Dauphinee, W. Dale MD; Anderson, M. Brownell MEd
Editor’s Note: Medical education research has evolved significantly in quality, scale, and scope over the last few decades. One important catalyst has been the Research in Medical Education (RIME) conference, which has been held in conjunction with the annual meeting of the Association of American Medical Colleges for a half century. Since 1990, the peer-reviewed, full-length articles accepted for presentation at a RIME conference also have been published in a supplement to Academic Medicine’s October issue.
I am delighted to report that these articles now will be published in the journal’s regular October issue. In part, this decision reflects the remarkable growth of medical education research as a discipline and its essential role in the mainstream discourse of academic medicine. In this guest editorial, Dauphinee and Anderson recount the 51-year history of the RIME conference and review key motivations for publishing these articles in the October issue instead of in a supplement. (The journal will, of course, continue to publish important medical education research articles throughout the year.)
This important change would not have been possible without the hard work and perseverance of Dale Dauphinee, Brownie Anderson, and the RIME program planning committee. Anne Farmakidis, Mary Beth DeVilbiss, Katherine McOwen, and Caroline Ford Coleman deserve special mention for their tireless efforts to ensure that every aspect of the RIME and journal processes wove together seamlessly.
At the midpoint of what promises to be a notable century of progress for RIME and for the study of medical education, it seems that now is the right time to make this change. - —Steven L. Kanter, MD
Research though toilsome is easy; imaginative vision, though delightful, is difficult. - —A.C. Bradley, Oxford Lectures on Poetry (1910)
With a focus on “transformation,” the 2011 Association of American Medical Colleges (AAMC) annual meeting marked two important developments for the Research in Medical Education (RIME) conference: the celebration of the 50th anniversary of the conference, and the decision to publish the accepted RIME submissions in an issue of Academic Medicine rather than as a special supplement. Thus, this issue contains the first collection of RIME articles published in a regular issue of the journal in the history of the RIME conference. This development was a joint decision by the RIME program planning committee and the journal’s editor in chief. What were the reasons for making this change?
A History of RIME
In 1961, the founders of the RIME program and those who participated in the nascent RIME conference were a more eclectic group than the RIME community is in 2012. They came from many areas of education: sociology; health services research; psychometrics and measurement; educational leadership; and, of course, teachers active in the medical education endeavor. The AAMC leadership supported the idea and were successful in getting the Carnegie Foundation for the Advancement of Teaching to support the development of an annual RIME program.
With time, the RIME program became the primary venue for researchers in medical education to present their work. For many years, researchers submitted written papers for peer review, and the successful submissions were published in the RIME proceedings, which, beginning in 1962, were special or supplementary content in the AAMC’s Journal of Medical Education and, from 1969 until 1990, were a separate document produced by AAMC staff. The proceedings were indexed in Index Medicus beginning in 1971. Since 1990, the RIME proceedings have been published as a supplement to Academic Medicine, until this year when the accepted submissions moved into a regular issue of the journal.
Since its inception, a steering committee of the educational community has overseen the RIME program. It is the RIME program planning committee, however, that has the responsibility for both the final peer review of the submitted papers and organizing the successful submissions around themes for the annual RIME program.
A New Era for RIME
In 2010, the RIME committee and editor in chief of Academic Medicine began to consider the advantages of moving the RIME articles into a regular issue of the journal. New opportunities to advance the mission and the impact of RIME greatly influenced the committee’s decision to publish accepted RIME submissions in the journal. The committee recognized several advantages to the new model, including
* creating opportunities for outside commentaries and independent feedback about RIME developments;
* broadening the audience for the RIME program’s contributions;
* engaging the broader AAMC and medical health sciences communities in the discussion on education; and
* adding value for researchers because publications in regular issues of journals are perceived by promotion and tenure committees as more valued than publications in supplements.
The RIME program planning committee also anticipated some challenges in the transition. The most obvious was that, in year one, the time available for revisions of accepted papers would be limited while the committee adapted to the new time frame and the need for editorial oversight of the selected papers. That meant that, in 2012, revisions had to be completed much more quickly than in the past. In previous years, a handful of submissions presented conceptually innovative ideas or were laden with too much jargon and, as a result, needed significant revisions to be acceptable. This year was no different, and although we may have been able to allot extra time for revisions in the past, some very interesting and potentially insightful papers could not be revised in sufficient time to meet this year’s editorial deadlines. Given the changes that the journal staff, program committee, and AAMC staff will put in place for 2013, this should not be a determining factor in the future.
Now, the accepted, peer-reviewed, full-paper RIME presentations will appear as articles in the October issue of the journal. Instead of limiting the exposure of the RIME program by publishing it in a supplement read by a more restricted community within the AAMC family, the RIME program has reached a new level of maturation in its history by opening itself to the wider AAMC and health sciences communities through the pages of the journal.
