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As an internationally oriented researcher in medical education and, more generally, in health professions education, I was pleased to receive an invitation to write an editorial for this issue of IATREIA, the journal of the Medical Faculty of the University of Antioquia, widely read in Latin America, at the occasion of its transition to a journal that is (a) devoted mainly to education in the health professions and (b) publishing in Spanish and English, which makes the journal (c) a contributor to a rapidly growing global community. Let me devote some words to each of these three features.
The educational mission
Medical education is not what is was 50 years ago. Starting around 1950, but speeding up after 1970, there has been a tremendous increase of development, insight, theories, studies in medical education, a domain that was more recently broadened to health professions education (HPE). Numerous journals, conferences, scholars, units in universities solely focused on research and development of health professions education, and many master courses and PhD programs for advanced degrees in HPE attest of a high need to respond to society’s desire for improved education in the health care sector (1,2).
Offering an education program to become a doctor or nurse can no longer be limited to asking various professors to each deliver a course. Decades ago, a medical curriculum would be not much more tan a time table to schedule courses that were pretty much unrelated. Now, educational objectives guide the content of education (3), collaboration and integration among disciplines, horizontally and vertically, determine courses, large lectures are no longer the dominant form, but are combined with small group problem-based learning, team-based learning, online content provision and other methods (4).
Clinical rotations are much better structured and few large exams are being replaced by frequent formative feedback (5), and preceded by skills training in simulated environments (6). Professional identity formation has received substantial interest (7) and trust and entrustment has become important concepts in clinical education (8,9).
All these innovations would have not become widely known and built upon without extensive studies and reports in the international literature. Medical journals occasionally publish education studies, but that remains a small percentage. The true advancements in education are published in dedicated journals for health professional education. The first of these, the US Journal of Medical Education, was launched in 1920. Half a century later a British Journal of Medical Education was added. A decade later this number had doubled, and another decade later quadrupled. The exponential growth has continued and now, one century after the first dedicated HPE journal had appeared, almost one hundred such journals have been established. Clearly, the education mission has found its way to journals.
The use of language
The increased communication between educators and education scholars in the health professions has led to increased use of the English language. In my own country, a Netherlands Journal of Medical Education (under various previous names) started in 1982, and fate had it that I was the first author of a brief article in the first issue of its first volumen (10). Since then, the journal became peer reviewed (1996), found a respected publisher (BSLSpringer, 2000), started to add English abstracts to the Dutch (2001), and turned into an English-only journal (2011), now called Perspectives on Medical Education, with a strong international editorial board. It received its first impact factor (2.95) in 2021.
Similarly, the Korean Journal of Medical Education, founded in 1989 with occasional English abstracts, has become fully English since 2016. A similar process is happening to the German GSM-Journal for Medical Education, founded in 1983, publishing in English and German since 2015, joining other journals such as Revista Brasileira de Educação Médica, the Canadian Medical Education Journal, that publish articles bilingually. And, of course, IATREIA, which publishes in Spanish and English.
Even if English is not the language with the world’s most native speakers (it would be easily surpassed by Spanish and Chinese), frankly it is the lingua franca of science and also of health professions education. So, to be heard internationally, scholars must publish and present in English.
The global community
The growth of journals of HPE reflects the increased number of scholars and educators who produce and read this work. A conservative estimate is that there are at least 20.000 HPE scholars worldwide (1). They do establish a community. This community starts building by interaction through writing and reading. Next, by meeting at national and international conferences. Here is where acquaintances come to life. The actual interaction, i.e., the exchange of ideas, findings, experiences and opinions, happens much better in face to face, during session-discussions, directly after presentations when scholars exchange their business cards, in the hallways and at coffee breaks. Without making this explicit, communities start when scholars meet with a handshake.
Communities can also be organized deliberately. Associations, like FAIMER (the Foundation for the Advancement of International Medical Education and Research) and the Association for Medical Education in Europe (AMEE) have stimulated community building through membership initiatives such as a fellowship structure (2,11). At national and local levels, Academies for medical educators have been established (12). Still, journals are pivotal to feed these communities. They would not function well if there were no exchange of ideas, so accessible journals are crucial.
Next, technology has brought an enormous stimulus to community building. Many readers, now becoming tired of the many months of video calls with little physical contact caused by the COVID-19 pandemic, may not realize that, at the same time, internet technologies have enabled connections that were not possible a decade ago, let alone before the turn of the century. But even improved connections to some extent happened in the COVID-19 era. A large annual European Neurology conference tripled its active participants from 6,919 in 2019 to 20,694 in 2020, and quintupled the number of sessions attended by individuals to 169,334 cumulatively in 2020, just because the conference became virtual (13). I have personally published 58 journal articles remotely in the period January 2020 through August 2021, with a total of 175 coauthors, without any other interaction than video calls and emails.
In conclusion
I congratulate IATREIA with the shift to an education journal and sincerely hope the journal will prosper, attract international authors, cross language barriers, and build a community of readers and contributors. May it be read widely and contribute to the common goal of better education, better students and residents, better healthcare and, eventually, to the wellbeing of patients.
