Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Medicine, McMaster University, McMaster Education Research, Innovation and Theory (MERIT) Program, Hamilton, Ontario, Canada.
Med Educ. 2024 Jan;58(1):157-163. doi: 10.1111/medu.15148. Epub 2023 Jun 7.
As the field of health professions education (HPE) continues to evolve, it is necessary to occasionally pause and reflect on the potential effects and outcomes of our research practices. While future-casting does not guarantee that impending negative consequences will be evaded, the exercise can help us avoid pitfalls. In this paper, we reflect on two terms that have taken hold as powerful idols in HPE research that stand above questioning and apart from critique: patient outcomes and productivity. We argue that these terms, and the ways of thinking they uphold, threaten the sustainability of HPE research-one at the level of the community and one at the level of the scholar. First, we suggest that HPE research's history of endorsing a linear and causal association ethos has driven its quest to connect education to patient outcomes. To ensure the sustainability of HPE scholarship, we must deconstruct and disempower patient outcomes as one of HPE's god-terms, as the pinnacle goal of educational activities. To be sustained, HPE research needs to value all of its contributions equally. A second god-term is productivity; it impairs the sustainability of the careers of individual researchers. Problems of honorary authorship, research output expectations, and comparisons with other fields have constructed a space where only scholars with sufficient privilege can prevail. If productivity persists as a god-term, the field of HPE research could decay into a space where new scholars are silenced-not because they fail to make important contributions, but because access is restricted by existing research metrics. These are two of many god-terms threatening the sustainability of HPE research. By highlighting patient outcomes and productivity and by acknowledging our own participation in propagating them, we hope to encourage others to recognize how our collective choices threaten the sustainability of our field.
随着健康职业教育（HPE）领域的不断发展，有必要偶尔停下来反思我们的研究实践可能产生的影响和结果。虽然未来预测并不能保证即将出现的负面后果得以避免，但这种做法可以帮助我们避免陷阱。在本文中，我们反思了两个在 HPE 研究中作为强大偶像的术语，它们凌驾于质疑和批判之上：患者结果和生产力。我们认为，这些术语以及它们所支持的思维方式，威胁着 HPE 研究的可持续性——一个在社区层面，另一个在学者层面。首先，我们认为 HPE 研究历史上一直支持线性和因果关系的精神，这推动了它将教育与患者结果联系起来的努力。为了确保 HPE 学术研究的可持续性，我们必须解构并削弱患者结果作为 HPE 的一个神圣术语的地位，即教育活动的最终目标。为了可持续发展，HPE 研究需要平等重视其所有贡献。第二个神圣术语是生产力；它损害了个体研究者职业生涯的可持续性。荣誉作者、研究成果期望和与其他领域的比较等问题，构建了一个只有拥有足够特权的学者才能占优势的空间。如果生产力继续作为一个神圣术语存在，那么 HPE 研究领域可能会退化到一个新学者被噤声的空间——不是因为他们没有做出重要贡献，而是因为现有的研究指标限制了他们的机会。这是两个威胁 HPE 研究可持续性的神圣术语之一。通过强调患者结果和生产力，并承认我们自己在传播它们方面的参与，我们希望鼓励其他人认识到我们的集体选择如何威胁我们领域的可持续性。
