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A decade of socially accountable medical student research – Western Sydney University’s Community Research Program

WSU Medical School’s research training program is founded on an unswerving commitment to support the school’s social accountability mission through community partnerships. Its mandatory Community Research course componenthas both research and community engagement learning outcomes. 

University Affiliation
Western Sydney University
Title of the Program
Community Research Program, WSU School of Medicine
Team Members
Wendy Hu (Professor of Medical Education & Associate Dean Learning & Innovation)
Community Research Inaugural Program Convenor
Lise Mogensen (Senior Lecturer Research & Evaluation)
Community Research & MD Projects Program Convenor
Brahm Marjadi (Senior Lecturer, Associate Dean Engagement)
Community Research Past Program Convenor
Sabrina Pit (Adjunct Fellow WSU, Research Translation Specialist, NSW Rural Doctors Network, Honorary Senior Research Fellow, University of Sydney)
Community Research Past Rural Coordinator, University Centre for Rural Health (UCRH) Lismore
Jannine Bailey (Senior Lecturer, Rural Health & Research)
Community Research & MD Projects Rural Coordinator, Bathurst Rural Clinical School
Natalie Edmiston (Senior Lecturer, Rural Research)
Community Research & MD Projects Rural Coordinator, UCRH Lismore
Aunty Kerrie Doyle (Professor & Associate Dean, Indigenous Health)
Community Research & MD Projects Stream Lead Indigenous Health
Date the program commenced

Why was the program undertaken? 

In 2007, the then University of Western Sydney School of Medicine opened its doors to the first intake of undergraduate medical students, galvanised by a mission to meet the health and workforce needs of Greater Western Sydney (GWS). One of the most diverse, geographically dispersed and fastest growing outer metropolitan regions in Australia, GWS encompasses communities affected by significant disadvantage as well as some of the most highly-educated residents and high-income suburbs of Sydney, and the largest urban Aboriginal population nationally.  

In 2010, the first cohort undertook the Community Medicine Group Project during Year 4 of their five-year Bachelor of Medicine and Surgery (MBBS) degree, which by then had expanded to include rural North Coast and Western NSW. In 2012, this mandatory research course component was renamed the Community Research (CR) program to better reflect its dual research and community engagement learning outcomes (see Figure 1) and equivalence to clinical placements.  

In 2019, the MBBS was replaced by the Doctor of Medicine (MD) but the essentials of CR have continued as the MD Project: to learn research and scholarship by doing it, through interconnected teaching, research and service activities. The program’s evolution and sustainability are founded on an unswerving commitment to evidencing the school’s social accountability mission through community partnerships (see Figure 2), alignment with WSU research strategy, and research-informed curriculum design and implementation. 

Figure 1: Community Research Learning Outcomes 
Community Research learning outcomes reflect the dual, integrated rotation – to be accountable to communities with health inequities through rigorous, collaborative and respectful research:   

  • Explain how the project’s aim and research question relates to the health issue in the community or study population 
  • Demonstrate an understanding of all aspects of the research process, from formulating research questions to standards of writing for publication  
  • Demonstrate a collaborative and respectful approach to project participants, such as health care providers, community services, clients and health care consumers.    
Figure 2: The North Coast Medical Education Collaboration (NCMEC) 
Through a partnership between rural communities of Northern Rivers NSW and WSU, Wollongong and Sydney medical schools, WSU students undertake their Community Research project during year-long rural placements. Students are co-supervised by local clinicians, researchers and the CR teaching team, to co-design and complete projects on health issues of local importance, leveraging contemporaneous public health issues and events such as music festivals to collect data and raise awareness. This rural CR program produces translatable evidence and is developing research capacity for the Northern Rivers, with a track record of 21 research publications and 11 conference posters and presentations, and media coverage on topics such as youth sexual behaviours, smartphone apps, voluntary pill and alcohol testing, cannabis, refugee wellbeing, depression, GP service needs, water fluoridation and vaccination (2015-2021). See Appendix for links to student projects. 

The WSU Medicine teaching philosophy of experiential learning is reflected in the CR program; while research principles and skills can be acquired through theoretical knowledge and evidence-based medicine critical appraisal exercises, this learning does not become “real” until students conduct research, experiencing its limits as well as the satisfaction of findings that are immediately relevant (see Figure 3). For example, collecting and analysing data, whether from medical records, community interviews or surveys, becomes authentic and effective learning about the impact of well-designed data collection on data quality – and thus the validity and reliability of research findings. 

