Accepted for publication in Medical Teacher Saudi

1 2

Original article

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

Why the research productivity of medical faculty declines after attaining professor rank? A multicenter study from Saudi Arabia, Malaysia and Pakistan From The College of Medicine Taibah University Almadinah Almunawwarah Kingdom of Saudi Arabia Authors 1. Professor Salman Yousuf. Guraya FRCS, Masters MedEd (Dundee) Professor of surgery and consultant colorectal surgeon Department of Surgery, College of medicine Taibah University Almadinah Almunawwarah Saudi Arabia Email; [email protected] 2. Prof. Khalid Ibrahim Khoshhal FRCS ED, ABOS Professor of orthopedic surgery and consultant pediatric orthopedic surgeon Department of orthopedic surgery, College of medicine Vice rector for research graduate affairs Taibah University Almadinah Almunawwarah Saudi Arabia Email; [email protected] 3. Dr. Muhamad Saiful Bahri Yusoff, MMEd, PhD Chairman, Medical Education Department School of Medical Sciences Universiti Sains Malaysia Kelantan, Malaysia Email; [email protected] 4. Prof Maroof Aziz Khan FRCS Professor of ENT and Head & Neck Surgery, King Edward Medical University, Lahore, Pakistan Email; [email protected] Corresponding author Professor Salman Y. Guraya FRCS, Masters MedEd (Dundee) Professor of surgery and consultant colorectal surgeon Department of Surgery, College of medicine Taibah University Almadinah Almunawwarah Saudi Arabia Email; [email protected]

47 Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

48

Abstract

49

Objectives: Research has shown a fall of research productivity of faculty members after their

50

promotion to the rank of professor. This study explores the factors that lead to this decline in research

51

productivity of professors in medical discipline with some remedial solutions.

52

Methods: This cross-sectional survey-based study was conducted using a 20-item questionnaire that

53

was distributed online to the medical professors of Taibah University Saudi Arabia, University Sains

54

Malaysia, and King Edward Medical University Pakistan. The participants were instructed to select

55

their responses on a 5-point Likert’s scale and the collected data was analyzed by the Statistical

56

Package for Social Sciences (SPSS) version 20 and NVIVO software for quantitative and qualitative

57

results.

58

Results: Of 161, 110 responded (response rate of 68.3 %), highest age range being 51-55 years. About

59

35% professors spent 1-4 hours and 2% spent 19-25 hours per week for research. As many as 7% did

60

not publish a single article and 29% had published 10 or more articles after attaining professor rank.

61

During the last two years, 44% professors had published 5 or more research articles. Mean ranks scores

62

for ‘I schedule time each week for my research’ and ‘I often collaborate with colleagues outside my

63

university on research projects’ showed significant variations, p values 0.04 and 0.03, respectively.

64

Majority pointed out the lack of research support and funds, administrative burden, and difficulty in

65

data collection as the main obstacles to their research.

66

Conclusion: This research has identified time constraints and insufficient support for research as key

67

barriers to medical professors’ research productivity. Financial and technical support, institutional

68

collaboration and lesser administrative work load are some suggested remedies to foster the professors’

69

research output.

70

Keywords; Research productivity; Professors; Academic promotions; Tenure; Promotions incentives


72

1. Introduction

73

Research and publications are perceived to be the Achilles heal of academia. In nearly all disciplines

74

and institutions, research plays a key role in recruiting and maintaining tenure, academic promotions,

75

and salary decisions (1). A tenure candidate’s excellent research productivity and impact can counter

76

balance poor teaching and administrative performance. This has been observed that scholarly

77

productivity is an accurate measure that can index faculty achievement and institutional prestige (2).

78

High profile and elite institutions tend to recruit truly eminent researchers and writers who are hired

79

after achieving eminence elsewhere. This phenomenon signals that ﬁnancial prowess, rather than

80

institutional climate, counts towards the institutional research-based stature (3). Nevertheless, its hard

81

to quantify the extent to which certain institutions cultivate a climate that facilitates scholarship by the

82

hired talented researchers and to what extent the permanent faculty contributes to research productivity

83

(4).

84

Based on life-long training and scholarships, academia from all disciplines should pursue their research

85

and publishing activities throughout their careers and achieving tenure should have little impact on

86

their subsequent scholarships (5). According to the hierarchical structure of the academic promotions,

87

each successful application is rewarded by a promotion typically linked with an upgrade of salary and

88

ranking (6). Historically, the required eligibility criteria for academic promotions include research

89

productivity, educational attainment, teaching experience, and community services (7). Of these,

90

research productivity of faculty members is the core criterion in determining academic promotions in

91

many institutions.

