Systematic review of interventions to encourage careers in academic medicine

Abstract

Aims: Academic medicine is a career route that historically struggles to recruit and retain suitable doctors. The aim of this paper is to review the evidence for interventions to encourage careers in academic medicine by way of a descriptive systematic review.

Methods: Key databases were searched in February 2017. Studies that evaluated interventions to encourage careers in academic medicine and that used a pre–post analysis or included a comparison group were included. Interventions reporting only learner satisfaction were excluded. The review was specific to medical students and graduates.

Results: Twenty-four studies were identified for inclusion within the review. The included studies identified interventions across five domains: postgraduate funding, postgraduate training, mentoring, undergraduate interventions, and institutional change. The papers varied in terms of strength of conclusion and method of analysis with broad, structured, well-funded programs having the most palpable results.

Conclusions: The five domains identified offer a framework that can be used by institutions who wish to develop similar programs. It also offers a body of research on which an evidence base can be built.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Daniel Darbyshire, MBChB, MMed, is an Emergency Medicine Trainee in the North West of England.

Morris Gordon, MBChB, MMed, PHD, FRCPCH, FAcadMED, FAMEE, FHEA, is a Consultant Paediatrician at Blackpool Victoria Hospital, Associate Professor at UCLan School of Medicine and Director of BEME international collaborating center, UCLan/Blackpool.

Paul Baker, MBChB, DipEd, FRCP,FRCGP, FAcadMEd, is Deputy Postgraduate Dean for Health Education England (North West).

Steven Agius, BA(Hons), MA, PhD, Assistant Professor in Medical Education, School of Medicine, University of Nottingham.

Sean McAleer, BSc, DPhil, is Programme Director and Senior Lecturer at the Centre for Medical Education, University of Dundee.

Glossary

Kirkpatrick's hierarchy: This model was initially described in 1959 by Donald Kirkpatrick, Professor Emeritus at the University of Wisconsin and past president of the American Society for Training and Development (ASTD), as his Four-Level training and evaluation model. It has had major updates in 1974 and 1994 when he published his best known work “Evaluating Training Programs” The four levels can be summarized as:

1. Reaction – what the trainees think, or how they feel, about the training. Typified by measuring participant satisfaction.

2. Learning – measuring learning, whether it be knowledge, skills or attitudes. An example would be a knowledge assessment pre and post a teaching session.

3. Behavior – this looks at how trainees apply the learning. An example would be delivering training on prescribing and reviewing actual prescriptions of the trainees pre and post training.

4. Results – in healthcare this is generally taken to be patient outcomes but it could relate to organizational outcomes such as cost savings. An example would be a measured reduction in patient harms from drug errors after prescribing training. These levels have been modified and split to fit the type of program being evaluated by many different authors but retain the principle as originally described.

Kirkpatrick D. 2007. The four levels of evaluation. American Society for Training and Development.