Figure 3: Community Research experiential learning pedagogy 
Self-Determination Theory was used to investigate WSU students’ research experiences, with findings informing CR design such as Relatedness to clinical practice and future careers, Competence through adequate scaffolding and just-in-time advice, Autonomy through choice of project and use of allocated time.  

Rosenkranz, S.K., Wang, S. & Hu, W. Motivating medical students to do research: a mixed methods study using Self-Determination Theory. BMC Med Educ15, 95 (2015). Reproduced under Creative Commons Attribution License 4.0

How was the program implemented?

The CR program is delivered to all WSU medical students (about 130 per year cohort), who work in groups of three to five, supported by allocated time in a four-week block in urban sites and sequential allocation over a year-long placement in rural sites. Scaffolding is provided in Years 1, 2 and 3 by aligning CR and graduate learning outcomes and assessments with Population Health and EBM teaching in lectures, small group workshops and online modules.

During Year 3, students select from an endorsed list of projects and supervisors, submit an assessable project plan and literature review, and obtain relevant ethical approvals. Students are thus prepared and ready to conduct data collection on the first day of their Year 4 CR placement. Supported by data analysis and report writing workshops and training tailored to the project’s study design, each group completes their project and submits a 4,000-word final report in the format of a research paper. CR study designs have included quantitative surveys, qualitative interviews and focus groups, medical record reviews and audits, systematic reviews, sub-projects within community-based randomised controlled trials, and novel approaches such as geospatial mapping. All assessments are threshold, and the final report is graded by experienced supervisors and the CR teaching team for anchoring and calibration.

The CR teaching team is founded on a strong collaborative culture and participatory practice, garnering university teaching awards for the strength of its collegiality and teamwork (see Figure 4). The team comprises the program convenor and two rural coordinators, with contributions from cognisant disciplines; team members possess strong expertise in qualitative, quantitative and mixed-methods research, and all are active and community-engaged researchers – we do and teach – with CR teaching being one of their many roles.

To inspire emerging clinician researchers, WSU students and alumni have joined the team as peer teachers and role models. Team teaching is particularly important for comparable learning experiences and assessment in a state-wide distributed program.

Figure 4: Recognition of Community Research Teaching Excellence

In 2017, the CR Teaching Team, led by Dr Lise Mogensen, was recognised for the strength of its team and its participatory and collaborative approach, demonstrating through practice the dual aims of the CR program: community engagement and rigorous research.

Community Research Teaching Team

Dr Lise Mogensen, Senior Lecturer, Medical Education, Research and Evaluation, School of Medicine (right)
Dr Sabrina Pit, Clinical Lead – Clinical and Educational Research, School of Medicine (left)
Dr Jannine Bailey, Senior Lecturer, Rural Health & Research, School of Medicine

“Engaging and educating medical students in real research, solving real world problems with disadvantaged communities in collaborations across Western Sydney and rural locations.”

“Doing what we teach” is reinforced by a scholarly approach to CR teaching through: reflection on teaching practice and continuous evaluation (e.g. WSU Medical Alumni Survey findings have been used to enhance and re-sequence Year 1-3 scaffolding, with subsequent improvements in student satisfaction measures); using and producing educational research; benchmarking.

WSU has initiated collaborative projects with research teachers in other medical schools, leading to publications and findings that have been implemented in the CR program, including supervisor knowledge of research ethics (with University of Wollongong), motivating students to do research (with Sydney University), and compulsory research components (with Melbourne Medical School) (see Figure 5).

Since 2019, regular meetings of a WSU-initiated network of research program leads, which now includes Sydney, Wollongong, UNSW, Newcastle, Melbourne, Flinders and Tasmanian medical schools, have led to assessment benchmarking activities and ongoing collaborative exchange for peer review and best practice.

Figure 5: Key findings from Community Research-initiated research on teaching research
Key findings from research involving WSU students and collaborators, and how they inform the design, delivery and ongoing improvement of the Community Research teaching program.

Determining expected research skills of medical students on graduation: a systematic review.

Lee, M.G.Y., Hu, W.C.Y. & Bilszta, J.L.C. Med Sci Educ 30, 1465–1479 (2020).

