Mathieu Albert

Grounded Theory, Mixed Methods, and Action Research

These commonly used methods are appropriate for particular research questions and contexts

Why use theories in qualitative research

Theories such as interactionism, phenomenology, and critical theory can be used to help design a research question, guide the selection of relevant data, interpret the data, and propose explanations of causes or influences

Research in Medical Education: Balancing Service and Science*

Since the latter part of the 1990’s, the English-speaking medical education community has been engaged in a debate concerning the types of research that should have priority. To shed light on this debate and to better understand its implications for the practice of research, 23 semi-structured interviews were conducted with “influential figures” from the community. The results were analyzed using the concept of “field” developed by the sociologist Pierre Bourdieu. The results reveal that a large majority of these influential figures believe that research in medical education continues to be of insufficient quality despite the progress that has taken place over the past 2 decades. According to this group, studies tend to be both redundant and opportunistic, and researchers tend to have limited understanding of both theory and methodological practice from the social sciences. Three factors were identified by the participants to explain the current problems in research: the working conditions of researchers, budgetary restraints in financing research in medical education, and the conception of research in the medical environment. Two principal means for improving research are presented: intensifying collaboration between PhD’s and clinicians, and encouraging the diversification of perspectives brought to bear on research in medical education.

Assessment: do we need to broaden our methodological horizons?

Although medical education is a broad field of research and practice, it has come to be dominated by issues of assessment. Reasons for this emphasis range from the focus on accountability for educational outcomes to the established relationship between assessment and student motivation. Researchers in the domain, especially in North America, have largely focused on methodologies taken from psychometrics and have overlooked the broader social sciences literature devoted to the analysis of social behaviour and social interaction. In this commentary we provide a critique of the ubiquitous use of psychometric methodologies and perspectives and argue that the social sciences offer other rich methodological resources for the study of assessment.

The Legitimation and Dissemination Processes of the Innovation System Approach The Case of the Canadian and Québec Science and Technology Policy

A new approach in science policy making named the innovation system (IS) approach has been developed during the past three decades. Its primary goal is to better understand the processes through which scientific knowledge is produced and transferred to businesses to improve their competitiveness and develop national and/or regional economies. This approach has been adopted as an analytical framework and guideline for science policy making by numerous public sector organizations around the world. Using a case study of the Canadian and Québec public sectors, our research seeks to understand why the IS approach has gained the adherence of government employees and how it has been disseminated from international organizations down to regional civil servants. Findings show that adherence to the IS approach stems from the prestige of the Organisation for Economic Cooperation and Development (OECD) and its associated epistemic community, and from the cultural authority science exerts on government employees; these two factors bestow cultural authority onto the IS approach. The perceived scientific validity of the IS approach also leads government employees to consider its underlying economistic worldview as an unquestionable reality.

The origins of the field of medical education research.

Purpose This paper answers two related questions: When did the education of doctors become a subject for scientific inquiry? And what were the political and economic contexts, the worldviews, structures and events, that enabled the emergence and development of medical education research at that time and in that manner? Method A detailed, concurrent, chronological textual analysis, with triangulation between textual form and contents, was conducted between 2006 and 2008. The primary texts were the complete volumes of the Journal of Medical Education (then the only journal in its field) from 1955 through 1959. Texts were analyzed within a theoretical framework grounded in the literature on interdisciplinary fields. Results In 1955, the academic medical community was just awakening to the possibility of medical education research; by 1959, it was institutionalized. Major factors contributing to its emergence included the increasing importance of scientific research generally, money for medical education research, the explosive growth of scientific knowledge, and growing calls for public accountability of medical education. Conclusions Many factors led to the emergence of medical education research in the late 1950s within a particular sociohistorical context. The nature of research in this field, which is currently the subject of debate, is also of necessity historically situated and contingent, drawing on its roots in this era. A historical understanding will inform further analysis of the events, structures, and worldviews that underpin the definition(s) of legitimate knowledge production within the field of medical education research.

The mindsets of medical education leaders: how do they conceive of their work?

