Conceptualizing the Research Culture in Postgraduate Medical Education: Implications for Leading Culture Change
- 705 Downloads
By recognizing symbols of research culture in postgraduate medical education, educators and trainees can gain a deeper understanding of the existing culture and mechanisms for its transformation. First, I identify symbolic manifestations of the research culture through a case narrative of a single anesthesia residency program, and I offer a visual conceptualization of the research culture. In the second part, I theorize the application of Senge’s (1994) disciplines of a learning organization and discuss leverage for enhancing research culture. This narrative account is offered to inform the work of enhancing the broader research culture in postgraduate medical education.
KeywordsEducation, medical, graduate Research training Organizational culture Organizational learning Action research
The author wishes to thank Dr. Patrick Renihan for asking the candidacy exam question that inspired this paper.
Lownsborough Memorial Scholarship in Education College of Education, University of Saskatchewan 2011–2012; Educational Administration Graduate Scholarship, College of Education, University of Saskatchewan 2011–2012.
Disclosure of funding received
This work was supported by the Lownsborough Memorial Scholarship in Education and the Educational Administration Graduate Scholarship, College of Education, University of Saskatchewan 2011–2012.
- Accreditation Council for Graduate Medical Education (ACGME). 2011. “Program Director Guide to the Common Program Requirements.” Last modified July. http://www.acgme.org/acwebsite/navpages/commonpr_documents/CompleteGuide_v2%20.pdf
- Argyris, Chris. 1993. Knowledge for Action: A Guide to Overcoming Barriers to Organizational Change. San Francisco: Jossey-Bass.Google Scholar
- Armstrong, Alicia Y., Alan DeCherney, Phyllis Leppert, Robert Rebar, and Yvonne T Maddox. 2009. “Keeping Clinicians in Clinical Research: The Clinical Research/Reproductive Scientist Training Program.” Fertility and Sterility 91:664–666.Google Scholar
- Bolman, Lee G., and Terrence E. Deal. 2008. Reframing Organizations: Artistry, Choice, and Leadership. San Francisco: Jossey-Bass.Google Scholar
- Buschbacher, Ralph, and Randall L. Braddom. 1995. “Resident Versus Program Director Perceptions About PM & R Research Training. American Journal of Physical Medicine & Rehabilitation 74(2), 90–100.Google Scholar
- Canadian Institutes of Health Research. 2011. Canada’s Strategy for Patient-Oriented Research. Toronto: Canadian Institutes of Health Research. http://www.cihr-irsc.gc.ca/e/44000.html.
- DeHaven, M J., Wilson, and O’Connor-Kettlestrings. 1998.Google Scholar
- Flood, Robert L. 2001. “The Relationship of ‘Systems Thinking’ to Action Research.” In Handbook of Action Research: Participative Inquiry and Practice, edited by Peter Reason and Hilary Bradbury, 133–144. Thousand Oaks: SAGE.Google Scholar
- Frank, Jason R., editor. 2005. The CanMEDS 2005 Physician Competency Framework. Better Standards. Better Physicians. Better Care. Ottawa: The Royal College of Physicians and Surgeons of Canada.Google Scholar
- Karras, David J., Linda K. Kruus, Brigitte M. Baumann, John J. Cienki, Michelle Blanda, Susan A. Stern, and Edward A. Panacek. 2006. “Emergency Medicine Research Directors and Research Programs: Characteristics and Factors Associated with Productivity.” Academic Emergency Medicine 13:637–644.CrossRefPubMedGoogle Scholar
- Lander, Bryn, Gillian E.Hanley, Janet Atkinson-Grosjean. 2010. “Clinician-Scientists in Canada: Barriers to Career Entry and Progress.” PLos One 5, no. 10: e13168. Published online 2010 October 4. doi: 10.1371/journal.pone.0013168.