92

Research has shown that faculty members tend to cease their research and publication conventions

93

about 10 years after the start of their academic career, perhaps after achieving their desired promotions

94

(8) (9). Several studies have reported a striking post-tenure drop of research productivity of faculty

95

members of various disciplines including medicine (10) (11) (12). As professor rank is the life-time

Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

96

achievement scholarship and these faculty members are capable of delivering their professional

97

expertise with excellence and authority. Nevertheless, a striking fall in research output undermines

98

their utility of professors who are holding influential positions in the highest tier of professional

99

rankings (13). However, there is a dearth of literature and scarcity of information about the key reasons

100

that deter professors, particularly in medical field, from maintaining the same pre-tenure pace of

101

research productivity after they attain the professor ranks (14).

102

This paper aimed to identify the factors that lead to a fall in research productivity of professors of

103

medical faculties of a Saudi, a Malaysian and a Pakistani medical school. This would help to determine

104

the regional variations in research productivity and to suggest some remedies that can foster research

105

output in medical field.

106 107 108 109 110 111 112 113 114 115 116 117


118

2. Materials and methods

119

A single-stage survey-based randomized study was conducted, in November 2015, using a self-

120

administrative English language validated questionnaire that was administered by SurveyMonkey to

121

the professors of medical faculties of Taibah University (TU), University Sains Malaysia (USM), and

122

King Edward Medical University (KEMU). The TU medical faculty has a diverse multi-cultural

123

environment that represents academics from Egypt, Pakistan, Jordan, Sudan, Saudi Arabia, Canada and

124

USA. TU delivers a competency-based PBL integrated curriculum. The School of Medical Sciences of

125

USM is the first Malaysian medical school that adopted an innovative PBL curriculum, featuring

126

integration of several disciplines from year one with main emphasis on community engagement. This

127

institution has adopted an innovative, community-based PBL curriculum that follows SPICES (Student

128

oriented, Problem based, Integrated, Community oriented, Electives driven, Systematic) model.

129

Teaching is integrated in an organ-based spiral model with a problem-oriented format. KEMU is

130

currently reforming the educational environment with a new integrated modular curriculum but the

131

research activities of faculty are hampered by lack of energy, resources and time allocated for research.

132

Ethical approval was obtained by the institutional review board.

133 134 135

The questionnaire contained close-ended as well as open-ended questions (Appendix 1) . The participants were asked to select their responses on a 5-point Likert’s scale; strongly agree, agree. don’t know, disagree, and strongly disagree.

136

Data analysis

137

The collected data was entered and analyzed by SPSS version 20 and NVIVO software. The

138

quantitative data analysis was performed by the non-parametric tests; chi-square, Mann-Whitney U and

139

Kruskal–Wallis tests. The chi-square goodness-of-fit test, a single-sample nonparametric test, was used

140

to determine the distribution of responses in a single categorical variable such as "strongly agree” or

141

“don’t know” or “strongly disagree”. The Mann-Whitney U and Kruskal–Wallis tests were applied to

142

exploring the variations among demographic variables; The Mann-Whitney U test analyzed variations

143

across two groups and Kruskal–Wallis test identified variations across more than two groups. The Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

144

qualitative analysis was done using the NVIVO software that generated new themes for further review.

145

Using NVIVO, reading the text by respondents was done by word query interface, then coding scheme

146

was developed by using word frequency tools, then word frequency count and tag cloud display output

147

was measured and finally text finding, searching and autocoding provided executive summary of

148

summarised codes. These codes were utilized in themes generation that are displayed in Figure 2.

149

A p value of less than 0.05 was considered to be significant.

150 151 152 153 154 155 156 157 158 159 160 161 162 163 164


165

3. Results

166

Of a total of 161, 110 responded (response rate of 68.3 %); 34 (31%) female and 76 (69%) male

167

respondents with highest age range of respondents being 51-55 years. There were 39 respondents from

168

TU, 37 from USM, and 34 from KEMU. Except for the two statements that were found to have

169

insignificant variations in responses, “I don't get motivated to do my research, as there is no incentive

170

from my institution” and “Before attaining professor title, all my research was promotion-oriented, all

171

other statements showed significant variations across three medical schools. (Table 1).

172

Figure 1 illustrates the research activities of professors after attaining the professor title. The majority

173

of respondents were promoted to professor rank in the last 1-10 years; 29% in 1-5 years and another

174

29% in 6-10 years. As many as 35% of respondents spend 1-4 hours per week and only 2% spent 19-25

175

hours per week on research. Concerning the research output, 55% had 26 or more research-based

176

publications before attaining professor title. In contrast, 7% did not publish a single article and 29%

177

published 10 or more articles after attaining professor rank. During the last two years, the majority of

178

respondents (44%) published about 5 peer-reviewed articles.

