Using a Co-Teaching Team to Enhance Research Proposal Feedback in an Online Medical Education Graduate Course

Technical Summary: Enhancing Research Proposal Feedback via Co-Teaching in Medical Education

Problem Statement
Medical education scholarship frequently suffers from a lack of scientific rigor, characterized by inadequate study design descriptions, insufficient literature reviews, and weak theoretical frameworks. This deficit is often attributed to a lack of advanced training in research methods and scientific writing among healthcare professionals. While experienced researchers possess the necessary clinical insights to align studies with operational realities, their clinical commitments often preclude them from serving as instructors in graduate research courses. Consequently, students pursuing advanced research training often lack access to the dual expertise required to bridge clinical feasibility with methodological rigor. Although co-teaching models have shown promise in K-12 and undergraduate settings, there is a scarcity of literature describing their implementation and outcomes in graduate-level medical education research training.

Methodology
This qualitative study employed a pragmatic worldview and an epistemological interpretive framework to analyze research proposal feedback within a Master of Education program for healthcare professionals. The study compared two instructional models:

1. Single Instructor Model: A non-physician instructor with a doctoral degree in education provided all feedback (Fall 2020 – Fall 2021).
2. Co-Teaching Model: A team consisting of a physician instructor and a non-physician instructor provided feedback (Summer 2023 – Spring 2024).

The study analyzed 53 research proposals (22 from the single instructor model; 31 from the co-teaching model). Two independent coders, blinded to the teaching model, analyzed de-identified feedback comments from the first drafts of student proposals. The coding process was grounded in Hattie and Timperley's feedback model, categorizing feedback into levels (Task, Process, Self-Regulation, Self) and developing specific codes for content granularity. The research team utilized an iterative process of independent coding, peer debriefing, and consensus building to refine the codebook and identify themes.

Key Contributions and Results
The analysis identified two primary themes regarding the nature of feedback provided to students:

1. Proposal-Specific Feedback (Common to Both Models):
   Both instructional models provided feedback focused on the immediate task and the specific project. This included:

   • Editing and Corrections: Instructions on formatting, tense consistency, citation requirements, and organizational structure.
   • Qualities of a Rigorous Study: Guidance on defining research gaps, refining conceptual frameworks, and addressing specific study design elements such as sampling, validity, and reliability.

2. Broader Scholarship Guidance (Exclusive to Co-Teaching Model):
   This theme emerged only in the co-teaching model, primarily driven by the physician instructors. It encompassed:

   • Scope and Feasibility: Feedback that helped students calibrate project ambition to the Master's timeline, suggesting the splitting of ambitious projects into manageable components or focusing on specific phases (e.g., needs assessment vs. full curriculum development).
   • Beyond the Masters Project: Guidance that extended into lifelong, self-regulated learning. This included advice on scholarly writing for publication, identifying target journals, utilizing university resources (e.g., writing centers), and framing the current project as a stepping stone for a future research agenda.

The study found that while both models addressed the mechanics of the proposal, the co-teaching model uniquely provided strategic guidance on the broader scholarly trajectory of the student's work.

Significance and Claims
The authors claim that the co-teaching model adds value to graduate medical education research training by increasing the rigor and methodological scope of student projects. Specifically, the integration of physician and non-physician instructors allows for:

• Complementary Expertise: Physician instructors contribute insights on clinical feasibility and the alignment of research with academic and clinical contexts, while non-physician instructors ensure adherence to program requirements and methodological standards.
• Enhanced Self-Regulated Learning: By providing guidance that extends beyond the immediate assignment, the model encourages students to view their work within a larger scholarly context, potentially fostering future publication and career development.
• Feasibility in Academic Settings: The model demonstrates a strategy to overcome the time constraints of practicing clinicians by dividing labor, allowing physicians to focus on high-level scholarly guidance rather than administrative tasks.

The paper concludes that while co-teaching requires additional resources and coordination, the benefits of providing multidisciplinary, comprehensive feedback may outweigh the costs, particularly in preparing healthcare professionals to produce high-quality educational scholarship. The authors note limitations, including the single-institution setting and the potential influence of individual instructor styles, and call for further quantitative evaluation of final project outcomes to definitively assess the model's impact.