phd by publication medical education

Study Postgraduate

Phd by published work (warwick medical school) (2024 entry).

Course code

See course overview

Flexible (depending on the duration of the admissions process)

1 year full-time

Qualification

Warwick Medical School

University of Warwick

Find out more about our PhD by Published Work course.

Our PhD by Published Work is open to individuals who have already undertaken a portfolio of published research to the standard of a PhD. Warwick Medical School is home to outstanding expertise, with guidance from an academic adviser you will complete and present your published work.

Course overview

An academic advisor will provide guidance on the presentation of your published work and the writing of a covering document linking the publications together.

Your submission should include further contextual information regarding the publications, including, but not limited to, the profile of journals that articles have been published in, the number of citations, and their significance to the field.

Course codes

• Medical Sciences: P-A34P
• Health Sciences: P-B91P
• Clinical education: P-B91F
• Medicine: P-A31P
• Interdisciplinary Biomedical Research: P-B92K
• Nursing: P-B718
• Healthcare: P-B717
• Health and Social Studies: P-L4PC

General entry requirements

Minimum requirements.

2:1 undergraduate degree or Merit in Master’s degree.

Please also see our consideration and application process information on the Warwick Medical School website Link opens in a new window .

Further information on entry requirements is also found on the University webpages: PHD by Published work Link opens in a new window

English language requirements

You can find out more about our English language requirements Link opens in a new window . This course requires the following:

• IELTS overall score of 6.5, minimum component scores not below 6.0.
• Overall IELTS (Academic) score of 7.0 and minimum component scores of two at 6.0/6.5 and the rest at 7.0 or above.

(The above depending on the course title).

International qualifications

We welcome applications from students with other internationally recognised qualifications.

For more information, please visit the international entry requirements page Link opens in a new window .

Additional requirements

Two academic references

Our research

Any relevant health-related published research.

Full details of our research interests  are listed on the Warwick Medical School website. Read more about our research strategy, research centres and research programmes.

You can also read our general University research proposal guidance.

Find a supervisor

Find your supervisor using the link below and discuss with them the area you'd like to research.

Explore our Warwick Medical School List of Approved Supervisors to where you will be able to search by research interests.

You should initially approach a suitable Academic Advisor (supervisor) from this list to discuss their work and to see if they would be willing to provide guidance on the presentation of the proposed Thesis for submission.

You can also see our general University guidance about finding a supervisor.

Tuition fees

Tuition fees are payable for each year of your course at the start of the academic year, or at the start of your course, if later. Academic fees cover the cost of tuition, examinations and registration and some student amenities.

Find your research course fees

Fee Status Guidance

The University carries out an initial fee status assessment based on information provided in the application and according to the guidance published by UKCISA. Students are classified as either Home or Overseas Fee status and this can determine the tuition fee and eligibility of certain scholarships and financial support.

If you receive an offer, your fee status will be stated with the tuition fee information. If you believe your fee status has been incorrectly classified you can complete a fee status assessment questionnaire (follow the instructions in your offer) and provide the required documentation for this to be reassessed.

The UK Council for International Student Affairs (UKCISA) provides guidance to UK universities on fees status criteria, you can find the latest guidance on the impact of Brexit on fees and student support on the UKCISA website .

Additional course costs

Please contact your academic department for information about department specific costs, which should be considered in conjunction with the more general costs below, such as:

• Core text books
• Printer credits
• Dissertation binding
• Robe hire for your degree ceremony

Scholarships and bursaries

Scholarships and financial support

Find out about the different funding routes available, including; postgraduate loans, scholarships, fee awards and academic department bursaries.

Living costs

Find out more about the cost of living as a postgraduate student at the University of Warwick.

Established in 2000, Warwick Medical School (WMS) forms part of the Faculty of Science, Engineering and Medicine at the University of Warwick. Alongside a range of educational opportunities, WMS has a reputation for research excellence, investigating solutions to significant global health challenges.

Find out more about us on our website Link opens in a new window

Our Graduate Entry Undergraduate course

• Medicine (MBChB - Graduate Entry Undergraduate Course)

Our Postgraduate Taught courses

• Advanced Clinical Practice (Critical Care) (MSc/PGDip/PGCert)
• Advanced Clinical Practice (MSc/PGDip/PGCert)
• Diabetes (PGDip/PGCert)
• Health Research (MSc/PGDip/PGCert)
• Interdisciplinary Biomedical Research (MSc)
• Medical Education (MMedEd/PG Dip/PGCert)
• Pre-Hospital Critical Care (PGCert)
• Public Health (MPH/PGDip/PGCert)

Our Postgraduate Online courses

• Clinical Research - iheed (PGCert/PGDip/MSc)
• Diabetes Care - iheed (PGDip/MSc)
• Healthcare Leadership - iheed (/PGCert/PGDip/MSc)
• Medical Education for Health Professionals - iheed (/PGCert/PGDip/MSc)
• Neuroscience and Psychology of Mental Health - iheed (PGCert/PGDip/MSc)
• Public Health - iheed (MPH)

Our Postgraduate Research courses

• MD Doctor of Medicine
• MSc by Research (at Warwick Medical School)
• PhD (at Warwick Medical School)
• PhD by Published Work

How to apply

The application process for courses that start in September and October 2024 will open on 2 October 2023.

