Global research aims for the study of cost and value in health professions education: A Delphi study of international experts

BACKGROUND: Health professions educators constantly make difficult choices about the allocation of finite resources. However, there is limited sound research available to guide their decision-making. The purpose of this study was to address this gap by establishing international consensus on research aims, considering diverse economic and cultural contexts.

METHODS: The authors conducted a three-round Delphi study, engaging an international panel of 73 experts in education research. Panelists were asked to identify (round 1), rank (round 2), and revise (round 3) research aims important for the study of cost and value in medical education. Round 3 results were discussed by an international steering group of nine medical education scientists actively involved in cost and value research, who finalized a list of 20 research aims. Steering group narratives were analyzed to identify additional conceptual insights.

RESULTS: From 597 research aims suggested in round 1, 20 research aims were identified after steering group discussion. These were clustered into three categories: (1) funding mechanisms for medical education (e.g. financial policies, cost-effectiveness, and equity impacts); (2) cost and outcomes, e.g. how costs in health professions education relate to concrete outcomes; and (3) economic evaluation of teaching, assessment, and training approaches; e.g. designing and applying formal economic evaluation methods. Steering group discussions noted the limited integration of economic theories into medical education research and the need for foundational studies beyond immediate, practical priorities. They further noted lack of consensus on definitions of cost and value, and appropriate methodologies; underutilization of accepted health economics approaches; and infrequent interdisciplinary collaborations. These collectively act as barriers to advancing the field.

CONCLUSION: The field of cost and value in health professions education remains theoretically and empirically underdeveloped. The research aims identified herein provide a strategic framework for addressing cost and value comprehensively.