience, honest answers to these questions represent value judgments about medical
education research, the individual investigator seeking support, or both.
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How many research labs can or should exist in a field with historically scarce resources? There
are very few medical education research grants available in the United States compared with
other disciplines in medicine. Is it even right to advocate for the growth of a research field in
which investigators are unlikely to financially sustain themselves? These questions of valuation
represent an existential crisis for the growing number of well-trained medical education
researchers trying to find their place in academic medicine. Our case examples can provide
roadmaps as to how to establish a research identity but not why or when one should or how long
one might need to establish a research identity. In our experience, those decisions must be
individualized and aligned to one’s current employment situation before any logistical decisions
about lab design can be made. Unsurprisingly, the best conceived plans for an education research
lab are subject to departmental and/or institutional culture. The choice to start a single PI lab will
depend on whether labs in other disciplines are common locally or if the institution has an
appetite for such innovation. Without these conditions (e.g., a well-resourced department and/or
a supportive institutional culture), we feel that the necessary support to start and maintain an
education research lab will be inadequate and that any successes such a lab may achieve may be
meager.
Conclusions
We believe that the successful launch of a medical education research lab is predicated on vision
and strategy. Investigators must be willing to create something that is unlikely to already exist
anywhere in their sponsoring institutions, and they must move beyond the standard processes and
methods they have seen role modeled. New lab directors will likely need to seek out models and
schemas from colleagues outside their institution, something that we hope has been made
somewhat easier by this article. In our experience, successful implementation requires a strategic
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plan for both the launch of the lab and its long-term viability, deliberate use of stakeholder
analyses, and a strong political acumen. Our case examples of medical education research labs
offer lessons for investigators preparing to establish their own labs. Questions remain as to why
and how much department leaders value education research labs and whether this valuation
ultimately dictates the design of a lab and its likelihood of success.
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References
1. Boyer EL, Moser D, Ream TC, Braxton JM. Scholarship Reconsidered: Priorities of the
Professoriate. Princeton, NJ: Princeton University Press; 1990.
2. Kahlke R, Varpio L. Positioning the work of health professions education scholarship units:
How Canadian directors harness institutional logics within institutional orders to convey
unit legitimacy. Acad Med. 2019;94(12):1988-1994.
3. Deiorio NM, Yarris LM, Hauswald M. Education research: Priority designs and common
misperceptions. Acad Emerg Med. 2013;20(11):1190-1193.
4. Hu WCY, Thistlethwaite JE, Weller J, Gallego G, Monteith J, Mccoll GJ. It was
serendipity: A qualitative study of academic careers in medical education. Med Educ.
2015;49(11):1124-1136.
5. Irby DM, O’Sullivan PS. Developing and rewarding teachers as educators and scholars:
Remarkable progress and daunting challenges. Med Educ. 2018;52(1):58-67.
6. Batool S, Raza MA, Khan RA. Roles of medical education department: What are
expectations of the faculty? Pak J Med Sci. 2018;34(4):864-868.
7. Academies Collaborative. Academies Collaborative.
https://www.academiescollaborative.com/. Accessed April 14, 2022.
8. Society of Directors of Research in Medical Education. Society of Directors of Research in
Medical Education (SDRME). http://www.sdrme.org/. Accessed April 14, 2022.
9. Thammasitboon S, Ligon BL, Singhal G, Schutze GE, Turner TL. Creating a medical
education enterprise: Leveling the playing fields of medical education vs. medical science
research within core missions. Med Educ Online. 2017;22(1):1377038.
ACCEPTED
Copyright © by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited
20
10. Schwengel DA, Toy S. Innovation in education research: Creation of an education research
core. Anesth Analg. 2019;129(2):520-525.
11. PRIME Collective. PRIME Collective. https://www.burkhardtprimelab.org/home. Accessed
April 14, 2022.
12. Precision Education and Assessment Research Lab. Precision Education and Assessment
Research Lab. https://pearl.stanford.edu. Accessed April 14, 2022.
