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Hauer K, Minhas P, McDonald J, Perez S, Phinney L, Lucey C, O'Sullivan P. Inclusive Research in Medical Education: Strategies to Improve Scholarship and Cultivate Scholars. J Gen Intern Med 2024:10.1007/s11606-024-08827-2. [PMID: 39103603 DOI: 10.1007/s11606-024-08827-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/15/2024] [Indexed: 08/07/2024]
Affiliation(s)
- Karen Hauer
- University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, USA.
- Office of Medical Education, University of California, San Francisco, San Francisco, CA, USA.
| | - Prabhjot Minhas
- Boston Combined Residency Program in Pediatrics, Boston Children's Hospital, Harvard University, Cambridge, MA, USA
| | | | - Sandra Perez
- University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, USA
| | - Lauren Phinney
- University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, USA
| | - Catherine Lucey
- University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, USA
| | - Patricia O'Sullivan
- University of California, San Francisco (UCSF), School of Medicine, San Francisco, CA, USA
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Kusurkar RA, Lilley P, Harden R. Medical Teacher's equity diversity inclusion policy. MEDICAL TEACHER 2024; 46:730-731. [PMID: 38557241 DOI: 10.1080/0142159x.2024.2334394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
Medical Teacher is a leading international journal in health professions education. The Journal recognizes its responsibility to publish papers that reflect the breadth of topics that meet the needs of its readers around the globe including contributions from countries underrepresented in the health professions education arena. This paper sets out the Journal's policy with regard to Equity Diversity Inclusion (EDI) and the steps to be taken to implement the policy in practice.
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Affiliation(s)
- Rashmi A Kusurkar
- Research in Education, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
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Naidu T, Cartmill C, Swanepoel S, Whitehead CR. Shapeshifters: Global South scholars and their tensions in border-crossing to Global North journals. BMJ Glob Health 2024; 9:e014420. [PMID: 38724078 PMCID: PMC11029397 DOI: 10.1136/bmjgh-2023-014420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/14/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Global South researchers struggle to publish in Global North journals, including journals dedicated to research on health professions education (HPE). As a consequence, Western perspectives and values dominate the international academic landscape of HPE. This study sought to understand Global South researchers' motivations and experiences of publishing in Global North journals. METHODS This study used a hermeneutic phenomenological perspective. Unstructured interviews were conducted with 11 authors from 6 Global South countries. Interview transcripts were analysed through a process of familiarisation, identifying significant statements, formulating meanings, clustering themes, developing exhaustive descriptions, producing a fundamental structure and seeking verification. RESULTS Participants described being motivated by local institutional expectations, to improve reputation, to meet Global North perceptions of quality and to draw attention to their Global South context. Participants described experiences where their work was deemed irrelevant to Global North audiences, they were unable to interpret rejections and had learnt to play the publishing game by attending to both local and global imperatives. These motivations and experiences revealed several practical, academic and transformational tensions that Global South authors faced. CONCLUSION The tensions and negotiations encountered by Global South authors who publish in HPE journals reflect a 'border consciousness' whereby authors must shift consciousness, or become 'shapeshifters', inhabiting two or more worlds as they cross borders between the Global South and Global North conventions. There is an added burden and risk in performing this shapeshifting, as Global South authors stand astride the borders of two worlds without belonging fully to either.
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Affiliation(s)
- Thirusha Naidu
- Behavioural Medicine, University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
- Public Health and Primary Care, University of Cambridge, UK
| | - Carrie Cartmill
- The Wilson Centre, University Health Network, Toronto, Ontario, Canada
| | - Sunitha Swanepoel
- University of KwaZulu-Natal College of Health Sciences, Durban, South Africa
| | - Cynthia Ruth Whitehead
- The Wilson Centre, University Health Network, Toronto, Ontario, Canada
- Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
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Stauss M, Floyd L, Woywodt A. Weighing up Open Access Publishing in Nephrology-Bronze, Platinum, or Fools' Gold? KIDNEY360 2023; 4:1637-1640. [PMID: 37853553 PMCID: PMC10695644 DOI: 10.34067/kid.0000000000000282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Affiliation(s)
- Madelena Stauss
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
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Naidu T. The personal is political in the struggle for equity in global medical education research and scholarship. MEDICAL TEACHER 2023; 45:991-996. [PMID: 37200518 DOI: 10.1080/0142159x.2023.2206535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Medical education research is rooted in a long tradition of objectivity, evidence-based methods, and clinical surety. However, the inexorable confidence, health professions research education, and scholarship have in the manifest supremacy of western science as the foundational epistemology is questionable. Is this bravado legitimate and if so by what authority? How does this dominance of western epistemic frames determine how we are seen and how we see ourselves as health professions educators scholars and researchers? In what ways does western epistemic dominance influence how and why we conduct research? What do we consider as important to research in health professions education (HPE)? The answers are different depending on where we position ourselves or are placed in a hierarchy of scholarly privilege. I pose that the supremacy of Western scientific epistemology in modern medical education, research, and practice blurs differently colored scientific lenses and silences marginalized voices from legitimate contribution to HPE.
