Knowledge syntheses in medical education: Meta-research examining author gender, geographic location, and institutional affiliation

Introduction Authors of knowledge syntheses make many subjective decisions during their review process. Those decisions, which are guided in part by author characteristics, can impact the conduct and conclusions of knowledge syntheses, which assimilate much of the evidence base in medical education. To better understand the evidence base, this study describes the characteristics of knowledge synthesis authors, focusing on gender, geography, and institution. Methods In 2020, the authors conducted meta-research to examine authors of 963 knowledge syntheses published between 1999 and 2019 in 14 core medical education journals. Results The authors identified 4,110 manuscript authors across all authorship positions. On average there were 4.3 authors per knowledge synthesis (SD = 2.51, Median = 4, Range = 1–22); 79 knowledge syntheses (8%) were single-author publications. Over time, the average number of authors per synthesis increased (M = 1.80 in 1999; M = 5.34 in 2019). Knowledge syntheses were authored by slightly more females (n = 2047; 50.5%) than males (n = 2005; 49.5%) across all author positions. Authors listed affiliations in 58 countries, and 58 knowledge syntheses (6%) included authors from low- or middle-income countries. Authors from the United States (n = 366; 38%), Canada (n = 233; 24%), and the United Kingdom (n = 180; 19%) published the most knowledge syntheses. Authors listed affiliation at 617 unique institutions, and first authors represented 362 unique institutions with greatest representation from University of Toronto (n = 55, 6%). Across all authorship positions, the large majority of knowledge syntheses (n = 753; 78%) included authors from institutions ranked in the top 200 globally. Conclusion Knowledge synthesis author teams have grown over the past 20 years, and while there is near gender parity across all author positions, authorship has been dominated by North American researchers located at highly ranked institutions. This suggests a potential overrepresentation of certain authors with particular characteristics, which may impact the conduct and conclusions of medical education knowledge syntheses.

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Knowledge syntheses in medical education: Examining author gender, geographic location, and institutional affiliation

10.1101/2021.03.01.21252622 ◽

2021 ◽

Author(s):

Lauren A. Maggio ◽

Anton Ninkov ◽

Joseph A. Costello ◽

Erik W. Driessen ◽

Anthony R. Artino

Keyword(s):

Medical Education ◽

Geographic Location ◽

The United States ◽

Evidence Base ◽

Knowledge Synthesis ◽

Middle Income ◽

University Of Toronto ◽

Middle Income Countries ◽

The United Kingdom ◽

The University

ABSTRACTPurposeAuthors of knowledge syntheses make many subjective decisions during their review process. Those decisions, which are guided in part by author characteristics, can impact the conduct and conclusions of knowledge syntheses, which assimilate much of the evidence base in medical education. Therefore, to better understand the evidence base, this study describes the characteristics of knowledge synthesis authors, focusing on gender, geography, and institution.MethodIn 2020, the authors conducted a case study of authors of 963 knowledge syntheses published between 1999 and 2019 in 14 core medical education journals using a publicly accessible dataset.ResultsThe authors of the present study identified 4,110 manuscript authors across all authorship positions. On average there were 4.3 authors per knowledge synthesis (SD=2.51, Median=4, Range=1-22); 79 knowledge syntheses (8%) were single-author publications. Over time, the average number of authors per synthesis increased (M=1.80 in 1999; M=5.34 in 2019). Knowledge syntheses were authored by slightly more females (n=2047; 50.5%) than males (n=2005; 49.5%) across all author positions (Pearson X2=22.02, p<.001). Authors listed affiliations in 58 countries, and 58 knowledge syntheses (6%) included authors from low- or middle-income countries (LMIC). Authors from the United States (n=366; 38%), Canada (n=233; 24%), and the United Kingdom (n=180; 19%) published the most knowledge syntheses. Authors listed affiliation at 617 unique institutions, and first authors represented 362 unique institutions with greatest representation from the University of Toronto (n=55, 6%) and the Mayo Clinic (n=31, 3%). Across all authorship positions, the large majority of knowledge syntheses (n=753; 78%) included authors at top 200 ranked institutions.ConclusionsKnowledge synthesis author teams have grown over the past 20 years, and while there is near gender parity across all author positions, authorship has been dominated by North American researchers located at highly ranked institutions. This suggests a potential overrepresentation of certain authors with particular characteristics, which may impact the conduct and conclusions of knowledge syntheses in medical education.

