Letters to the Editor
Dr. Levitt makes a very cogent observation about the difficulties in finding relevant medical education literature when searching MEDLINE. This difficulty stems from the original intent of the controlled vocabulary of the National Library of Medicine’s (NLM’s) Medical Subject Headings (MeSH), which was to organize literature in biomedicine. Anyone searching in fields outside of biomedicine, such as education, psychology, or the humanities, has struggled with the difficulty of using MeSH to find relevant literature, even when he or she knows it exists. Clearly, MeSH coverage of themes related to medical education could be improved.
Dr. Levitt’s reminder of the “suggestion box” that the NLM provides is valuable because many MEDLINE users do not know or remember that it exists. The NLM’s openness to user suggestions is admirable, but the results depend on the motivation and initiative of individual users. It is in this regard that I would offer a friendly amendment to Dr. Levitt’s proposal that we all propose new terms to the NLM. I would suggest that, rather than asking individual authors and scholars to make such proposals, the medical education research community as a whole should work together to identify a set of key words salient to medical education. These might then be proposed to the NLM, which might be more responsive to systematic, rather than piecemeal, modification of the MeSH structure. It would also reduce the variability in the suggestions that the NLM might receive from individuals.
Unfortunately, this would solve only some of our problems. For medical education researchers, MEDLINE remains a limited database from which to search for useful evidence in education. Much relevant literature resides in other databases, such as PsychINFO and ERIC, which have very different controlled vocabularies. Ideally, any effort on the part of medical educators (individually or collectively) to influence MeSH terms should seek to foster consistency in terminology between these various databases. Medical education, as a hybrid discipline of medicine, education, and the social sciences, will always struggle with and thrive on these disciplines’ connections. However, reducing the linguistic differences between these domains will facilitate the generation and dissemination of evidence in educational research and practice.
Larry D. Gruppen, PhD
Professor and chair, Department of Medical Education, University of Michigan, Ann Arbor, Michigan; firstname.lastname@example.org.