For research courses that start in September and October 2024 the application deadline for students who require a visa to study in the UK is 2 August 2024. This should allow sufficient time to complete the admissions process and to obtain a visa to study in the UK.

How to apply for a postgraduate research course  

After you’ve applied

Find out how we process your application.

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Track your application and update your details.

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See Warwick’s postgraduate admissions policy.

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Ask questions and engage with Warwick.

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Postgraduate fairs.

Throughout the year we attend exhibitions and fairs online and in-person around the UK. These events give you the chance to explore our range of postgraduate courses, and find out what it’s like studying at Warwick. You’ll also be able to speak directly with our student recruitment team, who will be able to help answer your questions.

Join a live chat with our staff and students, who are here to answer your questions and help you learn more about postgraduate life at Warwick. You can join our general drop-in sessions or talk to your prospective department and student services.

Departmental events

Some academic departments hold events for specific postgraduate programmes, these are fantastic opportunities to learn more about Warwick and your chosen department and course.

See our online departmental events

Warwick Talk and Tours

A Warwick talk and tour lasts around two hours and consists of an overview presentation from one of our Recruitment Officers covering the key features, facilities and activities that make Warwick a leading institution. The talk is followed by a campus tour which is the perfect way to view campus, with a current student guiding you around the key areas on campus.

Connect with us

Learn more about Postgraduate study at the University of Warwick.

Page updates

We may have revised the information on this page since publication. See the edits we have made and content history .

Why Warwick

Discover why Warwick is one of the best universities in the UK and renowned globally.

9th in the UK (The Guardian University Guide 2024) Link opens in a new window

67th in the world (QS World University Rankings 2024) Link opens in a new window

6th most targeted university by the UK's top 100 graduate employers Link opens in a new window

(The Graduate Market in 2024, High Fliers Research Ltd. Link opens in a new window )

About the information on this page

This information is applicable for 2024 entry. Given the interval between the publication of courses and enrolment, some of the information may change. It is important to check our website before you apply. Please read our terms and conditions to find out more.

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The Journal of Graduate Medical Education disseminates scholarship and promotes critical inquiry to inform and engage the graduate medical education community. It is open access, peer-reviewed, editorially independent, and published by the Accreditation Council for Graduate Medical Education.

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Division of Medical Education MPhil/PhD

London, Bloomsbury

Medical education research is a rich, cross-disciplinary field of enquiry. On this full or part-time PhD programme, you will have access to high levels of pedagogical expertise for your development as a successful independent researcher. It will prepare you for a diverse range of careers in medical education within the NHS, University and with partner organisations.

UK tuition fees (2024/25)

Overseas tuition fees (2024/25), programme starts, applications accepted.

• Entry requirements

A minimum of an upper second-class Bachelor’s degree in a relevant discipline from a UK university or an overseas qualification of an equivalent standard, plus Master's-level study in either education or medical education. A primary medical qualification is required for a clinically-orientated doctorate.

The English language level for this programme is: Level 1

UCL Pre-Master's and Pre-sessional English courses are for international students who are aiming to study for a postgraduate degree at UCL. The courses will develop your academic English and academic skills required to succeed at postgraduate level.

Further information can be found on our English language requirements page.

Equivalent qualifications

Country-specific information, including details of when UCL representatives are visiting your part of the world, can be obtained from the International Students website .

International applicants can find out the equivalent qualification for their country by selecting from the list below. Please note that the equivalency will correspond to the broad UK degree classification stated on this page (e.g. upper second-class). Where a specific overall percentage is required in the UK qualification, the international equivalency will be higher than that stated below. Please contact Graduate Admissions should you require further advice.

About this degree

Medical education research is fundamental to improving medical and health professional's practice, and spans the medical education lifespan from medical school to postgraduate training and through to continuing professional development.

The Research Department of Medical Education at UCL Medical School has a significant and vigorous educational research profile, which draw on a range of qualitative and quantitative focusing on a range of methodologies.

Our teaching is informed by our research, and our research is informed by our teaching. We are also dedicated to contributing to the wider education community by sharing our research findings and involving key stakeholders in our educational research.

This research degree involves conducting a single piece of research driven by your own interests, resulting in a 100,000-word thesis. You will be supported by academics and research staff from a variety of backgrounds, including education, psychology, health, and social sciences, as well as clinical specialties.

You can complete this programme full-time over three years, or part-time over five years.

Who this course is for

This research programme is particularly suitable for students who have completed a postgraduate course in medical education or an equivalent subject.

We welcome applications from medical, dental, and healthcare professionals who are interested in undertaking either quantitative, qualitative, or mixed method approaches to their work. It is also suitable if you have a background in health and social services, psychology, or education.

What this course will give you

This programme offers you the following benefits and opportunities.

• Support from an internationally renowned group of medical education researchers with vast experience in a range of qualitative and quantitative methodologies.
• High-level education and supervision to support your development as a medical education researcher.
• A research skills development programme delivered by the UCL Doctoral School.
• Access to a series of online research methods modules focusing on medical education.
• Supervision meetings in person and/or online.

The foundation of your career

This PhD will prepare you for a substantive career as an educational researcher. Graduates go on to high-level posts either as NHS consultants or academics in university settings, as well as roles in medical education with local/national and international influence.

Employability

Many graduates have continued to practise in healthcare while also playing a significant role in local education. You will be equipped for senior positions in other medical schools and in the postgraduate sector, or to go on to a research career.