Purpose How a leader perceives his or her organization affects that individuals decision making and beliefs about the best way to influence it. The goal of this study was to understand how medical education leaders conceive of their work. Method The first author interviewed 16 medical education leaders in the Faculty of Medicine at the University of Toronto from June 2005 until February 2006. The sample represented different practice contexts to ensure a diverse overview of experiences. Using the theoretical framework of Bolman and Deal, the authors examined and described the perceptual frames through which these leaders perceive their endeavors. Transcripts were analyzed and then mapped onto Bolman and Deals four cognitive lenses (i.e., frames). Results Fourteen of the 16 leaders used all cognitive frames. The human resource perspective was favored by all participants, followed closely by the symbolic (14/16) and political (14/16). Although most attended to the structural frame (14/16), only three placed any significant emphasis on it. In addition to identifying and describing the elements of this typology for medical education leadership, a new frame emerged of assessing interpersonal and work style in order to determine how to socially situate individuals. Conclusions This study uniquely contributes by supporting the utility of the Bolman and Deal typology in the medical education context and supports the value for leaders to reflect on their organizational work from a variety of perspectives (including the frames). Medical education leadership development programs need to attend to enhancing the awareness of these perspectives.

What do we do? Practices and learning strategies of medical education leaders

Background: Continuous changes in undergraduate and postgraduate medical education require faculty to assume a variety of new leadership roles. While numerous faculty development programmes have been developed, there is little evidence about the specific practices of medical education leaders or their learning strategies to help inform their design. Aim: This study aimed to explore what medical education leaders’ actually do, their learning strategies and recommendations for faculty development. Method: A total of 16 medical education leaders from a variety of contexts within the faculty of medicine of a large North American medical school participated in semi-structured interviews to explore the nature of their work and the learning strategies they employ. Using thematic analysis, interview transcripts were coded inductively and then clustered into emergent themes. Results: Findings clustered into four key themes of practice: (1) intrapersonal (e.g. self-awareness), (2) interpersonal (e.g. fostering informal networks), (3) organizational (e.g. creating a shared vision) and (4) systemic (e.g. strategic navigation). Learning strategies employed included learning from experience and example, reflective practice, strategic mentoring or advanced training. Conclusions: Our findings illuminate a four-domain framework for understanding medical education leader practices and their learning preferences. While some of these findings are not unknown in the general leadership literature, our understanding of their application in medical education is unique. These practices and preferences have a potential utility for conceptualizing a coherent and relevant approach to the design of faculty development strategies for medical education leadership.

Perspectives of clinician and biomedical scientists on interdisciplinary health research

Background: Interdisciplinary health research is a priority of many funding agencies. We surveyed clinician and biomedical scientists about their views on the value and funding of interdisciplinary health research. Methods: We conducted semistructured interviews with 31 biomedical and 30 clinician scientists. The scientists were selected from the 2000–2006 membership lists of peer-review committees of the Canadian Institutes of Health Research. We investigated respondents’ perspectives on the assumption that collaboration across disciplines adds value to health research. We also investigated their perspectives on funding agencies’ growing support of interdisciplinary research. Results: The 61 respondents expressed a wide variety of perspectives on the value of interdisciplinary health research, ranging from full agreement (22) to complete disagreement (11) that it adds value; many presented qualified viewpoints (28). More than one-quarter viewed funding agencies’ growing support of interdisciplinary research as appropriate. Most (44) felt that the level of support was unwarranted. Arguments included the belief that current support leads to the creation of artificial teams and that a top-down process of imposing interdisciplinary structures on teams constrains scientists’ freedom. On both issues we found contrasting trends between the clinician and the biomedical scientists. Interpretation: Despite having some positive views about the value of interdisciplinary research, scientists, especially biomedical scientists, expressed reservations about the growing support of interdisciplinary research.

Confronting complexity: medical education, social theory and the ‘fate of our times’

If we were to paint a canvas reflecting what is capturing our imaginations as medical education researchers, we would use rich, bold colours and overlapping strokes to convey our deep and diverse investment in developing ways to train clinicians to provide effective and compassionate care. We would then paint thick black lines across the canvas to represent how these efforts are compromised or eroded, sometimes by our own educational practices. The articles comprising this issue help us make sense of this paradox.