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 Table of Contents  
MEDICAL EDUCATION
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 328-330

Crossing the final hurdle: How is scholarship practically conceptualized in the lives of busy clinicians?


1 Higher Education, OISE/University of Toronto, Toronto, Canada
2 Professor of Surgery, Department of Surgery, University of Toronto, Toronto, Canada
3 Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada

Date of Submission03-Dec-2021
Date of Decision04-Dec-2021
Date of Acceptance05-Dec-2021
Date of Web Publication29-Dec-2021

Correspondence Address:
Dr. Elizabeth M Wooster
3101 Bloor St W, Ste 306, Toronto, ON M8X 2W2
Canada
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/amhs.amhs_285_21

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  Abstract 


Clinicians juggle many roles in addition to their clinical responsibilities. These roles include teaching and academic responsibilities. When academic responsibilities and productivity is discussed, the question of what is recognized and valued often surfaces. While large “R” research areas may have high barriers preventing entry by many clinicians, scholarly activity and scholarship may be enacted and realized through engagement with daily activities. In this paper, Wooster, Wooster and Maniate explore the role of scholarly activities, discuss practical tips, and reflect on a culture that may be enacted to support scholarly activities and scholarship in the future.

Keywords: Culture, research, scholarship


How to cite this article:
Wooster EM, Wooster DL, Maniate JM. Crossing the final hurdle: How is scholarship practically conceptualized in the lives of busy clinicians?. Arch Med Health Sci 2021;9:328-30

How to cite this URL:
Wooster EM, Wooster DL, Maniate JM. Crossing the final hurdle: How is scholarship practically conceptualized in the lives of busy clinicians?. Arch Med Health Sci [serial online] 2021 [cited 2022 Jan 22];9:328-30. Available from: https://www.amhsjournal.org/text.asp?2021/9/2/328/334021




  Background Top


At the best of times, clinicians are busy. In addition to clinical responsibilities, many are juggling other professional roles, such as teacher, researcher, administrator, leader, and others. In addition, clinicians have personal responsibilities that can range from their own activities of daily living, home activities, and caring for children and/or parents. Since the start of the COVID-19 pandemic, physician responsibilities have been further complicated by the complexities and acuity of clinical care for those impacted by COVID and by the societal impacts of the pandemic. In academic or university settings, the expectation remains that clinicians take on additional important teaching roles and remain academically productive. These added demands compete with the need to maintain personal wellness and support both families and colleagues. This results in many clinicians reassessing the demands on their time and reprioritizing personal and professional activities.


  What is Valued in the Academic Enterprise? Top


It is often difficult to find a definition or operationalization of what is meant by, or most highly valued in academic productivity in, health research. The World Health Organization (WHO) defines research for health as “the development of knowledge with the aim of understanding health challenges and mounting an improved response to them.”[1] The WHO definition explicitly states that improving health outcomes requires the involvement of many sectors and believes that research spans five activity areas “measuring the problem, understanding its cause(s), elaborating solutions, translating the solution into policy, practice and products, and evaluating the effectiveness of the solutions.”[1] While the WHO definition is broad and recognizes the multiple roles of multiple actors and processes when research is discussed in academic circles, it is often characterized by basic science laboratory work and clinical trials. The work that is done within these areas is that which is then often most highly valued.

Individuals involved in work in these areas share training and expertise with colleagues, relate to others doing similar work, and have corporate, government, institutional, or other infrastructure support.[2] They engage in longitudinal enterprise to achieve a better understanding of disease processes and management. They provide advances of value to patients and society; thus, the promulgation, promotion, and translation of such research are considered tangible outcomes. These are the types of research that are typically recognized for faculty promotion and achievement within higher education institutions.[3] This creates an environment that is difficult for busy clinicians to be involved with. There are many barriers to entering large “R” research projects. These include a lack of resources including limited time/competing pressures, a lack of expertise, a lack of interest, or a lack of connection with a “research enterprise.”[2],[4]

Although other forms of investigation and publication in areas such as leadership, social impact, health policy, education, guideline development, ethics, and administration are important and can be accessed in a less formal framework, such work may not be formally recognized in the same way. As a result, there is a perpetuation of the “traditional” view of research and placement of limits or restrictions on other ways of viewing problems faced within health care.


  What is the Scholarly Approach? How is it Different than “Research”? What Does Scholarship Look Like to a Busy Clinician? Top


Although areas of large “R” research may be difficult for a clinician to participate in, there are other ways to be involved in research and scholarship. In a previous paper, Wooster, Wooster, and Maniate explored concepts of scholarship and its importance to medical education.[5] The underlying tenets informed by the work by Boyer and Glassick also apply to clinical practice and the health-care system.[6],[7],[8] The multiple ways that research and scholarship are enacted need to be recognized and supported for the health-care system to realize its full potential.

Busy clinicians can begin to be involved in scholarly activity and scholarship by asking questions about the work they are already engaged with. It is important that these questions be asked and explored in a scholarly manner. A scholarly approach to any field can be defined as a deliberate, organized questioning in practice that leads to assaying available evidence, synthesizing new knowledge, and translating it into clinically useful formats that alter practice.[9] Questions to be considered include what is being done? why are things being done this way? what is the goal? what is trying to be achieved? how can it be made better? and what is being valued as “better” – the concept of efficiency or effectiveness?

