Tractenberg Rochelle E, Gordon Morris
a Departments of Neurology; Biostatistics, Bioinformatics, and Biomathematics; and Rehabilitation Medicine , Georgetown University Medical Center , Washington , DC , USA.
b Welfare, Professionalism, Transition and Careers , University of Central Lancashire , Preston , Lancashire , UK.
Teach Learn Med. 2017 Jul-Sep;29(3):268-279. doi: 10.1080/10401334.2017.1287572. Epub 2017 Mar 30.
Phenomenon: The purpose of "systematic" reviews/reviewers of medical and health professions educational research is to identify best practices. This qualitative article explores the question of whether systematic reviews can support "evidence informed" teaching and contrasts traditional systematic reviewing with a knowledge translation (KT) approach to this objective.
Degrees of freedom analysis (DOFA) is used to examine the alignment of systematic review methods with educational research and the pedagogical strategies and approaches that might be considered with a decision-making framework developed to support valid assessment. This method is also used to explore how KT can be used to inform teaching and learning.
The nature of educational research is not compatible with most (11/14) methods for systematic review. The inconsistency of systematic reviewing with the nature of educational research impedes both the identification and implementation of "best-evidence" pedagogy and teaching. This is primarily because research questions that do support the purposes of review do not support educational decision making. By contrast to systematic reviews of the literature, both a DOFA and KT are fully compatible with informing teaching using evidence. A DOFA supports the translation of theory to a specific teaching or learning case, so could be considered a type of KT. The DOFA results in a test of alignment of decision options with relevant educational theory, and KT leads to interventions in teaching or learning that can be evaluated. Examples of how to structure evaluable interventions are derived from a KT approach that are simply not available from a systematic review. Insights: Systematic reviewing of current empirical educational research is not suitable for deriving or supporting best practices in education. However, both "evidence-informed" and scholarly approaches to teaching can be supported as KT projects, which are inherently evaluable and can generate actionable evidence about whether the decision or intervention worked for students, instructors, and the institution. A DOFA can also support evidence- and theory-informed teaching to develop an understanding of what works, why, and for whom. Thus KT, but not systematic reviewing, can support decision making around pedagogy (and pedagogical innovation) that can also inform new teaching and learning initiatives; it can also point to new avenues of empirical research in education that are informed by, and can inform, theory.
现象：医学与健康职业教育研究的“系统”综述/综述者的目的是确定最佳实践。这篇定性文章探讨了系统综述是否能够支持“基于证据的”教学这一问题，并将传统的系统综述与针对这一目标的知识转化（KT）方法进行了对比。
自由度分析（DOFA）用于检验系统综述方法与教育研究以及教学策略和方法的一致性，这些教学策略和方法可能会与为支持有效评估而开发的决策框架一同被考虑。该方法还用于探索如何利用知识转化来为教学提供信息。
教育研究的性质与大多数（11/14）系统综述方法不兼容。系统综述与教育研究性质的不一致阻碍了“最佳证据”教学法和教学的识别与实施。这主要是因为确实支持综述目的的研究问题并不支持教育决策。与文献的系统综述相比，自由度分析和知识转化都完全适用于利用证据为教学提供信息。自由度分析支持将理论转化为特定的教学或学习案例，因此可被视为一种知识转化类型。自由度分析会对决策选项与相关教育理论的一致性进行检验，而知识转化会导致对教学或学习的干预，这些干预可以被评估。如何构建可评估干预措施的示例源自知识转化方法，而系统综述根本无法提供这些示例。见解：对当前实证教育研究进行系统综述并不适合推导或支持教育中的最佳实践。然而，“基于证据的”教学方法和学术性教学方法都可以作为知识转化项目得到支持，这些项目本质上是可评估的，并且可以生成关于决策或干预对学生、教师和机构是否有效的可操作证据。自由度分析还可以支持基于证据和理论的教学，以理解什么有效、为什么有效以及对谁有效。因此，知识转化而非系统综述能够支持围绕教学法（以及教学创新）的决策，这些决策也能够为新的教学和学习举措提供信息；它还可以指出由理论推动并能推动理论发展的教育实证研究的新途径。
