Educational research at Johns Hopkins University School of Medicine: a grassroots development.

The Divisions of General Internal Medicine at Johns Hopkins University School of Medicine have been a rich source of educational research. To better understand the facilitators and barriers to educational research within the divisions, the authors reviewed published educational research from the divisions published between 1995-2004 and examined the history, leadership decisions, and sentinel events that have allowed educational scholarship within the divisions to grow. The authors' analysis suggests a grassroots model of programmatic growth that includes a growing cadre of clinician-educator scholars, effective mentorship, a faculty development program, access to learners, access to research expertise, protected time for scholarship, some funding, and an institutional culture that stimulates scholarship. A medical education fellowship was integral to the model; fellows were first authors for 47% of reviewed manuscripts. Extramural funding has helped build an infrastructure that supports educational scholarship; however, only 12% of the publications have had extramural funding. Protected time for faculty is the characteristic of this model most at risk. While there has been a move toward more institutional support of educational research, it is clear that further growth in the educational research program will require noninstitutional resources.