Collaborative research in medical education: a discussion of theory and practice

Authors

  • Patricia S O’Sullivan,

    1. Office of Medical Education and Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, California, USA
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  • Hugh A Stoddard,

    1. Curriculum and Educational Research Office and Department of Family Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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  • Summers Kalishman

    1. Office of Undergraduate Medical Education and Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Patricia S O’Sullivan, Box 0410, 521 Parnassus Avenue, San Francisco, California 94143-0410, USA. Tel: 00 1 415 514 2281; Fax: 00 1 415 514 0468; E-mail: patricia.osullivan@ucsf.edu

Abstract

Medical Education 2010: 44: 1175–1184

Context  Medical education researchers are inherently collaborators. This paper presents a discussion of theoretical frameworks, issues and challenges around collaborative research to prepare medical education researchers to enter into successful collaborations. It gives emphasis to the conceptual issues associated with collaborative research and applies these to medical education research. Although not a systematic literature review, the paper provides a rich discussion of issues which medical education researchers might consider when undertaking collaborative studies.

Methods  Building on the work of others, we have classified collaborative research in three dimensions according to: the number of administrative units represented; the number of academic fields present, and the manner in which knowledge is created. Although some literature on collaboration focuses on the more traditional positivist perspective and emphasises outcomes, other literature comes from the constructivist framework, in which research is not driven by hypotheses and the approaches emphasised, but by the interaction between investigator and subject.

Discussion  Collaborations are more effective when participants overtly clarify their motivations, values, definitions of appropriate data and accepted methodologies. These should be agreed upon prior to commencing a study. The way we currently educate researchers should be restructured if we want them to be able to undertake interdisciplinary research. Despite calls for researchers to be educated differently, most training programmes for developing researchers have demonstrated a limited, if not contrary, response to these calls.

Conclusions  Collaborative research in medical education should be driven by the problem being investigated, by the new knowledge gained and by the interpersonal interactions that may be achieved. Success rests on recognising that many of the research problems we, as medical educators, address are fundamentally interdisciplinary in nature. This represents a transition to bridge the dichotomy often presented in medical education between theory building and addressing practical needs.

Introduction

Educational researchers in the medical education realm are inherently collaborators. We marshal our own expertise to facilitate the efforts of medical professionals to enhance their education and that of their students. Many of us engage in a variety of collaborative projects within our own universities or in projects that involve other institutions as well. Some of these collaborations centre on curriculum development or educational quality improvement. Others are specifically for research purposes and are undertaken to generate new knowledge.

As researchers in medical professions education, we are frequently asked to join collaborative research ventures, but we typically wonder about the potential of the collaborative effort and try to ascertain the benefits of our participation. In some instances, we consider engaging in collaborations to enhance the generalisability of our work.1 In other instances, we may collaborate to obtain a larger study sample. According to literature in the field, these undertakings may actually be examples of a merging of resources, which is termed ‘cooperation’, rather than collaboration,2 as a shared intellectual process is rarely present.

On inspection, one quickly recognises that collaboration is a complex issue. Among the factors that contribute to its complexity are: multiple uses of terminology and taxonomy; diverse conceptual models and frameworks, and pragmatic challenges in its implementation. These challenges include countervailing academic structures, systems and infrastructure models, and a lack of attention in training programmes to the preparation of interdisciplinary researchers. We have written this paper to provide readers with an understanding of those issues and to offer our recommendations. To aid our colleagues in medical education with their collaborative work, we began delving into the existing literature from related fields. The purpose of this paper is to discuss the theoretical frameworks, issues and challenges around collaborative research with the goal of preparing medical education researchers to enter into collaborations with a deep understanding and appreciation of the collaborative research process. Because of the nature of the topic, we will discuss a wide range of issues, but we have also identified practical resources that will allow readers to follow areas of particular interest to themselves. We have refrained from generating prescriptive checklists in order to give emphasis to the conceptual issues, discussion of which we found to be lacking in medical education research.

