The seven articles and eight case studies in this special theme issue are the result of a tremendous effort by some of the busiest people in the field of medical education research. It wasn't without some concern that I first contacted them, because of the time and effort I was asking for. I shouldn't have worried. Not only did they meet their deadlines at every step of the process (the way into an editor's heart), they produced a set of papers that will inform and advance the field for years to come (the other way into an editor's heart). The journal and the academic medicine community owe these authors a world of thanks for their commitment and contributions.
This theme issue differs from most in that, rather than coming together serendipitously, it was created intentionally. As Dr. Whitcomb explains in his editorial, the theme of this issue emerged from the provocative, ongoing debate over the role and conduct of medical education research, which he wrote about in November 2002.1 Deciding to continue this discussion in print, we weighed several options for presenting the views of researchers. We considered a half dozen permutations before agreeing readers would benefit most from a combination of framing articles and in-depth case studies of successful medical education research programs.
The initial topics for the framing articles morphed only slightly to become those discussed in this issue. Apart from our bare-bones content suggestions, our only other request was that authors focus on the future—easier said than done, of course. We asked Steve Wartman to revisit his 1989 call for a National Center for Health Professions Education Research. Since that time, attention to the outcomes of medical education has intensified, and the responses by medical schools, while often innovative, have remained mostly internal. Wartman maintains that a national infrastructure is needed to support continuing research. Jan Carline tackled what was, arguably, the toughest task: taking on the issue of funding medical education research. His article will be useful to any medical education researcher. His conclusion—that the funding crisis requires that medical educators both advocate the applicability of their research and undergird their work with stronger ties to theory building—begs the question: Is this the optimal environment for productive research?
Along with these pieces, we wanted an overview of the scholarship of the past few years. Glenn Regehr sorted through a mound of literature published since 2000, analyzing the major trends and themes. His observation—that programmatic lines of research are necessary to advance medical education research—is echoed by other authors in this issue. Shea, Arnold, and Mann have written a primer of sorts for the medical education research community, establishing a framework for medical education research and a threshold for quality. They also argue that training and collaboration can increase the research's impact. Dauphinee and Wood-Dauphinee describe the Best Evidence Medical Education (BEME) Collaboration, an innovative approach that integrates evidence-based practice with medical education practice and research.
Albert provides an intriguing commentary on the state of medical education research based on his “outsider's” perspective as a sociologist. Readers of Academic Medicine may not often encounter Bourdieu's field theory of sociology. But Albert's central question, “What are the power dynamics at play in medical education research?” and the conclusions he draws using Bourdieu's theory are practical and innovative. Finally, the piece by Chen and colleagues brings the articles full circle, outlining an agenda for researchers that links training with clinical outcomes.
The case studies section represents our effort to provide examples of successful medical education research programs. To identify these programs, we used publications as the primary selection criterion. Which program had published the most research in our journal over the past five years? Did including publications in other medical education journals affect the outcome? This criterion identified seven of the eight programs described in the case studies. The eighth was selected from a pool of schools with identical publication rates. Louise Arnold, who faced the unenviable pressure of having to wait the longest to get started, then produce under the shortest deadline, has synthesized the findings of these case studies and raised questions for future authors to tackle.
Despite our use of a single selection criterion for the case studies, a surprising variety of organizational structures, geographic locations, and sizes emerged. Still, the case studies presented in this issue represent a limited and elite cohort. Without question, there are other highly functioning medical education research departments, programs, and projects contributing to the scholarly literature. The Society of Directors of Research in Medical Education's Web site, <http://www.sdrme.org>, is an excellent resource for additional information on these national and international programs. Albanese, Dottl, and Nowacek2 have written general descriptions of U.S. offices of medical education research, but the in-depth look at the inner workings of successful programs presented here has not previously appeared in the literature.
This special theme issue continues the journal's commitment to the pressing issues in the dynamic field of medical education research. We invite readers to actively participate in this discussion at two symposia we are co-sponsoring with the GEA-RIME at this year's Association of American Medical Colleges (AAMC) Annual Meeting in Boston. The first, “Applying Medical Education Research to Change,” will be held Sunday, November 7, 8:30–10:00 AM and will feature Paul Ramsey, MD, vice president for medical affairs and dean, University of Washington School of Medicine, and Steven A. Wartman, MD, PhD, executive vice president for academic and health affairs and dean, University of Texas Medical School at San Antonio. The second, “Case Studies of Medical Education Research Programs: A Symposium on Institutional Frameworks,” will be held Wednesday, November 10, 8:00–9:30 am and will feature authors of the case studies. Further information regarding these symposia can be found in the Annual Meeting's program.
The expertise of my Academic Medicine colleagues, particularly Al Bradford and Lisa Hisel, has helped ensure the high quality of presentations in this issue. I'm grateful for their help. As medical education researchers focus on the future of their field, our journal will continue to publish their ideas.