An Invitation for Medical Educators to Focus on Ethical and Policy Issues in Research and Scholarly Practice

Abstract

Medical education research and medical education practice both involve being methodical, innovative, self-observing, forward-looking, and open to peer review, and both are scholarly activities. For these reasons, distinguishing between these two activities is often difficult. There are three important reasons to clarify the distinctions: the moral difference between education research and education practice; federal regulations governing education research that require more safeguards than often exist in education practice; and the fact that student participants in research have characteristics in common with members of special populations. The authors explain why attention to issues of safeguards in education research and practice is likely to grow at academic health centers, yet maintain that these issues are neglected in the medical education literature. They demonstrate this with findings from their review of 424 education research reports published in 1988 and 1989 and in 1998 and 1999 in two major medical education journals. Each article was evaluated for documentation of six ethically important safeguards and features (e.g., informed consent). The rates of reporting the six features and safeguards were relatively low (3-27%). Nearly half (47%) of the empirical reports offered no indication of ethically important safeguards or features, and no article mentioned all six. Furthermore, those rates did not increase substantially after ten years. The authors discuss a number of implications of their findings for faculty, training institutions, students, and editors and peer reviewers, and conclude with the hope that their findings will raise awareness of these neglected issues in medical education and will stimulate all those involved to reflect upon the issues and set standards on the ethical aspects of research and scholarly practice.

Clinician Educators??? Experiences with Institutional Review Boards: Results of a National Survey

“…Because the subjects of medical education research are often medical students-who are considered a special class of subjects by the Office for Human Research Protection in the U.S. Department of Health and Human Services-researchers engaged in medical education research need to take into consideration how to best uphold confidentiality and recruit learners as research subjects without implicit or explicit coercion, to optimize students' ability to give true consent (e.g., students may volunteer for research for the sole purpose of gaining a favorable recommendation or grade). 3,4 Although there is some debate about what constitutes research in medical education, 5 most academic health centers require that all research activities involving human subjects (e.g., students) that lead to generalizable knowledge (such as program evaluation where the results are disseminated beyond the institution) must be reviewed by the local institutional review board (IRB) to ensure that the aforementioned concerns are adequately addressed. 4 -6 Clinician educators, as opposed to clinician investigators, conduct the majority of the medical education research, because they have access to learners, work in the field of medical education, and seek to publish to achieve academic promotion.…”

“…to protect students from coercion and maximize their ability to give true consent. 5 RCR areas previously identified as important in medical education research include recruitment of students, informed consent and confidentiality practices, and use of existing medical education data for research (analogous to chart review of existing data initially obtained for nonresearch purposes in the clinical research realm). 6 Yet, it is not known how familiar clinician educators are with their local IRB policies pertaining to these RCR areas.…”

Overcoming Barriers to Addressing Education Problems With Research Design: A Panel Discussion

“…22 It is also important that they ensure that institutional review board approval is obtained, as learners are a vulnerable study population. 23 3. Select Outcomes.…”

“…23 Many education journals now require institutional review board approval for all studies involving human subjects. Network…”

Planification d'une étude expérimentale et rédaction d'une demande de subvention en 8 étapes et 28 questions

“…L' a p p robation éthique de l'étude proposée par les autorités institutionnelles devient de plus en plus la norme dans le domaine de la re c h e rche en éducation et est requise par les organismes subve n t i o n n a i res et les revues scientif i q u e s 15,16,17 . Le but visé est de protéger les participants et leurs dossiers (données) en évaluant les risques et béné-fices de participer à l'étude, les biais de sélection, la confidentialité et les incitatifs à participer à l'étude.…”