As mentioned, as metrics developed, researchers have identified indicators to capture "an effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia" (REF 2014). As detailed in Table 1 of the paper (email farah.friesen@unityhealth.to if your institution does not have access), these include metrics from many fields, such as health services and policy (Kuruvilla), biomedical sciences (Becker; Sarli), management (Aguinis), arts-based health research (Parsons), humanities & social sciences (HUMetrics), and research evaluation (Morton).

These works suggest new metrics and yet HPE might still look unproductive if using them (e.g. patents, quality of life, cost-effectiveness). It is not that health professions educators and researchers are unproductive, but that these metrics