Knowledge Translation for Education Journals in the Digital Age

Studies have revealed critical delays in translating clinical research findings into practice; they have also highlighted overly rapid adoption of new interventions with limited supporting evidence.¹ This too slow or too fast adoption of innovation occurs in medical education as well. Examples include the slow adoption of problem-based learning in the 1980s, the standardization of patients for assessment in the 1990s, and the current rapid move to online teaching modules for a wide array of objectives.^2–6

In colonial times, circa 1650, teachers used Horn Books—wood paddles with printed lessons—to help students learn. By the 1890s, our teaching strategies included chalkboards, paper, and pencil. In the 1930s, technology began to influence education with overhead projectors and classes broadcast over the radio.⁷ Now educators are using new digital connections to learners⁸ through crowd-sourced educational adjuncts,⁹ specialty blogs,¹⁰ wearable devices (eg, Google Glasses), webinars, mobile videos, and simulators for just-in-time practice.¹¹

Traditionally, journals have moved at a more leisurely pace due to relatively slow review and print publication processes, restricted word counts, and difficulty presenting dynamic content.¹² Now evidence in medical education is more rapidly accessible through e-print, ahead of publication alerts, e-table of contents linked to the article, and substantial online supplemental material. These changes enhance the translation of article content for immediate use. Some journals (eg, Academic Medicine) allow article images to be exported to a PowerPoint file, and may also provide a permissions link with options for posting online. Other online journals bypass the traditional journal review process and allow readers to judge articles and post comments; these processes may democratize the review process and broaden the concept of scholarship.^13,14

Other experimentation by journals includes tweets and Twitter feeds, blogs, discussion boards, podcasts, vodcasts, and YouTube channels. The impact of this outreach can be tracked using alternative metrics, or altmetrics.¹⁵ Altmetrics data are derived from online discussions about individual scholarly articles from social media sources (Twitter, Facebook, Google+, blogs), the traditional media (newspapers, magazines), online reference managers (Mendeley, CiteULike), and public policy documents. This new version of an impact score is available for many journals, including the Journal of Graduate Medical Education (JGME).

Yet there still appears to be a substantial gap between publication of useful educational developments and their replication in practice communities. The editors of JGME are interested in capturing the collective wisdom of our audience of diverse medical educators, who have had years of experience with educational interventions, including many never published. How can the collective experience and insights of medical educators be harnessed, in a reasonable time frame, to enhance readers' understanding of articles published in JGME?

To date, JGME editors have experimented with interactive workshops at large meetings, used Twitter to highlight new findings and survey readers, video recorded interviews of authors, and, detailed in this issue, participated in a virtual journal club in collaboration with the Alliance for Academic Life in Emergency Medicine (ALiEM).¹⁰ This project sought to create a forum for robust discussion among an article's authors, content experts, and a diverse community of medical educators. The virtual community created by using these mediums can “extend the conversation beyond the pages of the journal”¹⁶ and perhaps “share insights on items that would not typically make it into the journal's pages,”¹⁷ according to David Sklar, MD, and Kevin Eva, PhD, editors of Academic Medicine and Medical Education, respectively.

Several articles in this issue bridge the divide between editor-reviewer-author and medical education research consumers. The first article, by Sherbino and colleagues,¹⁸ describes the JGME virtual journal club collaboration with ALiEM. The online interactions for this virtual journal club spanned just a few weeks, yet they included medical educators across the globe. The discussion yielded new insights and a list of helpful resources. There was minimal promotion of the virtual journal club activities, which might capture a larger audience if continued forward in a predictable fashion. This type of interaction also allows participation by those who cannot attend national or international medical education conferences. However, the time involved in monitoring and curating the discussion was significant, which raises the question of return on investment—an area for further study. The possibility of sharing experiences internationally, for novel or controversial new research findings, remains highly attractive.

In the second article, Plante and colleagues¹⁹ describe their experience creating a wiki journal club for reviews of landmark clinical studies. Their crowdsourcing approach mirrors that used by the popular online encyclopedia Wikipedia.¹⁹

The third article on this topic is a short Rip Out that provides interested readers with the key steps to replicate a virtual journal club at one's institution.²⁰ This is a practical, step-wise approach written by authors with substantial expertise.

These various articles suggest that online technology for the review of scholarly publication has the potential to reach a wider audience, which can also facilitate a more diverse scholarly discourse. While institutions and journals like JGME are initiating asynchronous virtual conferences through wikis, blogs, and other modalities for educational purposes, the benefits remain under study.

JGME editors will continue to explore and share methods to increase the discussion and dissemination of important, novel work. Our objective is to shorten the knowledge-to-practice time for research that has strong evidence, and to reduce premature uptake of research that contradicts the collective experience of medical educators and researchers. Our goal is not to replace the benefits of expert review and editorial insights, but to amplify these resources with the wisdom of diverse communities of practice.