In this issue, you will find the second installment of TLM's annual Conversation Starters series. I am pleased to report that the first installment met with great enthusiasm, as reflected in numerous online views and—even better—initial evidence of citations and inquiries from independent researchers seeking to continue the work discussed. I hope that those of you familiar with Conversation Starters have opened this issue knowing what the fuss is about and are eager to keep the discussion going. For those of you unfamiliar with the series and interested in learning more, I recommend visiting last year's fourth quarter issue as part of your exploration. There, you will find a detailed explanation of the series in the Letter from the Editor (“Let's Talk …”) and the four excellent articles that composed the inaugural installment.
By way of brief introduction (or refresher), Conversation Starters represents the joint effort of TLM, the American Association of Medical Colleges Group on Educational Affairs (GEA), and the GEA's Medical Education Scholarship Research and Evaluation (MESRE) section to highlight groundbreaking inquiry by “the researcher next door.” This annual series comprises four short articles, each pairing a research abstract selected from one of the four regional GEA spring meetings with an integrated multiexpert commentary. These commentaries thoughtfully explore the implications of promising pilot studies for theory development, educational practice, and larger programs of research. The intent of this series is to foster collaboration, further inquiry, and ultimately successful GEA grant proposal submissions and scholarly publications.
In this year's installment, it is interesting that transitions seem to be a common, implicit theme across the articles. The Western Region article, “What's in a Transition? An Integrative Perspective on Transitions in Medical Education,” addresses the topic of transitions directly, proposing how general theoretical mechanisms of transition may be integrated with cognitive load theory to design interventions that foster personal and professional growth. The Northeast Region article, “Exploring the Role of Peer Advice in Self-Regulated Learning: Metacognitive, Social, and Environmental Factors,” focuses on several essential elements of transitioning smoothly to medical school—self-regulation, feedback, and interpersonal relationships—in its exploration of the mechanisms of peer study advice. The Southern Region article, “Coming in From the Cold: Physician Professional Development as Deepening Participation in the Healthcare Community,” posits a transitional process whereby physicians gradually develop agency by demonstrating total dedication to patient care appropriate to their experience and level of training. Finally, the Central Region article, “On the Origins of Perceptions: Student Perceptions of Active Learning and Their Implications for Educational Reform,” highlights the potential difficulties medical students can encounter when transitioning to an active-learning setting in the context of assessment practices typical of higher education and medical school.
It is interesting that all the studies featured in this year's selected abstracts either probed or identified divergent perspectives. Of particular interest to authors who explicitly examined divergent perspectives were faculty versus student perspectives on the very objectives of teaching and learning. The Western Region study (Colbert-Getz et al.) was a survey-based needs assessment that investigated what skills faculty and 1st-year medical students thought essential to transitioning to medical school. The Southern Region study (Wyatt) qualitatively examined preceptor, resident, and clerkship student definitions of patient “ownership,” a concept introduced by a clerkship director that raised questions about “what is owned” in the clinical learning setting. Abstract authors not necessarily setting out to examine divergence nevertheless discovered it among medical students, which raised questions about how people can hold seemingly opposing views simultaneously. In the Northeast Region study (Rashid et al.), 1st-year medical students reported via survey most commonly receiving study advice from their peers yet finding it the least helpful and least likely to be followed. Even so, these students reported that they would give this same type of advice to new 1st-year students in the future. The Central Region study (Istas et al.) gathered student perspectives on active learning via focus groups and found that students held accurate, shared, and positive conceptions of active learning yet nevertheless worried that it would fail to prepare them for institutional and licensure examinations.
Perhaps this year's Conversation Starters articles simply reflect that medical education is itself in a time of transition, a circumstance that tends to bring divergence—external and internal—to the fore. Transition is not new to medical education; numerous articles giving voice to growing pains, both in research and practice, have been published over the decades. Where instructional, assessment, and administrative practices are changing along with the evolving demands of modern healthcare, disequilibrium naturally results. This year's Conversations Starters articles highlight the value of stepping back to examine closely what we are doing and why. As with personal disequilibrium, community transition points—coupled with reflection and informed action—offer the opportunity for positive growth and meaningful change. Continued dialogue and collaborative inquiry on challenging problems will strengthen our community and everything we do to advance medical education and, ultimately, patient care.
In bringing this editorial to a close, I want to point out the diversity among the expert commentators who participated in this year's installment; their differing perspectives have greatly enriched the conversation. Half of the 12 commentators are female, and four are from outside the United States (two from the Netherlands and two from Canada). The roster also represents a nearly equal balance of Ph.D.s and M.D.s. Future conversation will benefit even more with involvement of expert commentators who are underrepresented in medicine and who come from other healthcare fields. I also acknowledge the MESRE representatives who directly supported this year's effort with their enthusiasm and assistance in selecting abstracts and nominating expert commentators: Sebastian Uijtdehaage, Steven Rougas, Nicole Borges, and Christy Boscardin. It has been a great pleasure and an excellent learning experience to work with everyone. I hope you enjoy reading this year's installment as much as I have enjoyed bringing it to you.
GEA informational links
GEA
National Grant Program: https://www.aamc.org/members/gea/gea_sections/mesre/
2017 Grant Proposals Due: TBD
GEA Central Region (CGEA)
Grant Program: https://www.aamc.org/members/gea/regions/cgea/
2017 Grant Proposals Due: TBD
Spring Meeting: https://www.aamc.org/members/gea/regions/cgea/meetings/257276/cgea_meetings.html
2017 Research Abstracts Due: November 1, 2016
GEA Northeast Region (NEGEA)
Grant Program: https://www.aamc.org/members/gea/regions/negea/453486/negeagrants.html/
2017 Grant Proposals Due: TBD
Spring Meeting: https://www.aamc.org/members/gea/regions/negea/meetings/
2017 Research Abstracts Due: November 1, 2016
GEA Southern Region (SGEA)
Grant Program: https://www.aamc.org/members/gea/regions/sgea/awards/
2017 Grant Proposals Due: TBD
Spring Meeting: https://www.aamc.org/members/gea/regions/sgea/meetings/
2017 Research Abstracts Due: November 1, 2016
GEA Western Region (WGEA)
Grant Program: https://www.aamc.org/members/gea/regions/wgea/
2017 Grant Proposals Due: TBD
Spring Meeting: https://www.aamc.org/members/gea/regions/wgea/meetings/
2017 Research Abstracts Due: November 1, 2016
Anna T. Cianciolo, Ph.D.
Editor-in-Chief