Lauren Dennis

Introduction: Inadequate scholarship is a common concern in graduate medical education. Many barriers to scholarship have been identified, but there are limited data on which are most important. A rank-order of barriers from learners’ perspectives would better enable programs to address perceived barriers. Methods: Given that learners are experts in their own perceptions, we applied the Delphi method of generating consensus expert opinion to construct ranked lists of physician-perceived barriers to scholarly activity at various sites. The survey was conducted within three separate health systems. Respondents were asked to identify their perceived barriers via free text and the listed barriers were consolidated by the research team. In the second round, respondents were presented with the consolidated lists and asked to rank them. In the third and final round, each respondent was shown a comparison of their own rankings to that of their peers and given an opportunity to make changes. Ranking differences between programs were compared using Rank Biased Overlap (RBO). Results: The Delphi method is a straightforward method to obtain a ranked list of perceived learner barriers to scholarly activity; its primary limitation is learner engagement and, of note in our study, high dropout rates. RBO is an effective method of ranking differences between programs and specialties. Top barriers across programs included time, overwhelm with the research process, and lack of interest or energy. Discussion: Several of the identified barriers may be addressed with enthusiastic mentors, streamlined administrative processes, and education. This could be done within a hospital system or on a national level through specialty organizations.