Medical Education Research: basics and a practical approach.

1. Medical Education
Research: a basic and
practical approach
for medical students
Prof. Wadie Elmadhoun, MBBS, MSc., MD
Medical Education Research– Session July 2020 – Prof. Wadie
1

2. “The beautiful and impossible”
Medical Education Research– Session July 2020 – Prof. Wadie
2

3. Presentation outlines
1. Intended learning outcomes (ILOs)
2. Definition of terms.
3. Aims of MedEd research
4. Themes of MedEd research
5. Practical steps in MedEd
Research
6. Quiz section.
Medical Education Research– Session July 2020 – Prof. Wadie
3

4. Intended Learning outcomes (ILOs)
• By the end of this session, the learner should be
able to:
1. Define medical education (MedEd) research and
state its objectives.
2. Describe the scope and Themes of (MedEd)
research
3. List the priority areas of (MedEd) research in
his/her institution
4. Enumerate the practical steps in conduction of a
(MedEd) research
5. Demonstrate appreciation of the importance of
(MedEd) research
Medical Education Research– Session July 2020 – Prof. Wadie
4

5. What is meant by research?
• Try to mention/write a few key words before
proceeding to next slide:
• ……………....
• ………………..
• ………………..
Medical Education Research– Session July 2020 – Prof. Wadie
5

6. Definition of research
• Research is defined as the
systematic process for the creation
of new knowledge and/or the use
of existing knowledge in a new and
creative way so as to generate
new concepts, methodologies and
understandings.
Medical Education Research– Session July 2020 – Prof. Wadie
6

7. • This could include synthesis
and analysis of previous
research to the extent that it
leads to new and creative
outcomes.
Medical Education Research– Session July 2020 – Prof. Wadie
7

8. What is Medical Education
(MedEd)?
1. ……….
2. …...…..
3. ………..
Medical Education Research– Session July 2020 – Prof. Wadie
8
Try to write 3 key words

9. Definition of Medical Education (MedEd)?
• A course of study directed toward imparting
to persons seeking to become health
professionals the knowledge and skills
required for the prevention and treatment of
disease.
• It also develops the methods and objectives
appropriate to the study of the still unknown
factors that produce disease or favour well-
being.
Medical Education Research– Session July 2020 – Prof. Wadie
9

10. • Among the goals of
medical education is the production
of health professionals sensitive to
the health needs of their country,
capable of ministering to those needs,
and aware of the necessity of
continuing their own education.
Medical Education Research– Session July 2020 – Prof. Wadie
10

11. Medical Education Research– Session July 2020 – Prof. Wadie
11

12. • It therefore follows that the plan of
education, the medical curriculum,
should not be the same in all
countries.
• Although there may be basic
elements common to all, the
details should vary from place to
place and from time to time.
Medical Education Research– Session July 2020 – Prof. Wadie
12

13. Curriculum should be dynamic
• Whatever form the curriculum
takes, ideally it will be flexible
enough to allow modification
as circumstances alter, medical
knowledge grows, and needs
change.
Medical Education Research– Session July 2020 – Prof. Wadie
13

14. • Medical education research may include
• evaluation of the transfer or
acquisition of
1. knowledge,
2. skills or
3. attitudes
• in any topic relevant to human health
among any type of learner, including
health professionals, students in the
health professions, and patients.
Medical Education Research– Session July 2020 – Prof. Wadie
14

15. What is the
principal aim of
MedEd research ?
• Take one minute to reflect on this question.
Medical Education Research– Session July 2020 – Prof. Wadie
15

16. What is the principal aim of MedEd
research ?
Medical education research aims
to advance the knowledge, skills,
and professionalism of medical
students by understanding and
evaluating educational
ecosystems.
Medical Education Research– Session July 2020 – Prof. Wadie
16

