The Experiences of Social Scientists in Medical Education Research: A Narrative Inquiry

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The Experiences of Social Scientists in Medical Education Research: A Narrative Inquiry

https://doi.org/10.21203/rs.3.rs-2063182/v1

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Although medical education research (MER) has been gaining recognition as an important area of research, the need for a social sciences perspective in such research is not always well understood. Available literature on the career progression of researchers in MER - with regards to factors like academic promotion and job satisfaction - have been largely limited to clinician or biomedical researchers. Thus, this narrative study aimed to explore and describe the experiences of social scientists developing careers within MER units housed in Canadian medical schools. It included semi-structured interviews with six faculty members of MER units in three Canadian medical departments. The data was then thematically analyzed, revealing the following themes: 1) challenges are systematic in nature but rewards tend to be interpersonal; 2) the development of MER units have helped improve social scientists’ experiences in MER; 3) interdisciplinary and interprofessional interactions act as both the greatest challenge and reward of a social scientist’s career in MER; 4) social scientists’ perceived experiences in MER are influenced by their perceived impact on institutional change; and 5) social scientists in MER retain and advocate for their identity as social scientists, but individual differences exist in the perceived gratification of advocacy work. The findings suggest the need for more interprofessional collaborations within and outside of MER to support systematic change in favour of an inclusive research environment, especially in departmental leadership and decision-making roles. Furthermore, there is a pressing need to implement standards within medical departments to recognize the contributions of social scientists to knowledge translation and mentorship.

Career progression

interdisciplinarity

medical education research

productivity

social sciences in medicine

tenure promotion

For years, the boundary between medical research and medical education research (MER) has remained unclear, raising concerns that research in medical education may not be translating into practice due to a lack of clarity and rigor in methodology (Cook et al., 2008). Although the need for evidence-based guidelines is recognized within the MER community, the lack of appreciation of MER beyond the field has challenged the advancement of research within (Todres et al., 2007). This lack of recognition may be attributed to the classification of MER as a branch of medical research (Monrouxe & Rees, 2009), leading to suggestions that taking a social sciences approach to MER would help advance the field. Nevertheless, social scientists have faced challenges navigating the realm of MER due to factors such as divergent views of academic excellence and research methods in MER (McKendree, 2016; Todres et al., 2007).

Despite the growing interest in MER, however, there has yet to be research in Canada on social scientists navigating the realm of MER (Canadian Medical Association [CMA], n.d.). Indeed, what is missing in current scholarly discussions regarding the state of the social sciences in MER are the stories of social scientists themselves. Understanding how careers in the MER community develop and communicating this to members of the field may be the first step in ensuring that social sciences have a place within MER. Thus, this study aims to explore the experiences of social scientists entering and developing a career within MER in Canada. Through their stories, I hope to enrich the understanding of the different facets of social scientists’ career evolution in the field, such as rewards, perceived identity, and barriers. I used the following research question to guide my research: How do social scientists experience the evolution of their careers in MER?

Background

Discussions surrounding MER first emerged in the mid-1950s from an anecdote about a project in medical education that involved a workshop on educational topics such as the teaching-learning process, evaluation, and communication (Miller, 2013). As MER gained recognition as an essential component of developing medical education (Goldszmidt et al., 2008), the formation of research units dedicated to MER within medical faculties and institutions ensued (Varpio et al., 2014). These units are characterized by clear educational research goals, advocacy to broaden the scope of MER beyond the field of medical research, and interdisciplinary collaboration that involve non-clinician educational researchers, clinicians, basic scientists, and administrative staff (Arnold, 2004).

Indeed, interdisciplinary interaction has been cited as one of the key components of success in MER (Arnold, 2004; Goldszmidt et al., 2008). While it is true that the role of non-clinician faculty members whose academic careers focus on education scholarship have become more prominent in recent years, there remains a distinct lack of recognition of social sciences research among medical researchers, which act as barriers to regular interdisciplinary interactions in practice (McKendree, 2016). For the most part, literature on academic careers within MER are also limited to clinician (e.g., medical doctors, nurses) perspectives, which has limited our knowledge on the experiences of non-clinician researchers. Clinical faculty in MER face issues with promotion due to a culture that prioritizes productivity as indicated by the number of publications and research grants attained over a period of time (Beasley et al., 1997; Blazey-Martin et al., 2016; Sánchez, 2020; Tootoonchi et al., 2014). In fact, the situation may be worse for non-clinician researchers who often have to “modify their research practices to gain recognition from their biomedical colleagues, which indicates the low value assigned to their research practices” (Albert et al., 2014, p. 24).

