Jb. Prystowsky et G. Bordage, An outcomes research perspective on medical education: the predominance oftrainee assessment and satisfaction, MED EDUC, 35(4), 2001, pp. 331-336
Context A fundamental premise of medical education is that faculty should e
ducate trainees, that is, students and residents, to provide high quality p
atient care. Yet, there is little research on the effect of medical educati
on on patient outcomes.
Objective A content analysis of leading medical education journals was perf
ormed to determine the primary foci of medical education research, using a
three-dimensional outcomes research framework based on the paradigm of heal
th services outcomes research.
Data sources All articles in three medical education journals (Academic Med
icine, Medical Education, and Teaching and Learning in Medicine) from 1996
to 1998 were reviewed. Pagers presented at the Research in Medical Educatio
n conference at the Association of American Medical Colleges annual meeting
during the same period, and published as Academic Medicine supplements, we
re also analysed.
Study selection Only data-driven articles were selected for analysis; thus
editorials and abstracts were excluded.
Data Extraction Each article was categorized according to primary participa
nt (i.e. trainee, faculty, provider and patient), outcome (performance, sat
isfaction, professionalism and cost), and level of analysis (geographic, sy
stem, institution and individual(s)).
Data synthesis A total of 599 articles were analysed. Trainees were the mos
t frequent participants studied (68.9%), followed by faculty (19.4%), provi
ders (8.1%) and patients (3.5%). Performance was the most common outcome me
asured (49.4%), followed by satisfaction (34.1%). Cost was the focus of onl
y 2.3% of articles and patient outcomes accounted for only 0.7% of articles
.
Conclusions Medical education research is dominated by assessment of traine
e performance followed by trainee satisfaction. Leading journals in medical
education contain little information concerning the cost and products of m
edical education, that is, provider performance and patient outcomes. The s
tudy of these medical education outcomes represents an important challenge
to medical education researchers.