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Affiliation(s)
- Thirusha Naidu
- Department of Behavioural Medicine, University of KwaZulu-Natal, Durban, South Africa
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Rashid MA, Griffin A. Is West Really Best? The Discourse of Modernisation in Global Medical School Regulation Policy. TEACHING AND LEARNING IN MEDICINE 2023:1-12. [PMID: 37401838 DOI: 10.1080/10401334.2023.2230586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/21/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
Phenomenon: In 2012, the World Federation for Medical Education (WFME) established a recognition programme to evaluate medical school regulatory agencies across the world, in response to a new U.S. accreditation policy. Given the predominantly Western origins and Eastern impacts of the WFME programme, this article deconstructs tensions in the programme using postcolonial theory. Approach: Critical discourse analysis examines the intersections of language, knowledge, and power relations to highlight what can or cannot be said about a topic. We employed it to delineate the dominant discourse underpinning the WFME recognition programme. We drew on the theoretical devices of Edward Said, whose work is foundational in postcolonial thinking but has not been widely used in medical education scholarship to date. An archive of literature about the WFME recognition programme dating back to 2003, when WFME first released global standards for medical education, was analyzed. Findings: In the globalization of medical school regulation, the discourse of modernization can be conceptualized as a means of holding knowledge and power in the West, and enacting this power on those in the East, playing on fears of marginalization in the event of non-engagement. The discourse allows these practices to be presented in an honorable and heroic way. Insights: By uncovering the representation of the WFME recognition programme as being modern and modernizing, this article explores how such conceptualisations can close off debate and scrutiny, and proposes further examination of this programme through a lens that recognizes the inherent inequities and geopolitical power differentials that it operates within.
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Affiliation(s)
- Mohammed Ahmed Rashid
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK
| | - Ann Griffin
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK
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Wondimagegn D, Whitehead CR, Cartmill C, Rodrigues E, Correia A, Salessi Lins T, Costa MJ. Faster, higher, stronger - together? A bibliometric analysis of author distribution in top medical education journals. BMJ Glob Health 2023; 8:e011656. [PMID: 37321659 PMCID: PMC10367082 DOI: 10.1136/bmjgh-2022-011656] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/11/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Medical education and medical education research are growing industries that have become increasingly globalised. Recognition of the colonial foundations of medical education has led to a growing focus on issues of equity, absence and marginalisation. One area of absence that has been underexplored is that of published voices from low-income and middle-income countries. We undertook a bibliometric analysis of five top medical education journals to determine which countries were absent and which countries were represented in prestigious first and last authorship positions. METHODS Web of Science was searched for all articles and reviews published between 2012 and 2021 within Academic Medicine, Medical Education, Advances in Health Sciences Education, Medical Teacher, and BMC Medical Education. Country of origin was identified for first and last author of each publication, and the number of publications originating from each country was counted. RESULTS Our analysis revealed a dominance of first and last authors from five countries: USA, Canada, UK, Netherlands and Australia. Authors from these five countries had first or last authored 70% of publications. Of the 195 countries in the world, 43% (approximately 83) were not represented by a single publication. There was an increase in the percentage of publications from outside of these five countries from 23% in 2012 to 40% in 2021. CONCLUSION The dominance of wealthy nations within spaces that claim to be international is a finding that requires attention. We draw on analogies from modern Olympic sport and our own collaborative research process to show how academic publishing continues to be a colonised space that advantages those from wealthy and English-speaking countries.