According to some, the potential and legitimacy of MER have been impaired by the lack of theoretical frameworks and epistemological discussions regarding the nature of the knowledge medical education researchers seek to create (Arnold, 2004; Bunniss & Kelly, 2010; Cleland and Durning, 2019). This issue is exacerbated by the fact that controlled, quantified evidence such as randomized controlled trials are often prioritized over other approaches, without any explicit theoretical justification; this may be due to the tendency to assume that those former approaches necessarily constitute better evidence and measures of ‘truth’ or ‘validity’, regardless of context (Sandars & Patel, 2015). Unfortunately, such tendencies have led to a dichotomy of evidence-based versus non-evidence based medical education – a poorly articulated and fruitless debate considering the definition of ‘scientific’ or ‘empirical’ research does not distinguish between quantitative and qualitative approaches (Hart & Harden, 2000; Otani, 2020). Although it is true that MER involves educational research that uses qualitative methodologies, that is not to say MER – or social sciences research in general – does not involve quantitative methods. In this regard, one of the issues stunting the potential of MER may be that the scope of its reach is often restricted to clinicians or medical scientists, who may or may not understand the pillars of social sciences research methodologies often employed in MER (Monrouxe & Rees, 2009).

The theoretical frameworks through which I interpreted the participants’ stories are constructivism and communities of practice (CoP). Constructivism will be used to frame individuals’ subjective interpretations. CoP will be used to interpret the social dynamic that they describe.

Constructivism

Constructivism is a learning theory associated with Piaget based on the idea that the construal of knowledge is tied to action and the assimilation of knowledge into action schemes through our experience as learners (Proulx, 2006; von Glaserfeld, 1982). An important consideration within constructivism is that “all knowledge is subjective and dependent on the learner” (Proulx, 2006) - that is, how compatible and viable knowledge about a topic or idea is in relation to the learner’s experiential world. In this study, constructivist thinking framed the analysis of social scientists’ lived experiences and their meaningful interpretations of their journey, offering insight into the types of knowledge each individual has constructed throughout their careers in MER.

Communities of Practice (CoP)

CoP is a philosophical perspective that frames communities as a living curriculum for knowing and learning (Wenger-Trayner & Wenger-Trayner, 2015). In contrast to traditional approaches to education that emphasize individual acquisition of knowledge in formal settings, it draws attention to levels of engagement and the informal learning that happens within different levels of participation (McMurtry et al., 2016).

Under the assumption that learning and knowing are functions of social dynamics that occur throughout various levels of participation, CoP classifies levels of participation within the community into core, active and peripheral participation (Wenger et al., 2002). Core participation is observed in members of the community who demonstrate the most active engagement in community discussions and activities and often hold leadership positions, while the peripheral group encompasses the large portion of community members who simply observe the interactions that take place within the community (Wenger et al., 2002). In this study, CoP framed the movement of social scientists from a peripheral to core participation within MER.

This study is a qualitative research study involving a narrative inquiry. This is one such approach that involves data collection through stories on how humans experience the world (Creswell, 2013; Connelly & Clandinin, 1990). Working under the assumption that “humans are story telling organisms who, individually and socially, lead storied lives” (Connelly & Clandinin, 1990, p. 2) a narrative approach serves to describe personal stories through collaborative research.

Sampling Procedure

I conducted semi-structured interviews on six faculty members affiliated with MER units in three Canadian medical schools. The inclusion criteria of the participants included researchers trained in social sciences research (e.g., sociology, education, or psychology) who had never received training as a clinician and were appointed to a MER unit in a Canadian medical faculty.

