Identifying the greatest perceived barriers to scholarly activity at an academic medical center using the delphi method

Context: Scholarly activity is an important part of medical training and practice. Many perceived barriers to scholarly activity have been identified, but it is difficult to identify which barriers are the most important to address. The Delphi method is a structured process used in to narrow the range of possible answers in a group towards a set of correct answer.

Objective: To use the Delphi method to identify a consensus ranked list of barriers to scholarly activity.

Study Design and Analysis: Iterative Delphi survey, descriptive statistics.

Setting: Academic Medical Center.

Population Studied: Residents, fellows, and faculty at Tower Health Instrument: A three-part Delphi survey. In Survey One, respondents are asked to identify their perceived barriers to scholarly activity. These barriers are consolidated (i.e., “Not enough time” and “Need more time” would be consolidated into a single barrier). In Survey Two, respondents are asked to rank the barriers from greatest to least. Rankings are weight-averaged to generate a ranked list. In Survey Three, respondents are shown their ranking and their peers’ weighted average ranking and given an opportunity to change their ranking.

Outcome Measures: A consensus ranked list of perceived barriers to scholarly activity.

Results: Respondents identified 23 unique barriers to scholarly activity. The top five consensus ranked barriers (greatest barrier to least) were: 1) Not understanding the overall process (from IRB approval to paper publication); 2) Complicated IRB process; 3) Lack of time; 4) Not knowing how to access available resources / how to engage the academic center’s system; and 5) Lack of training / lack of experience / not knowing where to start.

Conclusions: Lack of time is widely cited as a common barrier, and often a point of conflict between medical learners and staff and administration. What is noteworthy in our results is that while lack of time is a barrier, it is 3rd, after two other barriers that are relatively simple administrative coordination issues. It is remarkable that four of the five top barriers are addressable with academic training or administrative support and suggests that organizations may identify low-effort solutions to improve scholarly activity by using the Delphi method to identify consensus ranked barriers.