Our process for developing this paper was fairly intensive. We held bi-weekly conference calls for a year to discuss our readings in this area. We followed our initial literature searches by locating and analysing primary sources for the theoretical frameworks. Once we had mentally coalesced the broad spectrum of literature, we field-tested our ideas by presenting them to medical education colleagues in a workshop at a professional meeting. Our work also framed a national presentation at a subsequent professional meeting under the auspices of a different organisation. We circulated early drafts of this manuscript among our medical education colleagues, seeking input on the clarity and utility of our ideas. Given that it results from this prolonged and collaborative effort, we feel that this paper will fill a gap that has existed for many of us regarding the theoretical basis for research collaboration. Consequently, we recognised new gaps for those of us in medical education research regarding our own training and that of the variety of colleagues with whom we collaborate. This manuscript is not a systematic review or meta-analysis of the collaborative research literature. Nonetheless, it does provide a rich discussion of collaborative research, informed by a solid and practical foundation, for medical education researchers to consider when undertaking collaborative research studies.

Researchers have expressed some confusion about how to get a collaborative project started and then completed successfully. Empirical advice about how to make a collaboration work is readily available in the literature,3 but Lattuca and Creamer4 have noted that generally such reports evolve from personal experience rather than systematic study. There are, however, some scholarly examinations of the barriers to collaboration.5

The term ‘collaboration’ is used broadly and, at times, is conflated with the term ‘cooperation’. Collaboration is a more complex process than cooperation. One aspect of that complexity is that it has driven a contemporary emphasis on the undertaking of more interdisciplinary research. This drive stems from four challenges: the inherent complexity of nature and society; the desire to explore problems and questions that are not confined to a single discipline; the need to resolve societal problems, and the stimulus of enhanced technologies.5

Researchers in medical education may naively lack insight into the complexity of collaboration. To address these issues, this paper has three sections. Firstly, it provides an orientation to the theoretical frameworks describing collaboration in the context of progressing from research within a single discipline to transdisciplinary research so that researchers can conceptualise where their own research falls. Secondly, it reviews the factors that stimulate collaborative research, in a practical sense, and how researchers should be trained to be collaborators. This information will help to better prepare researchers to undertake collaborative studies. Thirdly, the paper provides a discussion of recommended strategies that will support collaborative research in medical education.

Theoretical frameworks for collaborative research

Collaborative research is not a singular phenomenon, but rather a continuum, ranging from unidisciplinary to transdisciplinary research. This section of the paper reviews frameworks that employ this continuum and provides guidance to help researchers recognise the type of collaboration in which they could be or possibly already are engaged.

Unidisciplinary research collaborations are those which involve two or more researchers who identify themselves as being in the same discipline. This is the common academic model, one in which most researchers are trained and in which universities are typically organised. Hanawalt6 described two ways in which the basic sciences structure research collaboration: (i) by the coalescence of studies underway in different laboratories that are focused on a common research problem, and (ii) by the initiation of a project by one laboratory where the initiating group recruits for input from other perspectives. In the case of the latter model, different groups may resolve only parts of the problem and the information may be subsequently reassembled by the principal investigator to resolve the larger question. This type of activity is more accurately described as ‘cooperative’ rather than ‘collaborative’.2 An example of unidisciplinary research cooperation in medical education might refer to medical educators who develop a survey on cultural competency and request that a larger group of medical educators distribute the survey at different sites in order to increase the total number of survey responses.

Although collaborations are not easy to undertake, Hanawalt6 recognised that success resulted when the collaborative effort was valued by the participants and when members took vital steps, such as those involved in maintaining quality control. The biomedical science fields have had great success in such unidisciplinary collaborations. Briggs noted that the traditional teamwork model ‘typically emphasise[s] careful selection of participants, shared goals, structured work plans, explicit roles and accountability for products and deadlines’.7 It is well established that successful biomedical, unidisciplinary research benefits from a clear set of shared concepts. In the framework of strong, unidisciplinary work in medical education, Papadakis and her medical education colleagues8–10 have presented some exemplary work in which they progressively studied the relationship between professionalism issues in medical school and residency and subsequent performance problems, starting with a single institution, expanding to multiple institutions and moving from students to residents.