Purposeful sampling was used to identify and select participants to ensure they were eligible and had relevant experience to the research topic (Palinkas et al., 2015). As this study involves a qualitative narrative inquiry in which the depth of understanding is critical, it was important that the participants selected for the study deemed their experience as relevant and were willing to share their stories. Following a review of the faculty webpage of MER units selected for the study, a total of nine researchers were identified based on their biography and research interests . These nine individuals were contacted via e-mail with information on the study (Appendix A). Two did not respond, and one did not self-identify as a social scientist. In the end, six researchers agreed to participate in the study (Table 1). To protect the identity of the researchers selected for this study, the targeted MER units and schools will not be identified.

Table 1

Participant Demographic Characteristics

Gender	Women	3
Gender	Men	3
Academic Rank	Professor Emeritus	1
	Associate Professor	4
	Assistant Professor	1
Years on Faculty	< 5 years	1
	5-10 years	2
	> 10 years	3
	Maximum	20 years
	Minimum	3 years
Years of Appointment (Scientist) at MER Unit	< 5 years	2
	5-10 years	2
	> 10 tears	2
	Maximum	20 years
	Minimum	3 years

Data Collection

Prior to the interview, participants were sent a consent form to review and were asked to share their curriculum vitae to allow for more personalized and fruitful discussions. The interviews were approximately 60 minutes long and the participants were asked a set of questions meant to explore their journey into MER, their experiences, their perceived identity as a social scientist, and the rewards and challenges they faced in developing their careers (Appendix C). Verbal consent was obtained at the beginning of the interview to record the Zoom session, and once again after the recording was started. All interviews were video recorded – this was inevitable due to the nature of the online communication platform used (Zoom). The participants were informed of this technological peculiarity ahead of the interview. They were also informed that while they were free to turn off their cameras if uncomfortable, only the audio files would be saved for analysis. Informed consent was obtained from all participants regarding this process. This study has obtained ethics approval from the University of Ottawa Research Ethics Board.

Data Analysis

In advance of the analysis, a partial verbatim transcription of the audio recorded interviews was made. Although an interview guide was developed to gather key information regarding the participants’ careers, the conversations often led to small talk irrelevant to this study, albeit helpful in allowing the interviews to unfold organically. Thus, we transcribed only the parts of the interview that were relevant to the participants’ career development and excluded discussions that concerned the researcher conducting the interviews (NK), or those on personal topics that went beyond the scope of this inquiry.

Upon completion of the interviews and prior to transcription, the audio recordings were transcribed as described above and the transcripts were read at least two times by NK. The initial read-through ensured that the data was accurately transcribed and included all relevant parts; a second read-through was conducted to review the transcript data in preparation for the main portion of the data analysis.

First, the interview guide was used to categorize the data, i.e., Background, Changes, Challenges, Rewards, and Other, in a restorying process guided by Creswell (2013). The data was then coded into themes by identifying commonalities in the participants’ responses to each question. The generated themes, presented in the Findings section, span the participants’ careers in MER and serve to highlight various aspects of their experience.

Trustworthiness

In order to assess the trustworthiness of the findings, the interpretations of the participants’ narratives were shared with them for member-checking. Member checking is a process of testing “‘data, analytic categories, interpretations and conclusions’ with members of the stakeholder group(s) from whom the original information was collected” (Lincoln & Guba, 1985, as cited in Doyle, 2007; Stiles, 1993). Participants were provided with their portion of the written narrative and informed of the exact quotes used to present the findings. They were asked to comment on any potential misinterpretations of their stories, which were then incorporated as revisions. The narratives can be found in Appendix E.

All six participants included in the interviews were affiliated with a MER unit and held a faculty position in a Canadian medical school. The participants were well-balanced in terms of gender, experience and departmental position (the participants’ basic demographic information is summarized in Appendix F). As described above, the interviews tracked the participant social scientists’ experiences of their career evolution in MER.

For all participants, the evolution of their academic careers into MER were non-linear and unintentional, facilitated through a series of unexpected and well-timed opportunities described as “serendipitous” (Participant 5; hereafter ‘P5’). The common motivations in entering the field of MER involved career opportunities (i.e., an opening for a faculty position) and a pre-existing interest for health-related topics.

