Pause for Thought . . . Are innovations a “re-invent the wheel” phenomenon?

By Lynfa Stroud

“Sometimes time spent reinventing the wheel results in a revolutionary new rolling device. But sometimes it just amounts to time spent reinventing the wheel.” – Steve Krug

Pause for thought

As a Clinician Educator, I attend a fair number of medical education conferences. These are great experiences with time spent hearing about the latest research and catching-up with colleagues. However, I was struck at a recent conference by just how much time and energy individual educators and teachers spend in developing new curricula, assessment tools, mobile apps, etc. It felt like almost every school – or in many cases, almost every speciality or different health profession within the same school – was in parallel creating new ways of doing things. It was a bit exhausting to see the output of countless hours of industry that, for the most part, seemed to have occurred in silos. It also seemed a bit, well, inefficient. So many people were doing the essentially the same thing.

My observation is not at all meant to diminish the great work that is being done, as many of the things were very creative and much cooler than anything I could develop. But I did wonder whether instead of always feeling that we had to create something new for our site or our program, whether a lot of time couldn’t be saved by somewhat ruthlessly determining what had worked well (and had not) for others and implement this at our own sites? Or even better, work collaboratively across programs within schools or between schools to further enhance materials and systems? Learning from each other’s successes and failures and working together would permit research to be conducted across sites and potentially ask more sophisticated research questions than: did it work and did learners like it? Not that these aren’t important basic questions, but they may be all educators are able to do after having spent so much time and energy on the creation of the materials or tools in the first place. Starting with existing materials and tools that have demonstrated usefulness already, opens up the possibility of doing more theoretically based research with these materials and tools.

Part of the reason that I perceive that the current model seems to propagate redundancy is that educators are rewarded most for innovation and developing unique artifacts for their own school or program, particularly with a view to promotion.  It may not seem as desirable to merely report having implemented something that is working well at school X when you are faculty at school Y. Related to this, and the lack of collaboration that might occur in the first place between faculty at school X and school Y is, what I believe – though certainly may not be the perception of others –  that we aren’t recognized as much for our collaboration with others as we are for being the individual leading a project, just like in research more broadly, even though projects with multi-site collaborations are almost certainly bound to be of higher caliber. Lastly, I think we are somewhat held back by a notion in medical education that replication studies are not necessary. In the past year, a very senior medical education researcher said to me when I pitched a study idea: “oh, that study was already done”. In clinical medicine, this concept would not exist. I would not suggest that we should do the exact same study as has been already done, but certainly looking at similar tools (drugs) with different populations of learners (patients) in different education (healthcare) contexts seems appropriate, yet we don’t do this often or do this well in education.

This post is not meant at all to suggest that great work is not being done. Quite the contrary, outstanding work is being done – but just too often by individuals in silos, and it sometimes feels like the wheel is continuously getting re-invented, when instead we might move further ahead by trying to improve the wheel, through working more collaboratively together, not being afraid to use each other’s innovations and ideas (giving credit for this use), and working to elevate the level of research being done. There are certainly many examples of great cross-site, collaborative work being done in medical education, I just think that there could be even more.