D. Hope is a senior lecturer in medical education, Medical Education Unit, University of Edinburgh, Edinburgh, Scotland, United Kingdom; ORCID: https://orcid.org/0000-0001-6623-2857 .
A. Dewar is a fellow in medical education, Medical Education Unit, University of Edinburgh, Edinburgh, Scotland, United Kingdom; ORCID: https://orcid.org/0000-0003-1992-6148 .
Acad Med. 2021 Jul 1;96(7):958-963. doi: 10.1097/ACM.0000000000004063.
Scholars are increasingly aware that studies-across many disciplines-cannot be replicated by independent researchers. Here, the authors describe how medical education research may be vulnerable to this "replication crisis," explain how researchers can act together to reduce risks, and discuss the positive steps that can increase confidence in research findings. Medical education research contributes to policy and influences practitioner behavior. Findings that cannot be replicated suggest that the original research was not credible. This risk raises the possibility that unhelpful or even harmful changes to medical education have been implemented as a result of research that appeared defensible but was not. By considering these risk factors, researchers can increase the likelihood that studies are generating credible results. The authors discuss and provide examples of 6 factors that may endanger the replicability of medical education research: (1) small sample sizes, (2) small effect sizes, (3) exploratory designs, (4) flexibility in design choices, analysis strategy, and outcome measures, (5) conflicts of interest, and (6) very active fields with many competing research teams. Importantly, medical education researchers can adopt techniques used successfully elsewhere to improve the rigor of their investigations. Researchers can improve their work through better planning in the development stage, carefully considering design choices, and using sensible data analysis. The wider medical education community can help by encouraging higher levels of collaboration among medical educators, by routinely evaluating existing educational innovations, and by raising the prestige of replication and collaborative medical education research. Medical education journals should adopt new approaches to publishing. As medical education research improves, so too will the quality of medical education and patient care.
学者们越来越意识到,许多学科的研究都无法被独立的研究人员复制。本文作者描述了医学教育研究如何可能容易受到这种“复制危机”的影响,解释了研究人员如何共同采取行动来降低风险,并讨论了可以增加研究结果可信度的积极步骤。医学教育研究为政策提供依据并影响从业者的行为。无法复制的发现表明原始研究不可信。这种风险增加了这样一种可能性,即由于原本看似合理但实际上不可靠的研究,导致对医学教育的无益甚至有害的改变已经付诸实施。通过考虑这些风险因素,研究人员可以增加研究产生可信结果的可能性。作者讨论并提供了 6 个可能危及医学教育研究可复制性的因素的例子:(1)样本量小,(2)效应量小,(3)探索性设计,(4)设计选择、分析策略和结果衡量标准的灵活性,(5)利益冲突,(6)非常活跃的领域有很多竞争的研究团队。重要的是,医学教育研究人员可以采用在其他地方成功使用的技术来提高他们调查的严谨性。研究人员可以通过在开发阶段更好地规划、仔细考虑设计选择以及使用明智的数据分析来改进他们的工作。更广泛的医学教育界可以通过鼓励医学教育者之间更高水平的合作、定期评估现有的教育创新以及提高复制和合作医学教育研究的声望来提供帮助。医学教育期刊应该采用新的出版方法。随着医学教育研究的改进,医学教育和患者护理的质量也将得到提高。