Development and maintenance of a medical education research registry

Wilhite et al. BMC Medical Education (2020) 20:199 https://doi.org/10.1186/s12909-020-02113-5 DATABASE Open Access Development and maintenance of a medical education research registry Jeffrey A. Wilhite1* , Lisa Altshuler1, Sondra Zabar1, Colleen Gillespie1,2 and Adina Kalet1,3 Abstract Background: Medical Education research suffers from several methodological limitations including too many single institution, small sample-sized studies, limited access to quality data, and insufficient institutional support. Increasing calls for medical education outcome data and quality improvement research have highlighted a critical need for uniformly clean and easily accessible data. Research registries may fill this gap. In 2006, the Research on Medical Education Outcomes (ROMEO) unit of the Program for Medical Innovations and Research (PrMEIR) at New York University’s (NYU) Robert I. Grossman School of Medicine established the Database for Research on Academic Medicine (DREAM). DREAM is a database of routinely collected, de-identified undergraduate (UME, medical school leading up to the Medical Doctor degree) and graduate medical education (GME, residency also known as post graduate education leading to eligibility for specialty board certification) outcomes data available, through application, to researchers. Learners are added to our database through annual consent sessions conducted at the start of educational training. Based on experience, we describe our methods in creating and maintaining DREAM to serve as a guide for institutions looking to build a new or scale up their medical education registry. Results: At present, our UME and GME registries have consent rates of 90% (n = 1438/1598) and 76% (n = 1988/ 2627), respectively, with a combined rate of 81% (n = 3426/4225). 7% (n = 250/3426) of these learners completed both medical school and residency at our institution. DREAM has yielded a total of 61 individual studies conducted by medical education researchers and a total of 45 academic journal publications. Conclusion: We have built a community of practice through the building of DREAM and hope, by persisting in this work the full potential of this tool and the community will be realized. While researchers with access to the registry have focused primarily on curricular/ program evaluation, learner competency assessment, and measure validation, we hope to expand the output of the registry to include patient outcomes by linking learner educational and clinical performance across the UME-GME continuum and into independent practice. Future publications will reflect our efforts in reaching this goal and will highlight the long-term impact of our collaborative work. Keywords: Medical education, Research registry, Graduate medical education, Undergraduate medical education, Medical education research Background Medical education research (MER) should and could improve the health of the public by informing policy and * Correspondence: 1 Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU Robert I. Grossman School of Medicine, 462 1st Avenue, New York, NY 10016, USA Full list of author information is available at the end of the article practice but it suffers from many methodological limitations including small sample sizes, cross sectional designs, and lack of attention to important context variables. There are increasing calls for medical education research, a poorly funded field, to go beyond the proximate outcomes of training to study more distal clinical outcomes using “big data” strategies [1, 2]. And yet, even within the same institution, data is collected © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Wilhite et al. BMC Medical Education (2020) 20:199 using different systems and a wide range of formats, without a shared ontology or structured language and therefore is not organized to enable longitudinal tracking of learners, learning, or linking with outcomes. While medical trainees must be afforded the same ethical and legal protections as any research subjects and U.S. federal regulations allow the use of educational data collected in the routine conduct of a required curriculum for research without written consent from learners, medical school research ethics review boards are not consistent in their approach to trainees as study subjects, complicating the ethical conduct of this type of research [3]. Establishing research registries can help overcome some of these barriers and facilitate higher impact, ethically rigorous programs of medical education research [4]. Research registries compile and maintain multiplesource, standardized information on potential study participants longitudinally for many purposes [5]. The National Leprosy Registry in Norway established in 1856, was the earliest disease specific registry, and the number of disease specific registries has increased steadily since [6]. More recently, research registries have focused on data integrity and quality improvement, following in the footprints of the Framingham Heart Study-style that began in 1970 [5, 7]. In 2006, the Research on Education Outcomes (ROMEO) unit of the Program for Medical Innovations and Research (PrMEIR) at New York University’s (NYU) School of Medicine established the Database for Research on Academic Medicine (DREAM) with funding from the Bureau of Health Professions (BHPr) of the department of Human Resource Services Administration (HRSA # D54HP05446). Borrowing from the constructs underlying disease registries, the goal of DREAM is to enable ethical, longitudinal study of outcomes in medical education through the collection of routine trainee and educational context data [8]. DREAM, a potential database assembled as needed to ask and answer specific research questions, is structured as two research registries - one for Medical Students (established in 2008, with 1438 current individuals enrolled) and the second, (...truncated)