The UCL Medical School offers events and activities that will give you the opportunity to network with medical educationalists across the UK and internationally. These will give you the chance to learn from their examples of good practice and their research findings.

You will also be encouraged to attend local, national, and international medical education conferences, such as the annual Association of Medical Education in Europe Conference.

Researchers are often involved in teaching our taught undergraduate and graduate programmes at UCL.

Teaching and learning

Most of your research will be carried out independently. There will also be a series of training requirements that you will need to complete in the early stages of the programme.

The following optional research methods modules are delivered via the University's online learning platform:

• Approaches to educational research
• Research and the theoretical field
• Research methods
• Qualitative data analysis
• Writing and presenting educational research & Information and literature searching
• Quantitative data analysis

Your first milestone will be to upgrade from MPhil to the PhD degree. For this, you will submit and present a report. In your final year, you submit a thesis covering your research and discuss this at a formal interview known as a viva examination.

Most of your time will be spent conducting independent research, alongside regular meetings with your supervisory team and completing your training requirements. We also encourage you to attend relevant research events at UCL and elsewhere.

Research areas and structure

• Assessment in medical education
• Clinical communication
• E-learning in medical education
• Equality and diversity in medical education
• Fitness to practise of doctors
• Interprofessional education
• Peer-assisted learning
• Professional identity
• Selection in medicine
• Medical revalidation
• Transitions in medical careers
• Work-based learning.

Research environment

The Research Department for Medical Education (RDME) is the research arm of UCL Medical School and one of the UK’s top medical education research departments. We draw together experienced doctors, nurses, psychologists, and educationalists to ensure that our work is based on strong pedagogical research foundations.

A key part of our ethos and research strategy is to ensure our research makes a difference. Our work on selection (including widening participation), postgraduate clinical assessments (including medical revalidation and differential attainment), mental health and well-being, and social justice broadly has had significant impact outside of academia. As a unit we uniquely submitted to the research excellence framework in 2014 and in 2021. Each time, our research led to impact case studies which have been rated highly.

Our award-winning public engagement projects ensure our work is informed by, and useful to, patients and the public. In 2021 we were awarded the Association for the study of medical education institution to citizenship, which is testament to our commitment to high quality research and high-quality research environment.

We help medical educators adopt evidence-based best educational practice and use our knowledge and experience to continually develop our undergraduate and postgraduate education programmes. We also work to aid development in other international institutions.

Our academic and research staff are from a variety of backgrounds, including education, sociology, psychology, philosophy, linguistics, and medical ethics, as well as clinical specialties. They all contribute to our interdisciplinary educational research activities. Our research outputs and reputation are of national and international importance.

When you accept your place on the programme, you will initially register for an MPhil in Medical Education.

In your first year, your programme will include the following optional research methods modules as part of the Doctoral Skills Training Programme. These are all delivered via an online learning platform:

• Approaches to Educational Research
• Research and the Theoretical Field
• Research Methods
• Qualitative Data Analysis
• Writing and Presenting Educational Research and Information and Literature Searching
• Quantitative Data Analysis.

You will be eligible to upgrade to PhD status between 9-18 months into your registration. Upgrade decisions are based on an evaluation of an upgrade report, which you produce with support from your supervisors, and a viva examination.

Throughout your programme, you will have the opportunity to play a full part in the life of the RDME.

• Research Methods.

You will be eligible to upgrade to PhD student status between 15-24 months into your registration. Upgrade decisions are based on an evaluation of an upgrade report, which you will draft with the support of your primary and subsidiary supervisors, as well as assessment by viva examination.

Accessibility

Details of the accessibility of UCL buildings can be obtained from AccessAble accessable.co.uk . Further information can also be obtained from the UCL Student Support and Wellbeing team .

Fees and funding

Fees for this course.

The tuition fees shown are for the year indicated above. Fees for subsequent years may increase or otherwise vary. Where the programme is offered on a flexible/modular basis, fees are charged pro-rata to the appropriate full-time Master's fee taken in an academic session. Further information on fee status, fee increases and the fee schedule can be viewed on the UCL Students website: ucl.ac.uk/students/fees .

Additional costs

Additional costs may include items such as books (perhaps £100-£200 per year), and expenses whilst attending conferences. Conferences are optional and costs vary significantly, but the average one-day event has registration fees of c. £280, plus travel (cost varies by location) and accommodation where relevant for longer events. Students will pay for their own attendance themselves unless there is a source of external funding.

Your research degree may be subject to an Additional Fee Element (also known as bench fees), which is payable by yourself or your sponsor. This covers the costs related to consumables, such as equipment and materials, which are not included in the tuition fee. As each research project is unique, this fee is calculated on an individual basis and is determined by your academic supervisor. It may also depend on whether you receive external funding to complete your degree.

For more information on additional costs for prospective students please go to our estimated cost of essential expenditure at Accommodation and living costs .

Funding your studies

For a comprehensive list of the funding opportunities available at UCL, including funding relevant to your nationality, please visit the Scholarships and Funding website .

Your deadlines and start dates will usually be dictated by funding arrangements so you will need to check with the department or academic unit to see if you need to consider these in your application. In most cases, you should identify and contact your potential supervisors before you apply.