Findings from 41 studies showed that medical student research teaching varied greatly and where reported, had poorly aligned aims, teaching assessment and evaluation methods. Whether the aim was to teach students by “doing”, “proposing to do”, or “critiquing”, good curriculum design requires constructive alignment. These recent findings reinforce the team’s approach to MD re-design of the CR program to ensure alignment of aims, program evaluation and blueprinting of assessments to the School mission and graduate outcomes.

Academic Guidance in Medical Student Research: How Well Do Supervisors and Students

Understand the Ethics of Human Research?  Weston, K.M., Mullan, J.R., Hu, W. et al. J Acad Ethics 14, 87–102 (2016).

Findings from a survey of academic staff and clinicians eligible to supervise medical student research at Wollongong and WSU medical schools showed that only two-thirds of academic staff (67.9 %) and less than half of clinicians (47.1 %) surveyed were aware that specific consent was required to include patient medical records in a research publication. There was limited awareness of requirements for participant information and consent forms and consent for clinical trials. These findings supported the CR team’s vetting of expressions of interest to supervise medical students, and to require that ethics approval is in place before including the project on a list for students to select from.

Motivating medical students to do research: a mixed methods study using Self-Determination Theory. Rosenkranz, S.K., Wang, S. & Hu, W. BMC Med Educ 15, 95 (2015).

This mixed methods study of all WSU student cohorts showed that few (7.5 %) of students had prior research experience. Experiencing the uncertainties of clinical practice during Year 3 clerkships (Pre-Clinical (48 %) vs Clinical Years (64 %), p < 0.001), and a sense of achievement through supported research activities conducted as a team (Pre- Community Research (51 %) vs Post-Community Research (66 %), p < 0.001), were associated with more positive attitudes to doing research as graduates. Applying Self-Determination Theory findings showed the importance of relevance to patient care and future career, social connectedness through teamwork, scaffolding to build confidence, and design that provides autonomy through time use and project choice in motivating students to do research. These elements were built into CR and now, MD design, through the sequencing and content of research teaching, including modules and workshops from Year 1 onwards, CR Team project proactive support and troubleshooting, and by retaining opportunities and assessing for group collaboration.

What is the Community Research Program achieving?

Increased research engagement: Community Research has become a focal point on the path toward increasing research engagement for WSU students. This compulsory component is positioned alongside additional research (e.g. embedded Honours, an intercalated year-long Bachelor of Medical Research leading to MPhil and PhD) and thus careers as clinical academics and clinician researchers (see Figure 6).

Figure 6: Student Profile: Marra Aghajani, Year 4 MBBS
Marra’s research journey has led to a combined MBBS-PhD and aspirations to continue teaching and research as a clinician researcher. In addition to being a Problem Based Learning and Indigenous student tutor, Marra was a peer role model in presentations on research opportunities to first year students.

“As a second year medical student, I became acutely aware of ongoing developments in the fields of cancer prevention, screening and treatment. I decided to defer my medical degree and enrol in the Bachelor of Medical Research, throughout which I investigated novel screening tools for the diagnosis of thyroid cancer. Following [this] I decided to enrol in the Doctor of Philosophy (Medicine) to pursue further research…

“It was certainly worthwhile pursuing research…I acquired experience in not only how to conduct research, but also in presenting at conferences via poster and oral presentations. Since the start of my PhD, I have also had the opportunity to develop invaluable skills in scientific writing and manuscript publication…Throughout my PhD, I also came to realise my passion for teaching.

“Despite the fact that, as medical students, we are taught research methods throughout our degree, I discovered that it was not until I had the opportunity to apply this knowledge that I could identify gaps in my understanding…I aspire to be a clinician researcher in the future, with the aim of actively participating in both clinical and translational research projects.”

Expedited ethics review: Another achievement of wide impact has been the creation of an expedited research ethics review and approval process (with advice from Wollongong colleagues). This process has now been replicated for WSU General Practice research, Physiotherapy research, WSU and Charles Sturt University medical education research and evaluation, and in a unique partnership with the NSW Aboriginal Health and Medical Research Council (see Figure 7).

