PeRLs: Changing the Way We View Lectures

Abstract

A junior emergency medicine faculty member is asked to develop a lecture on endocrine emergencies for off-service residents and students rotating through the emergency department of a prestigious academic medical center. Her first thought is, “Am I the first faculty member to present a lecture on endocrine emergencies to residents and students?” Although doubtful, she accepts the assignment and begins her PubMed search for DKA, thyroid storm, and other disastrous-sounding endocrine emergencies. Later that month, after countless hours of research, creative thought, and slide-crafting, she proudly presents the lecture to all five residents and students who appear at conference that day, to much acclaim. When discussing criteria for promotion and her scholarly activities with her chair a few years later, the young scholar discovers that the hours she devoted to developing, presenting, and annually updating the endocrine lecture are not valued highly by the institutional committee for promotion and tenure (P&T). Despite the fact that she spent as many hours on this educational project as she would have spent on a published review article, she will receive little academic recognition or credit for the work. At that same moment, in another academic department on the other side of the continent, a junior faculty member is assigned a lecture on endocrine emergencies. And so the process continues …. Academic Emergency Medicine’s (AEM) new Peer-reviewed Lectures (PeRLs) program began as an innovative proposal submitted to the American College of Emergency Physicians (ACEP) Academic Affairs Committee (AAC) in 2008. The concept proposal called for online publication of peer-reviewed lecture content distributed to a large audience via a truly rigorous and scholarly approach. Students, residents, and faculty members would have access to exemplary lectures on a wide variety of emergency medicine topics, and there would no longer be a need for every training program to develop lectures on every topic in the didactic curriculum. The PeRLs program would also legitimize the manner in which faculty were assessed and recognized for scholarly achievement in the area of didactic teaching. Hours of crafting detailed, evidence-based lectures would be appropriately rewarded when the time came for P&T Committee review. The AAC worked collaboratively with the Society for Academic Emergency Medicine (SAEM) and the Council of Emergency Medicine Residency Directors (CORD) in developing the program, and AEM, which was already developing online journal content, was found to be the most appropriate home for PeRLs. The PeRLs editorial board is composed of medical education experts appointed by ACEP, SAEM, and CORD in this ongoing collaborative effort. The journal’s existing peer-review process has been modified slightly to accommodate the new program, but closely parallels the peer review process used for other submissions to the journal, with expectations that hold to the same standards of rigor and scholarship. Detailed guidelines have been developed to assist potential authors in navigating the submission process, and step-by-step instructions on how to create and submit the specific files needed are now accessible on the AEM website (http://www.aemj.org). The PeRLs program is pleased to announce the release of its first peer-reviewed lecture this month entitled, appropriately enough, “The Millennial Generation and ‘The Lecture,’” presented by Danielle Hart, MD.1 This “publication” is cited in the AEM table of contents and future publications will be sited similarly in the months they are posted. All PeRLs publications will be open-access; we thank our publisher, Wiley-Blackwell, for agreeing to this. Academic medical centers strive for excellence in patient care, research, and education, and physician faculty members usually segregate into one of two groups: clinician researchers and clinician educators. Changes in the way that health care has been financed and delivered over the past two decades have resulted in a rapid expansion in the number of clinician-educator faculty in essentially all medical specialties and sparked a search by department chairs, promotions committees, and medical school deans for objective measures of excellence in patient care and teaching to recognize, reward, and inform decisions regarding the academic advancement of these faculty.2,3 Educational leaders have described the challenge and offered suggestions for measures of scholarly achievement in the realm of education: the development of innovative courses and educational materials, the receipt of teaching awards, and the publication of educational research are most commonly cited.4–8 The Association of American Medical Colleges has launched MedEdPortal, an online resource that provides peer-reviewed and electronic dissemination of original educational materials.9 To this list, we now add the PeRLs program: an opportunity for emergency medicine clinician-educator faculty to have their “creative scholarship” reviewed by a panel of experts in education within our field. Submissions that pass the review criteria will be published online and cited in AEM to document this objective measure of scholarly achievement for department chairs, promotions committees, and medical school deans to assist them in their deliberations.