179

The reasons for the decline in research output after attaining professor rank across age groups using the

180

Kruskal–Wallis test is shown in Table 2. The professors with age range 41-45 years had significantly

181

higher mean rank for the statement “I schedule time each week for my research” as compared to other

182

age groups. Likewise, other statements with their respective higher mean ranks are highlighted in

183

Table 2. On the other hand, a comparison of reasons for the decline in research output across the three

184

medical schools is shown in Table 3. The USM staff had significantly higher mean rank for 3

185

statements, while those from TU showed two statements with statistically significant mean ranks

186

(Table 3).

187

The qualitative analysis for the open questions using the NVIVO program identified themes as

188

portrayed in Figure 2. The three key reasons for low research output as suggested by respondents were; Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

189

personal problems, lack of support (research assistants, skilled technicians, funds) and difficulty in data

190

collection. The three key driving forces that could motivate research activities were the financial and

191

technical support, effective collaboration among institutions and lesser administrative work load for

192

professors.

193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208


209

4. Discussion

210

The rank of ‘full’ professor reflects the attainment of professional training and expertise, perhaps with a

211

national or international authority. “While the triumvirate of teaching, research, and service still reigns

212

supreme in most faculty work-lives, the emphasis put on one aspect over another in the quest to attain

213

full professorship varies across institutions”(15). Although academics are intrinsically motivated in

214

pursuing their teaching, administrative, research, and service roles, the core pressing factor that

215

determines their academic promotions is research productivity. Nevertheless, the results of our study

216

have indicated that 35% of professors would spend 1-4 hours and only 2% would spend 19-25 hours

217

per week for research. This reflects that either the responding professors lost interest in research and its

218

related incentives or they were over-burdened by teaching and administrative responsibilities. The low

219

input for research was further confirmed by the finding that while 55% respondents had published 26 or

220

more articles before attaining professor rank, 7% did not publish a single article and 29% had published

221

10 or more articles after attaining professor rank. Lastly, during the last two years 44% had published 5

222

or more peer-reviewed articles. These findings resonate with the conclusions deduced by McPherson et

223

al. who found that the quality of economics faculty members’ publications decreased with programme

224

ranking (16). Those promoted to professor generated fewer top-ten and total articles. However, there is

225

scarcity of published data from the medical discipline that can validate such findings.

226

The findings of this study draw attention to the differences in the weekly and monthly workload

227

allocated for faculty members across institutions. All three institutions have no clear regulatory role for

228

faculty members in terms of time allocated for research, administration and teaching. A study by

229

Crespo and Bertrand has proposed a typical average weekly workload of 56.97 hours; 44.1% for

230

teaching, 35.2% research, 14.8% public service, and 5.8% for administrative roles (17). However, there

231

were very little differences of workload by ranks and gender. Furthermore, this average weekly

232

workload is not uniform as it primarily depends on institutional and regional dynamics. According to a

233

study by Enders and Teichler, Dutch professors work 57 hours per week, German professors 53 hours, Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

234

US 46 to 52 hours, and British professors work for 50 to 52 hours with an average weekly workload of

235

48.4 hours for the tenured faculty (18). Interestingly, professors from all institutions were not satisfied

236

by the time allocated for research as other roles were given priority by administration. Another study

237

by Link et al. has shown the differences in workload by academic rank (19). The investigators found

238

that full professors spent more time on service at the expense of teaching and research; whereas

239

associate professors spent more time on teaching than research. Tenured faculty allocated lesser time to

240

research, teaching, and grant writing and more time to service.

241

In the present study, except for the factors “I don't get motivated to do my research, as there is no

242

incentive from my institution” and “Before attaining professor title, all my research was promotion-

243

oriented”, all other statements reported significant variations from three schools. The results of the

244

Kruskal–Wallis test showed that the professors with age range 41-45 years had significantly higher

245

mean rank for the statement “I schedule time each week for my research” as compared to other age

246

groups. Furthermore, “My age is not allowing me to spend more time on research” showed significant

247

p value of 0.00 and this may signal the need to inculcate a culture of research training and development

248

in younger faculties who can be more energetic and productive than their older counterparts (20) (21).

249

On the other hand, ageing but experienced faculty should also be given sufficient support for their well-

250

being and fitness to work.

