Back to the future

I was delighted and honoured to be invited to join John Bligh's new editorial team in 1998. It was an exciting time. Medical education was, at last, being taken seriously, both on the ‘shop floor’, as an important and worthwhile enterprise, and in academe, as a valid scholarly pursuit. Curriculum innovation and change was ubiquitous supported by a growing army of clinical educators. In his first editorial for Medical Education, John identified three broad readership groups—the medical teacher; the academic researcher; and the casual browser—and stated his aim for the journal to reach all of them.¹ The subtext was to increase the scholarly quality of the material published, to provide a forum for debate and discussion and to become the leading journal in the field.

Of these constituents, I think we always recognised that both the ‘jobbing’ clinical teacher and the casual reader were busy enough simply keeping up-to-date in their own disciplines without the challenge of having to get to grips with novel concepts and new paradigms (and the accompanying jargon!). Yet, it was clear that there was a need for a publication that focussed on the more practical and applied (rather than theoretical) aspects of teaching. This is not to say we did not think it is important for a teacher to understand something of the ‘why?’ as well as the ‘how’, the one informs the other after all; the challenge would be to make it accessible. And so The Clinical Teacher (TCT) was conceived, and, after a short gestation was finally born in March 2004.

In the first editorial, John Bligh heralded a new approach, ‘designed to be easy to read and difficult to put down’ containing ‘up to date and authoritative articles about matters that are important to today's clinical teacher’.² After a couple of volumes, with the newborn TCT seemingly doing well, I was asked to take over as ‘caretaker editor’ until a formal appointment was made. Starting in 2006, I oversaw four volumes, 3 to 6.

The first few issues—twice yearly for the first 2 years, then quarterly—were fairly didactic, featuring mostly ‘how to’ and ‘state-of-the-art’ pieces on a range of topics, written by ‘well known clinicians and educators from around the world’.² There was little original research; however, digests of interesting and relevant papers from Medical Education and other journals were included, along with ‘Airmail’ comprising reports from around the world. We were keen to involve students and a ‘Student's Perspective’ piece became a regular feature.

Looking back at those early days I am struck by a number of things. Firstly the sheer variety of topics covered, reflecting the dramatic increase in activity in the field, and vindicating the sentiment in my first editorial that in TCT there would be ‘surely something for everyone, and maybe everything for someone?’³ A number of recurring themes stood out, reflecting the discourse within the medical education community at the time, not least the challenges of assessment. Other popular areas included professionalism, problem-based learning, simulation, patient safety, peer-assisted learning, widening access, teaching communication, social responsiveness and cultural competence, and from the students' perspective, topics such as coping with transitions, welfare and boundaries, and the role of students in clinical settings (in one prescient piece, a discussion about the potential involvement of students in pandemic planning, in this instance H5N1 influenza.)⁴

Secondly, a shift in the style and content of articles can be discerned, as we encouraged authors to move beyond simply describing their work, as per an editorial written in advance of an increase in page length and broadening of scope: ‘If an article is well written, evaluation has been undertaken with rigour (ie not just on the back of an envelope), a link is made with underlying theory or literature, and it makes an interesting and relevant point, then TCT will be interested.’⁵ I sense that sentiment prevails.

Thirdly, it was interesting to see the appearance and evolution of ‘new’ topics, for example, interprofessional education, ‘the patient's voice’, and ‘e-learning’ (one article commenced with the claim that ‘increasing numbers of medical schools are using the internet’!).⁶

Finally, it was an enjoyable trip down memory lane to see in the authorship the names of some of the giants of medical education, many of them friends and former colleagues, also, rather gratifyingly, the names of people who were possibly publishing for the first time and who would go on to greater things.

Fifteen years on, scanning recent issues, it is interesting to see that many of those early themes continue to focus the minds of both academics and clinical educators, for example, assessment, the ‘student experience’, transitions, training versus service, and professionalism. More contemporary issues have emerged: resilience, well-being and burnout, virtual simulation, cybersecurity, gender and identity and so on. And there will be more, for example, as Jill Thistlethwaite wrote in her guest editorial, ‘the impact of artificial intelligence (AI) on writing and publishing, cybersecurity, health professional burnout and retention issues and environmental health amongst others’.⁷ But perhaps the most striking thing to me was the change in the scholarly depth and breadth of many articles, and the range of research methods and references to underlying theory, surely a sign of a thriving academic community. It was also reassuring to see things still grounded in serving the needs and interests of clinical educators on the ground, with regular ‘how to’ and ‘toolbox’ pieces. Still (surely) ‘something for everyone …’, etc.

The Association for the Study of Medical Education (ASME) finally got round to making an official editorial appointment, and I stepped down at the end of 2009. I was touched by the words of Graham Buckley (then chair of ASME) in an editorial announcing the end of my tenure, thanking me for ‘nurturing the infant journal through its vital early development’.⁸ I felt proud to be handing on a healthy toddler, to stretch the metaphor, into the care of Steve Trumble.

The aspirations of the new joint editors, Annette Burgess and Paul Crampton, as stated in their first editorial, are little different from the original aims. Long may the young adult TCT continue to provide ‘an accessible and visible platform for health professionals and educators to share scholarly educational innovations and research’.⁹

John Spencer: Conceptualization; writing—original draft; writing—review and editing.

The author has no conflict of interest to disclose.

The author has no ethical statement to declare.