17. What is the scope of MedEd research ?
• These ecosystems include:
1. policies related to admissions and curriculum,
2. people who serve as teachers and mentors,
3. instructional technology and other
resources,
4. the attitudes that pervade a given institution
or educational experience, and even the
students themselves.
Medical Education Research– Session July 2020 – Prof. Wadie
17

18. What is the ultimate goal of MedEd research ?
• Ultimately, research in medical education is
conducted to:
1. address contemporary issues and questions
in medical education
2. design, evaluate, and support curricular
innovations
3. assess and reform the culture underlying
medical education
Medical Education Research– Session July 2020 – Prof. Wadie
18

19. What Themes
does MedEd
research cover?
• You have 2 minutes to write a few words as
an answer for this question.
Medical Education Research– Session July 2020 – Prof. Wadie
19

20. Themes of MedEd research
• Topics often fall into one of the six
professional core competencies:
1. patient care,
2. medical knowledge,
3. practice-based learning and
improvement,
4. interpersonal and communication skills,
5. systems-based practice, and
6. professionalism
Medical Education Research– Session July 2020 – Prof. Wadie
20

21. Outcomes of research
• Legitimate outcome measures include:
•changes in knowledge,
skills, attitudes,
behaviors, and even
patient outcomes.
Medical Education Research– Session July 2020 – Prof. Wadie
21

22. Study population of MedEd
research
1. Medical school: students, faculty, curricula,
systems, ….
2. Residency training programs: candidates,
mentors, curricula, ….
3. Continuing medical education: activities,
outcomes, …..
4. Patients: education,….
Medical Education Research– Session July 2020 – Prof. Wadie
22

23. What is the
importance of
research in medical
education?
• In 2 minutes try to remember benefits gained
with regard to: human knowledge, patient
care, candidates’ progress, innovations,
quality of education….
Medical Education Research– Session July 2020 – Prof. Wadie
23

24. Importance of research in
medical education
1. Provision of trustworthy
information regarding medical
educational problems and their
solutions.
2. Maintaining quality of medical
education.
Medical Education Research– Session July 2020 – Prof. Wadie
24

25. Importance of research in medical
education
3- demonstration of specific ways in which
teachers can or already do help students feel a
sense of belonging in school and make gains in
learning.
4- understanding the science of learning, largely
through technologies that give a real-time look at
what happens in a student’s brain as they learn.
Medical Education Research– Session July 2020 – Prof. Wadie
25

26. Importance of research in medical education
5- Identifying facts regarding: enrolment,
retention, dropout, quality of medical education
and so forth.
6- Building new knowledge regarding the
methodology, pedagogy or other core subject
areas.
7- Adding of existing stock of knowledge related
to medical educational field
8- suggestion of solutions for problems related to
classroom, institution, administrative level, policy
level, resources, etc...
Medical Education Research– Session July 2020 – Prof. Wadie
26

27. Importance of research in medical
education
9- Invention of new teaching methods,
curriculum development strategies, effective
grouping technique and so forth.
10- Realizing the exact problems of medical
educational sector.
11- Assessing the effect of new methodology
of teaching on the educational process.
Medical Education Research– Session July 2020 – Prof. Wadie
27

28. Importance of research in medical
education
12- Explore understanding of teachers’
knowledge about latest evaluation
techniques.
13- Identification of the hindrances to achieve
universalization of education.
Medical Education Research– Session July 2020 – Prof. Wadie
28

29. Cooling break
Medical Education Research– Session July 2020 – Prof. Wadie
29

30. Nature and value of qualitative
studies in medical education
• Qualitative research is concerned with
'...developing explanations of social
phenomena...'
• The world in which we live-
• Why things are the way they are-
• Concerned with social aspects of our world-
Medical Education Research– Session July 2020 – Prof. Wadie
30

31. Qualitative studies
• Seek to answer questions about:-
1. Why people behave the way they do?
2. How opinions and attitudes are formed?
3. How people are affected by the events that go
on around them?
4. How and why cultures have developed in the
way they have?
• Why there exist differences between social
groups?
Medical Education Research– Session July 2020 – Prof. Wadie
31