Positivist frameworks of interdisciplinary collaboration

Given the existence of substantial records of historical success, why should we abandon or expand upon the unidisciplinary model? Although some might perceive that the current trend toward more interdisciplinary research may be related to the extensive funding directed toward multidisciplinary and translational research, the move away from unidisciplinary work actually has a long history rooted in attempts to resolve questions that proved to be irresolvable within a single discipline.

Aboelela and colleagues11 interviewed interdisciplinary researchers and systematically reviewed the literature on collaborative research. They found that physical and social scientists typically used a positivist or post-positivist mode of inquiry in their collaborative research and focused on hypothesis-driven research, by contrast with the interdisciplinary research carried out in the humanities, which focused on a constructivist framework. Rosenfield12 explicated the positivist framework, in which collaboration begins with a common problem or question. Rosenfield acknowledged that a discipline is a starting point for solving problems, but in many cases a single discipline is soon found to be too limiting. In order to comprehend a broader phenomenon, each collaborator must be familiar with concepts in each of the disciplines involved. Rosenfield developed a taxonomy of collaborative research in which she defined multidisciplinary, interdisciplinary and transdisciplinary collaborations.12 In Rosenfield’s taxonomy, multidisciplinary research occurs when researchers from different fields work in parallel, or sequentially from their own discipline-specific bases, to address a common problem. Interdisciplinary collaboration occurs when researchers work jointly, but maintain a focus from their respective disciplinary perspectives, to address a common problem. In the transdisciplinary approach, researchers work jointly using shared conceptual frameworks to address a common problem. These conceptual frameworks include, for example, a shared understanding of what constitute valid data and what methods should be used to draw conclusions from the gathered evidence.13 Multidisciplinary research tends to engage in specific, short-term problem solving and interdisciplinary research generates new programmes, whereas transdisciplinary research generates new concepts, methods, programmes or policies. In the years since the Rosenfield taxonomy was published, Stokols and colleagues14 have expanded her taxonomy to include unidisciplinary collaborations. We have constructed a representation of three primary dimensions of collaborative research, comprising: (i) the number of different administrative units represented on the research team (institutional context); (ii) the number of academic fields represented on the research team (homogeneous or heterogeneous), and (iii) the manner in which the work is performed and knowledge created (disciplinarity) (Table 1).

Table 1.   Collaborative research can be classified in three dimensions: the number of different administrative units represented in the research team (institutional context); the number of academic fields present on the research team (homogeneous or heterogeneous), and the manner in which the work is performed and knowledge is created (disciplinarity)
Institutional contextType of academic fields representedFramework of collaboration (descriptions from Rosenfield [1992]12)
UnidisciplinarityCross-disciplinary
MultidisciplinarityInterdisciplinarityTransdisciplinarity
Lone researcherIndividualNon-collaborative   
Simple group (all from a single administrative unit)HomogeneousResearchers from a single discipline work together to address a common research problem   
Heterogeneous Researchers work in parallel or sequentially from discipline-specific bases to address a common problemResearchers work jointly but still from discipline-specific bases to address a common problemResearchers work jointly using a shared conceptual framework drawing together discipline-specific theories, concepts and approaches to address a common problem
Complex group (researchers from multiple administrative units)HomogeneousResearchers from a single discipline work together to address a common research problem   
Heterogeneous Researchers work in parallel or sequentially from discipline-specific bases to address a common problemResearchers work jointly but still from discipline-specific bases to address a common problemResearchers work jointly using a shared conceptual framework drawing together discipline-specific theories, concepts and approaches to address a common problem
Multi-sector group (researchers from multiple units and multiple sectors (e.g. government, community, academic, business, etc.)HomogeneousResearchers from a single discipline work together to address a common research problem   
Heterogeneous Researchers work in parallel or sequentially from discipline-specific bases to address a common problemResearchers work jointly but still from discipline-specific bases to address a common problemResearchers work jointly using a shared conceptual framework drawing together discipline-specific theories, concepts and approaches to address a common problem

