Discussion Paper: Improving the participation of students in health professional education research
Keywords:medical education, health professional education, participation, recruitment
Health professional education (HPE) has grown as a field of research, with an increasing number of publications since the 1990s. Interprofessional education is a specific area of growth with ongoing debate in the literature, at least in part due to the challenges that exist in implementation, and further research is needed to inform ongoing practice. Participant recruitment is a major challenge, and poor participation rates lead to bias and a failure to demonstrate outcomes.
There is a lack of information about why students decline to participate in research to inform and improve education. Motivation for volunteerism in other contexts and recruitment of human participants in other types of research are examined as a way to understand the likely motivations of student participants. Disincentives to participate include time commitment, survey fatigue and a poor understanding of the value of HPE research and the processes involved. The ethical considerations for teacher-researchers add another layer of complexity to recruitment.
A multifaceted approach, involving all stakeholders and targeting known influences, is needed to improve recruitment in health professional education research, and clear communication of the research rationale and its potential impact on curriculum design is essential. Explicit communication and adequate information to allow informed student choice are also required, while improved literacy in HPE research may provide students with a better basis for decision making when considering participation. In addition, partnership and student co-design could be a mechanism for more meaningful engagement.
Adams, M. J. D., & Umbach, P. D. (2011). Nonresponse and Online Student Evaluations of Teaching: Understanding the Influence of Salience, Fatigue, and Academic Environments. Research in Higher Education, 53(5), 576-591. doi: 10.1007/s11162-011-9240-5
Aycock, D. M., & Currie, E. R. (2013). Minimizing risks for nursing students recruited for health and educational research. Nurse Educator, 38(2), 56-60. doi: 10.1097/NNE.0b013e3182829c3a
Bartholomay, E. M., & Sifers, S. K. (2016). Student perception of pressure in faculty-led research. Learning and Individual Differences, 50, 302-307. doi: 10.1016/j.lindif.2016.08.025
Beran, T. N., Kaba, A., Caird, J., & McLaughlin, K. (2014). The good and bad of group conformity: a call for a new programme of research in medical education. Medical Education, 48(9), 851-859. doi: 10.1111/medu.12510
Boileau, E., Patenaude, J., & St-Onge, C. (2018). Twelve tips to avoid ethical pitfalls when recruiting students as subjects in medical education research. Medical Teacher., 40(1), 20-25. doi: 10.1080/0142159X.2017.1357805
Brown, P. U. (2010). Teacher Research and University Institutional Review Boards. Journal of Early Childhood Teacher Education, 31(3), 276-283. doi: 10.1080/10901027.2010.500559
Callahan, C. A., Hojat, M., & Gonnella, J. S. (2007a). Volunteer bias in medical education research: an empirical study of over three decades of longitudinal data. Med Educ, 41(8), 746-753. doi: 10.1111/j.1365-2923.2007.02803.x
Chen, R. P. (2011). Student participation in health professions education research: in pursuit of the Aristotelian mean. Advances in Health Sciences Education: Theory and Practice, 16(2), 277-286. doi: 10.1007/s10459-009-9164-4
Christakis, N. (1985). Do Medical Student Research Subjects Need Special Protection? IRB: Ethics & Human Research, 7(3), 1-4
Cleary, M., Walter, G., & Jackson, D. (2015). Editorial. Contemporary Nurse, 49(1), 93-95. doi: 10.1080/10376178.2014.11081958
Cook, D. A., Andriole, D. A., Durning, S. J., Roberts, N. K., & Triola, M. M. (2010). Longitudinal research databases in medical education: facilitating the study of educational outcomes over time and across institutions. Academic Medicine, 85(8), 1340-1346. doi: 10.1097/ACM.0b013e3181e5c050
Cook-Sather, A., Bovill, C., & Felten, P. (2014). Engaging Students as Partners in Learning and Teaching: A Guide for Faculty. San Francisco: Jossey-Bass.
Cuskelly, G., Hoye, R., & Auld, C. (2006). Working with volunteers in sport: theory and practice London and New York: Routledge.
Cyr, D., Childs, R., & Elgie, S. (2013). Recruiting Students for Research in Postsecondary Education: A Guide. In Higher Education Quality Council of Ontario
DuBois, J. M. (2002). When Is Informed Consent Appropriate in Educational Research? Regulatory and Ethical Issues. IRB: Ethics & Human Research, 24(1), 1-8.