- Leahy, Natalie, Jordana Sheps, C. Shawn Tracy, Jason X. Nie, Rahim Moineddin, and Ross E.G. Upshur. 2008. “Family Physicians’ Attitudes toward Education in Research Skills during Residency: Findings from a National Mailed Survey.” Canadian Family Physician 54:413–4.e1-5.PubMedCentralPubMedGoogle Scholar
- Levine, Rachel B., Randy S.Hebert, and Scott M. Wright. 2005. “Resident Research and Scholarly Activity in Internal Medicine Residency Training Programs.” Journal of General Internal Medicine 20, no. 2:155–159.Google Scholar
- Lowe, Bernd, Mechthild Hartmann, Beate Wild, Christoph Nikendei, Kurt Kroenke, Dorothea Niehoff, Peter Henningsen, Stephan Zipfel, and Wolfgang Herzog. 2007. “Effectiveness of a 1-Year Resident Training Program in Clinical Research: A Controlled Before-and-After Study.” Journal of General Internal Medicine 23:122–128.PubMedCentralCrossRefPubMedGoogle Scholar
- Martin, Ann W. 2001. “Large-Group Processes as Action Research.” In Handbook of Action Research: Participative Inquiry and Practice, edited by Peter Reason and Hilary Bradbury, 200–208. Thousand Oaks: SAGE.Google Scholar
- McKay, William P.S. 2012. “Anesthesia Resident Research Programme.” Last modified February 1: http://www.medicine.usask.ca/anesthesiology/research-divison/research-resources/Resident%20Research%20Curriculum.pdf
- Reason, Peter, and Hilary Bradbury. 2001. “Introduction: Inquiry and Participation in Search of a World Worthy of Human Aspiration.” In Handbook of Action Research: Participative Inquiry and Practice, edited by Peter Reason and Hilary Bradbury, 1–26. Thousand Oaks: SAGE.Google Scholar
- Reid, Robert L. 2011. “Research in Residency, Other Health Care Training, and Practice: Why, When, and How?” In The Research Guide: A Primer for Residents, Other Health Care Trainees, and Practitioners, edited by Bart J. Harvey, Eddy S. Lang, and Jason R. Frank (Eds.), 11–14. Ottawa: Royal College of Physicians and Surgeons of Canada.Google Scholar
- Schafer, Andrew I. 2009. The Vanishing Physician-Scientist? Ithaca: Cornell University Press.Google Scholar
- Schein, Edgar H. 2010. Organizational Culture and Leadership. San Francisco: Jossey-Bass.Google Scholar
- Schon, Donald A. 1982. The Reflective Practitioner: How Professionals Think in Action. New York: Basic Books.Google Scholar
- Senge, Peter M. 1994. The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Currency Doubleday.Google Scholar
- Shea, Judy A., David T. Stern, Paul E. Klotman, Charles P. Clayton, Jessica L. O’Hara, Mitchell D. Feldman, Kathy K. Griendling, Marc Moss, Sharon E. Straus, and Reshma Jagsi. 2011. “Career Development of Physician Scientists: A Survey of Leaders in Academic Medicine.” The American Journal of Medicine 124:779–787.CrossRefPubMedGoogle Scholar
- Silcox, Lisa C., Ted L. Ashbury, Elizabeth G. VanDenKerkhof, and Brian Milne. 2006. “Residents’ and Program Directors’ Attitudes Toward Research During Anesthesiology Training: A Canadian Perspective.” Anesthesia & Analgesia 102:859–864.Google Scholar
- Weick, Karl E., and Frances Westley. 1996. “Organisational Learning: Affirming an Oxymoron.” In Handbook of Organisation Studies, edited by Stewart R. Clegg, Cynthia Hardy, and Walter R. Nord, 440–458. London: Sage.Google Scholar
- Yager, Joel, John Greden, Michael Abrams, and Michelle Riba. 2004. “The Institute of Medicine's Report on Research Training in Psychiatry Residency: Strategies for Reform--Background, Results, and Follow Up.” Academic Psychiatry 28:267–274.Google Scholar
- Zambudio, A. Rios, F Sanchez Gascon, L Gonzales Moro, and M. Guerrero Fernandez, G.M. 2004. Research Training During Medical Residency (MIR). Satisfaction Questionnaire. Revista Espanola de Enfermedades Digestivas 96:695–704.Google Scholar