Constructivist frameworks of interdisciplinary collaboration

By way of contrast, other literatures in collaboration are grounded in critical theory or constructivist frameworks. In such frameworks, the research is not driven by hypotheses and the approaches emphasise the subjective perception and the interaction between investigator and subject.11 Klein,15 who came from a feminist tradition, viewed transdisciplinary work as a movement toward coherence and simplicity of knowledge, by contrast with the development of new knowledge emphasised by Rosenfield.

In her examination of interdisciplinary scholarship as it related to faculty work, Lattuca16 developed a constructivist framework derived from socio-cultural and cultural-historical theories and expanded the ideas of context. In her work and her evolving theory, she linked faculty learning and activity to a variety of intersecting contexts. Lattuca believed that it was limiting to examine interdisciplinary work as merely a focus on integration of the disciplines rather than as a critique of disciplinary knowledge itself.16 She proposed that disciplinary scholarship might require outreach to other disciplines. Interdisciplinary scholarship might ask questions that link disciplines. Transdisciplinary scholarship poses questions that cross disciplines. Lattuca suggested an additional level of ‘conceptual interdisciplinary’ scholarship that would ask compelling questions without disciplinary bias.16

Lattuca and Creamer4 were concerned that in the collaborative process the learning that took place among participants was undervalued. They suggested that collaboration should refocus on learning among researchers. Therefore, the interaction and relationships amongst researchers were as central to the research as the nature of the inquiry in terms of the advancing and co-constructing of knowledge. Disciplinary knowledge was not a necessary prerequisite for participating in collaborative research; the learning from interaction alone was of value.17

Regardless of framework, researcher interactions and the products of research vary with the type of collaboration.11 Multidisciplinary collaboration is characterised by ‘parallel play’, where researchers publish in their respective literatures. In interdisciplinary collaboration, the researchers integrate some of their language and share in the publications, writing with language that is understandable to all in the involved fields. At the transdisciplinary level of collaboration, the researchers synthesise their methods and publish using new language developed to translate across disciplines.

At this point, we would like to provide a brief illustration of the implication of these stages for an educational research question. Our inspiration for this example came from a project that brought law students and medical residents together to study the issue of domestic violence and, more importantly, to explore the applicability of assessment models from medicine for use in law.18 The medical group introduced the idea of using standardised patients (SPs) for teaching and assessment to law education and both groups brought their particular knowledge orientation about domestic violence to an interprofessional session. Students worked through the case sequentially and each group interacted with the SP from its own perspective. Because the researchers worked in parallel, with an understanding of how assessment methodology and interprofessional discussion might influence learning, their approach exemplified multidisciplinarity. Imagine if the collaboration had evolved the researchers into thinking about how this experience affected the way they saw learning from another profession (a constructivist view) or had led them to identify issues that reframed their conceptual approach to interacting with the victims of domestic violence (a positivist view). Finally, if the training and evaluation with students from these two professions had facilitated the evolution of a new educational format that allowed for simultaneous learning from the same interaction, then it might have come to represent an example of transdisciplinarity in which new methods or programmes evolve.

Factors to stimulate collaborative research

Team science: working in collaboration

Recent literature in the health fields has focused on large-scale interdisciplinary research networks and centres. Much of this has been generated by the twentieth century shift of emphasis from the individual scientist to the collaborative team and research institutes, stimulated by many government funding mechanisms.19 This has led to the development of ‘team science’, which is research that is conducted within a single, focused discipline or which spans disciplines and can have substantial complexity, depending on the degree of integration needed or the problem to be solved.20

Stokols21 contended that the determinants of a successful team science collaboration related to the composition and goals of the teams. In the broader field of public health, he suggested three types of collaboration, whereby: (i) researchers from multiple disciplines collaborate on the development of interdisciplinary scientific products; (ii) researchers from different fields work with community members to translate scientific evidence into new interventions, and (iii) representatives of community organisations integrate expertise from multiple disciplines and professions to design and implement broad policies. Collaborations between researchers and practitioners must bridge disciplinary and professional perspectives in a broad range of settings. These types of collaborations are pertinent to medical education researchers, who often act as bridges between theoretical researchers and educational practitioners who teach medical trainees.

