If You Only Read Three

A few months ago, I wrote this email to a mentee who was planning to do a literature review (shared here without their name):

I think we have a nice plan for next steps. I made a Box folder and shared it with you. I am putting lots of papers in there on literature reviews, but I want to guide you a little more than that.

Attached are six papers to help you get oriented and figure out which kind of literature review you might want to conduct. The order I suggest is:

1. Maggio, Sewell, Artino
2. MacLeod, Varpio
3. Sullivan
4. Parker
5. Varpio
6. Maggio (optional)

After you read these and think you know which approach you are most considering, check out this link for more on each of the particular approaches: https://jgme.kglmeridian.com/page/jgme_literature_review_series

Of note – you are going to see the name Maggio come up a lot! She authored many of these papers, is cited a lot in the other papers, and many of the other papers mention her explicitly. Lauren Maggio is a total boss and works here at UIC (University of Illinois Chicago)! She is super nice, and if you’d like, I’d be happy to see if she is interested in working on this with us or advising us.

Looking back, I don’t think the papers I listed in that order are the appropriate ones.

My strategy with that first list was to move from broad to specific, the way I would learn a new area myself: why literature reviews matter (Maggio, Sewell, and Artino), the menu of review types (MacLeod and colleagues), why reviews are hard (Sullivan), how to do one (Parker and Sikora), how to choose (Varpio and colleagues), and how to search (Maggio, Tannery, and Kanter). There were a few problems with that: it was six papers, not three; the paper that would actually help my mentee make their next decision (which kind of review to do) was fifth on the list; and the first paper is really about the background literature review that sits inside a research study, not about a literature review as the study itself.

On second pass, the MacLeod paper should be first and then the Varpio paper second. Then, perhaps the Maggio Academic Medicine Last Page. Personally, I am a big fan of the Academic Medicine Last Page (AMLP) format, for a few reasons. First, it is highly visual, which works well for my brain. And, second, it is just one page and limited to 500 words or less. Seeing an AMLP as an assigned reading can be reassuring for some people when they look at three papers and see that one of them is a single page and full of color. I’ve said it before and I’ll say it again, I’m a simple man sometimes, and I am captivated by bright shiny things!

If I were to send this email again, this is the list of three I would send, in order:

1. MacLeod A, Parker R, Varpio L. Introduction to the JGME literature review series. J Grad Med Educ. 2021;13(6):797-800.
2. Varpio L, Parker R, MacLeod A. Understanding the differences that differentiate: a model for deciding which literature review to conduct. J Grad Med Educ. 2024;16(2):146-150.
3. Maggio LA, Tannery NH, Kanter SL. AM Last Page: how to perform an effective database search. Acad Med. 2011;86(8):1057.

This list only includes what my mentee needs for their next decision, in the order they will need it: the menu of review types, how to choose among them, and how to get started. This "menu, how to choose, how to start" is just one approach to selecting three papers for a mentee to read.

NOTE: If any of these is behind a paywall for you, ask a librarian, email the author (most are happy to send a copy), or ask a friend or colleague at another institution.

Here are some other ideas I have had about sending just three papers related to a phenomenon, theory, or framework.

A past, present, and future approach. So, papers that answer the questions: where did it come from, where is it now, and where might it be going?

I am using this "past, present, and future" approach for a course I am building about controversies in medical education. It is designed for the students in our longitudinal medical education track at UIC (the EdMED track, which I direct), with the working title “The Past, Present, and Future of Controversies in Medical Education.” The pre-reading for each session covers the past and present. Then the sessions start with a debrief of the reading (or an activity to reach consensus on the past and current state), and then we think about the future.

Please, reach out if you want to talk about this course and whether you might want to deploy it at your institution! As always, geoffstetson@mededmentor.org

A background, application, and critique approach. So, a paper that is a good overview, a paper that is an application of it, and a paper that critiques it or provides controversy about it.

On the MedEdMentor website, on our theory pages, we often have at least three papers in which a theory is better described and at least three in which it is applied. We don’t have an explicit section for papers that critique the theory, but, @Greg, that sounds like a good addition to the site! Right?!?

But what about phenomena? Like feedback in the clinical learning environment?

Phenomena tend to be things that we apply theory to in order to better understand them. So one option is three lenses: three papers that use a different theory to better understand the phenomenon. Feedback can be read as information (is it specific enough to act on?), as a relationship (does the learner trust the person giving it?), or as a skill set that teachers and learners need to bring to their interactions (do teachers know how to facilitate a feedback conversation, and/or do learners know how to solicit it and use it?). Seeing all three tells the mentee that “feedback” is really three or more different problems, and that their project should probably pick one or two approaches that really fit their world view.

I don’t want to be prescriptive about which approach to use for these different tasks, so think of these as options for choosing three papers. Below, I present what I think might be best for each task a mentee needs to do, and what it would look like to use one of the other approaches for that same thing.

