Strengthening Teachers' Professional Identities Through Faculty Development

"Teaching capital"- a sociological analysis of medical educator portfolios for promotion

Medical educator portfolios (MEP) are increasingly recognized as a tool for developing and documenting teaching performance in Health Professions Education. However, there is a need to better understand the complex interplay between institutional guidelines and how teachers decode those guidelines and assign value to teaching merits. To gain a deeper understanding of this dynamic, this study employed a sociological analysis to understand how medical educators aspiring to professorships use MEPs to display their teaching merits and how cultural capital is reflected in these artefacts. We collected 36 medical educator portfolios for promotion from a large research-intensive university and conducted a deductive content analysis using institutional guidelines that distinguished between mandatory (accounting for the total body of teaching conducted) and optional content (arguing for pedagogical choices and evidencing the quality, respectively). Our analysis showed that the portfolios primarily included quantifiable data about teaching activities, e.g., numbers of students, topics and classes taught. Notably, they often lacked evidence of quality and scholarship of teaching. Looking at these findings through a Bourdieusian lens revealed that teachers in this social field exchange objectified evidence of hours spent on teaching into teaching capital recognized by their institution. Our findings highlight how institutional guidelines for MEPs construct a pedagogical battlefield, where educators try to decode and exchange the "right" and recognized teaching capital. This indicates that MEPs reflect the norms and practices of the academic field more than individual teaching quality.

Alienation in the Teaching Hospital: How Physician Non-Greeting Behaviour Impacts Medical Students' Learning and Professional Identity Formation

Introduction

Clinical workplaces offer unrivalled learning opportunities if students get pedagogic and affective support that enables them to confidently participate and learn from clinical activities. If physicians do not greet new students, the learners are deprived of signals of social respect and inclusion. This study explored how physicians' non-greeting behaviour may impact medical students' participation, learning, and professional identity formation in clinical placements.

Methods

We analysed 16 senior Norwegian medical students' accounts of non-greeting behaviours among their physician supervisors in a reflexive thematic analysis of focus group interview data.

Results

The main themes were: A) Descriptions of non-greeting. Not being met with conduct signalling rapport, such as eye contact, saying hello, using names, or introducing students at the workplace, was perceived as non-greeting, and occurred across clinical learning contexts. B) Effects on workplace integration. Non-greeting was experienced as a rejection that hurt students' social confidence, created distance from the physician group, and could cause avoidance of certain workplace activities or specific medical specialties. C) Impact on learning. Non-greeting triggered avoidance and passivity, reluctance to ask questions or seek help or feedback, and doubts about their suitability for a medical career.

Conclusion

Medical students' accounts of being ignored or treated with disdain by physician superiors upon entering the workplace suggest that unintended depersonalising behaviour is ingrained in medical culture. Interaction rituals like brief eye contact, a nod, a "hello", or use of the student's name, can provide essential affective support that helps medical students thrive and learn in the clinic.

Medical teachers' identity learning during major curriculum renewal: A landscapes of practice perspective

PURPOSE

To explore how medical teachers navigate their professional identities when required to implement critical pedagogy during an undergraduate curriculum renewal initiative.

METHODS

A qualitative exploratory study was conducted, using focus groups and individual interviews with twenty-six purposively selected undergraduate medical teachers at a South African university. Data were transcribed, coded, and thematically analysed. Concepts of Landscapes of Practice Theory and Teacher Identity Learning provided an interpretive framework.

RESULTS

Findings show that medical teachers' perceived capacity to implement critical pedagogy was influenced by identities that were constructed within the boundaries of a traditional biomedical curriculum. Three themes were identified, highlighting the inherent liminality of traversing a changing educational landscape: engaging in new practices: moving into the boundary space; attempting alignment: navigating identity in the boundary space; imagining the future: embracing identity in the boundary space.

CONCLUSION

Globally directed curriculum renewal imperatives may challenge the established pedagogical practices and professional identities of medical teachers. There is a need for institutional spaces that foster collaboration, dialogue, and reflection with a view to supporting the ongoing identity learning and development of knowledgeability of medical teachers responsible for curriculum transformation.

How community and organizational culture interact and affect senior clinical educator identity

PURPOSE

The development of Educator Identity has a significant impact on well-being, motivation, productivity, and the quality of teaching. Previous research has shown that conflicting responsibilities and a challenging work environment could negatively affect the development of Clinical Educator Identity within an organization. However, there is a lack of research that identifies the factors affecting Clinical Educator Identity Formation and provides guidance on how organizations can support its development, maintenance, and advancement.