Is collaborative research a fad or a new paradigm?

Stokols and colleagues,14 who were proponents of interdisciplinary training, pointed out that critics have suggested that the relative value of collaborative research to science and society has been overstated and that perhaps collaborative research is just a fad. In fact, Toomela22 noted that collaboration does not always lead to increased productivity or greater efficiency. Collaborative research draws investigators away from their discipline-based research, in which they may actually be more productive working independently than in collaboration.

The conflict between working as an individual or as a member of a team was well captured by the historian, Steven Shapin.23 Shapin examined the manner in which a scientist has been perceived over the last century. The scientist has often been portrayed as a moral person who pursues science for its own sake and is free of bias. The university was the ‘proper and only home’ for this kind of inquiry. Shapin’s historical review indicated that rarely has there actually been a scientist who was free of biases and, thus, this stereotyped image of the scientist has been challenged throughout the twentieth century. Given the stereotype, the development of scientific teams represented a ‘culture crisis’ for science. A scientist may struggle in a team, given his or her desire to stay within his or her own specialised knowledge. Yet teams have been productive and flexible and have allowed for interpersonal relationships. Teams have been successful and have characterised science at the end of the twentieth century. Shapin suggested that the tension between academic models and team models stems from an outdated, romantic image of the scientist.

Despite this movement toward interdisciplinary collaboration, collaboration is not something that necessarily comes easily to researchers. Empirical research designed to quantify the nature of collaborative research has been able to define a network of collaboration by mapping the links among authors.24 Using journals in a given field, co-authors of articles were defined as collaborators and a network map was created using the links represented by co-authorship. By applying this social network theory, one study found greater separation and less clustering for authors cited in MEDLINE than within other science fields.24 In another application of this method, the economics literature was found to exhibit a high degree of clustering, which featured ‘star’ authors around whom highly interconnected clusters formed.25 Nonetheless, in general, natural sciences tended to exhibit more clustering than social sciences.26 This absence of clustering may indicate a paucity of interdisciplinary approaches with which to tackle social science research problems.

Strategies to support collaborative research

Practical success in collaborative research

There is a great deal of experiential advice and empirical evidence on how to make collaborations successful, such as that delivered by Aboelela et al.,11 Amabile et al.27 and Stokols and colleagues28 and in Facilitating Interdisciplinary Research.5 Perhaps the most critical advice refers to the axiom from Eigenbrode et al.,13 who stated that collaborations are more effective when, at the outset, participants overtly clarify their motivations, values, beliefs about science, definitions of appropriate data and accepted methodology for research. These philosophical factors should be discussed and agreed upon prior to commencing a study because in order to effectively create new knowledge there must be consensus on the nature of the knowledge being sought. In a related vein, Bammer29 outlined three management challenges to research collaborations: the need to effectively harness differences; the need to set defensible boundaries, and the need to gain legitimate authorisation. Amabile and colleagues27 made six recommendations to those contemplating the forming of an academic–practitioner research team: carefully select the team members; clarify their roles and expectations; facilitate regular communication; develop relationships and trust among collaborators; occasionally examine the effectiveness of team functioning, and ensure that member organisations are tolerant of individual researchers.