Consider your choices

We recommend that you read these tips for studying medical education at doctoral level and familiarise yourself with our research staff to consider who might supervise your project.

If you decide to apply, you will need to send a CV and a research proposal of approximately 2,000 words to [email protected] .

The proposal should include your research interests and proposed topic and address the following:

• The research problem and your research questions
• Background, including a brief literature review
• Relevant theoretical and methodological perspectives
• Methods, including sample, recruitment, data gathering, data analysis
• Your new contribution to knowledge
• Timetable and bibliography.

If your proposal has potential and we believe we can match you to a supervisor, we will arrange an interview. This can take place online for applicants who are currently overseas.

If you are successful after this, we will invite you to apply using our application platform and to provide references.

Please note that you may submit applications for a maximum of two graduate programmes (or one application for the Law LLM) in any application cycle.

Choose your programme

Please read the Application Guidance before proceeding with your application.

Year of entry: 2024-2025

Year of entry: 2023-2024, got questions get in touch.

UCL Medical School

[email protected]

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Doctoral Program in Medical Education Curriculum

Curriculum of the ph.d. in medical education program.

The curriculum consists of 60 hours of online coursework beyond the LECOM MSMEd degree. The curriculum can be completed in an accelerated two-year track or in three years with coursework delivered in a trimester format. The dissertation project involves a mentored education research project intended to yield a publication in a peer-reviewed journal.  Asynchronous online assignments allow busy healthcare professionals the temporal and spatial flexibility to successfully complete coursework anywhere connection to the internet is available. The online courses are categorized into three competencies of an educator-scholar leader, including:

Advanced Educational Practice:

• Advanced Cognitive Psychology
• Advanced Clinical Teaching Skills
• Teaching Practicum 1: Interprofessional Education
• Teaching Practicum 2: Online Teaching Environments

Advanced Educational Research & Scholarship:

• Conducting Literature Reviews
• Advanced Educational Research Methods
• Advanced Statistical Analysis: Correlation & Regression
• Education Journal Clubs 1, 2, 3, & 4
• Dissertation 1: Educational Research Proposals
• Dissertation 2: The IRB Process
• Dissertation 3: Implementation of Educational Innovations
• Dissertation 4: Data Analysis & Results
• Dissertation 5: Discussion & Conclusion
• Dissertation 6: Presentation & Defense

Advanced Leadership & Administration:

• Preparing for the Professoriate
• Developing Faculty Developers
• Strategic Planning & Accreditation
• Educational Law & Finance  

Mentored Dissertation Education Research Project

Six sequential courses systematically lead students through their dissertation project, which is focused on solving an educational issue or problem of interest.  Students navigate the stepwise dissertation coursework throughout the entire research process from research idea conceptualization to publication.  The program director serves as the designated dissertation mentor and the student selects the committee members.

Distance Learning Delivery

The PhD in Med Ed curriculum is delivered online through distance education.  Faculty are readily available through email, discussion forums, zoom, or by phone.  LECOM instructional technology provides additional support.  Students are required to meet in Erie, PA, one time over a weekend near the end of the program to publicly present and defend their Dissertation.

How is learning assessed?

Student learning is assessed through coursework submitted in LECOM’s online course management system.  These case-based, problem-solving assignments include scholarly writing assignments, application papers, forum discussions, written examinations, dissertation, and participation in a conference of the student’s choice.  In the spirit of distance education and the competency-based education model, flexibility in assignment due dates is permitted to make success a priority.  

How can I get started?

The first step in the application process is to complete an online inquiry here: Make an Inquiry – Main | Ph.D. Programs Inquiry | LECOM Portal

Accreditation

LECOM received full approval for the PhD in Medical Education programs from the Commonwealth of Pennsylvania State Board of Education.

Distance Education Complaint Process for Out-of-State Students View for information regarding LECOM participation in the State Authorization Reciprocity Agreement.

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Introduction: Demystifying the PhD by Publication

• First Online: 28 September 2022

Cite this chapter

• Sin Wang Chong   ORCID: orcid.org/0000-0002-4519-0544 3 &
• Neil H. Johnson   ORCID: orcid.org/0000-0001-8604-1193 4  

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This chapter documents the rationale for compiling a collection on the PhD by Publication. The aim of the book is to “demystify” this alternative route of doctoral education because there is a dearth of publications (journal articles or books) on this PhD route which is gaining popularity around the world. This book attempts to “demystify” PhD by Publication by identifying pertinent issues and (mis)conceptions pertaining to policies and practices through research, research syntheses, and surveys of university policies on the PhD by Publication internationally (Part I – Landscapes of PhD by Publication). Another layer of “demystification” pertains to experience (Part II: Narratives of PhD by Publication). The inclusion of reflective and autobiographical accounts by PhD by Publication supervisors, students, and graduates internationally provides a vivid insider’s perspective toward this PhD route. This chapter closes with an outline of each chapter of the book.

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Chong, S. W. (2020). PhD by published work and “doctorateness”: My experience at a UK university. Innovative Practice in Higher Education, 4 (1), 1–12. http://journals.staffs.ac.uk/index.php/ipihe/article/view/204/319

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Chong, S. W. (2021). Demystifying commentary guidelines of PhD by published work in the UK: Insights from genre analysis. In Innovations in education and teaching international (pp. 1–10). Advanced online publication. https://doi.org/10.1080/14703297.2020.1871396

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Hyland, K. (2015). Genre, discipline and identity. Journal of English for Academic Purposes, 19 , 32–43.