METHODS

To examine the phenomenology of Professional Identity Development in experienced Senior Clinical Educators in Singaporean hospitals, the study utilized an exploratory qualitative approach. The data was collected from September 2021 to May 2022 through one-to-one interviews. Four investigators analyzed the data using constant comparative analysis to identify relevant themes.

RESULTS

Eleven senior educators revealed that personal, relational, and organizational factors influenced the development of Clinical Educator Identity. The relational aspect was a vital enabler, while organizational culture was a strong barrier. The study also identified several ways in which organizations can support Educator Identity development.

CONCLUSION

The study findings provide insight into how organizations can support the development of Clinical Educator Identity. The results could aid organizations in understanding the areas where they can channel resources to support Clinical Educator Identity development.

Self-perception of the acquisition of transferable competencies by the participants in a research congress for undergraduate students: A cross-sectional study

Context

Several curricular initiatives have been developed to improve the acquisition of research competencies by Health Science students.

Objectives

To know how students self-perceived of whether their participation in the XIV National Research Congress for Undergraduate Students of Health Sciences had helped them in the acquisition of 36 research-related transferable competencies (TCs) common to Health Science degrees.

Methods

A survey design (Cronbach's alpha = 0.924), using a self-administered questionnaire, was conducted among undergraduate students who voluntarily participated in the Congress. Data analysis was performed using SPSS 25 and Statgraphics 19. Statistical significance was considered for P < 0.05.

Results

Eighty-one students from 12 Health Science degree programs responded. Key findings are presented in a structured manner, using a Likert-5 scale. Twenty-five of the competencies surveyed obtained an average ≥ 4 highlighting: "Critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret, and communicate scientific and health information"; "To be able to formulate hypotheses, collect and critically evaluate information for problem solving, following the scientific method", "Critical analysis and research" and "Communicate effectively and clearly, orally and in writing with other professionals". Significance was found in 15 competencies. The development of the competencies "Teamwork", "Critical reasoning" and "Analysis and synthesis abilities" was considered to be of greater "personal utility" by the respondents.

Conclusion

Participation in this event contributed to the development of research-related TCs, critical analysis and information management and communication, especially in relation to learning the sources of clinical and biomedical information, to know, following the scientific method, how to formulate hypotheses that allow students to solve problems in their professional activity. The experience was significantly influenced by the respondents' year, the type of participation in the event and the gender of the students. Limitations and suggestions regarding future research are discussed to encourage further exploration of the topic.

Develop Your CORE2 for Career Flourishing: A Career Development Workshop for Hospitalists

Introduction

Appreciative inquiry harnesses an individual's strengths to realize positive change, and a flourishing-focused mindset emphasizes engagement, social connectivity, and seeking meaningful work. Though the impact of these models on physician well-being and career planning has been evaluated in graduate medical education, their integration into career development initiatives for faculty has been limited. We designed a workshop to nurture hospitalist career development, based on our CORE2 conceptual framework (character strengths, overall vision, role assessment, explicit goals, and evaluation).

Methods

We presented the workshop at the 2022 and 2023 Society of Hospital Medicine (SHM) annual conferences. This 1.5-hour workshop comprised four modules and three small-group activities designed to help participants identify their signature character strengths, draft a professional vision statement, prioritize professional roles, and develop SMART goals aligned with these roles.

Results

At the 2023 SHM annual conference, 36 participants attended the workshop, and 32 (89%) completed pre- and postworkshop surveys. After workshop completion, participants' self-assessed familiarity with their signature character strengths, knowledge of evidence-based principles to develop SMART goals, and confidence in their ability to write a vision statement and SMART goals all increased significantly (p < .05).

Discussion

This workshop provides a valuable framework for self-directed longitudinal career development and reflection. We build on prior curricula on educator identity formation by guiding participants from identity definition to professional vision development to professional role evaluation to aligned goal creation and iterative evaluation. Our workshop's principles are readily generalizable to clinician-educators across medical disciplines.

Curriculum renewal towards critically conscious graduates: Implications for faculty development

INTRODUCTION

Globally, faculty development initiatives in support of health professions (HP) educators continue to extend their remit. This work becomes more critical as HP curriculum renewal activities are influenced by needing to move beyond a biomedical focus attending to issues such as social accountability, social justice and health equity. This raises questions about how best to support our HP educators who may need to change their teaching practice as they embrace these more complex, social constructs.