As well as advice on successful collaboration, several studies have provided details about factors to which success might be attributed. Mebane and Galassi30 found that group process and leadership variables were more closely related to success than variables pertaining to the task itself. Ritchie and Rigano31 identified friendship and solidarity as important outcomes of the relationships built during a successful collaboration. An interesting finding32 of critical practical value to educational researchers suggests that collaborative research which bridges administrative units appears to be more problematic than that which bridges disciplines. Administrative and ‘cultural’ differences between institutions are cited as among the most common sources of such inter-institutional problems.

Collaborative projects seem to go through phases. In an examination of these phases, the need for clarification, for trust and for careful feedback along the way emerges.15,33,34 A collaborative group that has been formed along either research or interpersonal lines or both requires careful and constant feedback during the research process.

Educational preparation for collaborative research

As noted in Facilitating Interdisciplinary Research,5 we need to restructure the way we educate researchers if we want them to be able to undertake collaborative, interdisciplinary research. Klein noted: ‘Education, as usual, is the most earnestly invoked but persistently neglected component.’15 Despite the call for researchers to be educated differently, Klein pointed out that most curricula have had a limited, if not contrary, response to these calls. Gebbie and colleagues35 developed, through a Delphi process, a set of competencies for interdisciplinary research that they proposed as necessary for scholars in doctoral programmes. Beyond becoming advocates for interdisciplinary research, Gebbie et al. recommended competencies related to conducting interdisciplinary research, emphasising the use of theories and methods from multiple disciplines.

Nair et al.,36 while seeking to establish what made interdisciplinary research work, identified the notion that researchers who were trained in interdisciplinary graduate research programmes developed an ability to bridge the knowledge, methods and approaches used in different disciplines. Early-career researchers, particularly women, may benefit from collaborations in which diffused competitive expectations exist among the members of the team.37 Nash38 pointed out that transdisciplinary training can happen at any career level and that it requires not only new knowledge, but also multiple mentors and relationship skills. Established faculty members should immerse themselves in the languages, cultures and knowledge of their collaborators. Educators should facilitate interdisciplinary research by providing educational and training opportunities.5 Academic institutions need to develop a reward structure that is comparable for collaborative researchers, which includes the provision of ‘publication credit’ for work in interdisciplinary journals or outside discipline-specific literature. A major barrier to such a structure concerns the development of equitable and flexible budget policies.5 Mentkowski and associates39 found that the academic structural issues of tenure and faculty members’ responsibilities thwarted research on teaching and learning, themes common to much of medical education research. Mentkowski et al. noted the drawbacks of limiting research about the scholarship of teaching and learning to a single disciplinary perspective. Broadening the research collaboration to include multi- and interdisciplinary perspectives would be more likely to enhance knowledge generation.

Discussion

In this paper, we have concluded that collaborative research should be driven by the problem being investigated, by the new knowledge to be gained or by interpersonal interactions with a group of colleagues. Regardless of the motivation, the work must start with a philosophical discussion to clarify methods, values and epistemological beliefs amongst collaborators in anticipation of the inevitable obstacles and to foresee potential facilitators in the collaboration. Personal relationships are probably more critical to success than the particular tasks or structural issues at hand. In deliberating whether to embark on a collaborative venture, institutional culture and the requirements for tangible support for collaborative research, including the leadership, time and resources associated with the research, should be balanced against the value of the new knowledge to be gained, the value of the resolution of the question to be answered, and the value of the professional relationships that might be cultivated. Understanding these trade-offs in the course of assessing whether or not to embark on a collaborative research endeavour will increase the likelihood of success and help medical education researchers to identify productive outlets for their collaborative energy.