Each year approximately 20 CR project proposals are submitted to the WSU Human Research Ethics Committee (HREC) as sub-project amendments, under an overall approval for low and negligible risk medical student research, and approved within two to four weeks. As one of their supported learning-by-doing experiences, students complete ethics amendment applications using templates for project protocols, participant information sheets and consent forms. These are submitted to WSU HREC only after CR team review and students completing any necessary revisions. This pathway has saved students and supervisors much time and effort, reinforced learning about research ethics, prevented students from being discouraged about future research involvement (as reported by early cohorts who had to obtain full ethics approvals), and encouraged projects better suited to the community engagement aims of the CR program.

Figure 7: Promoting Aboriginal Health Research: partnering with the Aboriginal Health & Medical Research Council of NSW (AH&MRC) Human Research Ethics Committee (HREC)

Relationships, respect and reciprocity in researching with Aboriginal communities are central tenets of the CR program. As part of the strategy to build research capacity and co-produce relevant research for under-served communities, the Professor of General Practice worked with the AH&MRC HREC to establish a partnership with the CR Program. This resulted in an expedited research ethics process modelled on the CR Program ethics process for low-risk, community-based student research. Projects have been completed on hypertensive disorders of pregnancy (pre-eclampsia), chronic Hepatitis B care, transport needs of older clients of Aboriginal Medical Services, and on an audit of AH&MRC research ethics applications. Subsequent Aboriginal Health projects include a virtual interview study on sleep habits with Elders, community members and GPs, and an innovative exploration of Aboriginal bush medicine through walking interviews in two Healing Gardens with an Elder. All projects were co-developed and conducted with community, and students returned reports and findings to the community.

Campbelltown Hospital Reconciliation Garden, featuring Elders Aunty Fran Bodkin and Uncle Ivan Wellington

Peer-reviewed publications: A 2017 audit revealed 44 students had published, 65 students had delivered conference presentations and 41 had manuscripts undergoing peer review. The very successful Northern Rivers (see Figure 2) Rural CR team, working with local clinicians, researchers and community partners, has alone produced 21 peer-reviewed research publications with CR students as authors, and the findings of these publications are being cited and influencing practice. Tracking research outcomes into the postgraduate years is not straightforward; similar to monitoring graduate practice locations, reporting these important outcomes calls for a unified and collaborative approach between medical schools.

Continuous improvement

Lessons from our decade of CR teaching experience, together with contemporary developments in medical education, continue to guide the program’s evolution as it is replaced by the MD Project. As a result, research skills teaching has now been re-sequenced and strengthened, and there is greater horizontal and vertical integration with Population Health, EBM, biomedical and clinical science disciplines.

MD Projects are completed by individuals rather than groups of students. While the work required of students has been moderated, CR experience shows that allocated time is crucial, so this has been increased. CR experience in recruiting supervisors and ensuring that projects are suitable for students with no research experience has led to a surplus of CR projects each year, but many more are required for the MD. The CR team – now in charge of designing and implementing MD Projects – strategically used opportunities provided by WSU partnerships with new academic health precincts in Western and South Western Sydney, the Central West and the Northern Rivers districts of NSW to increase the number and range of projects.

MD Projects now cover a comprehensive suite of student interests and professional capabilities in medicine, including biomedical, population health, medical education and rural research, Aboriginal Health and clinical quality improvement. Regardless of whether it is the clinician, patient or Aboriginal or rural community, all projects remain grounded by engagement with community and that community’s needs. For example, the WSU rural programs in Bathurst, Lismore and now Orange NSW (in partnership with Charles Sturt University) are designed to deliver comparable learning and assessment that is still relevant and contextualised to local communities. Importantly, these research programs build rural research capacity and support rural careers for future doctors.

Growth in research capacity and medical workforce are vital to maintaining the strength and continuity of the teaching team and for reciprocity when partnering with under-served communities, so that research becomes core business and is resilient in the face of COVID and other unanticipated challenges.

Ultimately, impact on graduate practice and life-long skills such as problem solving, teamwork and time management is paramount. Whether graduates are on clinical or clinical research career paths, they often report such outcomes, and that literature searching and appraisal needed to do research has helped them become more effective users of research for patient care (see Figure 8).

Since 2010, the CR program has purposively and pre-emptively adapted to shifting conditions but remained focused on teaching and producing rigorous, ethically approved research that is underpinned by the School’s social accountability mission to be relevant, embedded and of benefit to the communities that it serves.