Once these questions have been asked and explored as they relate to clinical practice, the next step is to consider how to translate the knowledge that has been gained into forms that can be used by others to improve their clinical practice. Options to translate knowledge include incorporating it into teaching activities, discussing it with others, exploring the same or comparable questions within other practices, and writing and publishing about it. These provide the opportunity to expand the clinical knowledge base, as well as receive feedback and commentary on the knowledge being developed. Enacting this step is important as it is an essential component to assisting in distinguishing between scholarly activity and scholarship.[5],[8] Physicians engaged in active scholarly work and scholarship should be seen as fulfilling many of the definitive aspects of “research” and thus should be recognized in promotion or other forums.


  Practical Tips to Incorporate Scholarship into One's Daily Practice Top


  1. Pause and reflect: Do this by making a list of existing roles and responsibilities, both personal and professional
  2. Evaluate and understand: Upon review and reflection on the list, identify the academic/professional roles or responsibilities that may no longer align with career and scholarly goals and how they may be reallocated or reassigned
  3. Divest by investing: Recognize if there is someone else in your network for whom the role or responsibility would be opportune and academically/professionally beneficial for their own career journey and scholarly contribution
  4. Purposefully integrate: Explore integrating a scholarly approach into the remaining “work” you do to increase its academic value and provide you with the institutional credit that confers legitimacy and credibility within the higher education sphere. This approach affords an individual the opportunity to convert “work” in the clinical context into a “benefit” or something that is valued in the academic context
  5. Identify mentors: It is important to seek out individuals who can provide you mentorship on the scholarship process. It is invaluable to having an outside perspective on your life to ask you critical questions of what you are doing to ensure there is alignment with your goals, but also to connect you with potential collaborators
  6. Find collaborators: Scholarship is increasingly recognized as a collaborative activity and those that work within highly collegial teams are often the most successful in both initiating but also implementing, completing, and disseminating their projects. Being within a collegial team allows the burden and rewards of academia to be shared among many. Depending on the nature of your scholarship, these collaborators may or may not be within the health professions. Increasingly, there is an appreciation that scholarship initiatives are enriched through transdisciplinary approaches, including the inclusion of patient partners in the process.



  Reflecting and Changing Culture Top


The COVID-19 pandemic has provided clinicians and institutions with a unique series of opportunities. The challenges that have emerged have forced the health-care system to pivot and reimagine its approach to many traditional health-care pathways. Within this environment, it is important to reconsider the current definition and understanding of academic productivity. The pivots that have occurred, and continue to occur, provide opportunities to redesign the concept of academic productivity and the value placed on the resulting products. Questions that should be considered to help reframe the discussion include what activities are “important” from a personal role, professional role, clinical role, and academic role? what activities are “important” at each level of career? are these activities being allocated the appropriate level of support (dedicated time, etc.)? and could the use of a scholarly approach to planning academic activities result in a more productive allocation of responsibilities (i.e., “double dipping”)? By taking this approach to scholarship, we have an opportunity to role model for others another way to positively make an impact academically and professionally even as the busyness of life continues.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. WHO Strategy on Research for Health. Geneva: World Health Organization; 2012. Report No: 978 92 4. 150325. Available from: https://www.who.int/phi/WHO_Strategy_on_research_for_health.pdf. [Last accessed on 2021 Nov 24].  Back to cited text no. 1
    
2.
Lamontagne F, Rowan KM, Guyatt G. Integrating research into clinical practice: Challenges and solutions for Canada. CMAJ 2021;193:E127-31.  Back to cited text no. 2
    
3.
Van Melle E, Lockyer J, Curran V, Lieff S, St Onge C, Goldszmidt M. Toward a common understanding: Supporting and promoting education scholarship for medical school faculty. Med Educ 2014;48:1190-200.  Back to cited text no. 3
    
4.
CelesteR. F, Griswold A, Straf ML, Editors. Committeeon Assessing the Value of Research in Advancing National Goals; Division of Behavioral and Social Sciences and Education; National Research Council Understanding the Research Enterprise as a Complex System. Available from: https://www.ncbi.nlm.nih.gov/books/NBK253891/. [Last accessed on 2021 Nov 03].  Back to cited text no. 4
    
5.
Wooster EM, Wooster DL, Maniate JM. Defining medical education scholarship: Its evolution and its importance. Arch Med Health Sci 2021;9:132-5.  Back to cited text no. 5
  [Full text]  
6.
Boyer EL. Scholarship Reconsidered: Priorities of the Professoriate. Princeton, NJ: Carnegie Foundation for the Advancement of Teaching; 1990. Available from: https://eric.ed.gov/?id=ED442420. [Last accessed on 2020 Dec 09].  Back to cited text no. 6
    
7.
Boyer EL. Scholarship Reconsidered: Priorities of the Professoriate. Princeton, NJ: Carnegie Foundation for the Advancement of Teaching; 1990. Retrieved from https://eric.ed.gov/?id=ED442420. [Last accessed on 2020 Dec 09].  Back to cited text no. 7
    
8.
Glassick CE. Boyer's expanded definitions of scholarship, the standards for assessing scholarship, and the elusiveness of the scholarship of teaching. Acad Med 2000;75:877-80.  Back to cited text no. 8
    
9.
Richardson D, Oswald A, Chan MK, Lang ES, Harvey BJ, editors. Scholar. In: Frank JR, Snell L, Sherbino J, editors. Can Meds 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015. Available from: https://eric.ed.gov/?id=ED442420. [Last accessed on 2021 Oct 27].  Back to cited text no. 9
    




 

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