251

Our study showed variations in opinions of professors from three schools. The USM staff had

252

significant mean rank of 60.56 for “Before attaining professor title, all my research was promotion

253

oriented” (p 0.00). On the other hand, TU professors marked highest mean rank of 60.08 for “Before

254

attaining professor title, all my research was promotion oriented” (p 0.00). Surprisingly, KEMU

255

professors did not score significant mean rank for any statement. Such dissimilarities reflect differences

256

in institutional characteristics, available resources, and research-driven motivational incentives. We

257

identified three major factors that could potentially lead to low research output; personal problems, lack

258

of research support (research assistants, skilled technicians, funds) and difficulty in data collection. Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

259

Time allocated for research is a major issue for all faculty staff as they have other important roles as

260

teachers and administrators (22). Bland et al. stated that “sufficient time, intrinsic motivation, formal

261

mentorship, research-oriented culture, and a network of external colleagues are associated with greater

262

research productivity” (23). Another group of researchers have shown that the most common support

263

from the medical schools deans was verbal encouragement (24). In their study, insufficient time for

264

research and publications was shown to be the most important barrier to research productivity by

265

faculty professors. Ma and Runyon have published similar results and further deduced that faculty

266

collaboration and interprofessional practice could provide some spare time for research, especially

267

among the new academia (25). Again, we could not find sufficient number of published reports about

268

the medical disciplines.

269

The respondents in our study have recommended the provision of financial and technical support,

270

effective collaboration and lesser administrative work load as the primary factors that can enhance the

271

research productivity and its impact on the institutional ranking and prestige. This has also been shown

272

that when senior professors are delegated to supervise research projects, they lose the spirit and vigor to

273

produce quality research and go into a static and dormant state (26). Faculty development programs

274

(27), faculty engagements in research (28) and training (29), and encouraging the usage of modern

275

digital technologies in research (30) are other factors that can facilitate research environment in the

276

medical faculties.

277 278 279 280 281 282 Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

283

5. Study limitations

284

To the authors’ knowledge, this is the first study that has captured the perceptions of medical

285

professors about their low research productivity in three medical schools of Saudi Arabia, Malaysia and

286

Pakistan. However, further studies are needed to validate our findings and to compare the situation in

287

medical discipline with other fields. Furthermore, the authors assumed that the non-respondents would

288

have responded in the same way as those who did, which is not right. This could have been fixed by

289

pilot surveying the non-respondents and comparing their responses to the respondents.

290 291

6. Conclusion

292

There is a great variation in the reported workload and time spent for research by the medical

293

professors in this study. It varies from one country to the other and within the same institution. There

294

are some similarities and some dissimilarities by gender, age group, and institution for the research

295

productivity across the studied Saudi, Malaysian, and Pakistani medical colleges. While these

296

differences in research profile of medical professors may be reflected by specific institutional

297

characteristics and service demands, there is uniformly low research productivity by medical

298

professors. This research reiterates that the medical faculty research is incentive-oriented, mainly

299

focused on academic promotions, till the attainment of professor rank. The faculty feels contend after

300

attaining the lucrative title of professor and, despite being the most seasoned and experienced

301

professionals, show reluctance to active research avenues. Lack of time, inadequate institutional

302

support and collaboration, and indulgence in more administrative work account for assigning low

303

priority to research portfolios. This is point to ponder by educators. In parallel with the practice

304

implemented for getting and maintaining accreditations and certifications, a similar protocol can be

305

enforced for the professor recruitment and maintenance in institutions.


307

7. Authors ‘contributions

308

KIK conceived the idea and reviewed the initial and final draft. SYG conducted survey, collected and

309

analyzed data and wrote and revised all drafts. MSY provided the USM participants’ contacts and

310

revised the first and final drafts. MAK provided the KEMU participants’ contacts and revised the first

311

and final drafts. All authors approved the final draft of manuscript.

312

8. Acknowledgement

313

Authors are deeply thankful to all participants from Saudi Arabia, Malaysia and Pakistan for providing

314

their insightful feedback and opinions that made this research possible. We are also grateful to the

315

Research center of the College of Medicine TU for supporting this research.

316

Conflict of interests

317

No interests declared

318

References

319 320 321

1. Salem RO, Al-Mously N, Nabil NM, Al-Zalabani AH, Al-Dhawi AF, Al-Hamdan N. Academic and socio-demographic factors influencing students’ performance in a new Saudi medical school. Medical teacher. 2013;35(sup1):S83-S9.

322 323 324

2. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of internal medicine. 2009;151(4):W-65-W-94.

325 326

3. Kumar S, Zayapragassarazan Z. Electives in Graduate Medical Education. Online Submission. 2013;20(1):2-3.

327 328 329

4. Hamdy H, Telmesani A, Al Wardy N, Abdel-Khalek N, Carruthers G, Hassan F, et al. Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 1). Medical teacher. 2010;32(3):219-24.

330 331 332

5. Leary H, Walker A, Shelton BE, Fitt MH. Exploring the relationships between tutor background, tutor training, and student learning: a problem-based learning meta-analysis. Interdisciplinary Journal of Problem-based Learning. 2013;7(1):6.