Figure 8: Impact on graduate practice and different career paths: Mohammad Rehmanjan and Benji Pfister
Benji Pfister PGY5, Orthopaedic Surgery Trainee

“Community Research was fun and well supervised…and it was an awesome opportunity for us to get to know the community that we were living in…Performing research as a student was an invaluable opportunity to work on skills such as teamwork, innovation and critically appraising literature, skills that directly translate into day-to-day practice in medicine. Formulating a research project from the ground up required originality and problem solving – once again these are skills applicable to the dynamic nature of orthopaedic surgery in which I now train…the major influence that Community Research has had on my current practice is by introducing me to the critical appraisal of literature. I have improved on these skills since my days as a student and apply them on a regular basis. These appraisals allow me to judge ‘evidence’ more objectively and therefore help me apply the appropriate medicine to the applicable patient cohort…Despite the enjoyment I get from research…I remain steadfastly devoted to practicing orthopaedic surgery in a clinical role. However, I recognise the importance of future research to improve patient care, continue to develop innovation and establish working relationships with our colleagues around Australia and the world. I will continue to be involved in research throughout my career, and my positive experience at WSU has inspired me to act in an encouraging and supervisory role to junior doctors interested in research.”

Mohammad Rehmanjan PGY7, Neurosurgery and Paediatrics Trainee

“As part of the program, I did a Community Research project looking at awareness and practice of Hospital-In-The-Home (HITH) amongst General Practices. The community research project was worthwhile in that it enhanced my interpersonal skills by working with my colleagues as a team. I learnt the importance of collaboration for efficient and productive research…Our Community Research project was great in that it involved field work which further encouraged me to do clinical orientated research work. I was encouraged to continue with an Embedded Honours project as part of my medical degree and was able to incorporate basic research and publication principles into my Honours project…This was tricky at times to balance with other commitments, but it also gave me a realistic idea about the challenges of balancing work and family life as a clinician and academic. It encouraged me to prioritise tasks and it built up resilience for my career…Doing research as a student encouraged me to look at authentic sources of information and critically appraise literature when addressing clinical questions in practice…By completing research as a student, especially Embedded Honours, I have been motivated to pursue a career as a clinician and academic. I wish to pursue my interests in teaching and research yet contribute to clinical care of patients. The beauty of research is that it opens your mind and enhances your critical thinking skills…One of the greatest satisfaction one can obtain from their research work is when it translates into clinical practice.”


The North Coast Medical Education Collaboration

Community Research Student Publications:

Chan, R., Smith, R., Nguyen, M., Spencer, S., Pit, S.W. Effect of serial anthropometric measurements and motivational text messages on weight reduction amongst workers: Pilot Randomised Controlled Trial. JMIR Mhealth Uhealth 7, e1183 (2019).

Day, N., Criss, J., Griffiths, B., Gujral, S., John-Leader, F., Johnston, J., & Pit, S.W. Music festival attendees’ illicit drug use, knowledge and practices regarding drug content and purity: a cross-sectional survey. Harm Reduct J 15, 1 (2018).

Fitzpatrick, M., Garsia, K., Eyre, K, Blackhall, C., & Pit, S.W. Emotional exhaustion among regional doctors in training and the application of international guidelines on sustainable employability management for organisations. Aust Health Rev 44, 609-617 (2020).

Jeffrey, B., Bagala, M., Creighton, A., Leavey, T., Nicholls, S., Wood, C., Longman, J., Barker, J., & Pit, S.W. Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: a qualitative study among app users and non-app users. Diabetol Metab Syndr 11, 84 (2019).

Wood, N., Charlwood, G., Zecchin, C, Hansen, H., Douglas, M., & Pit, S.W. Qualitative exploration of the impact of employment and volunteering upon the health and wellbeing of African refugees settled in regional Australia: a refugee perspective. BMC Public Health. 19, 143 (2019).

Garga, S., Thomas, M.T., Bhatia, A., Sullivan, A., John-Leader, F., & Pit, S.W. Motivations, dating app relationships, unintended consequences and change in sexual behaviour in dating app users at an Australian Music Festival. Harm Reduct J 18, 49 (2021).