Our findings narrate various aspects of social scientists’ careers in MER including their journey into MER, challenges, and rewards. The main themes around which the findings were organized are as follows: 1) challenges are systematic in nature but rewards tend to be interpersonal; 2) the development of MER units have helped improve social scientists’ experiences in MER; 3) interdisciplinary and interprofessional interactions act as both the greatest challenge and reward of a social scientist’s career in MER; 4) social scientists’ perceived experiences in MER are influenced by their perceived impact on institutional change; and 5) social scientists in MER retain and advocate for their identity as social scientists, but individual differences exist in the perceived gratification of advocacy work.

Challenges are Systematic in Nature but Rewards Tend to be Interpersonal

The main challenges identified in the participants’ career progression were systematic issues that involved having their work evaluated according to criteria set up for clinical or biomedical research, having to justify their selected readership or journals (especially those with lower impact factors) to their clinical departments, dedicating time and effort into translating their “disciplinary perspective” (P1) for their clinical or biomedical colleagues, and navigating “tons of [conflicting] opinions” (P6) regarding the quality of their work. One individual believed that his academic achievements were stunted “because [he] decided to stay a social scientist” (P1) as he believed his work did not receive the recognition it deserved in MER. Other challenges identified by some of the participants that added to their workload but was not considered ‘burdensome’, included learning to write up their research in a different style to suit the requirements of medical journals (P5), advocacy for social sciences research, and mentorship for incoming social scientists in MER (P2, P3, P5, P6).

On the other hand, the “big rewards” (P1) of being a social scientist in MER were interpersonal in nature. Most (5 of 6) participants stated that their work in MER was fulfilling and interesting in ways that would not have been possible in their home discipline due to the wide variety of topics and researchers they could engage with. Although a direct comparison was not possible as they “ha[ve]n’t been down that path” (P3), they did not feel as though they were ‘missing out’ by not having pursued a professional career in their home discipline.

The Development of MER Units Have Helped Improve Social Scientists’ Experiences in MER

The development of research units dedicated to MER improved social scientists’ perceived experience in the field. Although the systematic challenges addressed above remain, participants found their appointment in their MER units helpful as “support from fellow social scientists [is] available” (P3). Many of the participants agreed that it was initially difficult to find their identity, to deal with having less academic freedom/voice, and to establish their reputation as an academic. But they felt that “a strong foundation was already laid” (P5) in their MER units from “the superstars […] who opened up the field” (P6), which made the systematic challenges much easier to navigate for my participants.

Interdisciplinary and Interprofessional Interactions Act as Both the Greatest Challenge and Reward of a Social Scientist’s Career in MER

Navigating interdisciplinary and interprofessional interactions are challenging. The participants often felt as though they were “forever trying to educate people on who [they were] and what [they] did” (P2) in MER. Indeed, “becoming a full professor [is] an adventure” (P2), as translating and educating clinician colleagues and departments would impact their productivity. After all, “it takes a tremendous time to build partnerships” (P4).

Researchers were also often faced with “tons of [conflicting] opinions” between their medical department and MER unit, which can be “consuming to navigate as a novice researcher” (P6). Indeed, the goal for support in MER units can “juxtapose against a university’s expectation for individual achievement” (P5), leaving some (especially early career) researchers feeling lost.

Navigating interdisciplinary and interprofessional interactions are rewarding. Despite the challenges of engaging in interdisciplinary and interprofessional interactions in MER, all six of the social scientists interviewed found it rewarding to work with clinicians “who bring [to them] knowledge of health professions that [they] didn’t have” (P1). These interactions made the additional efforts worthwhile for our participants, as they felt like they could “help a lot of different kinds of people” (P5). Most (5 of 6) enjoyed the partnerships they had sought out with those who were “willing to have conversations in other languages” (P2) and cherished these partnerships as “golden when it comes to the mitigating of the problems associated with the climb into where [they] want to be in [MER] and the impact [they] want to have” (P2). Participants (4 of 6) identified MER units as a source of support, describing the community as “a critical mass of individuals who [were] all coming from different disciplines, [who were] friendly to each other, collegial, […] and reinforcing [of] each other’s work by keeping each other abreast of opportunities” (P6).

