Professor Tim Swanwick

Do we needhealth education research?Professor Tim SwanwickPostgraduate Dean, HEE NC&E London

‘…at the heart of every efficient, effective, informed clinician is an educational system that understands the processes of teaching, learning and practice. This understanding comes from research within the field of ‘medical education’’.

‘…improving the processes and outcomes of education and training and adds to our understanding of how to create better learners and a more informed, progressive and adaptive workforce.’

What is the purpose of health education research?

To improve the quality and safety of patient care?

To direct investment and effort more effectively?

To promote a culture of enquiry and criticality?

Cooper H et al (2001) Developing an evidence base for interdisciplinary learning: a systematic review. Journal of Advanced Nursing 35(2): 228-237.

‘The overall aim of the study was to explore the feasibility of introducing interdisciplinary education within undergraduate health professional programmes…The number of studies found was 141 but only 30 (21%) were included in the analysis because of lack of methodological rigour in the research and poorly developed outcome measures.’

Cook DA et al (2013) Technology-enhanced simulation to assess health professionals: A systematic review of validity evidence, research methods, and reporting quality. Academic Medicine 88(6): 872-883.

…evidence for simulation-based assessments is sparse and is concentrated within specific specialties, tools, and sources of validity evidence. The methodological and reporting quality of assessment studies leaves much room for improvement.

Schucan Bird K et al (2015) Workplace-based learning for undergraduate and pre-registration healthcare professionals: A systematic map of the UK research literature 2003-2013. EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London.

• none of the studies reported quantitative measurements of the impacts of workplace-based learning on health service delivery or the quality of patient care.

Ahmed R, Farooq A, Storie D, Hartling L, Oswald A (2015) Building capacity for education research among clinical educators in the health professions: A BEME (Best Evidence Medical Education) Systematic Review of the outcomes of interventions: BEME Guide No. 34.

‘Unfortunately, most of the included studies lacked detailed description of the intervention and were of low to moderate quality with post-test only design.’

‘Lessons drawn from the evidence-based practice movement of the last ten years and the current experience with BEME suggest that, although BEME will inform some educational policies and practices, its initial success may be limited because of the paucity of studies that meet current standards for evidence and the great difficulty in conducting methodologically rigorous studies in the complex social interaction called education.’ (Dauphinee D, Academic Medicine, 2004)

Technological

Political

Cultural

House E (1981). Three perspectives on innovation: technological, political and cultural. In: Lehming R, Kane M (eds.), Improving schools: Using what we know.

Beverley Hills, CA: Sage Publications.

‘the major use of social research is not the application of specific data to specific decisions. Rather, government decision makers tend to use research indirectly, as a source of ideas, information, and orientations to the world. Although the process is not easily discernible, over time it may have profound effects on policy. Even research that challenges current values and political feasibilities is judged useful by decision makers.’

Weiss C H (1977) Research for Policy's Sake: The Enlightenment Function of Social Research. Policy Analysis 3(4): 531-545.

Do we needhealth education research?• Does it make a difference to patients?• Does it have a significant influence?• How, and over what timescale?• Does it require more/less investment?• Should we research more, less, better?• What are the ‘big’ research questions?• How could research capacity be developed?