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The burgeoning role of global health diplomacy to alleviate suffering of cancer patients in low- and middle-income countries

International Health ◽

10.1093/inthealth/ihaa004 ◽

2020 ◽

Vol 12 (3) ◽

pp. 231-233

Author(s):

Melissa Adomako ◽

Alaei Kamiar ◽

Abdulla Alshaikh ◽

Lyndsay S Baines ◽

Desiree Benson ◽

...

Keyword(s):

Global Health ◽

Evidence Base ◽

International Affairs ◽

Global Health Diplomacy ◽

Middle Income ◽

Middle Income Countries ◽

Health Diplomacy ◽

Health Practitioners ◽

And Control ◽

Low And Middle Income

Abstract The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies.

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Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach

Journal of Neurosurgery ◽

10.3171/2020.2.jns192517 ◽

2020 ◽

pp. 1-9

Author(s):

Anthony T. Fuller ◽

Ariana Barkley ◽

Robin Du ◽

Cyrus Elahi ◽

Ali R. Tafreshi ◽

...

Keyword(s):

Scoping Review ◽

Data Extraction ◽

Medical Personnel ◽

The United States ◽

Middle Income ◽

Middle Income Countries ◽

Gray Literature ◽

Current State ◽

Study Selection ◽

Research And Education

OBJECTIVEGlobal neurosurgery is a rapidly emerging field that aims to address the worldwide shortages in neurosurgical care. Many published outreach efforts and initiatives exist to address the global disparity in neurosurgical care; however, there is no centralized report detailing these efforts. This scoping review aims to characterize the field of global neurosurgery by identifying partnerships between high-income countries (HICs) and low- and/or middle-income countries (LMICs) that seek to increase neurosurgical capacity.METHODSA scoping review was conducted using the Arksey and O’Malley framework. A search was conducted in five electronic databases and the gray literature, defined as literature not published through traditional commercial or academic means, to identify studies describing global neurosurgery partnerships. Study selection and data extraction were performed by four independent reviewers, and any disagreements were settled by the team and ultimately the team lead.RESULTSThe original database search produced 2221 articles, which was reduced to 183 final articles after applying inclusion and exclusion criteria. These final articles, along with 9 additional gray literature references, captured 169 unique global neurosurgery collaborations between HICs and LMICs. Of this total, 103 (61%) collaborations involved surgical intervention, while local training of medical personnel, research, and education were done in 48%, 38%, and 30% of efforts, respectively. Many of the collaborations (100 [59%]) are ongoing, and 93 (55%) of them resulted in an increase in capacity within the LMIC involved. The largest proportion of efforts began between 2005–2009 (28%) and 2010–2014 (17%). The most frequently involved HICs were the United States, Canada, and France, whereas the most frequently involved LMICs were Uganda, Tanzania, and Kenya.CONCLUSIONSThis review provides a detailed overview of current global neurosurgery efforts, elucidates gaps in the existing literature, and identifies the LMICs that may benefit from further efforts to improve accessibility to essential neurosurgical care worldwide.

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Could massive open online courses improve health and medical education?

Public Health Forum ◽

10.1515/pubhef-2017-0072 ◽

2018 ◽

Vol 26 (1) ◽

pp. 61-63 ◽

Cited By ~ 2

Author(s):

Stefanie Schütte ◽

Sophie-Hélène Goulet-Ebongue ◽

Khamsa Habouchi

Keyword(s):

Medical Education ◽

Health Care Professionals ◽

Online Courses ◽

Massive Open Online Courses ◽

Special Focus ◽

Massive Open Online ◽

Middle Income ◽

The Public ◽

Middle Income Countries ◽

Technological Advances

Abstract Technological advances during the last decade have provided novel opportunities for development of health and medical education. Education of health care professionals by massive open online courses (MOOCs) has been suggested in order to improve care and treatment of patients and the health literacy of the public. This article discusses the strengths, weaknesses, opportunities and threats of MOOCs in health and medical education by taking a special focus on low and middle-income countries.