METHODS

The research question for this qualitative study was: What implications are there for faculty development that can support HP educators as they are expected to incorporate the principles of critical consciousness and social accountability into their teaching as part of a curriculum renewal process? Data from 11 focus group discussions and 11 subsequent individual interviews with HP educators from two undergraduate programmes were thematically analysed after which further analysis focussed on the implications of these findings for faculty development. Transformative learning theory and models about change provided a sensitising framework.

RESULTS

Our findings pointed to an expanded role for HP educators and consequently also for those responsible for faculty development. Three main ideas were highlighted: Curriculum renewal catalyses a renewed need for faculty development, the nature of faculty development that can enable change and new foci for faculty development.

CONCLUSIONS

Faculty development can make a significant contribution to enabling change, including in the context of curriculum renewal that often extends the roles and responsibilities of HP educators. When renewal seeks to shift fundamental curriculum principles, providing support to embrace this expanded remit results in an equally expanded remit for faculty developers-one that calls for initiatives that enable critical, dialogic encounters that might foster critical consciousness, leading to change in HP education. This challenges us, as faculty developers, to turn the mirror on ourselves to consider the nature of such expanded support.

Situations that prompt teachers in problem-based curricula to reflect on their beliefs, identity and mission

Teachers have different perceptions of how to enhance student learning. Whereas some take a teacher-centred perspective, others lean more towards a student-centred approach. Many studies in higher education have invoked Korthagen's onion model (2014) to explain how teachers' perspectives can impact their teaching practices. Spanning six interrelated layers, this model contains both outer (environment, behaviour, competencies) and inner (beliefs, identity, and mission) aspects. Focusing essentially on teachers' outer aspects, previous studies have paid scant attention to how particular situations affect teachers' inner aspects and, consequently, how teachers perceive student-centred learning. In this descriptive qualitative study, we explored situations that encouraged or discouraged teachers to embrace student-centred beliefs, identities and missions. We held three focus-group discussions with 18 teachers from two Indonesian medical schools, performing a thematic analysis of the data thus obtained. We found that certain situations made teachers reflect on their inner aspects, which either favourably or adversely affected their acceptance of a student-centred learning approach. Teachers' outer aspects (i.e. their prior problem-based teaching and learning experiences, learning situations from their own training as well as clinical duties) strongly interacted with their inner aspects, thereby shaping their teaching perspectives. Understanding how specific situations can influence teachers' inner aspects might help institutions to design faculty development programmes that address teachers' specific educational needs.

Transforming professional identity of medical teachers in Pakistan by a certificate program in health professions education: a thematic analysis of reflective essays

Introduction

A teacher's professional identity development is a dynamic and continuous process that requires rigorous, longitudinal, faculty development initiatives which are designed to work on individual professional growth. Impact of such programs must be evaluated by qualitative means to identify the process of change; The purpose of our study was to investigate whether and how our thoughtfully designed 6-month certificate program has transformed the professional identity of medical teachers.

Methods

The study was conducted in National University of Medical Sciences, Pakistan using thematic analysis, wherein a weekly task of guided reflective writing, on Moodle, was given. Data was analyzed in six phases to achieve credibility and transferability.

Results

By analyzing 202 reflective writings, seven subthemes were identified which manifest transformation in certain aspects of identity of participants and grouped under three major themes. The seven subthemes represent transformative journey of participants and include recognizing millennial learners' dilemma, identifying learning gaps and overcoming barriers, discovering a newer version of self, alternative frame of thinking, transforming traditional classroom, conducive learning environment and Community of Practice. Three major themes identified were Awareness, Modeling and Socialization which represent three processes bringing transformation in participants.

Conclusion

Our faculty development program has transformed certain aspects of professional identities of medical teachers by incorporating informal teaching strategies of experiential learning, professional socialization, reflections, and role modeling. Participants' beliefs and practices on teaching were challenged by giving a disorienting dilemma of millennial learners and learning theories. They underwent critical discourse with professional peers and mentors in community of practice, reflected on their traditional teaching practices, acquired new insight, underwent self-discovery, and introduced digitalization and interactive learning strategies within their classrooms.