Social Scientists’ Perceived Experiences in MER are Influenced by their Perceived Impact on Institutional Change

Participants’ perception of how their work contributed to institutional change, such as influencing departmental frameworks on evaluating academic productivity, acted as a decisive factor on whether they deemed their career in MER to be worthwhile. All participants mentioned how advocacy to prove the legitimacy of social sciences research to their clinical department was a lot of additional work, and one that gets “tiring” (P2). Nevertheless, they “actually never ultimately tired of having that extra layer of work” (P2); they had seen the advocacy lead to institutional changes with “people embedded in different locations across the system with different leadership positions” (P6), and growing partnerships with clinician colleagues who were “willing to have conversations in other languages” (P2). Although frustrating and burdensome at times, advocacy was described as ‘fun’ when “people see the work and people get it” (P3).

Social Scientists in MER Retain and Advocate for their Identity as Social Scientists, but Individual Differences Exist in the Perceived Gratification of Advocacy Work

All participants demonstrated great pride in their identity as a social scientist. Although one felt that she didn’t “contribute to theory nearly to the depth and breadth as [her social science] colleagues” (P3), none the others perceived a shift in their identity as a social scientist throughout their career. Another participant, however, did experience tensions which she described as “inevitable and requiring a lot of work on [her] part to negotiate” (P6).

Two participants (of 6) stated that if being a medical education researcher meant having to let go of their social science identity, they would “rather look for a different place than make [themselves] fit in what [they] don’t” (P4). These participants felt frustrated when “people in MER self-identif[ied] as social scientist when their perspectives are only situated within medicine” (P4). They speculated that as the field of MER advanced, it became harder to “remain a social scientist according to what it is to be a social scientist outside [of] medicine” (P1) due to the relatively limited scope of research in MER. P1 described the field as becoming increasingly “insular.”

Meanwhile, other participants embraced the education and translation of their work into applied medical contexts as a part of their identity as a social scientist in MER. They regarded this additional work not as a “sacrifice,” but rather an “expansion” (P2). One participant framed it as a “deliberate choice” and felt “reassure[ed]” to push for “what the field needs” (P6) as she now regarded the introduction of social science paradigms into MER as part of her responsibility. Participants who shared this opinion felt as though they “joined a very strong community of researchers,” with “social scientists hav[ing] quite a dominant presence in [MER]” (P5).

Social Scientists’ MER Experience in One Word: A Synopsis

During the interviews, the participants were asked to select one word to describe their career progression in MER to get a brief and consolidated overview of their perceived experiences in the field. Their synopses included the following words: failure, opportunism, boundary-breaking, curiosity, fascinating, and fresh. We present on Table 2 the reasoning the participants provided for each word selection.

Table 2

Word Choice and Reasoning

Word Choice	Reason
Failure	Academic promotion stunted due to decision to retain social science practice. The only way to succeed in MER is to convert to “the clinical way of publication”. “I will never become full professor because I have decided to stay a social scientist.” (P1)
Opportunism	“If I looked to the milestones of my career, most of them occurred due to two things. One, remarkable good fortune that came along, and two, the sense to know that it was an opportunity. And maybe three, having an idea of what to do to actually bring it to some kind of fruition.” (P2)
Boundary-breaking	“I was the education person, so I felt like it was a lot of boundary-breaking. We forged a path where people now seek us, while before, they just didn’t understand us or think that we were legitimate research.” (P3)
Curiosity	“I went into it due to curiosity. I’m still very curious. Curiosity is a value for me. If curiosity disappears for me, I have to look at something else to do.” (P4)
Fascinating	“I’ve been encouraged to dance around many different problems and phenomena that interest me, and there’s so many in the context of medical education and clinical practice, so I’ve had a tremendous amount of flexibility to choose projects that interest me. […] I’ve never felt bored, I’ve never felt pigeon-holed. I’ve always just felt like I’m growing and that my ideas are always of interest to others and it’s just been extremely fascinating.” (P5)
Fresh	“The thing that makes me very happy is the capacity to feel fresh and new because there is so much more that we can be doing, there are so many openings in the field. So being able to contribute in different ways, that’s very exciting to me.” (P6)

