Publish or Perish? Getting Off the Research Block

How would you feel if you were hired by a university to teach physics and then one day the dean came into your office and said you now would be expected to teach Italian as well — or risk losing your job? Chances are good that you would feel frustrated, angry, confused, and perhaps even scared. You may be tempted to quit your job or consult a lawyer. An ambitious few might sign up for an Italian course through Khan Academy.

As implausible as this scenario seems, it is not much different from the situation faced by PA educators, who increasingly are being asked to perform more scholarly activity or face the consequences. Historically, PA faculty have not been on the tenure track and have not faced dismissal for failing to produce scholarly work. But now more and more universities are demanding that PA faculty participate in the research mission of the institution.

Most PA programs do not emphasize research methods in the core PA training, and few programs require students to produce original research as a requirement for graduation. So unlike other faculty on campus who have completed 5–7 years of research training, PA faculty typically are not well-prepared to perform their own research.

Find a Mentor or Be a Mentor

Cody Sasek joined the faculty at the University of Nebraska Medical Center (UNMC) PA Program in January 2014 straight from five years of clinical practice with a non-academic orthopedic surgery group. I found him to be a congenial, enthusiastic colleague who was eager to embrace the faculty role, so shortly after his arrival, I encouraged him to kick off his academic career by writing a clinical article for JAAPA. Like most PA faculty, he had no research background or training but was willing to give it a try. After drafting a manuscript, he shared it with me and other faculty to get our feedback, then modified his article and submitted it to JAAPA. Not long after that, his article was accepted. Several months later, he received a request from the JAAPA editorial staff asking him to review an orthopedic manuscript. Again, with the help of UNMC colleagues, he got his first taste of peer-reviewing.

“How do I not sound like an idiot when saying, ‘If I can do it, anyone can’?” Cody asked me. “It seems like this complicated thing that only research folks can do, but the opportunities out there are not as intimidating as you might think. Finding those around you who have the skills, experience, and expertise makes all the difference. The part I thought would be most stressful — the feedback loop — was actually the part I enjoyed the most. I’ve now started to look for opportunities to pose new questions.”

Baby Steps: Helping You Get Started

I often hear from PA faculty how they feel pressured to perform the “big study” but are limited by time, expertise, and money. Yet, there’s no need to jump right into the deep end. Several types of scholarly activity will meet at least some of the requirements universities hold for faculty — and are not as burdensome to perform. Here are some options that will allow you to do good work AND get the dean off your back!

Basic steps:

1. Find out exactly what is considered scholarly activity by your chair, dean, or university. Everyone thinks of a peer-reviewed original study published in a journal, but most universities have a substantially broader view of what is considered scholarly activity. These may include:
   • Peer-reviewed clinical article. Write a review of a clinical topic with which you are familiar. Follow the author guidelines to the letter to increase your chances of a successful submission, and submit it to JAAPA or Clinical Advisor. If you can partner with a doctor, you may be eligible to submit a clinical review to American Family Physician or another clinical journal aimed at the physician community.
   • Peer-reviewed clinical book chapter. If you work at an academic medical center, speak with doctors in your specialty to see who authors “the book” in that specialty and offer to write or co-write a chapter.
   • Presentation at a state, national, or specialty meeting on a clinical or education topic. State meetings are a great place to try out your new talk. Often high-quality talks that are first given at state meetings are accepted for presentation the next year at the AAPA conference.
   • Peer-reviewed educational innovation. MedEd Portal is a website that publishes peer-reviewed medical education interventions. Sponsored by the Association of American Medical Colleges, the portal is well-respected throughout the medical education community. Many PA educators are doing innovative work, so tell the world about your great idea!
   • New curricula. Some universities will allow new curricula you have written to be counted as scholarly activity if you can show that you incorporated educational or medical best practices into the development of the new curriculum.
   • Training manual. The development of a training manual may count as research at your institution. Similar manuals may also be eligible to be published as an educational innovation on MedEdPortal.
   • Policy briefs. Have you prepared a policy brief for your state’s PA academy? Some universities will consider this scholarly activity, particularly if you have experience with or are interested in health policy.
   • Grants you have received for educational innovation may be counted toward scholarly activity if they include a rigorous evaluation piece.
   • Peer review. Some universities count service as a peer-reviewer on a journal as scholarly activity (others count this as professional service).

2. Collaborate! Faculty on your campus in departments of education, psychology, public health, or other health professions may be willing to work with you, especially if you are willing to start as the junior partner. If you can do some of the less exciting tasks of research for them and lighten their load, you can get an inside view on how to write an Institutional Review Board (IRB) application, collect data, train interviewers, etc. In addition, many health professions grants these days mandate “interprofessional involvement,” and a more experienced faculty member may be thrilled to have a PA on her team.Another idea is to work with a PA researcher from another institution. JPAE encourages multi-institutional research for publication in our journal, because these studies offer wider applicability to the PA education community at large. Offer your university as a site to test new innovations and gain the chance to work closely with an experienced PA education researcher.

3. Consider performing a “secondary analysis” on a public data set. Hate the idea of working with an IRB? No money to collect your own data? Want to be able to look at nationwide trends? Very large datasets are available for free from the Centers for Disease Control and Prevention. You can see the original data collection instruments and the data dictionaries online, which can help you define your question.

A note of caution: It is crucial to understand exactly how the questions were asked to know if you can use the data. If you are going to do a secondary analysis, it is definitely worthwhile to get some professional help, which may be available from a statistics or biostatistics service at your university.

Back at UNMC, my former colleague Cody Sasek has clearly caught the research bug and is on a roll. He currently has another clinical article that’s been accepted by JAAPA and is working on a manuscript to present some survey research he conducted himself.

“It does not have be groundbreaking work to contribute to the knowledge base,” he explained. “I wouldn’t have guessed that I would be interested in this process, but because I tested the waters, I discovered an interest I didn’t know I had.”