NOTES: The table below uses shorthand citations with the full citations at the end of this piece. And pick just one column per row, as each cell is a set of three.

A personal rule should be that reading assignments can include a maximum of one book, but ideally none. The reasoning is that these are really busy people, and I want the work to be manageable. Expecting busy trainees or faculty to read a book is often a tall ask, unfortunately. If they read the first three and come back for more, that is often a better time to suggest a book.

If a mentee reads the three and comes back, that is a very exciting turn of events and an opportunity to move on to the next step in mentoring. Often, this turns into a conversation that looks very much like a qualitative interview, where you learn more about what they learned from the different papers, how the ideas in those papers influenced their thinking, and how their altered thinking might influence their approach to their problem, phenomenon, or theory. Then you can help them to devise a clear and meaningful set of next steps.

I would love to hear your thoughts on these different approaches to selecting three papers, and whether you use any other frameworks or approaches to selecting a subset of the literature. Once again, geoffstetson@mededmentor.org.

Thanks for reading, and I’ll see you back here next Monday!

1. MacLeod A, Parker R, Varpio L. Introduction to the JGME literature review series. J Grad Med Educ. 2021;13(6):797-800.
2. Varpio L, Parker R, MacLeod A. Understanding the differences that differentiate: a model for deciding which literature review to conduct. J Grad Med Educ. 2024;16(2):146-150.
3. Maggio LA, Tannery NH, Kanter SL. AM Last Page: how to perform an effective database search. Acad Med. 2011;86(8):1057.
4. Burgess A, McGregor D. Peer teacher training for health professional students: a systematic review of formal programs. BMC Med Educ. 2018;18:263.
5. Meyer HS, Larsen K, Samuel A, Berkley H, Harvey M, Norton C, Maggio LA. Teaching medical students how to teach: a scoping review. Teach Learn Med. 2022;34(4):379-391.
6. Cohen A, Steinert Y, Ruano Cea E. Teaching medical students to teach: a narrative review and literature-informed recommendations for student-as-teacher curricula. Acad Med. 2022;97(6):909-922.
7. Buckley H, Steinert Y, Regehr G, Nimmon L. When I say . . . community of practice. Med Educ. 2019;53:763-765.
8. Burgess A, Haq I, Bleasel J, Roberts C, Garsia R, Randal N, Mellis C. Team-based learning (TBL): a community of practice. BMC Med Educ. 2019;19:369.
9. O’Brien BC, Battista A. Situated learning theory in health professions education research: a scoping review. Adv Health Sci Educ Theory Pract. 2020;25:483-509.
10. Wenger E. Communities of practice and social learning systems. Organization. 2000;7(2):225-246.
11. Terry DR, Nguyen H, Peck B, Smith A, Phan H. Communities of practice: a systematic review and metasynthesis of what it means and how it really works among nursing students and novices. J Clin Nurs. 2020;29:370-380.
12. Hodson N. Landscapes of practice in medical education. Med Educ. 2020;54:504-509.
13. Balmer DF, Rosenblatt S, Boyer D. Navigating landscapes of practice: a longitudinal qualitative study of physicians in medical education. Med Educ. 2021;55:1205-1213.
14. Ende J. Feedback in clinical medical education. JAMA. 1983;250(6):777-781.
15. Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education. Acad Med. 2015;90(5):609-614.
16. Carless D, Winstone N. Teacher feedback literacy and its interplay with student feedback literacy. Teach High Educ. 2023;28(1):150-163.
17. Sargeant J. Future research in feedback: how to use feedback and coaching conversations in a way that supports development of the individual as a self-directed learner and resilient professional. Acad Med. 2019;94(11 Suppl):S9-S10.
18. Lentz A, Siy JO, Carraccio C. AI-ssessment: towards assessment as a sociotechnical system for learning. Acad Med. 2021;96(7S):S87-S88.
19. Asch DA, Parker RM. The Libby Zion case: one step forward or two steps backward? N Engl J Med. 1988;318(12):771-775.
20. Bilimoria KY, Chung JW, Hedges LV, et al. National cluster-randomized trial of duty-hour flexibility in surgical training. N Engl J Med. 2016;374(8):713-727.
21. Silber JH, Bellini LM, Shea JA, et al. Patient safety outcomes under flexible and standard resident duty-hour rules. N Engl J Med. 2019;380(10):905-914.
22. Bennett CL, Finch A, Vuong K, McDonald D, Rennie S; Wiley E, Hall DV, Stull MJ; Anderson JE, Brown EG; Goldstein LR; Ruff J. Surgical resident duty hours [letters]. N Engl J Med. 2016;374(24):2399-2402.
23. Bilimoria KY, Hoyt DB, Lewis FR. Surgical resident duty hours [reply]. N Engl J Med. 2016;374(24):2402-2403.