The participants’ stories provided insight into social scientists’ experiences in navigating a career in MER units housed in medical schools across Canada. Our findings both concurred and contrasted with previous literature, which suggested that social scientists often struggle to progress their research within medical faculties due to differing standards and the limited availability of funding (Albert et al., 2014; McKendree, 2016; Todres et al., 2007).

Systematic Challenges Remain but MER Units Help to Maximize Rewards

As depicted through the first three themes, overarching performance standards and funding still challenge social scientists’ career progression. The development of MER units, however, have alleviated the degree to which such systematic challenges impact social scientists’ careers in MER, acting as a community of support for both experienced and novice faculty members. Such findings support Arnold’s (2004) observation that successful MER units implement strong mentorship for newly recruited researchers and additional support such as teaching academies and awards. Further, our findings highlight the significance of interprofessional relationships in the development of social scientists’ careers in MER, supporting the notion that social capital – the network and social relationships an individual has that helps to advance their position in society – plays an important role in professional development within the academic context (Hu et al., 2015; LaMantia et al., 2012).

Social Scientists’ Experiences in MER: A Constructivist Interpretation

Our findings present one way to interpret Albert et al.’s (2014) description of social sciences and humanities scholars’ experiences in medical schools. As depicted in last two themes, a group of researchers who share the same identity can have differing views on their career progression. The social scientists interviewed could be classified into the following cohorts identified by Albert et al. (2014): reaffirmation (those who were able to maintain their research practices in MER); conversion (those who adopted to the style of applied research more commonly used in medical schools); partial adaptation (those who modified their research practices to align with the standards and expectations of their medical departments); and resistance (those who did not adjust their research practice but did so at a cost in career development). Despite the apparent differences between the cohorts in the way they adapted to a career in MER, our interpretation of the participants’ stories revealed how their perceived impact on institutional change – usually towards a more amiable environment for interprofessional and interdisciplinary collaborations – dictated their level of satisfaction in pursuing a career in MER.

Indeed, from a constructivist perspective, how different individuals interpret or make meaning of experiences depends on their life context (Proulx, 2006). In this context, that means that how each social scientist experiences their career progression through MER depends heavily on their meaningful interpretation of their work in relation to their career accomplishment. That is, the degree to which an individual social scientist engages in meaningful work – and thus makes their work in MER worthwhile – may shape their perception of their career. The fact that most (5 of 6) participants regarded the additional time and cognitive flexibility dedicated to advocacy and knowledge translation as worthwhile attests to the fact that there is great potential for MER to support interdisciplinary and interprofessional collaborations. Nevertheless, this is conditional on the establishment of environments in which social scientists (or more broadly, non-clinician researchers) feel that their efforts are being recognized and utilized to contribute to inclusive research practice.

Social Scientists’ Experiences in MER: Communities of Practice

Our findings build upon the theoretical paradigm of CoP, as well. Traditionally, the CoP of medical education researchers were largely divided into medical science research and research from other disciplines such as the social sciences. This divide had led to the dichotomy discussed in previous literature between the medical and social science researchers and rendered social scientists ‘invisible’ in medical schools (Albert et al., 2014; McKendree, 2016; Todres et al., 2007). The systematic challenges discussed in the interviews, as well as by Albert et al. (2014), may be attributed to such a dichotomy.

