An invitation for medical educators to focus on ethical and policy issues in research and scholarly practice

Medical education research and medical education practice both involve bein g methodical, innovative, self-observing, forward-looking, and open to peer review, and both are scholarly activities. For these reasons, distinguishi ng between these two activities is often difficult. There are three importa nt reasons to clarify the distinctions: the moral difference between educat ion research and education practice; federal regulations governing educatio n research that require more safeguards than often exist in education pract ice; and the fact that student participants in research have characteristic s in common with members of special populations. The authors explain why attention to issues of safeguards in education rese arch and practice is likely to grow at academic health centers, yet maintai n that these issues arc neglected in the medical education literature. They demonstrate this with findings from their review of 424 education research reports published in 1988 and 1989 and in 1998 and 1999 in two major medic al education journals. Each article was evaluated for documentation of six ethically important Safeguards and features (e.g., informed consent). The r ates of reporting the six features and safeguards were relatively low (3-27 %). Nearly half (47%) of the empirical reports offered no indication of eth ically important safeguards or features, and no article mentioned all six. Furthermore, those rates did not increase substantially after ten years. Th e authors discuss a number of implications of their findings fur faculty, t raining institutions, students, and editors and peer reviewers, and conclud e with the hope that their findings will raise awareness of these neglected issues in medical education and will stimulate all those involved to refle ct upon the issues and set standards on the ethical aspects of research and scholarly practice.