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The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

Journal of Social Policy ◽

10.1017/s0047279418000715 ◽

2018 ◽

Vol 48 (03) ◽

pp. 569-594 ◽

Cited By ~ 18

Author(s):

FRANCESCA BASTAGLI ◽

JESSICA HAGEN-ZANKER ◽

LUKE HARMAN ◽

VALENTINA BARCA ◽

GEORGINA STURGE ◽

...

Keyword(s):

Evidence Base ◽

Cash Transfers ◽

Cash Transfer ◽

Future Research ◽

Unintended Effects ◽

Screening Process ◽

Middle Income ◽

Middle Income Countries ◽

The Impact ◽

Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

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The Effectiveness of Social Media Use as a Supplement Media of Clinical Skills Lab Learning for Undergraduate Medical Students in Low- and Middle-Income Countries during COVID-19 (Preprint)

10.2196/preprints.30677 ◽

2021 ◽

Author(s):

Zahira Noor Fathiyya ◽

Muhammad Reza Utama ◽

Yelvi Levani ◽

Yuli Wahyu Rahmawati

Keyword(s):

Systematic Review ◽

Social Media ◽

Medical Education ◽

Medical Students ◽

Clinical Skills ◽

Learning Method ◽

Undergraduate Medical Students ◽

Middle Income ◽

Middle Income Countries ◽

Skills Lab

BACKGROUND Before COVID-19, it was recommended that medical education be conducted using the blended learning method in order to achieve an effective learning experience. However, it seems that distance learning is currently the best alternative to the previous learning method. Clinical skills lab activities, which are one of the learning methods in medical education, must adapt because they cannot be administered in-person. Social media has been proven giving a potential to supplement formal medical education for undergraduate student. OBJECTIVE This systematic review aims to examine the effectiveness of media social use as a supplement for clinical skills lab learning on undergraduate medical students in low- and middle-income countries (LMIC) during the COVID-19 pandemic. METHODS We designed a protocol for creating a systematic review on the effectiveness of social media as a supplement media in clinical skills lab learning for undergraduate medical students in LMIC during COVID-19. We will be extracting information from appropriate sources online obtained from journal websites’ databases guided by the PRISMA-S checklist in accordance with the research problem. The included sources include randomized controlled trials, systematic review, and meta-analysis published between 2020-2021. RESULTS This manuscript is still a protocol and has not been implemented. CONCLUSIONS In this systematic review, we will discuss the effectiveness of social media as a clinical skills lab learning for undergraduate medical students in LMIC during the COVID-19 pandemic.

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Trump's Declaration of the Global Gag Rule

Rhetoric and Sociolinguistics in Times of Global Crisis - Advances in Linguistics and Communication Studies ◽

10.4018/978-1-7998-6732-6.ch015 ◽

2021 ◽

pp. 277-294

Author(s):

Sudeep Uprety ◽

Obindra B. Chand

Keyword(s):

United States ◽

Health Research ◽

The United States ◽

Middle Income ◽

Government Organization ◽

Middle Income Countries ◽

Us Government ◽

Securitization Theory ◽

The Media ◽

The Impact

The current expanded policy on the Global Gag Rule by the United States (US) government and President Donald Trump has led to wider debate and discussions among the non-government organization (NGO) sector, especially in low and middle income countries (LMICs) such as Nepal that are heavily reliant on US funding for health research and intervention projects. Debates and discussions are also shaped by how the media shapes the narrative. Using the securitization theory, this chapter attempts to unfold the trend and the nature of stories reported in Nepali media on the Global Gag Rule declaration, meticulously unfolding the impact it has had in Nepal.

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Tracheostomy During the COVID-19 Pandemic: Comparison of International Perioperative Care Protocols and Practices in 26 Countries

Otolaryngology ◽

10.1177/0194599820961985 ◽

2020 ◽

pp. 019459982096198

Author(s):

Carol Bier-Laning ◽

John D. Cramer ◽

Soham Roy ◽

Patrick A. Palmieri ◽

Ayman Amin ◽

...