Nevertheless, the recent advancement and institutionalization of MER units have led to the development of a CoP specific to MER, creating a sense of support and opportunities for collaborations both within and outside of MER and alleviating some of the challenges previously identified by Albert et al. (2014), McKendree (2016), and Todres et al. (2007). These changes helped to shift social scientists’ perception of their careers from being ‘burdensome’ and ‘conflicting’ to ‘worthwhile’ and ‘rewarding’. Indeed, most (5 of 6) of those interviewed found it rewarding to work alongside their MER colleagues who share a domain of interest – situating interdisciplinarity in MER through the integration of experts of differing disciplines and in doing so, challenging the systematic barriers that exist in their medical departments (Wenger-Trayner & Wenger-Trayner, 2015). As social scientists engage with others in their MER units, they shift from peripheral to core participation within the CoP of MER, while shifting away from core participation in their home disciplines. Meanwhile, as social scientists gain more recognition for their research in MER, they tend to become more actively involved in advocacy and mentoring for the co-existence of social science paradigms and methodologies within their medical departments. As such, core participation in the MER CoP not only helps social scientists adapt to MER, but also negotiate the CoP in medical research. The presence (and active participation) of social scientists within the medical CoP extends their impact to cultivate more diversity and interprofessional interactions within the medical departments to which MER units belong, as social scientists bring a different perspective to medical research questions that have previously only been addressed from the medical perspective (McMurtry et al., 2016; Wenger et al., 2002).

Next Steps

Although the systematic changes proposed in this article will not likely result in drastic changes to MER and affiliated departments in the near future, it is evident that more social scientists are finding their way into leadership positions. This may be a beginning of change that, in the next decade or two, will result in changes in systematic standards and the scholarly discussions surrounding educational topics within MER. In this regard, future research on the career progression of social scientists in MER may involve the following research questions:

What kinds of evaluation standards have been implemented for academic promotion in medical departments in the past ten years that deviate from traditional measures of productivity such as impact factor or number of publications?
In what ways have social scientists advocated for the legitimacy of social sciences research within departments dominated by biomedical and clinical research?

Limitations

Although our narrative study design granted access to thoughtful, comprehensive accounts of social scientists’ experiences in MER, there were some limitations pertaining to sampling. First, we used purposeful sampling. We individually contacted researchers whom we believed, based on their online profiles, would be a good fit for our study. Although this approach successfully enabled us access to an eligible group of individuals, our findings may not be transferable across settings or contexts given the specificity of my targeted cohort and sampling process. Second, clinicians were excluded from the study regardless of whether they had a social science background, as clinical training would have given them an advantage(s) (i.e., recognition) that their social science colleagues would not have access to. Although this ensured that we captured the perspective of a foreigner navigating the tensions described, the specificity of the background of the participants limits the transferability of our findings. Lastly, the sample size of our study was quite small, involving only six medical education researchers from three different MER units. Although a small sample size is usually preferred in narrative studies to allow deep, case-oriented analyses, having more participants and including other MER units may have improved the richness of the data generated through this study. This is especially true given that MER units, depending on the medical school they belong to, can have different characteristics such as institutional structure.

This study provides insight into a previously understudied cohort of medical education researchers using a narrative methodology framed by constructivism and CoP, facilitating an in-depth exploration of social scientists’ careers in MER. The combined use of learning theories reinforced the complexity of human experience and enabled me to capture a more multi-dimensional interpretation of the participants’ career evolution, while our methodology served as an example of how personal narratives could be used to justify a research problem.

The participants’ narratives revealed several interesting points. Our findings revealed that the presence of MER units have helped social scientists feel supported, although systematic challenges remained, such as low funding and productivity measures geared to medical science researchers. Furthermore, interdisciplinary and interprofessional interactions were identified as both a challenge that negatively impacted their productivity, and a reward that led to positive institutional changes and kept them motivated. Social scientists seemed to perceive their work as more worthwhile when they believed their work influenced their department to become more interdisciplinary, although not everyone appreciated the amount of advocacy they had to partake in to preserve their social science identity.

Overall, our findings suggest the need for more interprofessional collaborations within and outside of MER to support systematic change in favour of an inclusive research environment. Involving social scientists in leadership and decision-making roles within medical departments (beyond their MER units) may be one practical step to mitigate the issues pertaining to measures of productivity. Moreover, our findings may serve as a call for action for medical departments to implement standards to recognize the additional efforts medical education researchers – particularly the non-clinicians – are putting into knowledge translation and mentorship.

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The Experiences of Social Scientists in Medical Education Research: A Narrative Inquiry

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