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Jackson, D. (2013). Completing a PhD by publication: A review of Australian policy and implications for practice. Higher Education Research and Development, 32 (3), 355–368. https://doi.org/10.1080/07294360.2012.692666

O’Keeffe, P. (2019). PhD by publication: Innovative approach to social science research, or operationalisation of the doctoral student … or both? Higher Education Research and Development, 39 (2), 288–301. https://doi.org/10.1080/07294360.2019.1666258

Smith, S. (2017). Supervising on a PhD by published work route: An exploration of the supervisory role. Zeitschrift für Hochschulentwicklung. Journal for Higher Education Development, 12 (2), 19–43.

Smith, S. (2019). The challenge of supervising students who are doing a PhD by published work . Trust Me! Blog. Retrieved from https://eprints.leedsbeckett.ac.uk/id/eprint/5648/1/TheChallengeOfSupervisingStudentsWhoAreDoingAPhdByPublishedWorkAM-SMITH.pdf

Wilson, K. (2002). Quality assurance issues for a PhD by published work: A case study. Quality Assurance in Education, 10 (2), 71–78. https://doi.org/10.1108/09684880210423555

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About this chapter

Chong, S.W., Johnson, N.H. (2022). Introduction: Demystifying the PhD by Publication. In: Chong, S.W., Johnson, N. (eds) Landscapes and Narratives of PhD by Publication. Springer, Cham. https://doi.org/10.1007/978-3-031-04895-1_1

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Clinical Education PhD

Awards: PhD

Study modes: Full-time, Part-time

Funding opportunities

Programme website: Clinical Education

Discovery Day

Join us online on 18th April to learn more about postgraduate study at Edinburgh

View sessions and register

Research profile

This new PhD in clinical education builds on our world-renowned expertise in the field of clinical education, and our well-established and respected Masters in Clinical Education programme.

It is an ideal programme for those wishing to further their career in academic clinical or medical education, who already have experience of delivering education for healthcare professionals, whether students, doctors, nurses, allied health professionals, dental or veterinary practitioners. It will particularly appeal to those seeking leadership positions or to undertake independent high-quality research in clinical education.

Some of our current research focuses on:

• Faculty development
• Assessment and feedback in medical education
• Psychometrics
• Learning outcome development and mapping
• Students learning to teach and Peer Assisted Learning (PAL)
• Preparation for practice
• International medical education
• Clinical skills

The Centre for Medical Education has 25 members of academic staff (including fixed-term Fellows), 5 administrators, approximately 100 distance-learning MSc students, and typically 5-7 doctoral students.

We have good collaboration between university faculty, clinicians, NHS Education for Scotland and other institutions.

Training and support

The Centre has an excellent track record in providing training within clinical education to MSc students, undergraduate medical students and fixed-term clinical Fellows.

Doctoral students receive direct support from at least two academic supervisors during their studies, and a dedicated thesis committee provides guidance throughout the programme of research.

Research training is tailored to each doctoral student, but typically includes material from the well-established MSc ‘Research in Clinical Education’ and ‘Dissertation’ courses, an extensive programme of university PhD training workshops and meetings, and fortnightly ‘Medical Education Forum’ and ‘CME Research Meeting’ events for presentation of completed research and work-in-progress.

The Centre for Medical Education is based in The Chancellors Building, Little France, next to the Royal Infirmary of Edinburgh.

Most faculty and doctoral students share three large offices, with others based in the state-of-the-art Clinical Skills Centre.

Entry requirements

These entry requirements are for the 2024/25 academic year and requirements for future academic years may differ. Entry requirements for the 2025/26 academic year will be published on 1 Oct 2024.

A UK masters degree, or its international equivalent, in a clinical, medical or health field, and a primary clinical qualification, such as an MBChB, BVS, BDS or Bachelor of Nursing.

You must have experience of clinical, medical, allied healthcare or veterinary education, for example teaching undergraduate or postgraduate students.

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Getting Published in Medical Education: Overcoming Barriers to Scholarly Production

Michael gottlieb.

* Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois

† University of Mississippi Medical Center, Department of Emergency Medicine, Jackson, Mississippi

Jaime Jordan

‡ Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California

Suzanne Bentley

§ Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York

Megan L. Ranney

|| Alpert Medical School, Brown University, Department of Emergency Medicine, Providence, Rhode Island

# University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa

Sorabh Khandelwal

** The Ohio State University, Department of Emergency Medicine, Columbus, Ohio

Sally A. Santen

†† University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan

INTRODUCTION

Medical education is experiencing rapid growth with an increasing number of publications and journals dedicated to education research. 1 , 2 Several new journals and special education issues (including the CDEM/CORD supplement by the Western Journal of Emergency Medicine ) have arisen in recent years to address this increasing interest. As clinician educators, it is important to produce and disseminate research both for promotion and development of a subject niche, as well as to disseminate findings for others to learn from novel and successful educational interventions.

However, the quality of existing medical education research has been variable. 3 , 4 Studies have suggested this may be due to limited mentorship, 5 as well as challenges including available time, funding, small sample sizes, ability to navigate the institutional review board process, and difficulty with defining relevant and measurable outcomes. 6 , 7 This article discusses five common challenges to education scholarship and provides suggestions for overcoming them.