13. Texas Emergency Medicine Research Center. Texas Emergency Medicine Research Center.
https://med.uth.edu/temrc/. Accessed April 14, 2022.
14. Gordon Center. Gordon Center. https://gordoncenter.miami.edu/. Accessed April 14, 2022.
15. McMaster Education Research, Innovation and Theory (MERIT) Program. McMaster
Education Research, Innovation and Theory (MERIT) Program.
https://healthsci.mcmaster.ca/merit/home/1. Accessed April 14, 2022.
16. Servant-Miklos VFC, Norman GR, Schmidt HG. A short intellectual history of problem-
based learning. In: Moallem M, Hung W, Dabbagh N, eds. The Wiley Handbook of
Problem-Based Learning. Hoboken, NJ: John Wiley & Sons, Ltd;2019:3-24.
17. Eva KW, Rosenfeld J, Reiter HI, Norman GR. An admissions OSCE: The multiple mini-
interview. Med Educ. 2004;38(3):314-326.
18. Varpio L, Bidlake E, Humphrey-Murto S, Sutherland S, Hamstra SJ. Key considerations for
the success of medical education research and innovation units in Canada: Unit director
perceptions. Adv Health Sci Educ. 2014;19(3):361-377.
19. Varpio L, O’Brien B, J. Durning S, et al. Health professions education scholarship unit
leaders as institutional entrepreneurs. Acad Med. 2017;92(8):1189-1195.
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Copyright © by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited
21
20. Varpio L, O’Brien B, Hu W, et al. Exploring the institutional logics of health professions
education scholarship units. Med Educ. 2017;51(7):755-767.
21. Simulation Research Collaboratory. Simulation Research Collaboratory.
https://www.kumc.edu/ziel/simulation-research-collaboratory.html. Accessed August 18,
2021. [No longer available.]
22. The METRIQ Study. The METRIQ Study. https://metriqstudy.org/. Accessed April 14,
2022.
23. Translational Simulation Collaborative. Translational Simulation Collaborative.
https://bond.edu.au/researchers/research-strengths/faculty-research-centres/translational-
simulation-collaborative. Accessed April 14, 2022.
24. Brazil V. Translational simulation: Not ‘where?’ but ‘why?’ A functional view of in situ
simulation. Adv Simul. 2017;2(1):20.
25. Simulcast. Simulcast. http://simulationpodcast.com/. Accessed April 14, 2022.
26. ALiEM. ERLI: Education Research Lab and Incubator. https://www.aliem.com/erli-
education-research-lab-and-incubator/. Accessed April 14, 2022.
27. EMERA. Emergency Medicine Education Research Alliance. http://emeranetwork.org.
Accessed April 14, 2022.
28. Thoma B, Hall AK, Clark K, et al. Evaluation of a national competency-based assessment
system in emergency medicine: A CanDREAM study. J Grad Med Educ. 2020;12;4;425-
434.
29. Archer J, McManus C, Woolf K, et al. Without proper research funding, how can medical
education be evidence based? BMJ. 2015;350:h3445.
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Figure Legends
Figure 1
Depictions of the organizational configurations of the 5 common typologies of research team
structures in medical education research as identified by the authors. Abbreviation: PI, principal
investigator.
Figure 2
Medical education research lab start-up guide as developed by the authors. The guide is meant to
help those looking to start a lab consider leader(s), vision and mission, organizational structure,
resource and infrastructure needs, and funding mechanisms.