The Program as a Reflection of Challenges Facing Society and Our Community
The 2012 RIME program, as compared with previous years, includes certain themes and patterns of change. Some are familiar, but some are clearly different from themes apparent in past RIME programs. The most obvious differences are that this year’s selections focus on processes and that their methodology is much more oriented to mixed methods and qualitative approaches than the quantitative measurement that is typical of the RIME conference. Although this change could be due to the selection process by the external reviewers and the RIME program planning committee, we suggest that it is more reflective of current developments in health care and education. This year’s RIME selections question where we are going, examine how we face change, and ask whether this is a time for transformation. In fact, a careful review of the papers presented at the RIME conference over the past 51 years illustrates that they reflect the state of our community and our society at any point in time. This is true as we consider the content of the articles in this issue.
For the 2011 RIME conference, the committee examined the topics of all the papers selected for presentation during RIME’s first 50 years. Comparing the topics of this year’s accepted submissions with those covered in past decades, the topics from 1960 to 1970 overlap the most with those to be presented at the 2012 RIME conference. Similar to 1960 to 1970, admissions, assessment, relationships, cognition, reasoning, and instruction are the major themes presented in the RIME articles in this issue. Other themes include continued professional development, emotions, competencies, and self-assessment.
Are we revisiting topics examined over 40 years ago and building on that work, or are we recreating the same approaches? Has the pendulum swung away from numbers and strictly objective measurements back to more insightful and socially relevant assessments of attitude, team relationships, personality, and language or discourse? Have our reviewers and committee members changed their approach to reading research in medical education? Clearly, more qualitative research methods appear in this year’s program, but have we abandoned quantitative methods in an effort to answer the questions we are facing in this time of transition?
To a large degree, the studies in the 2012 RIME program focus on specific details of the educational process and short-term evaluation rather than long-term outcomes for the broader field. These reports provide useful data for understanding the challenges we face and pave the way for clearly defined paths of future research that could provide insightful and generalizable new knowledge to the field of medical education or that could influence the field across schools and programs. This next step is important, as medical education research is even more in need of a coherent direction in these challenging and changing times.
Medical education research requires an intellectual structure, a framework into which seemingly random studies can come together to improve learning and practice. The challenge before us is to look forward and develop a well-laid plan to further the field of medical education research nationally and internationally. We must take advantage of this time of transition and transformation to build the necessary scaffold on which to develop medical education research. The current work of the Medical Education Scholarship Research and Evaluation (MESRE) section of the AAMC’s Group on Educational Affairs and the medical education research certificate (MERC) program workshops are examples of activities under way to build the intellectual structure necessary for a strong medical education research program.
The RIME conference is much more than an opportunity to hear presentations. The conference is an arena for learning, for creativity, for scholarly interaction,
…an annual forum within which interested medical faculty can critically analyze and discuss the results of students and research in medical education [that] will be essential to a continuing and growing activity.1
RIME’s Maturation and Future Directions
The maturation of the RIME conference program is not just a matter of natural aging. It is a matter of seeking to inform educational practices and innovation in a publicly accountable manner for all of the health professions and sciences. Thus, the call for a wider research agenda does require a national and international vision, but it also means being informed, relevant, and accountable to the broad array of institutions involved in health care and health professions education.
That wider mission is the foundation of the decision to include the successful RIME submissions in a regular edition of Academic Medicine. Doing so enables us to speak to a wider audience, engaging the broader AAMC community of clinicians, scientists, and interdisciplinary groups in the debate about the future of education and its emergent challenges. It is not a discussion and debate limited to the RIME conference and its community of researchers. The discussions and debates within the RIME community need to include the views of others and to seek in print the comments of knowledgeable experts. Being part of the mainstream of discussions within the AAMC’s journal is an essential step toward opening our work and ideas to the broader academic and research communities. We must build foundations for the future by analyzing current societal challenges, clarifying better ways forward by innovation and research, and hearing what others can contribute to our collective success. We congratulate the RIME community and the staff of Academic Medicine on this step forward and encourage them to take the necessary next steps to broaden the discussion, increase participation, and develop that imaginative vision, difficult and challenging as it may be.
W. Dale Dauphinee, MD and M. Brownell Anderson, MEd
Dr. Dauphinee is adjunct professor of medicine, Clinical and Health Informatics Research Group, McGill University Faculty of Medicine, Montreal, Quebec, Canada, and senior scholar, Foundation for the Advancement of International Medical Education and Research, Philadelphia, Pennsylvania.
Ms. Anderson is senior academic officer, National Board of Medical Examiners, Philadelphia, Pennsylvania.