COMMON BARRIERS

1. lack of clarity in the research question.

The first challenge is developing the research question. While this may seem like a relatively straightforward task, developing a clear and important research question evolves from an iterative process. This process generally begins with an educator’s interest in a topic and a broad research question. For example, consider the case of a program director who is interested in identifying factors related to resident burnout. This is a broad topic because the “factors” are not clearly defined nor is the hypothesis clarified. Nonetheless, this is enough information to conduct a literature review to begin to understand prior work in the area, identify where there is a gap in knowledge, identify the novel research question, and to provide a link between the research idea and a conceptual framework.

The conceptual framework is a vital component to developing a good research question, yet it is often overlooked in medical education studies. A review of published medical education studies found that 55% did not mention a conceptual framework. 4 The conceptual framework serves as the foundation of the study that informs all aspects of the research design and should not be ignored. Frameworks relevant to medical education may be found in fields outside of medicine, especially education and psychology; so medical education scholars may want to extend their literature search outside of their medical specialty. In the example above, a thorough search of the literature would reveal that burnout studies are often framed within the context of the Multidimensional Theory of Burnout, a theory found primarily within the psychology literature. 8 Further discussion of conceptual frameworks and how they can be used to develop medical education research projects can be found in the classic paper by Bordage. 9

After conducting a thorough literature review and identifying a specific problem to address, medical educational researchers can use two mnemonic tools to further develop their research question. The first is the PICOT framework, which is used to transform a broad question into a specific one that includes all of the necessary components: P opulation, I ntervention, C omparison, O utcomes, and T ime frame. One study demonstrated that research reports that used the PICOT format were rated as having better overall quality than those that did not. 10 Figure 1 includes an example of a structured question using the PICOT format ( Figure 1 ).

Example of a research question in PICOT formatting.

PICOT , population, intervention, comparison, outcomes, time frame.

The other valuable tool for designing a research question is the FINER criteria ( Figure 2 ). As opposed to the PICOT framework, which helps to determine that all elements of a study question are present, the FINER criteria assess the quality and likelihood of success of a given research study. The authors recommend applying both sets of criteria to a given study question to ensure that the question is adequately refined, so as to maximize the success of each academic endeavor.

FINER criteria for assessing study questions.

FINER , feasible, interesting, novel, ethical, relevant; IRB, institutional review board.

2. Inadequate Methodology to Assess the Study Question

Editors and reviewers desire to publish interpretations that are generalizable and accurate (i.e., supported by validity evidence). Despite recommendations that medical education research adhere to the same rigorous methodological standards as clinical research, medical education research often fails in this regard. 11 One study of submissions to a major medical education journal found that the top reasons for rejection included inappropriate statistics, over-interpretation of the results, an inadequate research instrument, an insufficient problem statement, inadequate literature review and an insufficient data, while a sound problem statement and study design significantly increased the likelihood of publication. 12

Moreover, medical education research also fails to report substantial validity evidence, which presents a challenge to publication. 13 , 14 Many of these threats can be minimized by choosing an appropriate study design, standardizing study conditions, and collecting and reporting detailed information about study participants and procedures.

While the measurement instruments in clinical research are typically well validated (e.g., d-dimer, troponin), education research instruments are rarely as fortunate. Therefore, not only do education researchers need to define and collect meaningful outcomes for research, they also need to ensure the validity and reliability of their measurements. Many education studies focus on novel curricula, innovations, learner behaviors, or the exploration of education concepts or environments, for which previously established instruments are unavailable. If a new instrument needs to be created, or if using an instrument from another field (e.g., psychology, sociology, secondary education), the researcher is advised to first assess the validity of the instrument with respect to the intended measurement. In order to gather enough validity evidence to support the instrument, it is essential that the instrument be matched to the goals and objectives, piloted to ensure that it performs as expected, and compared to other similar measurements or available data. 15 The mere act of gathering validity evidence for an instrument or measurement (i.e., showing that it measures what it states it is going to measure and that it accurately distinguishes the target outcome from other outcomes) can be an important research study.

Novice education researchers faced with multiple competing demands may attempt to capitalize upon existing work by converting an ongoing education project into a research study. For example, an educator may develop a new curriculum and then subsequently decide to assess it after it has been ongoing for several months. Unfortunately, these research attempts are often unsuccessful due to insufficient planning and inadequate methodology and outcomes. To have a methodologically sound and successful study it is vital to define appropriate outcome measures at the onset and select an appropriate study design that best allows the researcher to measure the desired outcomes with minimal threats to validity. The researcher should collect validity evidence to create the assessment instrument during the developmental phase to ensure that the instrument is appropriate for the study. Involving a statistician or experienced education researcher early in the process is extremely beneficial to help avoid fatal flaws and wasted effort.

3. Losing Momentum

While manuscript publication should be one of the ultimate goals, it is important to set stepwise, attainable, intermediate milestones and celebrate their accomplishment on the route to manuscript completion and publication. Examples of early milestones in the scholarly process include abstract submission, initial paper development, and local and national presentations. There are also several digital mediums to publish medical education innovations. One example is the Academic Life in Emergency Medicine IDEA (Ideas in Didactics and Educational Activities) series ( https://www.aliem.com/category/non-clinical/idea-series/ ), which allows authors to showcase novel education interventions to the broader medical education community. Additionally, educators may publish curricula online in MedEdPORTAL or the Journal of Education & Teaching – Emergency Medicine . Moreover, many institutions host “work in progress” sessions to highlight and discuss ongoing studies.