32. Qualitative questions:
• How?
• Why?
• What?
Medical Education Research– Session July 2020 – Prof. Wadie
32

33. • Qualitative research is a process
of capturing lived-in experiences of
individuals, groups, and society.
• It is an umbrella concept which
involves variety of methods of data
collection
Medical Education Research– Session July 2020 – Prof. Wadie
33

34. Differences Between Qualitative and
Quantitative studies
• Although the two methods are
often seen as antagonists,
there is a growing recognition
that the distinctions between
the methods are unnecessary.
Medical Education Research– Session July 2020 – Prof. Wadie
34

35. Qualitative vs. quantitative studies
• They cannot be compared side by
side but for the purposes of trying
to understand some key
characteristics of each of the types
of research, we will look at
qualitative and quantitative
methods and how they might
complement one another.
Medical Education Research– Session July 2020 – Prof. Wadie
35

36. • When collecting and analyzing data,
quantitative research deals with numbers
and statistics,
• while qualitative research deals with words
and meanings. Both are important for
gaining different kinds of knowledge.
Medical Education Research– Session July 2020 – Prof. Wadie
36

37. Qualitative vs. quantitative studies
• In terms of objectives,
qualitative research is
inductive and aims to explore
new things, insights, generate
theories, patterns, themes,
and hypotheses.
Medical Education Research– Session July 2020 – Prof. Wadie
37

38. Qualitative vs. quantitative studies
• On the other hand, quantitative
research is deductive so it
investigates the validity of facts,
estimates relationships, and
predicts outcomes,
• It controls, describes, or
confirms hypotheses.
Medical Education Research– Session July 2020 – Prof. Wadie
38

39. Qualitative vs. quantitative studies
• There's a lot more breadth to
quantitative methods,
• whereas there's a lot more
depth to qualitative.
Medical Education Research– Session July 2020 – Prof. Wadie
39

40. Qualitative vs. quantitative studies
• Qualitative research is
subjective, flexible, and
naturalistic.
• Quantitative on the other
hand is experimental and
uses statistics.
Medical Education Research– Session July 2020 – Prof. Wadie
40

41. Cooling break
Medical Education Research– Session July 2020 – Prof. Wadie
41

42. Steps of Conducting researches
• Step 1: Identify the Problem.
• Step 2: Review the Literature.
• Step 3: Clarify the Problem.
• Step 4: Clearly Define Terms and Concepts.
• Step 5: Define the Population.
• Step 6: Conduct the Implementation Plan.
• Step 7: Collect Data.
• Step 8: Analyze Data.
• Step 9: Write and publish your work.
Medical Education Research– Session July 2020 – Prof. Wadie
42

43. Priority Research Areas
• These should be agreed upon by each institution.
• Examples:
• teaching methods and learning techniques,
• job descriptions and professional skills of graduates,
• quality management in education,
• second language,
• clinical education,
• science production in medicine,
• faculty evaluation and
• information technology.
Medical Education Research– Session July 2020 – Prof. Wadie
43

44. Why should there be priority topics
for MedEd research?
• Research must add to the
current knowledge by
addressing clearly defined
needs or questions and the
results must have the potential
to affect the educational
practice.
Medical Education Research– Session July 2020 – Prof. Wadie
44

45. a list of the top themes in medical education research cited in
the 20-year review.
1. Student assessment & evaluation
2. Use of simulations
3. Clinical skills training
4. Admission to medical school
5. Clinical clerkships
6. Medical licensing exams
7. Problem-based learning
8. Knowledge retention
9. Community-based training
10.Specialty choice
11.Clinical competence assessment
12.Patient safety
13.Teaching the clinical sciences
14.Scholarship in education
15.Communication skills training
16. Humanities in medicine
17. Student characteristics
18. Teaching through lectures
19, Objective structured clinical exam
20, Interprofessional education
21. Teaching the basic sciences
22. International medical graduates
23. Nature of clinical reasoning
24. Women’s health
25. Professionalism in medicine (incl.
attitudes, cultural competence, ethics)
26. Underrepresented minority students
27. Costs of medical education
28. Computer-assisted instruction
29. Faculty development
Medical Education Research– Session July 2020 – Prof. Wadie
45

