Graduate Medical Education in Pathology

Graduate Medical Education (GME) in Pathology

Context: Pathologists have created extensive literature on GME, but it is diverse and poorly characterized.
Objective: To analyze concepts, methods, and publication trends in GME research specific to pathology.

Data Sources: Systematic scoping review across all literature since 1980 in PubMed and Embase.
Findings: GME research in pathology is evenly distributed across various educational topics and would benefit from theoretical frameworks, improved study designs, and evidence-based approaches.

Purpose: Medical residency programs ensure physicians develop competencies for independent practice.
Importance: GME programs need to leverage the best available evidence to adapt to evolving clinical environments and enhance educational effectiveness.
Research Gap: Despite a substantial body of literature, comprehensive characterization is lacking to identify knowledge consolidation areas and new research opportunities.

Scoping Review Methodology: Conducted per JBI Manual for Evidence Synthesis, PRISMA-ScR, and PRISMA-S guidelines.
Registration: Protocol registered with Open Science Foundation.
Literature Search: Led by a medical librarian, peer-reviewed using PRESS guidelines.
Inclusion Criteria: Studies focused on GME in pathology published post-1980, covering any pathology subdiscipline.
Exclusion Criteria: Studies related to undergraduate education, non-pathology GME, or outside the U.S. were excluded.

Initial Screening: Screening of titles and abstracts for potential relevance.
Full-Text Review: Detailed evaluation of included studies to categorize into types and disciplines.
Focus on Quantitative Studies: Emphasis on those with primary or secondary quantitative data.

Information Extracted: Year of publication, journal, authors, population focus (residents, fellows), and discipline/subdiscipline of pathology.
Educational Focus: Categories included assessment, curriculum development, learning environment, and pedagogy.
Assessment Category: Included studies developing assessment methodologies or presenting assessment results.

Study Types: Cross-sectional and longitudinal studies categorized by whether they used primary or secondary data.
Hypothesis Testing: 45% of studies utilized hypothesis testing, with various measures of outcomes.

Publications Overview: From the search, 425 articles related to pathology GME were noted, with 171 quantitative studies analyzed for further detail.
Publications Trends: Post-2011, the number of published studies increased significantly.
Survey Usage: Surveys were a common method across studies, with two-thirds including a survey to gather data on satisfaction and experiences.

Breakdown of publication focus:
- Anatomic Pathology (AP): 33% of total publications.
- Clinical Pathology (CP): 19%.
- Educational Studies: Majority directed at assessing competency and curriculum.

Frequent topics included new technologies in pathology education (17%), national testing assessments (14%), and COVID-19 related adaptations (7%).

Insights on Research Gaps: Many studies were single-institution based, limiting generalizability. There's a need for multi-institutional studies and more longitudinal approaches for a deeper understanding of educational impacts.
Challenges Identified: Assessment methodologies generally lacked detailed frameworks and validity, indicating a need for improved measurement and evaluation strategies.

Call for Comprehensive Research: Expansion of GME studies to include diverse pathology areas and systematic reviews on identified topics.
Policy Evidence: Research should support educational policy decisions for ACGME.

GME literature in pathology is developing, yet there remains a significant need for more robust research methodologies and theoretical backing to enhance educational dynamics and support future developments in the field.