Medical professions educational research fits well within the frameworks of collaboration presented in this paper. As Albert40 summarised, medical education research since the 1990s has been embroiled in debates around epistemology, methods, purpose and quality. Albert applied a sociological framework to these debates and argued that there is a struggle between those who see the need for educational research as theory building and those who see the research as addressing practical needs. This struggle may be diminished if we employ framing from team science, which requires the gap between the theoretical and the practical to be bridged in order to advance our knowledge and to influence actual change in our communities. Our collaborative research should build toward new knowledge in medical education that will have meaning in our educational process. Perhaps this harks back to Norman’s41 call for better understanding about learning, which is a demanding challenge regardless of methodology. Monrouxe and Rees42 highlighted the need for medical education research to be seen as a social rather than a medical science. That view correlates well with the perspectives of our paper as it argues that a broader theoretical perspective should be brought to collaborative educational research. Lest it be seen that this situation is limited to medical education, we should note that the discussion likewise generates enthusiastic debate in the educational research literature.43

The obstacles to collaboration, whether the collaboration is uni- or cross-disciplinary, are real; however, the literature provides some solutions. Success rests on recognising that, as medical educators, many of the research problems we address and the questions we wish to answer are fundamentally interdisciplinary in nature. Collaboration should strive to not only answer a research question, but also to develop new knowledge, a task that requires more perspectives than those available through single-discipline approaches. We should advocate increasing the capacity of our current researchers to engage in this process.

Balswer and Baruchin44 have recognised that academic medical centres are engaged in making a transition toward interdisciplinary research. They identified the challenges and barriers that hamper the goal of expanding collaborative research, including published rankings of universities and academic health centres and competition among universities for federal funds. Like most works cited in our paper, Balswer and Baruchin’s44 call to overcome barriers within and across institutions indicates their strong support for interdisciplinary research and a culture to facilitate it. Comprehensive reports, such as Facilitating Interdisciplinary Research,5 similarly promote increased collaborative, interdisciplinary work. Aboelela and colleagues11 advocate the development of interdisciplinary research as the standard for research and single-discipline research as the exception within our institutions. Clearly, such a standard poses a challenge of great magnitude. The long-term call to fund such approaches in medical education needs to be addressed.45,46

To summarise, we would like to revisit the research problem cited earlier, involving medical residents and law students.18 Based on the concepts presented in our paper, we can imagine how this might evolve into a transdisciplinary research collaboration. From a positivist framework, we propose starting with the problem of domestic violence because of its costs to the victim, family and society. Training future professionals to deal with this problem cannot be adequately addressed within a single discipline. To address the problem from a transdisciplinary perspective, the examination of professional learning would perhaps include a sociologist and a psychologist as the process evolves. As a research activity, educational researchers could contribute to understanding the learning that might occur in such a scenario and to cultivating an interdisciplinary perspective that might begin to address the larger social problems involved in caring for victims of domestic violence and seeking means of eliminating it. Together, all of the professionals might begin to think about how interprofessional learning about this issue might look very different and how our assessment methods might become far more complex than a sequential SP examination. The researchers might need to educate one another in their unique professional and research vocabularies. At this point, a constructivist framework might be helpful. The researchers would probably develop a broader understanding of clinical and legal reasoning and the evidence each uses to develop new insights into professional learning. The researchers might need to consider how to assess the learning and how to publish the results in a manner and a medium that attended to their many differences. The outcomes might include a holistic approach to domestic violence in which legal and medical perspectives intersect or are integrated in prevention, management and treatment. Transdisciplinary collaborative research in the education of professionals might enlarge the knowledge framework and support the larger body of generalised knowledge.

This paper has provided guidance that we believe relocates the discussion of collaborative research to a more important position in the framing of medical education research. It is limited by the literature we explored, but we believe we have organised wide-ranging perspectives on this topic. Based on this synthesis, we conclude that the work that is necessary to answer questions in medical education requires us to approach all research as well-educated collaborators; this paper has attempted to elucidate what that process might be like.

Contributors:  POS initially conceptualized this paper, reviewed literature and led the writing of this paper. HS and SK reviewed literature and contributed extensively to the writing of the manuscript. All three authors approved the final version of this paper.

Acknowledgments

Acknowledgements:  the authors would like to acknowledge Ilene Harris and Arianne Teherani for their informative comments on an early draft of this paper and David Irby and Bridget O’Brien for their help with a later draft.

Funding:  none.

Conflicts of interest:  none.

Ethical approval:  not applicable.

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