46. Can you list some topics that you
consider as priority research
areas in your institution
1. ...
2. ...
3. …
4. …
5. …
• In 5 minutes try to figure out the
hot topics that you think need to be
investigated or researched.
Medical Education Research– Session July 2020 – Prof. Wadie
46

47. Take a fresh breath
Medical Education Research– Session July 2020 – Prof. Wadie
47

48. Now you have chosen a topic
for research, what tool should
you use to collect data?
Medical Education Research–
Session July 2020 – Prof. Wadie
48

49. How to design a good survey
tool for your research
• This is the most important step
• and once properly achieved
every other step would be ok.
• On the other hand; if done less
satisfactorily every other step
would be a mess.
Medical Education Research– Session July 2020 – Prof. Wadie
49

50. Medical Education Research– Session July 2020 – Prof. Wadie
50

51. A questionnaire
Medical Education Research–
Session July 2020 – Prof. Wadie
51

52. A seven-step, survey scale design process
for medical education researchers.
1. Conduct a literature review: To
ensure that the construct
definition aligns with relevant prior
research and theory and to
identify existing survey scales or
items that might be used or
adapted
Medical Education Research– Session July 2020 – Prof. Wadie
52

53. A seven-step, survey scale design process
for medical education researchers.
2. Conduct interviews and/or
focus groups: To learn how the
population of interest
conceptualizes and describes
the construct of interest
Medical Education Research– Session July 2020 – Prof. Wadie
53

54. A seven-step, survey scale design process
for medical education researchers.
3. Synthesize the literature review
and interviews/focus groups: To
ensure that the conceptualization of
the construct makes theoretical
sense to scholars in the field and
uses language that the population of
interest understands
Medical Education Research– Session July 2020 – Prof. Wadie
54

55. A seven-step, survey scale design process
for medical education researchers.
4. Develop items: To ensure
items are clear, understandable
and written in accordance with
current best practices in survey
design
Medical Education Research–
Session July 2020 – Prof. Wadie
55

56. A seven-step, survey scale design process
for medical education researchers.
5. Conduct expert
validation: To assess how
clear and relevant the
items are with respect to
the construct of interest
Medical Education Research– Session July 2020 – Prof. Wadie
56

57. A seven-step, survey scale design process
for medical education researchers.
6. Conduct cognitive
interviews: To ensure that
respondents interpret items in
the manner that survey
designer intends
Medical Education Research–
Session July 2020 – Prof. Wadie
57

58. A seven-step, survey scale design process
for medical education researchers.
7. Conduct pilot testing: To
check for adequate item
variance, reliability and
convergent/discriminant
validity with respect to other
measures
Medical Education Research– Session July 2020 – Prof. Wadie
58

59. A final break before the end
Medical Education Research– Session July 2020 – Prof. Wadie
59

60. What are the steps
for developing a
scholarly MedEd
project?
Medical Education Research– Session July 2020 – Prof. Wadie
60

61. 1. Refine your study question:
1. Review the literature to identify
gaps.
2. Clearly state a problem and the
significance of addressing it.
3. Develop a conceptual framework: a
theory model, or approach that
places a question within a
theoretical context.
Medical Education Research– Session July 2020 – Prof. Wadie
61

62. 2. Define your outcomes:
1. An outcome is the dependent variable of
your study and should help you answer
your specific question directly
2. Challenge yourself to predict the outcome
of your study. What would your study
suggest if your prediction was proven to be
true or false?
3. Plan to collect information about your
outcome in an unbiased manner.
Medical Education Research– Session July 2020 – Prof. Wadie
62

