What a great year to be part of the RIME Planning Committee. The theme of the 2006 conference is Pursuing Excellence, Creating Value, and looking back over the past seven years, this year was one of the most successful and productive in terms of conference submissions. There were 92 research papers, five review papers, and 248 abstracts submitted for the RIME sessions of the annual conference program. The committee accepted 31 research papers and one review paper for presentation and publication in this supplement. Of the 128 abstracts selected for the program, 82 will be presented as posters and 46 will be oral presentations. The review paper accepted for this year’s program is “Literature in Medicine: A Problem of Assessment” by Ayelet Kuper. The program committee’s task of selecting submissions for the conference program would not be possible without the efforts of a small army of RIME reviewers who took the time to make many thoughtful comments and complete their reviews within the requested time frame. The success and quality of the RIME program relies on the generosity and insights of these individuals.
This year, we are very pleased to have Lee Shulman as the speaker for the RIME invited address. Dr. Shulman is President of The Carnegie Foundation for the Advancement of Teaching and his current work focuses on the discipline-specific signature pedagogies. He is very enthusiastic about returning to his medical education roots and speaking to us about insights gained from investigations of education in other professions.
For many of us, the annual meeting ends with the RIME Wrap-Up, a session that provides highlights and insights from a broad view of the medical education research represented by the RIME program. This year we are happy to have Lorelei Lingard from the University of Toronto and Georges Bordage from the University of Illinois at Chicago sharing the Wrap-Up duties. In addition, the 2005 Wrap-Up presentation from Warren Anderson, PhD, is included as part of this supplement.
The 2006 program will have a strong representation of research related to prediction, with presentations related to student selection, certification examinations, and postgraduate outcomes. Research related to the assessment of clinical skills, professionalism, communication skills, and clinical reasoning are again well-represented this year. Unlike past years, there were relatively few submissions related to training and implementation of standardized patients, resident work hours, and technology including simulation and e-learning. These changes in program content could be a reflection of the growing number of opportunities for those interested in medical education to present their work outside of the RIME conference. In part, it could also represent a lull in original research as the initial novelty of these recent innovation trends has diminished.
There continue to be relatively fewer submissions directly linking the effects of medical education research to patient outcomes. This is surprising with the recent emphasis in several reports by the Institute of Medicine and others on patient safety, reducing medical errors, and improving the overall quality of patient care. It may be too early to judge the response of these reports. However, we feel there needs to be a closer link between those carrying out medical education research primarily directed at the undergraduate medical student level with those who provide clinical education and patient care at the graduate and continuing medical education level. Only then will we be able to better measure the effects of education and training on clinical practice and outcomes. We feel that RIME not only has a responsibility to steward “Research” in Medical Education and ensure the highest rigor of scholarship, but also an obligation to endorse “Relevancy” in Medical Education. RIME is in a unique position within the Association of American Medical Colleges (AAMC) to bridge expertise among UME, GME, and CME to make this happen. The research paper, “Effect of Critical Care Medicine Fellows on Patient Outcome in the Intensive Care Unit,” by Adam Peets and colleagues is an example of one such study.
Medical education research as represented by RIME submissions shows a continued lack of multicenter and multi-institutional studies. Despite common issues, the greatest challenge is funding. This is especially true with fewer funding sources available to growing numbers of interested researchers. This is exemplified by the recent decision by the Centers for Medicare and Medicaid to reduce their funding support to graduate medical education programs for activities not directly related to patient care and those that are performed outside the hospital complex; many worry that limitations on resident working hours will result in reduced funding to graduate training programs, thereby affecting the most vulnerable area—education. This highlights a growing need to identify successful models of multi-institutional collaboration and to disseminate lessons learned regarding innovative approaches to identify funding for such projects. For example, in the past year, the federal government has offered grants totaling several millions of dollars in the areas of patient safety, improving quality of health care, and disaster, and bioterrorism response.
The RIME Planning Committee introduced a number of changes to the submission and review process this year. One explicit goal for this year was to provide reviewer feedback to authors for all submitted papers. Given the many thoughtful reviewers who took time to provide constructive feedback, the committee members felt it important to attempt to give feedback for all submitted papers. Often there are more quality papers than can be accepted for the program, and one of the limiting factors for accepting papers is that the revisions required can be accomplished on a very tight schedule to assure meeting the publication deadlines for the RIME supplement of Academic Medicine. The RIME committee met in April this year, almost a month earlier than has been typical in order to give authors more time to revise their manuscripts for publication. There are always a number of well-conceived papers that cannot be accepted because the revisions are too extensive for the available timeline.
Another change that was implemented this year was the requirement that if a paper reports a study using human subjects, the authors must state in their paper whether they received human subjects approval, and if not, why not. This change was adopted to be consistent with increased scrutiny of medical education research and evaluation by local Institutional Review Boards as well as the assurances required by many scholarly journals.
Finally, the RIME Planning Committee would like to acknowledge the invaluable support from the AAMC Division of Medical Education for providing the infrastructure for RIME. In particular, we appreciate Caroline Coleman and her efforts to manage all of the submissions as they make their way through the review process. Brownie Anderson also deserves our gratitude for her guidance and support of RIME in ways too numerous to mention.
Co-Chairs, 2006 RIME Planning Committee