Improving Medical Education Research

Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan 48109-0201, USA.
Teaching and Learning in Medicine (Impact Factor: 0.66). 02/2007; 19(4):331-5. DOI: 10.1080/10401330701542370
Source: PubMed
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Available from: Larry D Gruppen, Apr 16, 2014
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    • "However, the quality of educational research has been shown to be directly associated with study funding29, and we acknowledge that prohibitive cost, noted as a limiting factor in at least one study we assessed36, is one factor limiting implementation of rigorous studies. Some solutions to improve study quality include increasing power with multi-institutional studies similar to those utilized in multicenter clinical trials and the development of multi-institutional shared databases50. For curricula that apply to different health professions (such as cross-cultural communication skills), providers/learners could be combined and results analyzed by subgroups. "
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    ABSTRACT: Cultural competency training has been proposed as a way to improve patient outcomes. There is a need for evidence showing that these interventions reduce health disparities. The objective was to conduct a systematic review addressing the effects of cultural competency training on patient-centered outcomes; assess quality of studies and strength of effect; and propose a framework for future research. The authors performed electronic searches in the MEDLINE/PubMed, ERIC, PsycINFO, CINAHL and Web of Science databases for original articles published in English between 1990 and 2010, and a bibliographic hand search. Studies that reported cultural competence educational interventions for health professionals and measured impact on patients and/or health care utilization as primary or secondary outcomes were included. Four authors independently rated studies for quality using validated criteria and assessed the training effect on patient outcomes. Due to study heterogeneity, data were not pooled; instead, qualitative synthesis and analysis were conducted. Seven studies met inclusion criteria. Three involved physicians, two involved mental health professionals and two involved multiple health professionals and students. Two were quasi-randomized, two were cluster randomized, and three were pre/post field studies. Study quality was low to moderate with none of high quality; most studies did not adequately control for potentially confounding variables. Effect size ranged from no effect to moderately beneficial (unable to assess in two studies). Three studies reported positive (beneficial) effects; none demonstrated a negative (harmful) effect. There is limited research showing a positive relationship between cultural competency training and improved patient outcomes, but there remains a paucity of high quality research. Future work should address challenges limiting quality. We propose an algorithm to guide educators in designing and evaluating curricula, to rigorously demonstrate the impact on patient outcomes and health disparities.
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    ABSTRACT: Research in medical education aims at deepening the knowledge and understanding of learning, teaching or education by studying phenomena, interactions, and interventions; by formulating models, theories, and predictions; and by studying what works, why, how, and for whom. This paper seeks to clarify the term research in medical education and presents four broad categories of research approaches: exploratory, interventional, observational, and translational studies. Central to any research approach in medical education is a conceptual, theoretical framework of learning and education.
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    ABSTRACT: Medical education research is often criticized for its methodological flaws. This raises questions about the prospect of evidence-based medical education practice. Critics call for more rigorous research with randomization, greater control, and tight execution. But randomization and control are rarely achieved in applied field settings, the site of most medical education research. Consequently, research in medical education has relied on quasi-experimentation, which by definition is compromised methodologically. So is medical education research doomed to a reputation for flawed research that undermines the promise of evidence-based practice? We think not. We argue in this article that the problem is due to incomplete and uncritical use of quasi-experimentation. This practice ignores a critical step in the quasi-experimental process, a step that follows the design and execution of the research, that is, ruling out threats to validity posed by methodological flaws. Validity threats must be evaluated critically when drawing research conclusions, to establish a credible evidence base for medical education practice.
    No preview · Article · Apr 2008 · Teaching and Learning in Medicine
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