From field of dreams to back to the future? Exploring barriers to participating in continuing professional development (CPD) programs

BACKGROUND

In 2009, Yvonne Steinert et al., at McGill University, published a study exploring barriers to faculty development (FD) participation among urban faculty. Over a decade later, we set out to replicate and expand on that study to learn what has changed in continued professional development (CPD) and what the current barriers are to participation in CPD for specialists and family physicians in rural and urban locations.

METHODS

Informed by a collaborative inquiry research framework, we invited faculty across rural and urban Saskatchewan to focus groups and interview sessions. The results were analyzed for themes.

RESULTS

Thirty-four faculty members from both rural and urban areas participated in this study. Of these, 50% were female, 74% practiced in urban areas, and 56% had over 20 years of experience. Frequently cited reasons for nonparticipation included time constraints, organizational and logistical challenges, poor resonance with material and presenters, and lack of recognition for teaching provided. Racism contributed to feelings of disconnectedness among physician faculty members.

CONCLUSION

Even after more than a decade, our research uncovered consistent reasons for nonparticipation in locally organized CPD events. New findings highlighted feelings of disconnectedness, notably stemming from racism and workplace discrimination. However, with recent societal developments brought about by the COVID-19 pandemic, can we ride these major waves of change to a new future of engagement? The pandemic led to a shift to virtual and hybrid professional development programs, presenting both benefits and challenges. Additionally, the peri-COVID anti-racism movement may positively address previously unidentified reasons for nonattendance. Harnessing these major changes could lead to a new future of engagement for continued professional development.

Maturing through awareness: An exploratory study into the development of educational competencies, identity, and mission of medical educators

PURPOSE

Faculty development in learning-centred medical education aims to help faculty mature into facilitators of student learning, but it is often ineffective. It is unclear how to support educators' maturation sustainably. We explored how and why medical educators working in learning-centred education, more commonly referred to as student-centred education, mature over time.

METHODS

We performed a qualitative follow-up study and interviewed 21 senior physician-educators at two times, ten years apart. A hierarchical model, distinguishing four educator phenotypes, was employed to deductively examine educators' awareness of the workplace context, their educational competencies, identity, and 'mission,' i.e. their source of personal inspiration. Those educators who grew in awareness, as measured by advancing in educator phenotype, were re-interviewed to inductively explore factors they perceived to have guided their maturation.

RESULTS

A minority of the medical educators grew in awareness of their educational qualities over the 10-year study period. Regression in awareness did not occur. Maturation as an educator was perceived to be linked to maturation as a physician and to engaging in primarily informal learning opportunities.

CONCLUSIONS

Maturation of medical educators can take place, but is not guaranteed, and appears to proceed through a growth in awareness of, successively, educational competencies, identity, and mission. At all stages, maturation is motivated by the task, identity, and mission as a physician.

Development of complex pedagogical competencies and reflexivity in clinical teachers via distance learning: a mixed methods study

Clinical reasoning is the cornerstone to healthcare practice and teaching it appropriately is of utmost importance. Yet there is little formal training for clinical supervisors in supervising this reasoning process. Distance education provides interesting opportunities for continuous professional development of healthcare professionals. This mixed methods study aimed at gaining in-depth understanding about whether and how clinical teachers can develop complex pedagogical competencies through participation in a Massive Open Online Course on the supervision of clinical reasoning (MOOC SCR). Participants self-assed their clinical supervision skills before and after partaking in the MOOC SCR through the Maastricht Clinical Teachers Questionnaire. Item scores and the distribution of response proportions before and after participation were compared using paired t-tests and McNemar's tests respectively. In parallel, the evolution of a subset of MOOC participants' pedagogical practice and posture was explored via semi-structured interviews throughout and beyond their MOOC participation using simulated and personal situational recalls. The verbatim were analysed with standard thematic analysis. Quantitative and qualitative findings converged and their integration demonstrated that partaking in the MOOC SCR promoted the development of complex pedagogical competencies and reflexivity with the participants. This was quantitatively evidenced by significantly higher self-assessed supervision skills and corresponding attitudes after completing the MOOC. The qualitative data provided rich descriptions of how this progression in pedagogical practice and posture occurred in the field and how it was shaped by participants' interaction with the MOOC's content and their motivations to progress. Our findings provide evidence for the development of pedagogical skills and corresponding attitudes for the supervision of clinical reasoning through participation in the MOOC SCR and contribute to the literature body on the opportunities that distance learning provides for the development of pedagogical competencies. The extent to which the pedagogical underpinnings of the MOOC contributed to these developments remains to be determined.