Ensuring early and attainable wins helps to maintain momentum for projects. 16 To be successful, researchers must actively plan and establish short-term goals and recognize the accomplishment of these goals and the specific team member contributions throughout the process. 16 Additionally, without a clear outline, unified writing plan, and identification of clear short-term goals, efforts can easily lose all momentum and dissolve into a disorganized, inactive to-do list without an end product. It is valuable to have regularly scheduled meetings or conference calls to ensure that all members are on track, especially for multi-institutional projects.

Education researchers should also consider maximizing the return on a given project by considering additional opportunities for expansion of a given project. 17 Often, it requires little additional effort to convert one project into several deliverables, such as an abstract, manuscript, presentation, and digital description of the innovation. Tables 1 and ​ and2 2 provide a list of potential arenas for publication, as well as examples of different formats. For example, the start of a project might include the publication of a review article or perspective on that topic. This could also be converted into a didactic for residents or training session for faculty development. As the work progresses, you might consider a reflection or short thought piece. This approach can also help maintain momentum by assisting with the early wins described above. We would like to emphasize that researchers must be conscious to avoid self-plagiarizing or artificially separating out study components to create multiple publications from a study addressing a single concept (i.e., “salami slicing”). 18

Publication venues for medical education scholarship.

Outlets for digital dissemination.

4. Lack of Follow Through

Once the study is completed, it is important to go beyond the abstract with the goal of publishing it in a peer-reviewed journal. Historically, only 25–50% of abstracts presented at emergency medicine (EM) and medical education conferences are subsequently published as manuscripts. 19 – 24 Peer-reviewed publication is important because it increases dissemination of information and is a significant consideration in achieving promotion, tenure, and future grant funding. 25 , 26 This is particularly important for medical education research because of the relatively smaller proportion of outcomes-based studies in this field compared with clinical research. 3 , 4

To make this process easier, the authors recommend that the researcher begin manuscript preparation at the start of protocol development, filling in components as the project progresses. Often, the introduction, research hypothesis, and methods can be drafted before the study begins, as part of the institutional review board proposal. This early planning will make the remainder of the paper more manageable when the study is completed.

When working as a team there may be more accountability to complete the paper; but team authorship can also create conflicts in author order. We therefore recommend discussing criteria for authorship, and drafting a potential order-of-authorship list, prior to beginning a study. Authors should also be aware that most publications are not accepted on the first submission, and often they may require submission to multiple journals. 27 Authors should not let a paper linger after the first rejection. Rather, they should read the review, make appropriate edits, and quickly re-submit to another journal. Authors should also be aware that different medical education journals have different foci, and publication will be more successful if they select journals that publish similar topics or types of articles in line with their particular manuscript.

It is not unusual for authors to hit a roadblock during the writing process. This can occur at any point throughout the process from beginning to end. It can be helpful to set specific goals prior to initiating the writing process. Each goal should have a specific deadline, which can help maintain momentum and accountability. Education researchers often have many competing demands; scheduling specific times on one’s calendar for writing, similar to other appointments, can ensure dedicated time away from distractions for the author to concentrate on writing the manuscript. 28 , 29 In order to focus on the manuscript itself, authors should avoid checking emails and other distractions. 30 It may also be valuable to include small breaks when the author feels his or her attention waning.

Another tip is to start small. Rather than attempt to draft everything at one time, which may seem overwhelming, authors should start with either the first paragraph or the methods section (which are typically easier to write) and then expand from there. Use the standard framework for the manuscript, incorporating journal-specific components as needed. Since most articles follow a general layout, it is much easier to fill in the paper piece-by-piece using the layout as a recipe than attempting to create one’s own format. 30 Write the first draft spontaneously and uncritically allowing for editing after the draft is written. 30 Attempting to edit while writing can interrupt concentration and flow. Finally, authors should have other people review their work whenever possible. This provides an external perspective and helps identify errors and confusing concepts that the investigators may have overlooked. It may be valuable to include non-physician researchers (e.g., PhD, EdD, PsychD) who can provide a highly valuable external interpretation, as many reviewers for medical education journals may not be physicians.

5. Lack of Expertise

For faculty who lack local experts with an education research background, getting started can be difficult. In these situations, it may be helpful to reach out to the clinical researchers within or outside of the department. Likewise, many academic systems have medical education researchers in other departments or in the school of medicine who may provide guidance. Another option is to join a project team from another institution. EM research is improved by multi-site collaboration, and working with a broader group may help develop skills.

There are formal options for research skill development. These include advanced degrees such as a Masters of Health Professions Education, institutional faculty development programs in education research, or the MERC (Medical Education Research Certificate) through the Association of American Medical Colleges. Often, the EM national meetings host workshops on research methodology. In addition, finding a virtual mentor in EM or another specialty might provide support for the educational scholarship one hopes to accomplish.

FUTURE DIRECTIONS

As medical education-focused researchers, we urge our specialty to consider future directions for creation and dissemination of our work. Just as we actively advocate for increased production, training and funding of EM clinical research, we must do the same for medical education research. First, we must start by growing the body of rigorously-conducted medical education trials published in high-quality journals. Second, we must take on the critical task of growing and promoting junior faculty who can expand our methodologic and content expertise. This step involves developing and promoting high-quality fellowships, which must include specific research training. We must encourage our mentees and colleagues to use state-of-the-art methods. This step may also consist of honest inquiry into continued barriers to methodologically-sound research studies.

