#KeyLIMEpodcast 135: Academics as businesspeople? How our #MedEd research leaders can change our organizations

This week’s article selection was from Linda, and it asked, if HPESUs (health professions education scholarship units) are defined as “organizational structures within which a group of people is substantively engaged in health professions education scholarship’’ …does this mean heads of HPESUs act as Institutional Entrepreneurs?

What do you think? To see the conclusions the authors came to, view the abstract below. Did the KeyLIME co-hosts agree? You’ll have to check out the podcast here (or on iTunes!) to find out.


KeyLIME Session 135 – Article under review:

Listen to the podcast

View/download the abstract here.


Varpio L, O’Brien B, Durning S, van der Vleuten C, Gruppen L, Ten Cate O, Humphrey-Murto S, Irby DM, Hamstra SJ, Hu W. Health Professions Education Scholarship Unit Leaders as Institutional Entrepreneurs. Academic Medicine. 2017. Jan 24 [ePub ahead of print]

Reviewer: Linda Snell (@LindaSMedEd)


HPESUs (health professions education scholarship units) are “organizational structures within which a group of people is substantively engaged in health professions education scholarship’’. There has been a proliferation of these units over the past decades, yet few researchers have studied them. As the structure and function of units are quite variable, it can be difficult to compare lessons learned at one unit to others and to generalize.

Recent studies in Canada and ANZ looked at perceptions of the leaders of these units from different perspectives, and the 2 research teams recognized an opportunity for international collaboration and comparison, looking at themes leading to sustainability and success.

They reviewed theories of institutional leadership and their data, and thought that the concept of an institutional entrepreneur (IE) offered insights into the leadership strategies employed by HPESU leaders. They used the concept of IE to shape research question and inform secondary analyses.

IEs “have an interest in particular institutional arrangements and leverage resources to create new institutions or to transform existing ones.” This definition “highlights the importance of individuals who work to develop, maintain, and/or change institutional forms.” They institute new practices, initiate and enact change, persuade others…


To examine the microlevel if leaders of HPESUs work as IEs in their university and/or hospital contexts, to understand how their activities were used to develop and/ or secure a legitimate standing for the HPESU in their local context

Type of Paper

Research: secondary analysis: ‘reconceptualization’, qualitative analysis of two preexisting datasets

Key Points on Methods

‘Recontextualizing’ two datasets:  not just combining existing data;

Adds a layer of context and analysis around existing data through iterative data analysis to re-explore, expand, and refine interpretations.

Requires: 1. Data fit new research question, and (2) researchers have contextual knowledge of the data to recontextualize.

Researchers reviewed lit on IE, then iteratively read datasets and applied IE concepts.

Key Outcomes

Participants described microlevel actions of HPESU leaders in ways that were consistent with the activities of IEs.

-theorizing, creating arguments and positions about institutional problems, and how the HPESU was a solution to these. “Encouraged members of the institution to look favorably upon its existence and/or growth.”

-cultivating strategic relationships, create strategic links to disseminate their theorizations. With Dean, academic and clinical department heads, individuals who wished to pursue health professions education-related careers (create a pipeline)

-increasing visibility: disseminate the legitimizing theories, by developing publicity strategies, participating in local committees, being aligned with, and supported by, powerful interests

The discussion proposes ways an HPESU could reflect on the goals that an IE could achieve in their context; driving change in highly institutionalized work contexts, subverting entrenched practices, creating new performance standards, for securing an institution’s lead. IEs play a critical role in helping institutions grow and evolve.

Key Conclusions

The authors conclude that “recontextualizing data with the institutional entrepreneurship theoretical construct offers practical applications that can support the growth of HPESUs in a variety of contexts. The concept of IE gives a framework for understanding how HPESU leaders achieve change at their institution. Institutional leaders who wish to drive change in the field of health professions education scholarship and to initiate and legitimize new educational practices in their local context should consider the advantages that could be reaped by having a well-supported, IE savvy HPESU leader at their institution.

Spare Keys – other take home points for clinician educator

  1. Concept of IE – from the organizational science literature, has applications in medicine (HPE and beyond)
  2. Secondary analysis of qualitative data is not just combining datasets or reanalyzing. Guidelines exist.

Shout out

All authors.

Access KeyLIME podcast archives here

Check us out on iTunes