333 334 335

6. Hmelo-Silver CE, Duncan RG, Chinn CA. Scaffolding and achievement in problem-based and inquiry learning: A response to Kirschner, Sweller, and Clark (2006). Educational psychologist. 2007;42(2):99-107.

336 337

7. Barrows HS. A taxonomy of problem‐based learning methods. Medical education. 1986;20(6):481-6. Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

338 339

8. Guraya SY, Almaramhy HH. Small group teaching improves students’ acquisition of knowledge and skills. Saudi medical journal. 2012;33(12):1304-9.

340 341

9. Khoshhal KI, Guraya SS, Almunawwarah A. Time to Change the Undergraduate Curriculum at the College of Medicine, Taibah University in Terms of SPICES Model.

342 343

10. Harden RM, Sowden S, Dunn WR. Educational strategies in curriculum development: the SPICES model. Medical education. 1984;18(4):284-97.

344 345

11. Worley P, Silagy C, Prideaux D, Newble D, Jones A. The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice. Medical education. 2000;34(7):558-65.

346 347

12. Mahoney S, Walters L, Ash J. Urban community based medical education: General practice at the core of a new approach to teaching medical students. Australian family physician. 2012;41(8):631.

348 349

13. Gulbrandsen M, Smeby J-C. Industry funding and university professors’ research performance. Research policy. 2005;34(6):932-50.

350 351 352

14. Paik AM, Mady LJ, Villanueva NL, Goljo E, Svider PF, Ciminello F, et al. Research productivity and gender disparities: a look at academic plastic surgery. Journal of surgical education. 2014;71(4):593-600.

353 354

15. Guraya SY, Norman RI, Roff S. Exploring the climates of undergraduate professionalism in a Saudi and a UK medical school. Medical teacher. 2016:1-3.

355 356

16. Taylor D, Miflin B. Problem-based learning: where are we now? Medical teacher. 2008;30(8):742-63.

357 358

17. Johnson B, Pyburn R, Bolan C, Byrne C, Jewesson P, Robertson-Malt S, et al. Qatar Interprofessional Health Council: IPE for Qatar. Avicenna. 2011(2011):2.

359 360

18. Azer SA. Problem-based learning. Challenges, barriers and outcome issues. Saudi medical journal. 2001;22(5):389-97.

361

19.

362 363

20. Barrows HS, Tamblyn RM. The portable patient problem pack: a problem-based learning unit. Academic Medicine. 1977;52(12):1002-4.

364 365 366

21. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews. 2015;4(1):1.

367 368

22. Baker PG. Framework for action on interprofessional education and collaborative practice. 2010.

369 370

23. Reeves S, Goldman J, Oandasan I. Key factors in planning and implementing interprofessional education in health care settings. Journal of Allied Health. 2007;36(4):231-5.

371 372

24. Cusack T, O'Donoghue G. The introduction of an interprofessional education module: students' perceptions. Quality in primary care. 2012;20(3):231-8.

373 374

25. Zanotti R, Sartor G, Canova C. Effectiveness of interprofessional education by on-field training for medical students, with a pre-post design. BMC medical education. 2015;15(1):1.

375 376

26. Seifert Jr WE, Cleary LJ, Strobel HW. Issues in obtaining promotion. Med Sci Educ. 2015;25:75-9.

377 378

27. Horsburgh M, Lamdin R, Williamson E. Multiprofessional learning: the attitudes of medical, nursing and pharmacy students to shared learning. Medical education. 2001;35(9):876-83.

Hamdy H. The fuzzy world of problem based learning. Medical teacher. 2008;30(8):739-41.


379 380

28. Freeth D, Reeves S. Learning to work together: using the presage, process, product (3P) model to highlight decisions and possibilities. Journal of interprofessional care. 2004;18(1):43-56.

381 382

29. Freeth D, Reeves S, Koppel I, Hammick M, Barr H. Evaluating interprofessional education: A self-help guide. 2005.

383 384

30. Williams B, Webb V. Examining the measurement properties of the Interdisciplinary Education Perception Scale (IEPS) in paramedic education. Nurse education today. 2013;33(9):981-5.

385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412


413

Table 1:

The reasons for the decline in research output after attaining professor rank as

414

analyzed by Chi-square goodness-of-fit test (N= 110)

Answer Options

SD

D

N

A

SA

Mean

Chi-Square

Asymp. Sig.