Finally, to truly change the trajectory of medical education we must pursue outside funding. The sources of funding for medical education research are currently limited. As a specialty, we actively encourage government and foundation funding sources to dedicate resources to EM-relevant clinical questions. Similarly, building upon our existing contributions to medical education within and outside of EM, we must push for external groups to fund high-quality, multi-center studies of innovative educational methods. This direction should include the following: partnerships with researchers who are not primarily education focused; training of our colleagues in ways to bridge the funding divide; and possibly creation of novel funding sources (such as the Society for Academic Emergency Medicine’s medical education research grants).

Medical education research continues to grow within EM and it is imperative that educators produce and disseminate high-quality publications to continue to advance this field. This article discusses several challenges and strategies for overcoming barriers to publication, in order to assist the educator with producing quality education research. It is the hope of the authors that this will encourage educators to publish more research to disseminate findings with the ultimate goal of further improving education and patient care.

Section Editor: Ed Ullman, MD

Full text available through open access at http://escholarship.org/uc/uciem_westjem

Conflicts of Interest : By the West JEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Making research accessible: The role of active participation in scientific inquiry in medical student education

Michael Friedlander, Fralin Biomedical Research Institute executive director and senior dean for research at the Virginia Tech Carilion School of Medicine, shares Virginia Tech’s integrated research model as a part of a panel on medical education.

Leigh Anne Kelley

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Virginia Tech Carilion School of Medicine students spend 1,200 or more hours conducting research at the Fralin Biomedical Research Institute, Virginia Tech labs, Carilion Clinic, or with other partners. Some, like Kenneth Young, have extended their studies to earn an M.D.+Ph.D. degree. Photo by Clayton Metz for Virginia Tech.

Michael Friedlander, founding director of the Fralin Biomedical Research Institute at VTC, will stress the importance of doing research as part of medical training April 3 at an Association of American Medical Colleges conference in Arlington.

Friedlander works closely with Leslie LaConte , associate dean for research at VTC School of Medicine, who leads the research curriculum and works closely with all of the medical students on their research projects.

Friedlander will share perspectives from the experience of building of a culture at the Virginia Tech Carilion School of Medicine (VTCSOM), partly based on students actively participating in research that provides them additional opportunities to advance health and well-being for all, including people who may benefit from their findings in the future.

“Through this process, medical students are imbued with a deep appreciation of both the power and the limitations of data and how they are obtained, interpreted and applied,” Friedlander said.

“This provides them with exciting opportunities and a broadened perspective through their deep engagement with all aspects of the research enterprise, from identifying the knowledge gap and need to conceptualizing the question and approach to implementation of the methodology and interpretation and application of the findings,” Friedlander said. “Moreover, the students have the opportunity to amplify the impact of their work through presenting their findings at conferences, publishing it in peer-reviewed journals, and even commercializing it to bring their discoveries to patients.”

Friedlander has informed perspective, not only as Virginia Tech’s vice president for health sciences and technology, but as the senior dean for research at the Virginia Tech Carilion School of Medicine.

He also served on the  Scientific Foundations for Future Physicians  committee, a partnership between the Association of American Medical Colleges (AAMC) and the Howard Hughes Medical Institute, that identified the need for U.S. medical education to increase its emphasis on the emerging science of medicine and the role of the discovery process — principles that have been embraced and incorporated in the Virginia Tech Carilion School of Medicine since its inception under the leadership of previous Dean Cynda Johnson and current Dean Lee Learman.

The research institute and  Virginia Tech Carilion School of Medicine  were founded as part of a unique public-private partnership between Virginia Tech and Carilion Clinic and are in connecting, adjacent buildings on the Health Sciences and Technology campus in Roanoke.

Nearly 70 medical students selected mentors based in labs at the Fralin Biomedical Research Institute, while many others are carrying out their research at Carilion Clinic , on the Virginia Tech main campus in Blacksburg, or with mentors at the Children’s National Hospital .

“The research these students do contributes to their development as true scientists and physicians, sharpening their skills as clinicians. It is very gratifying to hear the reports of how deeply knowledgeable Virginia Tech Carilion medical students are about their research, both in integrating their clinical skills on wards as well as when they interview for residency positions after graduating,” Friedlander said. “The opportunity to share not only the VTCSOM experience but to contribute to the national dialogue as an invited panelist at the AAMC’s spring meeting is compelling and a chance to facilitate the consideration and incorporation of the VTCSOM model nationally in medical education.”

The panel discussion “How Learners can Distinguish Themselves Through Medical Research” is part of this joint conference that brings together the association's Council of Faculty and Academic Societies, the Group on Resident Affairs, and the Organization of Resident Representatives for three days of programming. 

Others who are part of the panel include Martha Alexander-Miller, professor and chair of the microbiology department at the Wake Forest University School of Medicine; Stella Hartano, a physician-scientist and allergy and immunology fellow at the National Institute of Allergy and Infectious Disease at the National Institutes of Health; and moderator Neil Osheroff, professor of biochemistry and medicine at the Vanderbilt University School of Medicine.

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