What really matters for successful research environments? A realist synthesis

Ajjawi, Rola; Crampton, Paul; Rees, Charlotte E.

doi:10.1111/medu.13643

Cited by 41 publications

(40 citation statements)

References 64 publications

(268 reference statements)

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“…The team consisted of practitioners, academics and researchers from medical and social science background disciplines, with QA knowledge ranging novice-expert 19. Team members were vastly experienced in qualitative methods20 21 and had previously applied a realist lens to understand complex interventions in healthcare education 22…”

Section: Methodsmentioning

confidence: 99%

Realist evaluation of UK medical education quality assurance

Crampton

Mehdizadeh²,

Page³

et al. 2019

BMJ Open

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ObjectivesThe aim of the study was to explore what components of the General Medical Council’s (GMC) Quality Assurance Framework work, for whom, in what circumstances and how?SettingUK undergraduate and postgraduate medical education and training.ParticipantsWe conducted interviews with a stratified sample of 36 individuals. This included those who had direct experiences, as well as those with external insights, representing local, national and international organisations within and outside medicine.InterventionThe GMC quality assure education to protect patient and public safety utilising complex intervention components including meeting standards, institutional visits and monitoring performance. However, the context in which these are implemented matters. We undertook an innovative realist evaluation to test an initial programme theory. Data were analysed using framework analysis.ResultsAcross components of the intervention, we identified key mechanisms, including transparent reporting to promote quality improvement; dialogical feedback; partnership working facilitating interactions between regulators and providers, and role clarity in conducting proportionate interventions appropriate to risk. The GMC’s framework was commended for being comprehensive and enabling a broad understanding of an organisation’s performance. Unintended consequences included confusion over roles and boundaries in different contexts which often undermined effectiveness.ConclusionsThis realist evaluation substantiates the literature and reveals deeper understandings about quality assuring medical education. While standardised approaches are implemented, interventions need to be contextually proportionate. Routine communication is beneficial to verify data, share concerns and check risk; however, ongoing partnership working can foster assurance. The study provides a modified programme theory to explicate how education providers and regulators can work more effectively together to uphold education quality, and ultimately protect public safety. The findings have influenced the GMC’s approach to quality assurance which impacts on all medical students and doctors in training.

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Section: Methodsmentioning

confidence: 99%

Realist evaluation of UK medical education quality assurance

Crampton

Mehdizadeh²,

Page³

et al. 2019

BMJ Open

Self Cite

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“…Specifically, it has been cited as a key factor in establishing a research environment and in influencing the academic productivity of clinical educators . It is also associated with increased career satisfaction and can help individuals develop a “research identity,” which promotes self‐efficacy and a sense of belonging within a research community …”

Section: Implications For Education and Training In Emmentioning

confidence: 99%

Barriers and Solutions to Advancing Emergency Medicine Simulation–based Research: A Call to Action

Bentley

Stapleton

Moschella

et al. 2019

AEM Education and Training

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Simulation technology has successfully improved patient safety and care quality through training and assessment of individuals, teams, and health care systems. Emergency medicine (EM) continues to be a leader and pioneer of simulation, including administration of simulation-based fellowships and training programs. However, EM simulation-based research has been limited by low rates of publication and poor methodologic rigor. The Society for Academic Emergency Medicine (SAEM) Simulation Academy is leading efforts to improve the quality of scholarship generated by the EM simulation community and to foster successful research careers for future generations of EM simulationists. Through a needs assessment survey of our membership and a year-long consensus-based approach, we identified two main clusters of barriers to simulation-based research: lack of protected time and dedicated resources and limited training and mentorship. As a result, we generated four position statements with implications for education, training, and research in EM simulation and as a call to action for the academic EM community. Recommendations include expansion of funding opportunities for simulation-based research, creation of multi-institutional simulation collaboratives, and development of mentorship and training pathways that promote rigor in design and methodology within EM simulation scholarship.

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“…The realist review completed by Ajjawi et al reminds us that an individual scholar's success is not shaped solely by his or her research practices and decisions . Their synthesis focuses on how research environments impact on researcher productivity, highlighting the fact that not all environments support all forms of productivity, or all people …”

mentioning

confidence: 99%

“…In reading this work, we were struck by how the research environments studied in this review seemed to share one characteristic: a local, physical presence. We agree that local research environments have a significant impact on scholarly activities, and we acknowledge that the emphasis on physically present communities reflects the body of literature synthesised.…”

mentioning

confidence: 99%