Diversity in health professional education scholarship: a document analysis of international author representation in leading journals

OBJECTIVES: The global distribution of health professionals and associated training programmes is wide but prior study has demonstrated reported scholarship of teaching and learning arises from predominantly Western perspectives. DESIGN: We conducted a document analysis to examine authorship of recent publications to explore current international representation. DATA SOURCES: The table of contents of seven high-impact English-language health professional education journals between 2008 and 2018 was extracted from Embase. ELIGIBILITY CRITERIA: The journals were selected according to highest aggregate ranking across specific scientific impact indices and stating health professional education in scope; only original research and review articles from these publications were included for analysis. DATA EXTRACTION AND SYNTHESIS: The table of contents was extracted and eligible publications screened by independent reviewers who further characterised the geographic affiliations of the publishing research teams and study settings (if applicable). RESULTS: A total 12 018 titles were screened and 7793 (64.8%) articles included. Most were collaborations (7048, 90.4%) conducted by authors from single geographic regions (5851, 86%). Single-region teams were most often formed from countries in North America (56%), Northern Europe (14%) or Western Europe (10%). Overall lead authorship from Asian, African or South American regions was less than 15%, 5% and 1%, respectively. Geographic representation varied somewhat by journal, but not across time. CONCLUSIONS: Diversity in health professional education scholarship, as marked by nation of authors’ professional affiliations, remains low. Under-representation of published research outside Global North regions limits dissemination of novel ideas resulting in unidirectional flow of experiences and a concentrated worldview of teaching and learning.