6

20

8

24

36

3.68

32.170

0.000*

I schedule time each week for my research

8

24

14

26

22

3.32

12.170

0.016**

I am currently active in research

4

6

8

46

30

3.98

72.596

0.000*

18

18

10

30

18

3.13

10.894

0.028**

6

20

14

38

16

3.40

36.426

0.000*

2

6

6

54

26

4.02

101.106

0.000*

6

12

10

38

28

3.74

41.213

0.000*

20

22

16

20

16

2.89

1.532

0.821

8

12

14

40

20

3.55

33.872

0.000*

22

18

14

24

16

2.94

3.660

0.454

8

22

18

36

10

3.19

26.638

0.000*

10

34

10

20

20

3.06

20.681

0.000*

I have not taken a break from research after being promoted to full professor

More job responsibilities have not affected my time for conducting research I get feedback on my research from researchers outside my university I often collaborate with my university colleagues on research projects I often collaborate with colleagues outside my university on research projects I don't get motivated to do my research, as there is no incentive from my institution I would have a better research output if I had fewer administrative duties Before attaining professor title, all my research was promotion oriented Lack of modern research skills have negatively affected my research output Overloaded teaching schedules restrict and reduce the time available to conduct research


Overloaded administration schedules restrict and 6

20

12

38

18

3.45

30.894

0.000*

0

10

14

42

28

3.94

27.021b

0.000*

10

28

12

32

10

3.04

24.957

0.000*

12

38

14

26

4

2.70

37.702

0.000*

52

28

4

4

2

1.62

105.778

0.000*

54

28

4

2

6

1.70

105.787

0.000*

38

36

4

12

4

2.02

61.106

0.000*

44

30

10

4

6

1.91

64.936

0.000*

reduce the time available to conduct research Difficulty in accessing research funds has adversely affected my research output Mentoring and supervision of students reduce the time available to conduct research Mentoring and supervision of colleagues reduce the time available to conduct research My health is not allowing me to spend more time on research My age is not allowing me to spend more time on research My social and personal issues restrict my research output Being full professor, I don't prioritize researchbased activities anymore

415

Note: Here SD stands for strongly disagree, D for disagree, N for neutral, A for agree, and SA for

416

strongly agree. * and ** represent variable significant at 1% and 5% level of significance.

417 418 419 420 421 422 423 Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

424

Figure 1: The pictorial presentations of professors’ research output before and after attaining the

425

professor rank (N=110) Since how many years you have been promoted to full professor? 7% 2%

How many hours per week do you dedicate to research, writing and publishing activities?

0% 0 1-5

18%

4%

2% 7% 7%

0 1-4

6-10

15%

11-15

29%

29%

18%

5-7

35%

8-12

16-20

13-18

27%

21-25

19-25

over 25

How many peer-reviewed articles have you published before attaining the professor title?

How many peer-reviewed articles have you published after attaining professor title?

7%

7%

9% 18%

55%

11%

11-15

16% 44% 20% 16%

29%

18%

21--25

20%

26%

How many peer-reviewed researchbased manuscripts did you submit to a journal, in the last year?

0

27%

13%

5 or more

0 1

2 3-4

5-10 10 or more

26 or more

1

1-2 3-5

16-20

How many peer-reviewed articles have you published in the last two years?

4%

0

5-10

22% 18%

2 3-4

20%


5 or more

427

Table 2: Factors causing the decline of research productivity after attaining professor rank

428

across age groups (N=110)

Answer Options

41-45

46-50

51-55

Above

Kruskal–

Asymp.

60

Wallis

Sig.

56-60

I have not taken a break from research 52.00

42.40

40.75

39.17

58.50

5.14

0.27

65.50

42.77

45.70

25.17

56.50

19.48

≤ 0.001*

56.00

39.95

43.77

36.06

56.50

7.43

0.12

32.50

36.41

50.70

39.72

55.50

8.55

0.07***

54.75

29.50

46.77

37.28

72.50

22.66

≤ 0.001*

55.00

37.14

40.30

42.28

64.25

11.51

0.02**

57.00

44.95

37.83

39.17

57.00

7.59

0.11

37.50

46.23

40.97

45.94

46.00

1.34

0.85

63.00

46.86

38.17

46.39

28.25

10.75

0.03**

36.75

36.86

47.77

54.28

28.25

9.84

0.04**

after being promoted to full professor I schedule time each week for my research I am currently active in research More job responsibilities have not affected my time for conducting research I get feedback on my research from researchers outside my university I often collaborate with my university colleagues on research projects I often collaborate with colleagues outside my university on research projects I don't get motivated to do my research, as there is no incentive from my institution I would have a better research output if I had fewer administrative duties Before attaining professor title, all my research was promotion oriented