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Figure 1
Single PI labs Multiple PI
labs Research centers
Research collaboratives
Research networks
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Figure 2
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25
Chart 1
Description of the 5 Common Typologies of Research Team Structures in Medical Education Researcha
Description
Single PI labs: Labs
with a single PI, similar
to a traditional basic
science lab
Multiple PI labs: Labs
with a small group of
PIs, all within the same
institution
Research centers:
Institution-wide research
entities that support
investigators across
multiple departments,
usually with significant
research support
infrastructure; may also be
called research institutes
Research collaboratives:
Multiple investigators
from different departments
or with project-specific
teams, often with little
infrastructure
Research networks:
Loose associations of
investigators,
collaborators, and/or
site leads that coalesce
as needed to conduct
multicenter trials
Usual leadership
Single senior investigator
Small group of senior
investigators
Single director
Project-specific, may be
consolidated or diffuse
Small group of senior
investigators
Typical research mission
Well-defined education
research agenda
Education research
agenda with a central
theme
Education research agenda
with a broad central theme
Broad multi-institutional
education research agenda
Project-based multi-
institutional education
research agenda
Infrastructure
Research team at a single
institution
Dedicated research team
or administrative staff at
a single institution
Dedicated administrative
and research staff within a
single institution with
formal organizational
structure and governance
that are explicitly defined
by formal regulations and
rules
Multi-institutional group
employing robust, digital
communication tools
Multi-institutional
group employing
project-specific
communications plans
Collaboration
May include faculty
collaborators on some
projects, oversight by the
May include faculty
collaborators on some
projects, but most
Multiple investigators
across departments
Collaborative members
participate in project-
specific teams
Participation by many
institutions with
individual site directors
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PI
projects include
members of the research
team who are led by the
PI
Research trainee presence
Common
Common
Occasional
Less common; trainees
may be part of project-
specific teams, rather than
having a distinct status as
a trainee
Uncommon
Budget and funding
Primarily grant-
supported with some
administrative support
Multiple grant sources
with some
administrative support
Well-defined budget with
multiple sources of
funding, including
institutional support,
grants, and philanthropy
Determined by the
sponsoring institution if
there is one, otherwise
generally unfunded
Projects are funded by
large grants
Advantages
Signals the status of
the PI as a research
leader to the
institution
Robust infrastructure
may provide
economy of scale to
enhance productivity
Signals the status of
the PI as a research
leader to the
institution
Multiple individuals
can hold grants
May provide
economy of scale to
enhance
productivity
Valued institutional
resource
Robust infrastructure,
often including a large
budget and many
investigators
Streamlines multi-
institutional projects
Variety of investigator
perspectives can
strengthen project
design
Organizational
structure necessary
for large-scale,
multi-institutional
projects
Flexibility to
pursue projects that
may be beyond the
capacity of
unfunded
collaboratives
Challenges
Excessive pressure
on PI to self-fund
and maintain
infrastructure; time
Potential for
conflict among
leaders in defining
research agenda
Large
infrastructure
costs create
significant and
Funding for
infrastructure is
unclear or absent;
distributed
Funding is
complex as it
requires multiple
stakeholders and
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spent on grant
applications may
limit opportunities
for creativity
Single
director/investigato
r (i.e., the PI) is a
linchpin to the lab’s
continuation
and selecting
projects
ongoing pressure
to sustain funding
accountability for
finances
Responsibility falls to
individual researchers
to acquire and
subsequently share
funds with other
members
Requires IT
infrastructure to
maintain community,
productivity, and
communications
sites
Central leadership
with loose
associations of site
investigators who
have little agency
to propose new
projects
Minimal sense of
community
between
collaborators
Case examples
PRIME Collective
PEARL
Texas Emergency
Medicine Research
Center
Gordon Center for
Simulation and
Innovation in Medical
Education
MERIT Program
ZIEL CoLab
METRIQ Study
Collaborative
Translational
Simulation
Collaborative
ALiEM ERLI
TEaCH Hub
EMERA
CanDREAM Team
Abbreviations: PI, principal investigator; IT, information technology; PRIME, Policy Analysis, Research, and Innovation in Medical Education;
PEARL, Precision Education and Assessment Research Lab; MERIT, McMaster Education Research, Innovation and Theory; ZIEL, Zamierowski
Institute for Experiential Learning; METRIQ, Medical Education and Translational Resources: Impact and Quality; ALiEM ERLI, Academic Life
in Emergency Medicine Education Research Lab and Incubator; TEaCH, Technology, Education, and Collaboration in Healthcare; EMERA,
Emergency Medicine Education Research Alliance; CanDREAM, Canadian Data Research for Evaluation and Analytics in Medicine.
aAs identified by the authors.
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