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Affiliation(s)
- Dawit Wondimagegn
- College of Health Sciences, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Cynthia Ruth Whitehead
- The Wilson Centre, University Health Network and Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Family & Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - Carrie Cartmill
- The Wilson Centre, University Health Network and Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Eloy Rodrigues
- Documentation and Library Services, University of Minho, Braga, Portugal
| | - Antónia Correia
- Documentation and Library Services, University of Minho, Braga, Portugal
| | - Tiago Salessi Lins
- Department of Health Promotion, Federal University of Paraiba, Paraiba, Brazil
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Maggio LA, Costello JA, Ninkov AB, Frank JR, Artino AR. The voices of medical education scholarship: Describing the published landscape. MEDICAL EDUCATION 2023; 57:280-289. [PMID: 36282076 PMCID: PMC10098831 DOI: 10.1111/medu.14959] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/15/2022] [Accepted: 10/21/2022] [Indexed: 05/21/2023]
Abstract
INTRODUCTION The voices of authors who publish medical education literature have a powerful impact on the field's discourses. Researchers have identified a lack of author diversity, which suggests potential epistemic injustice. This study investigates author characteristics to provide an evidence-based starting point for communal discussion with the intent to move medical education towards a future that holds space for, and values, diverse ways of knowing. METHOD The authors conducted a bibliometric analysis of all articles published in 24 medical education journals published between 2000 and 2020 to identify author characteristics, with an emphasis on author gender and geographic location and their intersection. Article metadata was downloaded from Web of Science. Genderize.io was used to predict author gender. RESULTS The journals published 37 263 articles authored by 62 708 unique authors. Males were more prevalent across all authorship positions (n = 62 828; 55.7%) than females (n = 49 975; 44.3%). Authors listed affiliations in 146 countries of which 95 were classified as Global South. Few articles were written by multinational teams (n = 3765; 16.2%). Global South authors accounted for 12 007 (11.4%) author positions of which 3594 (3.8%) were female. DISCUSSION This study provides an evidence-based starting point to discuss the imbalance of author voices in medical education, especially when considering the intersection of gender and geographical location, which further suggests epistemic injustice in medical education. If the field values a diversity of perspectives, there is considerable opportunity for improvement by engaging the community in discussions about what knowledge matters in medical education, the role of journals in promoting diversity, how to best use this baseline data and how to continue studying epistemic injustice in medical education.
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Affiliation(s)
- Lauren A. Maggio
- MedicineUniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Joseph A. Costello
- Center for Health Professions Education, Henry M. Jackson FoundationBethesdaMarylandUSA
| | - Anton Boudreau Ninkov
- École de bibliothéconomie et des sciences de l'informationUniversité de MontréalMontréalQuébecCanada
| | - Jason R. Frank
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
| | - Anthony R. Artino
- George Washington University School of Medicine and Health SciencesWashingtonDistrict of ColumbiaUSA
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Ford CA, Boyer CB, Halpern CT, Katzman DK, Ross DA. The Journal of Adolescent Health's Commitment to Diversity, Equity, and Inclusion. J Adolesc Health 2023; 72:165-170. [PMID: 36604008 DOI: 10.1016/j.jadohealth.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
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Kusurkar RA. The leaky pipeline of publications and knowledge generation in medical education. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:70-72. [PMID: 35239162 PMCID: PMC8941050 DOI: 10.1007/s40037-022-00700-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 05/13/2023]
Affiliation(s)
- Rashmi A Kusurkar
- Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
- LEARN! research institute for learning and education. Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands.
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Lawson M. Resetting the compass for research on trauma education. Injury 2021; 52:2489-2490. [PMID: 34489060 DOI: 10.1016/j.injury.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Mary Lawson
- Visiting Senior Lecturer, School of Medicine, Deakin University, Geelong and Fry-IT Ltd..
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V Nadarajah VD. Gender and medical education authorship: Moving forward comfortably with necessary conversations. MEDICAL EDUCATION 2021; 55:670-672. [PMID: 33617662 DOI: 10.1111/medu.14478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Vishna Devi V Nadarajah
- Division of Human Biology, School of Medicine and IMU Centre for Education (ICE), International Medical University, Kuala Lumpur, Malaysia
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Yip SWL, Rashid MA. Editorial diversity in medical education journals. CLINICAL TEACHER 2021; 18:523-528. [PMID: 34047056 DOI: 10.1111/tct.13386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In recent years, the field of medical education has sought to amplify the voices of those from traditionally marginalised groups and medical education journals have sought to become more accessible and diverse. This study sought to examine the gender and geographical representation of editors and editorial board members in medical education journals. METHODS Information about individual editors and editorial board members of 10 medical education journals was retrieved from their websites in January 2021, including their gender and the country in which they were based. Countries were categorised according to World Bank Income Classification and World Bank Geographical Regions. We then calculated the Composite Editorial Board Diversity Score for each journal. FINDINGS Of 488 editors and editorial board members, 283 (58.0%) were male, 452 (92.6%) were based in high-income countries and 322 (66.0%) were from the four countries with greatest representation (the United States, the United Kingdom, Australia and Canada). DISCUSSION The composition of medical education journals' editorial leadership teams remains dominated by males and those from higher income and Western countries. Strikingly, little change has taken place since this was last examined 17 years ago despite the field becoming apparently more globalised. As medical education strives to become a more inclusive and diverse discipline, developing policies to create more globally representative editorial leadership teams should now be an urgent priority.
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