Keyword(s):

Resource Constraints ◽

Invasive Mechanical Ventilation ◽

The United States ◽

Postoperative Management ◽

Reference Points ◽

Data Sources ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Evidence Based Care

Objective The coronavirus disease 2019 (COVID-19) pandemic has led to a global surge in critically ill patients requiring invasive mechanical ventilation, some of whom may benefit from tracheostomy. Decisions on if, when, and how to perform tracheostomy in patients with COVID-19 have major implications for patients, clinicians, and hospitals. We investigated the tracheostomy protocols and practices that institutions around the world have put into place in response to the COVID-19 pandemic. Data Sources Protocols for tracheostomy in patients with severe acute respiratory syndrome coronavirus 2 infection from individual institutions (n = 59) were obtained from the United States and 25 other countries, including data from several low- and middle-income countries, 23 published or society-endorsed protocols, and 36 institutional protocols. Review Methods The comparative document analysis involved cross-sectional review of institutional protocols and practices. Data sources were analyzed for timing of tracheostomy, contraindications, preoperative testing, personal protective equipment (PPE), surgical technique, and postoperative management. Conclusions Timing of tracheostomy varied from 3 to >21 days, with over 90% of protocols recommending 14 days of intubation prior to tracheostomy. Most protocols advocate delaying tracheostomy until COVID-19 testing was negative. All protocols involved use of N95 or higher PPE. Both open and percutaneous techniques were reported. Timing of tracheostomy changes ranged from 5 to >30 days postoperatively, sometimes contingent on negative COVID-19 test results. Implications for Practice Wide variation exists in tracheostomy protocols, reflecting geographical variation, different resource constraints, and limited data to drive evidence-based care standards. Findings presented herein may provide reference points and a framework for evolving care standards.

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Implementation of Multicolor Melt Curve Analysis for High-Risk Human Papilloma Virus Detection in Low- and Middle-Income Countries: A Pilot Study for Expanded Cervical Cancer Screening in Honduras

Journal of Global Oncology ◽

10.1200/jgo.17.00035 ◽

2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Scott A. Turner ◽

Sophie J. Deharvengt ◽

Kathleen Doyle Lyons ◽

Jorge Arturo Plata Espinal ◽

Ethan P.M. LaRochelle ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Medical Center ◽

Virus Detection ◽

The United States ◽

Middle Income ◽

Rural Village ◽

Middle Income Countries ◽

Dartmouth Hitchcock Medical ◽

Low And Middle Income

Purpose Cervical cancer is a leading cause of cancer-related mortality in low- and middle-income countries (LMICs) and screening in LMICs is extremely limited. We aimed to implement on-site high-risk human papillomavirus (hrHPV) DNA testing in cohorts of women from an urban factory and from a rural village. Methods A total of 802 women were recruited for this study in partnership with La Liga Contra el Cancer through the establishment of women’s health resource fairs at two locations in Honduras: a textile factory (n = 401) in the city of San Pedro Sula and the rural village of El Rosario (n = 401) in Yoro. Participants received a routine cervical examination during which three sterile cytobrushes were used to collect cervical samples for testing. hrHPV genotyping was performed using a hrHPV genotyping assay and a real-time polymerase chain reaction instrument. Results hrHPV status across all participants at both sites was 13% hrHPV positive and 67% hrHPV negative. When hrHPV status was compared across all three testing sites, hrHPV-positive rates were approximately equal among the factory (13%), village (12%), and confirmatory testing at Dartmouth-Hitchcock Medical Center (Lebanon, NH; 14%). hrHPV genotype was compared across sites, with HPV16 showing the highest infection rate (15%), followed by HPV59 (12%), and HPV68 (11%). There was a low prevalence of HPV18 observed in both populations compared with the hrHPV-positive population in the United States. Conclusion In collaboration with oncologists and pathologists from La Liga Contra el Cancer, we were able to provide a continuum of care once health-fair testing was performed. We established a method and implementation plan for hrHPV testing that is sustainable in LMICs.

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