Authors' reply to Sharp and Curlewis, Ahmed and colleagues, and Sreeharan

We agree with Sharp and Curlewis that all healthcare students, including medical students, should learn to be critical readers and users of research; few students will want or need to be able to lead research (“doers”). We waste students’ time and serve them poorly by assuming that teaching them all to be doers will make them good users.

Our experience is the reverse: teaching all healthcare students and workers to be proficient users of research is essential to them all and is a great start for the few who will become doers. And ideally the doers should learn about good—and poor—research from critical appraisal, ideally by doing at least one systematic review and by working with experienced researchers, as in the STARSurg multicentre research model.

As pointed out by Ahmed and colleagues and Sreeharan, change will require reduced incentives—for students and academics—to publish what they refer to as “low level publications.” Incentives to publish can undermine incentives to “research for the right reasons,” as Doug Altman said. Poor research is not simply a waste in itself; it also distracts and distorts our institutional, clinical, and publication systems for doing research for the right reasons.