An outcomes research perspective on medical education: Has anything changed in the last 18 years?

Abstract

Purpose

Medical education research focused on patient-centered outcomes holds the promise of improved decision-making by medical educators. In 2001, Prystowsky and Bordage demonstrated that patient-centered outcomes were evaluated in fewer than one percent of studies published in a survey of major medical education journals. Though many have called for increased inclusion of patient-centered outcomes in medical education literature, it remains uncertain to what degree this need has been addressed systematically.

Methods

Using the same data sources as in the original report (Academic Medicine, Medical Education, and Teaching and Learning in Medicine), we sought to replicate Prystowsky and Bordage’s study. We extracted data from original empirical research reports from these three journal sources for the years 2014–2016. We selected 652 articles that met the inclusion criteria for further analysis.

Results

Study participants were largely trainees (64% of studies) or faculty (25% of studies). Only 2% of studies included patients as active or passive participants. Study outcomes reported were satisfaction (40% of studies), performance (39%), professionalism (20%), and cost (1%).

Conclusions

These results do not differ significantly from the original 2001 study. The medical education literature as represented in these three prominent journals has made little progress in placing a greater focus on patient-centered outcomes.

Keywords:

• Medical education
• outcomes
• research

Disclosure statement

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

Additional information

Notes on contributors

Matt Emery

Matt Emery, MD, currently serves as Medical Director for Simulation for UME for the Michigan State University College of Human Medicine. Prior roles include core faculty member in the MSU-CHM residency program in Emergency Medicine in Grand Rapids, MI, for 15 years and in that role served as educational assistant for simulation education for 8 years. He also previously served as an oral board examiner for the American Board of Emergency Medicine for 18 years. Twenty-nine years of experience as an attending physician in Emergency Medicine, at both academic and community Emergency Departments. received MD degree from the University of Kentucky College of Medicine. Graduated Emergency Medicine Residency, Butterworth Hospital, Grand Rapids, MI in 1992.

Margaret Wolff

Margaret Wolff, MD, MPHE, joined the faculty of the Department of Emergency Medicine at the University of Michigan after completing pediatric emergency medicine fellowship training at Children’s Hospital of Philadelphia and pediatrics training at the Boston Combined Residency Program where she served as a Chief Resident. She earned her Masters in Health Professions Education from the University of Michigan. Her academic interests are focused on medical education including interactive teaching techniques, coaching, and self-directed learning. Currently, she serves as the Associate Program Director for the Pediatrics Residency and the Program Director for the Emergency Medicine Medical Education Fellowship at the University of Michigan.

Chris Merritt

Chris Merritt, MD, MPH, MHPE, is a pediatric emergency medicine specialist with a medical education focus; he hopes to improve the care of sick and injured children by preparing pediatricians and emergency physicians to provide excellent pediatric emergency care. He is currently the program director of the BrownEM Medical Education Research Fellowship in the Department of Emergency Medicine at the Alpert Medical School of Brown University.

Herodotos Ellinas

Herodotos Ellinas, MD, MHPE, finds communication with patients and families one of his strongest suits. Practiced internal medicine and pediatrics in the private sector for almost ten years only to return to an academic position at the Medical College of Wisconsin (MCW) as an anesthesiologist after completing his pediatric anesthesiology fellowship at Children’s Hospital of Boston. Now a professor of Anesthesiology at MCW, he is the director of the perioperative anesthesia evaluation center in Milwaukee, the co-director of the collaboratories (medical education grants project) at the Kern Institute in Milwaukee, and the co-chair for the Committee on Diversity, Equity and Inclusion for the Society for Education in Anesthesia.

Douglas McHugh

Douglas McHugh, PhD, MHPE, is the Assistant Dean for the Foundational Sciences Curriculum and Director of the Scholarly Reflection & Concentration/Capstone course at the Frank H. Netter MD School of Medicine. His teaching responsibilities include: pharmacology, neuroscience, physiology, cell biology, biostatistics, critical appraisal of scientific literature, and responsible research practice. Education Scholarship Interests: Visual Design—Teaching Interactions; Spaced Learning Algorithms; Intrinsic Motivation & Learner Engagement; Educational Topography.

Mohammad Zaher

Mohammad Zaher, MD, is an Emergency Medicine Physician. Passionate about medical education/simulation and well-being in residency. Director, Academic and Training Affairs, and Director, Emergency Medicine Residency Training Program at Al-Riyadh Governorate, Saudi Arabia where he also serves as a Consultant, Emergency Medicine and Medical Simulation.

Meghan L. Semiao

Meghan L. Semiao, BS, CHSE, is the Manager of Medical Simulation and Education and the Standardized Patient Program for the Inova Center for Advanced Medical Simulation (ICAMS) located on the Inova Fairfax Medical Campus in Falls Church, VA. She has worked within the field of medical education for the last 12 years and has maintained her certification as a Certified Healthcare Simulation Educator (CHSE) since March 2016.

Larry D. Gruppen

Larry D. Gruppen, PhD, is a Professor in the Department of Learning Health Sciences at the University of Michigan Medical School, where he directs the competency-based Master in Health Professions Education program. His research interests center around the development of expertise, knowledge and performance assessment, self-regulated learning, and educational leadership development. He has held the offices of president of the Society of Directors of Research in Medical Education and chair of the Association of American Medical College’s (AAMC) Central Group on Educational Affairs. He was also the founding Chair of the AAMC's Medical Education Research Certificate (MERC) program. He has over 135 peer-reviewed publications on a variety of topics in medical education and has been recognized for career productivity by the Association of American Medical College’s Central Group for Educational Affairs’ Medical Education Laureate Award, the 2015 John P. Hubbard Award from the National Board of Medical Examiners, and the Merrel Flair Award from the AAMC Group on Educational Affairs.