Garga, S., Thomas, M.T., Bhatia, A., Sullivan, A., John-Leader, F., & Pit, S.W. Geosocial Networking Dating App Usage and risky sexual behaviour in young adults attending a music festival: cross-sectional questionnaire study. J Med Internet Res 23, e21082. (2021) .

Pathirana, N., Medveczky, D., Deng, W., Abel, S., Zask, A., Rolfe, M., Preston, P., & Pit, S.W. Factors affecting blood alcohol concentration (BAC) estimation and drinking intention during voluntary breath testing (VBT): a cross-sectional study. Drugs: Education, Prevention & Policy. 1 June (2021).

Walmsley, G., Prakash, V., Higham, S., Barraclough, F., Pit, S.W. (2021) Identifying practical approaches to the normalisation of interprofessional collaboration in rural hospitals: A qualitative study amongst health professionals. J Interprof Care 35, 662-671 2021.

Hansen, V., Pit, S.W., Phelan, S., Fiorentino, M., Campion, S., Abraham, R., & Cheng, J. Changes in antidepressant medication use in the workplace and sustainable employability: a qualitative study of experiences, strategies and solutions. Arch Environ Occup Health 10 November (2020).

Southey, M., Kathirgamalingam, A., Crawford, B., Kaul, R., McNamara, J., John-Leader, F., Heslop, J., & Pit, S.W. Patterns of ecstasy use amongst live music event attendees and their opinions on pill testing: a cross sectional study Subst Abuse Treat Prev Policy 15, 55 (2020).

Chandiok, K., Marathe, S., Rooney, M., Stocker, J., Tellis, B., & Pit, S.W. Cannabis and its therapeutic value in the ageing population: attitudes of health-care providers. (2021) Austral J Ageing 40, 261-274 (2020).

Fitzgerald, K., Pit, S.W., Rolfe, M., McKenzie, J., Matthews, V., Longman, J, & Bailie, R. Cross sectional analysis of depression amongst Australian business owners following cyclone-related floods. J Occup Med Toxicol 15, 12 (2020).

Fitzpatrick, M., Garsia, K., Eyre, K, Blackhall, C., & Pit, S.W. Emotional exhaustion among regional doctors in training and the application of international guidelines on sustainable employability management for organisations. Aust Health Rev 44, 609-617 (2020).

Holtzhausen, N., Fitzgerald, K., Thakur, I., Ashley, J., Rolfe, M., Pit, S.W. (2020) Swipe-based dating applications use and its association with mental health: A cross-sectional study. BMC Psych 18, 22 (2020).

Valiukas S, Pickering M J, Hall T G, Seneviratne N, Aitken A, John-Leader F, & Pit S.W. (2019) Sexting and mental health among young Australians attending a music festival: a cross sextional study. Cyberpsychol Behav Soc Netw 22, 521-528. (2019),

Southey, M., Rees, T., Rolfe, M., Pit, S.W. (2019) An evaluation of the Maintenance To Abstinence (MTA) Program in achieving abstinence in opioid users and improving mental health and quality of life. Addict Sci Clin Pract 14, 4 (2019)

Fernando, M., Buckland J., Melwani, P., Tent, V., Preston, P., & Pit, S.W.Perceived driving safety and estimated blood alcohol concentration the morning after drinking amongst young Australians attending a music festival: A cross-sectional survey. Subst Abuse Treat Prev Policy 13, 25 (2018).

De Silva, T., Prakash, A., Yarlagadda, K., Johns, M., Sandy, K., Hansen, V. Phelan, S, & Pit, S.W. General practitioners’ experiences and perceptions of mild moderate depression management and factors influencing effective service delivery in rural Australian communities: a qualitative study. Int J Ment Health Syst, 11, 54 (2017).

Knox, M.C., Garner, A., Dyason, A., Pearson, T., & Pit, S.W. Qualitative investigation of the reasons behind opposition to water fluoridation in regional NSW, Australia. Public Health Res Pract 27,(1):e2711772 (2017).

Hall, K., Brieger,D.G.,Pfister, B.F., Youlden, D., De Silva, S., John-Leader, F., & Pit, S.W. Errors and Predictors of Confidence in Condom Use amongst Young Australians Attending a Music Festival,” J Sex Transm Dis 2016, 6054870 (2016).



PDF of case studies available here: Research in the Medical Curriculum, Volume 1 – A window on innovation and good practice 2022