Researching researchers: A system dynamics view on researchers’ methodological choice within the medical field

Abstract

Objective: As healthcare shifts toward individual oriented care, the call for a shift in thinking within evidence-based medicine has spotlighted the increasing need for novel methods in the medical research field. This study aims to model the perceived structure, feedback mechanisms, and main drivers behind medical researchers’ methodological choices. Methods: A qualitative system dynamics approach was used to analyze and connect interacting factors from eleven semi structured interviews. A causal loop diagram was constructed to identify the structure and feedback loops driving researchers’ methodological choice. Results: The resulting causal loop diagram was divided into four sections: Method exposure, method acceptance, method funding, and funding subsystem. Ten reinforcing feedback loops were identified. A system archetype called the “success to the successful” was identified in the funding subsystem. Main drivers include funding, the evidence hierarchy, exploring the topic, line of research, and the pressure to publish. Conclusion: The reinforcing feedback loops allow for circumstances to arise where one method develops over another through its exposure, acceptance, and funding. Methodologies without funding may still develop, but in a delayed way. Healthcare institutions wanting to facilitate novel methods can implement policies which relieve the pressure to publish in high impact journals and offer funding opportunities.