Whitcomb, Michael E. MD
This year's meeting of the journal's editorial board was a particularly important one. Unlike previous meetings, which focused on the journal's performance during the preceding year, I asked the board to provide advice on what the primary focus of the journal's content should be in the future. Why did I feel it was important for the board to discuss this issue? In this editorial I answer that question, summarize the advice given by the board, and explain our common view of a new goal for the journal.
To begin, it is necessary to recall an important factor that currently influences decisions about the journal's content. In a previous editorial,1 I explained that Academic Medicine is perhaps unique among journals in that it serves two distinct audiences. On the one hand, the journal publishes research reports and articles that will most likely interest the members of the medical education community, individuals who are primarily educators and/or teachers. This is a role the journal has played for many decades. At the same time, the journal publishes articles, and some research reports, that will most likely interest the members of the leadership community, such as deans, department chairs, heads of teaching hospitals, and others. I expressed in that editorial my belief that the journal provides an important service by allowing “both communities to communicate with and learn from each other.” But I now think the time has come to reexamine whether that should be the main role of the journal.
One of the reasons for reexamining that role is that it is clear that present and future leaders of academic medicine must be better prepared to address an array of very serious challenges if academic health centers are to retain their preeminent role in American medicine. As I scan the journals those individuals are likely to be reading, I find that very few publish articles that address those challenges on a regular basis. And I suspect that many individuals who might be willing to write about the issues involved don't do so because they think there are no journals willing to publish such articles. Indeed, I suspect that many may still believe that to be the case with Academic Medicine.
Another reason I think it is important to reevaluate the journal's content relates to my views on the state of medical education research. Regular readers of the journal know that on more than one occasion I have expressed my concerns about the very uneven quality and general lack of relevance of the majority of the research reports submitted to the journal. Indeed, I have also discussed this issue with leaders of the medical education research community. I recognize that members of that community look to Academic Medicine to publish their work. But that is not, in and of itself, a sufficient reason for the journal to continue to publish reports that have a very limited ability, if any, to meaningfully influence the quality of medical education.
So with that as background, what did the members of the editorial board have to say during the March meeting? Before summarizing their views, I want to remind readers that the board is composed of individuals drawn from a number of the constituencies of the academic medicine community, including prominent medical educators and leaders within the medical education research community.
First, readers should know that the members of the board took the issue of the journal's future content quite seriously and discussed it in depth. As a group, the board stated its strong opinion that Academic Medicine should now strive to be the journal that those holding leadership positions in medical schools and teaching hospitals turn to first for information that will help them address the major challenges facing their institutions and academic medicine as a whole. Not surprisingly, the board said that to achieve that goal, the journal should continue to publish research reports and articles addressing medical education issues. It also made clear that the journal should give preference to certain types of research reports. Among these are reports that address either particularly promising medical education innovations or new, more effective approaches for managing educational programs. And the board also encouraged the publication of (1) research reports of multiinstitutional studies of educational interventions, particularly ones that show how the intervention affected the actual behaviors of the learners or the outcomes of their encounters with patients, and (2) reviews that enhance understanding of a topic by expertly summarizing and evaluating a large body of work.
The board members also said that to truly achieve the new goal, the journal must publish a greater number of articles addressing issues of importance to the leadership community and must do so in a more timely fashion. But to ensure that the overall quality of the journal's content does not suffer in the process, they recommended that the editorial staff develop clear criteria for evaluating those kinds of articles. The board also challenged the editorial staff to develop strategies for informing potential authors about the journal's interest in articles focusing on specific leadership issues. It recommended that the staff solicit, and publish simultaneously, commentaries on some of the articles accepted for publication to provide readers with a broader perspective on the issues being addressed. The board once again expressed its support for publishing theme issues and collections of articles addressing various aspects of a specific topic.
I strongly agree with the board's recommendations. Implementing them has implications for the operation and management of the journal and will ultimately affect the journal's content. Indeed, readers will notice some changes in content in the months ahead as topics that have infrequently been addressed in the journal become the focus of individual articles and theme issues. In a future editorial, I will talk about another issue discussed by the board—how innovations in technology can be used to more effectively organize and present the journal's content to readers.
The intent of the forthcoming changes is to begin to achieve the goal the editorial board recommended for the journal—that is, to make Academic Medicine the journal that academic medicine's leaders and its institutions’ faculty members read to learn more about contemporary issues affecting their institutions. Working toward that goal is a challenge that I and the rest of the editorial staff welcome!
Michael E. Whitcomb, MD