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December 22/29, 2004

Educational Epidemiology—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(24):2969-2971. doi:10.1001/jama.292.24.2970-b

In Reply: The additional barriers identified by Drs Beckman and Cook as influencing quality research in medical education are important to keep in mind. Observational studies can and should provide the basis for randomized clinical trials, something that has occurred extensively in clinical research but not in medical education. These can help us understand and control for such sources of variation. An unvalidated outcome measure is a serious flaw in any study, and we agree that untested instruments are often used in educational research, a practice that must change. We point to the numerous validity studies on the United States Medical Licensing Examination1,2 to underscore that large-scale well-validated national data do exist for practicing physicians in the United States, while acknowledging that predictive validity is lower among subgroups of learners.3 We must develop and rigorously test instruments in educational research so that we can address their strengths and limitations in interpreting findings.

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