Edwards, P., Roberts, I., Clarke, M., DiGuiseppi, C., Pratap, S., Wentz, R., & Kwan, I. (2002). Increasing response rates to postal questionnaires: systematic review. British Medical Journal, 324(7347), 1183.
Einolf, C., & Chambré, S. M. (2011). Who volunteers? Constructing a hybrid theory. International Journal of Nonprofit and Voluntary Sector Marketing, 16(4), 298-310. doi: 10.1002/nvsm.429
Ferguson, L. M., Yonge, O., & Myrick, F. (2004). Students' involvement in faculty research: Ethical and methodological issues. International Journal of Qualitative Methods, 3(4), 56-68.
Forester, J. P., & McWhorter, D. L. (2005). Medical Students’ Perceptions of Medical Education Research and Their Roles as Participants. Academic Medicine, 80(8), 780- 785.
Gneezy, U., Meier, S., & Rey-Biel, P. (2011). When and Why Incentives (Don't) Work to Modify Behavior. Journal of Economic Perspectives, 25(4), 191-210. doi: 10.1257/jep.25.4.191
Heflin, M. T., DeMeo, S., Nagler, A., & Hockenberry, M. J. (2016). Health Professions Education Research and the Institutional Review Board. Nurse Educator, 41(2), 55-59. doi: 10.1097/NNE.0000000000000230
Henry, R. C., & Wright, D. E. (2001). When Do Medical Students Become Human Subjects of Research? The Case of Program Evaluation. Academic Medicine, 76, 871- 875.
Holdsworth, C. (2010). Why Volunteer? Understanding Motivations For Student Volunteering. British Journal of Educational Studies, 58(4), 421-437. doi: 10.1080/00071005.2010.527666
Hornstein, H. A., & Law, H. F. E. (2017). Student evaluations of teaching are an inadequate assessment tool for evaluating faculty performance. Cogent Education, 4(1). doi: 10.1080/2331186x.2017.1304016
Iqbal, I., Lee, J. D., Pearson, M. L., & Albon, S. P. (2016). Student and faculty perceptions of student evaluations of teaching in a Canadian pharmacy school. Currents in Pharmacy Teaching and Learning, 8(2), 191-199. doi: 10.1016/j.cptl.2015.12.002
Jenkins, V., & Fallowfield, L. (2000). Reasons for accepting or declining to participate in randomized clinical trials for cancer therapy. British Journal of Cancer, 82(11), 1783-1788. doi: 10.1054/bjoc.2000.1142
Keune, J. D., Brunsvold, M. E., Hohmann, E., Korndorffer, J. R., Jr., Weinstein, D. F., & Smink, D. S. (2013). The ethics of conducting graduate medical education research on residents. Academic Medicine, 88(4), 449-453. doi: 10.1097/ACM.0b013e3182854bef
Khatamian Far, P. (2018). Challenges of Recruitment and Retention of University Students as Research Participants: Lessons Learned from a Pilot Study. Journal of the Australian Library and Information Association, 67(3), 278-292. doi: 10.1080/24750158.2018.1500436
Limkakeng, A., Phadtare, A., Shah, J., Vaghasia, M., Wei, D. Y., Shah, A., & Pietrobon, R. (2013). Willingness to participate in clinical trials among patients of Chinese heritage: a meta-synthesis. PLoS ONE, 8(1), e51328. doi: 10.1371/journal.pone.0051328
Maggio, L. A., Artino, A. R., Jr., Picho, K., & Driessen, E. W. (2018). Are You Sure You Want to Do That? Fostering the Responsible Conduct of Medical Education Research. Academic Medicine, 93(4), 544-549. doi: 10.1097/ACM.0000000000001805
Matthews, K. E., Mercer-Mapstone, L., Dvorakova, S. L., Acai, A., Cook-Sather, A., Felten, P., . . . Marquis, E. (2018). Enhancing outcomes and reducing inhibitors to the engagement of students and staff in learning and teaching partnerships: implications for academic development. International Journal for Academic Development, 1-14. doi: 10.1080/1360144x.2018.1545233
McCann, S., Campbell, M., & Entwistle, V. (2013). Recruitment to trials: insights from a meta-ethnography of qualitative studies. Trials, 14(Suppl 1), O69. doi: 10.1186/1745-6215-14-s1-o69
McCann, S. K., Campbell, M. K., & Entwistle, V. A. (2010). Reasons for participating in randomised controlled trials: conditional altruism and considerations for self. Trials, 11, 31. doi: 10.1186/1745-6215-11-31
McDonald, A. M., Knight, R. C., Campbell, M. K., Entwistle, V. A., Grant, A. M., Cook, J. A., . . . Snowdon, C. (2006). What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies. Trials, 7, 9. doi: 10.1186/1745-6215-7-9
Newington, L., & Metcalfe, A. (2014). Factors influencing recruitment to research: qualitative study of the experiences and perceptions of research teams. BMC Medical Research Methodology, 14(10), 10. doi: 10.1186/1471-2288-14-10
Phillips, A. W., Reddy, S., & Durning, S. J. (2016). Improving response rates and evaluating nonresponse bias in surveys: AMEE Guide No. 102. Med Teach, 38(3), 217-228. doi: 10.3109/0142159X.2015.1105945
Regan, J.-A., Baldwin, M. A., & Peters, L. (2012). Ethical Issues in Pedagogical Research. Journal of Pedagogic Development, 2(3).