63. 3. Identify designs and methods to enable you to study your
outcome such as:
1. Observations: Determine relationships or associations
between variables
2. Experiments: study the effect of changing one variable on
another
3. Qualitative research: study the reasons behind certain
behaviors and decisions
4. Validations: collect evidence to test the predictive value of
scoring instruments (e.g. course evaluations)
5. Surveys: Ask questions to better understand a subject’s
characteristics
6. Systematic Reviews: Use an established method/criterion to
summarize previously published studies
Medical Education Research– Session July 2020 – Prof. Wadie
63

64. How do I develop a research question?
• Sometimes the hardest part of a
research project is coming up with
an idea that is
1. feasible,
2. can have a meaningful impact, and
3. has not already been done.
Medical Education Research– Session July 2020 – Prof. Wadie
64

65. How do I develop a research question?
• Limiting the scope of your idea to a time
frame and level of effort that won’t unduly
interfere with your ongoing studies is also
challenging.
• Thankfully, ideas don’t spring from a
vacuum, and medical students are not
expected to independently lead something
they’ve never done before.
Medical Education Research– Session July 2020 – Prof. Wadie
65

66. How do I develop a research question?
• Ideas emerge from mindfully participating in
everyday experience with others.
• A great way to generate research questions is
to:
1. participate in ongoing educational
innovations at your home institution,
2. collaborate as a junior partner in ongoing
MedEd research projects, and
3. build relationships with others at your
institution who are doing MedEd research.
Medical Education Research– Session July 2020 – Prof. Wadie
66

67. Summary and
Take home
messages
Medical Education Research– Session July 2020 – Prof. Wadie
67

68. What are the practical steps in research
conduction? Take home messages
1. Sharpen your: ideas, research questions,
objectives and outcome indicators.
2. Think of an appropriate action plan: that
includes dates, logistics and cost.
3. Write your research proposal as draft, then
refine its items.
4. Plan well for the implementation phase:
consider minor details.
5. Document every thing you do immediately.
Medical Education Research– Session July 2020 – Prof. Wadie
68

69. Take home messages
6. Passion, Consistency and Patience
(PCP) are the most essential ingredients of
success.
7. Always keep in touch with seniors and
experts, even if you are not in 100%
agreement with their views.
8. The backbone of research writing (the
manuscript) is similar, whatsoever the type of
research: IMRAD (Introduction, Methods,
Results and Discussion).
Medical Education Research–
Session July 2020 – Prof. Wadie
69

70. Take home messages
9. Research is a practical skill, not theoretical
knowledge, (similar to football): Trail and
error approach.
10. Adequate language skills and knowledge
of basic statistical methods are essential tools
in research( not so essential if you are a team
member, other players may compensate).
11. Teamwork is the essence of research:
(would you expect Leonel Messi to succeed if he played alone
for Barcelona?)
Medical Education Research– Session July 2020 – Prof. Wadie
70

71. Quiz section
1. Mention three keywords in the definition of
MedEd Research.
2. What personal benefits would you expect to
gain of conducting MedEd Research?
3. What public benefits would be achieved
through conduction and publication of sound
MedEd Research?
4. Would you summarize the practical steps of
conducting MedEd Research?
Medical Education Research– Session July 2020 – Prof. Wadie
71

72. Thanks for your attention
Medical Education Research– Session July 2020 – Prof. Wadie
72

73. References and further readings
1. https://www.aamc.org/system/files/c/2/429856-
mededresearchprimer.pdf
2. https://www.hopkinsmedicine.org/gim/research/cont
ent/med_ed.html
3. https://www.mededpublish.org/manuscripts/400
4. https://en.wikipedia.org/wiki/Medical_education
5. https://www.scribbr.com/methodology/qualitative-
quantitative-research/
Medical Education Research– Session July 2020 – Prof. Wadie
73