Time is a great teacher, but unfortunately it kills all its pupils.—Louis Hector Berlioz
The quest for an educational process with a lower mortality rate than that provided by time has led to the current medical education system, with all of its strengths and weaknesses. The challenge has been to craft a series of largely independent programs that efficiently and effectively takes a person from novice to expert clinician and then facilitates continual reeducation of the expert.
However, whether the current educational system achieves optimal efficiency or effectiveness is in doubt. There are questions about the length of undergraduate medical education,1-2 further reductions in resident work hours,3 and splitting generalist training from subspecialty training.4 High-quality evidence that educational strategies result in the best patient outcomes is generally lacking5; conversely, some of the basic tenets behind continuing medical education may have weak foundations.6
As with the practice of medicine, the best hope for understanding the quality of current educational techniques and for evaluating proposed new approaches is by conducting and disseminating research based on sound principles. Like clinical studies, this research ideally should be designed to avoid or account for biases, measure clinically important outcomes rather than easily assessed proxies, and be critically assessed for internal validity and generalizability. Decisions must be made in the face of imperfect information, but these decisions should recognize and account for the limitations in the evidence.
JAMA continues its annual focus on this important topic with the next theme issue on medical education, which will be published in December 2009. (Frequent readers of the Medical Education theme issue will note that this is later than the typical September publication date). We invite authors to submit manuscripts related to all aspects of the educational process. We are particularly seeking studies that either incorporate the most relevant educational outcomes (effects on clinical practice and patient care, rather than measures of knowledge, skills, or attitudes) or address better techniques for their measure.
Recent topics have included diversity in medical education; career choices and the physician workforce; the effect of changes in resident work hours on patient mortality, patient safety, and physician health; education in evidence-based medicine; methods, quality, and funding of medical education research; effects of communication skills; teaching quality improvement; cross-cultural care; inaccuracy of physician self-assessment; and Internet-based education. While these remain of interest for this issue, other potential topics include (but are not limited to) the appropriate use of medical literature, successful models for providing incentives to faculty for teaching, professionalism and ethics, and the use of interdisciplinary approaches to learning. Given the role of educator that all physicians play, we are also interested in studies of the effectiveness of training physicians to be teachers, if these studies are conducted with methodological rigor and include important objective outcome measures.
We will consider all original research papers, systematic reviews, and scholarly commentaries addressing medical education, including randomized trials, high-quality observational studies, evidence-based reviews, and presentation of novel methodologies. The effects of medical education at the student, physician, patient, and societal levels are all appropriate for consideration. As with all research published in JAMA, we are seeking studies that meet the highest standards for validity and generalizability; preference will be given to studies that include large sample sizes and multiple study sites.
Manuscripts received by May 31, 2009, will have the best chance for consideration for publication in the Medical Education theme issue. All submitted manuscripts will undergo JAMA's usual rigorous editorial evaluation and review. Authors should consult the JAMA Instructions for Authors7 for guidelines on manuscript submission and preparation.
AUTHOR INFORMATION
Financial Disclosures: None reported.
Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.