Ridley, R. T. (2009). Assuring ethical treatment of students as research participants. Journal of Nursing Education, 48(10), 537-541. doi: 10.3928/01484834-20090610-08
Rooshenas, L., Scott, L. J., Blazeby, J. M., Rogers, C. A., Tilling, K. M., Husbands, S., . . . Romio feasibility study, g. (2019). The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation. Journal of Clinical Epidemiology, 106, 108-120. doi: 10.1016/j.jclinepi.2018.10.004
Sandars, J. (2009). The use of reflection in medical education: AMEE Guide No. 44. Medical Teacher., 31(8), 685-695.
Sarpel, U., Hopkins, M. A., More, F., Yavner, S., Pusic, M., Nick, M. W., . . . Kalet, A. L. (2013). Medical students as human subjects in educational research. Medical Education Online, 18, 1-6 doi:10.3402/meo.v18i0.19524
School of Psychological Sciences. (2017). Procedures for researchers to recruit undergraduate participants (April ed.). Western Australia: The University of Western Australia.
Schuwirth, L. W., & Durning, S. J. (2018). Educational research: current trends, evidence base and unanswered questions. Medical Journal of Australia, 208(4), 161-163. doi: 10.5694/mja17.00805
Spooren, P., & Christiaens, W. (2017). I liked your course because I believe in (the power of) student evaluations of teaching (SET). Students’ perceptions of a teaching evaluation process and their relationships with SET scores. Studies in Educational Evaluation, 54, 43-49. doi: 10.1016/j.stueduc.2016.12.003
Stovel, R. G., Ginsburg, S., Stroud, L., Cavalcanti, R. B., & Devine, L. A. (2018). Incentives for recruiting trainee participants in medical education research. Med Teach, 40(2), 181-187. doi: 10.1080/0142159X.2017.1395402
Thayer, E. K., Rathkey, D., Miller, M. F., Palmer, R., Mejicano, G. C., Pusic, M., . . . Carney, P. A. (2016). Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education. Medical Education Online, 21, 32021. doi: 10.3402/meo.v21.32021
Thornton, L., Batterham, P. J., Fassnacht, D. B., Kay-Lambkin, F., Calear, A. L., & Hunt, S. (2016). Recruiting for health, medical or psychosocial research using Facebook: Systematic review. Internet Interventions, 4, 72-81. doi: 10.1016/j.invent.2016.02.001
Uttl, B., White, C. A., & Gonzalez, D. W. (2017). Meta-analysis of faculty's teaching effectiveness: Student evaluation of teaching ratings and student learning are not related. Studies in Educational Evaluation, 54, 22-42. doi: 10.1016/j.stueduc.2016.08.007
Voo, T.-C. (2009). Using Medical Students as Research Subjects. Annals of the Academy of Medicine, 38(12), 1019-1020.
Walsh, K. (2013). Medical students as human subjects in educational research – the importance of responder bias. Medical Education Online, 18(1), 20757. doi: 10.3402/meo.v18i0.20757
Walsh, K. (2014). Medical education research: is participation fair? Perspectives in Medical Education, 3(5), 379-382. doi: 10.1007/s40037-014-0120-5
Warburton, J., & Smith, J. (2003). Out of the generosity of your heart: are we creating active citizens through compulsory volunteer programmes for young people in Australia? Social Policy & Administration, 37(7), 772-786.
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