Lack of modern research skills have negatively affected my research

46.50

45.68

38.30

52.17

34.50

5.22

0.27

59.25

36.23

44.03

45.50

41.25

5.62

0.23

55.25

51.86

38.03

40.28

36.50

7.18

0.13

50.50

49.95

39.77

42.61

34.75

4.32

0.36

36.25

41.14

43.14

49.17

35.25

2.86

0.58

42.00

42.77

48.23

41.83

33.00

2.84

0.59

41.50

36.20

42.86

53.28

23.50

12.70

0.01**

47.50

34.86

44.57

58.94

24.50

18.21

≤ 0.001*

46.75

42.50

38.10

53.61

40.50

5.25

0.26

37.50

38.68

44.90

59.94

20.50

18.50

≤ 0.001*

8.50

28.95

50.17

51.94

70.83

38.76

≤ 0.001*

output Overloaded teaching schedules restrict and reduce the time available to conduct research Overloaded administration schedules restrict and reduce the time available to conduct research Difficulty in accessing research funds has adversely affected my research output Mentoring and supervision of students reduce the time available to conduct research Mentoring and supervision of colleagues reduce the time available to conduct research My health is not allowing me to spend more time on research My age is not allowing me to spend more time on research My social and personal issues restrict my research output Being full professor, I don't prioritize research-based activities anymore Since how many years you have been


promoted to full professor? How many hours per week do you dedicate to research, writing and

57.75

36.86

47.57

30.50

53.50

12.12

0.02**

37.25

43.86

46.70

38.50

35.50

2.79

0.59

38.00

31.59

47.83

40.83

66.83

12.88

0.01**

50.75

46.23

40.30

33.50

55.83

6.74

0.15

51.00

48.95

42.43

24.61

61.50

16.60

≤ 0.001*

publishing activities? How many peer-reviewed articles have you published before attaining the professor title? How many peer-reviewed articles have you published after attaining professor title? How many peer-reviewed articles have you published in the last two years? How many peer-reviewed researchbased manuscripts did you submit to a journal, in the last year?

429

Note: Here mean ranks of different levels of age group shown in column 2-6. While *, ** and ***

430

represents variable significant at 1%. 5% and 10% level of significance.

431 432 433 434 435 436 437 Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

438

Table 3: The variations in the reasons for decline of research productivity after attaining

439

professor rank across different centres (N=110) Answer Options

TU

USM

KEMU

Kruskal–Wallis

I have not taken a break from research

Asymp. Sig.

46.46

55.94

20.75

11.82

≤ 0.001*

45.12

52.91

40.00

2.48

0.29

45.69

53.26

34.75

4.11

0.13

50.73

44.44

39.50

1.95

0.38

49.27

51.09

20.75

9.28

0.01**

41.04

60.56

34.00

16.06

≤ 0.001*

46.19

49.62

47.00

0.36

0.84

51.00

41.68

49.50

2.56

0.28

46.00

52.68

35.25

3.30

0.19

60.08

29.03

44.25

28.00

≤ 0.001*

45.65

47.26

60.50

2.23

0.33

after being promoted to full professor I schedule time each week for my research I am currently active in research More job responsibilities have not affected

my

time

for

conducting

research I get feedback on my research from researchers outside my university I often collaborate with my university colleagues on research projects I often collaborate with colleagues outside my university on research projects I don't get motivated to do my research, as there is no incentive from my institution I would have a better research output if I had fewer administrative duties Before attaining professor title, all my research was promotion oriented Lack of modern research skills have


negatively affected my research output Overloaded teaching schedules restrict and reduce the time available to conduct

45.50

49.62

51.50

0.71

0.70

43.85

54.62

41.00

4.05

0.13

46.46

49.15

47.25

0.23

0.89

48.82

43.32

45.50

0.94

0.63

45.23

46.62

66.00

4.49

0.11

43.88

46.69

53.17

1.01

0.61

45.77

46.68

62.25

3.29

0.19

44.81

47.85

63.50

3.73

0.16

50.88

40.50

55.25

4.27

0.12

53.79

34.50

42.50

11.64

≤ 0.001*

43.71

50.15

36.50

2.42

0.30

research Overloaded

administration

schedules

restrict and reduce the time available to conduct research Difficulty in accessing research funds has adversely affected my research output Mentoring and supervision of students reduce the time available to conduct research Mentoring and supervision of colleagues reduce the time available to conduct research My health is not allowing me to spend more time on research My age is not allowing me to spend more time on research My social and personal issues restrict my research output Being full professor, I don't prioritize research-based activities anymore Since how many years you have been promoted to full professor? How many hours per week do you


dedicate

to

research,

writing

and

publishing activities? How many peer-reviewed articles have you published before attaining the

41.58

51.38

44.00

3.45

0.18

45.83

49.91

24.75

6.39

0.04**

36.17

59.44

42.25

17.77

≤ 0.001*

36.25

59.62

41.00

16.96

≤ 0.001*

professor title? How many peer-reviewed articles have you published after attaining professor title? How many peer-reviewed articles have you published in the last two years? How many peer-reviewed researchbased manuscripts did you submit to a journal, in the last year?

