The challenge of conducting qualitative research to understand the factors that influence equity in medical education: A scoping review

JOHN SANDARS, JEREMY BROWN, CHIDIEBERE NWOLISE, Mumtaz Patel, Nisha Dogra, AXEL KAEHNE, JAYNE GARNER, SIMON WATMOUGH, MICHELLE MADEN, VICKY DUCKWORTH

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Abstract

Introduction
There are national and international concerns about equity in basic and postgraduate medical education, especially about differential rates of access and attainment across groups of learners. Qualitative research has been increasingly used to understand the factors that influence equity but there are potential limitations to this understanding related to how the research has been conducted. The aim of the scoping review was to identify how qualitative research exploring the factors that influence equity in basic and postgraduate medical education has been conducted. The intention was to inform future research.

Methods
The electronic databases British Education Index, Campbell Library, CINAHL, Cochrane Library, EMBASE, ERIC, Google Scholar, Health Management Information Consortium (HMIC), MEDLINE, PsycINFO, Web of Science and medical education journals were searched to identify relevant published articles between 2008 and April 2019.

Results
Among 19,523 articles identified from the literature search, 72 full text articles were included in the review. Most studies had a focus on only one background characteristic and only two studies had a strengths-based focus on individuals. Recommendations for change was at the ‘policy level’ in ten studies and four studies had learner recommendations for change. No studies with a participatory approach were identified.



Conclusion
The approach to conducting previous qualitative research appears to limit greater understanding of the complexity of factors that influence equity. In response to this challenge, we recommend that future research widen the focus to consider the experiences and strengths of individual learners in addition to those identified by background characteristics. Future qualitative research is recommended to have a broad focus on both the ‘policy level’ and ‘local level’, especially from multiple perspectives. We also recommend greater collaboration of participants with researchers throughout the research process.
Original languageEnglish
JournalMedEdPublish
Early online date30 Apr 2020
DOIs
Publication statusPublished - 30 Apr 2020

Keywords

  • equity
  • basic medical education
  • postgraduate medical education
  • qualitative research

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