Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Acad Med. 2010 Aug;85(8):1340-6. doi: 10.1097/ACM.0b013e3181e5c050.
Many education research questions cannot be answered using participants from one institution or short periods of follow-up. In response to societal demands for accountability and evidence of effectiveness, new models of research must be developed to study the outcomes of educational activities. Following the 2007 Millennium Conference on Medical Education Research, organizers assigned a task force to explore the use of longitudinal databases in education research. This article summarizes the task force's findings. Similar to the Framingham studies in clinical medicine, longitudinal databases assemble prospectively collected information to retrospectively answer questions of interest. Many studies using such databases have been published. The task force identified three general approaches to database-type research. First, institutions can obtain identified information from existing sources, link it with school-specific information and other identified information, deidentify it, and merge it with similar information from other collaborating schools. Second, researchers can obtain from existing sources deidentified information on large samples and explore associations within this dataset. Third, investigators can design and implement databases to prospectively collect trainee information over time and across multiple institutions for the purpose of education research. Although costly, such comprehensive, purpose-built databases would ensure the availability of information needed to answer a variety of medical education research questions. Millennium Conference participants believed that stakeholders should explore the funding and development of such prospective databases. In the meantime, education researchers should use existing sources of individualized learner data to better understand how to develop competent, compassionate clinicians.
许多教育研究问题无法仅通过一个机构的参与者或短期随访来回答。为了响应社会对问责制和有效性证据的需求,必须开发新的研究模式来研究教育活动的结果。在 2007 年医学教育研究千禧年会议之后,组织者指派了一个工作组来探索在教育研究中使用纵向数据库。本文总结了工作组的发现。类似于临床医学中的弗雷明汉研究,纵向数据库收集前瞻性收集的信息,以回顾性地回答感兴趣的问题。已经发表了许多使用此类数据库的研究。工作组确定了数据库类型研究的三种一般方法。首先,机构可以从现有来源获得已识别的信息,将其与学校特定的信息和其他已识别的信息相关联,对其进行去识别,并将其与来自其他合作学校的类似信息合并。其次,研究人员可以从现有来源获得大量样本的去识别信息,并在此数据集内探索关联。第三,调查人员可以设计和实施数据库,以便随着时间的推移和跨多个机构前瞻性地收集学员信息,目的是进行教育研究。尽管成本高昂,但这种全面的、专用的数据库将确保提供回答各种医学教育研究问题所需的信息。千禧年会议的参与者认为,利益相关者应该探索为这种前瞻性数据库提供资金和开发。同时,教育研究人员应该利用现有的个体化学习者数据来源,以更好地了解如何培养有能力、有同情心的临床医生。