440

Note: Columns 2-4 mean ranks for TU, USM, and KEMU. * and ** represents variable significant at

441

1% and 5% level of significance.

442


443 444

Figure 2: Qualitative analysis by NVIVO showing themes causing fall of research productivity Personal problems

Difficulty in data collection

Work load

Difficulty in getting research grant

Weak research infrastructure

Supervision of students

Publication in areas of interest

Career promotion

Amanah

Exposure and CV up gradation

Lack of research assistants, skilled technicians

Students, labs and funds Self-motivation

Universities support and collaboration

Factors affecting research output

Research for research

Driving force

Professor’s research output

Suggestions to enhance research

Improve research infrastructure

Reduce work load by assigning admin work to junior staff

Research grant

Publish or retire

Availability of research assistants

Less red tape from upper management

Encourage M.Sc. /Ph.D. studies

Government support


Effective collaboration Track record of faculty every 6 months

445

Appendix 1;

446

* What is your gender?

447 448 449 450 451 452 453 454 455 456 457

o Female o Male * What is your age? o o o o o o

35-40 41-45 46-50 51-55 56-60 >60

Q3. Please provide with your honest opinion about the questions asked hereafter 1=Strongly Disagree 2=Disagree

3=Neutral

4=Agree

5=Strongly Agree

Statement I have not taken a break from research after being promoted to full professor I schedule time each week for my research I am currently active in research More job responsibilities have not affected my time for conducting research I get feedback on my research from researchers outside my university I often collaborate with my university colleagues on research projects I often collaborate with colleagues outside my university on research projects I don't get motivated to do my research, as there is no incentive from my institution I would have a better research output if I had fewer administrative duties Before attaining professor title, all my research was promotion oriented Lack of modern research skills have negatively affected my research output Overloaded teaching schedules restrict and reduce the time available to conduct research Overloaded administration schedules restrict and reduce the time available to conduct research Difficulty in accessing research funds has adversely affected my research output Mentoring and supervision of students reduce the time available to conduct research Mentoring and supervision of colleagues reduce the time available to conduct research My health is not allowing me to spend more time on research My age is not allowing me to spend more time on research My social and personal issues restrict my research output Being full professor, I don't prioritize research-based activities anymore


1 2 3 4

5

459 460 461 462 463 464 465 466

Q4. Since how many years you have been promoted to full professor? o 0 o 1-5 o 6-10 o 11-15 o 16-20 o 21-25 o over 25

467 468 469 470 471 472 473 474

Q5. How many hours per week do you dedicate to research, writing and publishing activities? o 0 o 1-4 o 5-7 o 8-12 o 13-18 o 19-25 o over 25

475

Q6. How many peer-reviewed articles have you published before attaining the professor title?

476 477 478 479 480

o o o o o

5-10 11-15 16-20 21-25 26 or more

481 482 483 484 485 486

Q7. How many peer-reviewed articles have you published after attaining professor title? o 0 o 1-2 o 3-5 o 6-10 o over 10

487 488 489 490 491 492

Q8. How many peer-reviewed articles have you published in the last two years? o 0 o 1 o 2 o 3-4 o 5 or more

493 494 495 496 497 498 499

Q9. How many peer-reviewed research-based manuscripts did you submit to a journal, in the last year? o 0 o 1 o 2 o 3-4 o 5 or more


501 502 503 504 505

Q10. Please provide any other reason which you might think has affected your research output after attaining professor title positively or negatively.

506

Q11. If you are still doing substantial research, please mention the main driving force.

507 508 509 510 511 512 513 514 515 516 517 518

Q12. What do you think is more important in encouraging researchers to do research (please select three most important factors in your opinion): o o o o o o

Monetary reward Recognition Availability of research assistant Availability of research labs and equipment Availability of help in writing and statistics Any other reason which is not addressed before

Q13. What can you suggest to enhance research output of professors in their respective fields?

519 520 521 522 523 524 525 526 527 528 529 Accepted for publication in Medical Teacher Saudi Supplement on 06 Dec 2016

530

Practice points Research productivity of faculty members significantly declines after attaining the rank of professor Low research productivity by the most senior and experienced faculty of professors is deemed as a setback to institutional scientific stance Time constraints, insufficient support for research and collaboration, and administrative workload are key barriers to medical professors’ research productivity Financial and technical support, institutional collaboration and lesser administrative work can potentially foster the professors’ research output

531 532 533