A systematic review of faculty development programs based on the Harden teacher's role framework model

BACKGROUND

Despite the changing roles of faculty in the health professions over the past two decades, none of the reviews has been paid enough attention to the impact of the faculty development programs on these roles. The objective of this review is to synthesize the existing evidence that addresses the questions: "What are the types and outcomes of faculty development programs based on the Harden teachers' role framework and which of the areas described by Harden and Crosby are the authors referring to?"

METHODS

This review was conducted according to the guidance for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. In 2020, a literature search was conducted in MEDLINE/PubMed, Scopus, ERIC, ScienceDirect, Google Scholar, Magiran and SID databases. The review included 119 studies (between 1990 and 2020) that met the review criteria. Data were extracted using a modified coding sheet. We used the modified Kirkpatrick model to assess the educational outcomes of faculty development programs.

RESULTS

The majority of faculty development programs were workshops (33.61%) with various durations. Most programs focused on the domain of information provider and coach (76.47%), followed by the facilitator of learning and mentor (53.78%) and assessor and diagnostician (37.81%). Only five faculty development programs focused on the domain of role model. The majority (83.19%) of outcomes reported were at level 2B, level 1 (73.95%) and level 2A (71.42%). Gains in knowledge and skills related to teaching methods and student assessment were frequently noted. Behavior changes included enhanced teaching performance, development of new educational curricula and programs, improved feedback and evaluation processes, new leadership positions, increased academic output and career development. The impact on the organizational practice continued to be underexplored.

CONCLUSION

Based on the review findings, broadening the scope of faculty development programs beyond the traditional roles of the faculty members by utilizing a competency-based framework for developing a comprehensive faculty development program is recommended. Attention to individualized form of faculty development programs and incorporating more informal approaches into the design and delivery of faculty development programs is also needed.

Mentorship in health professions education - an AMEE guide for mentors and mentees: AMEE Guide No. 167

This AMEE guide discusses theoretical principles and practical strategies for health professions educators to promote impactful mentoring relationships. Traditional definitions are challenged, distinctions are made between roles such as mentor, advisor, coach and sponsor. As educational environments change and options for professional development expand, we argue that the traditional dyadic format of mentoring alone will not help mentees to maximise their professional growth. Newer formats of mentoring are discussed in detail and their advantages and disadvantages compared. We use a variety of theoretical concepts to anchor the practice of mentorship: self-focussed and other-focussed motives; psychological safety; personal interpretive framework; Daloz model for balancing support and challenge; zone of proximal development; communities of practice; and development along multiple layers of competence. Recommended strategies for effective mentoring are based on extensive review of literature, as well as combined professional mentoring experiences of the authors. We use key principles from the theories described and phases of mentoring relationships as foundations for the suggested best practices of mentorship. Finally, we emphasise the role of mentees in their own professional development and provide tips for them on seeking mentors, expanding their mentoring network and taking the lead in setting the agenda during mentoring meetings and formulating action plans for their own advancement.

Professional Identity Formation of Basic Science Medical Educators: A Qualitative Study of Identity Supports and Threats

PURPOSE

Basic science medical educators (BSME) play a vital role in the training of medical students, yet little is known about the factors that shape their professional identities. This multi-institutional qualitative study investigated factors that support and threaten the professional identity formation (PIF) of these medical educators.

METHOD

A qualitative descriptive study was conducted with a purposive sample of 58 BSME from 7 allopathic medical schools in the U.S. In-depth semi-structured interviews of individual BSME were conducted between December 2020 and February 2021 to explore the facilitators and barriers shaping the PIF of BSME. Thematic analysis was conducted.

RESULTS

Factors shaping PIF were grouped into 3 broad domains: personal, social, and structural. Interrelated themes described a combination of factors that pushed BSME into teaching (early or positive teaching experiences) and kept them there (satisfaction and rewards of teaching, communities of like-minded people), as well as factors that challenged their PIF (misunderstanding from medical students, clinical, and research faculty, lack of formal training programs, and lack of tenure-track educator positions). The structural environment was reported to be crucial for PIF and determined whether BSME felt that they belonged and were valued.

CONCLUSIONS

This study shows that although most BSME derive a sense of fulfillment and meaning from their role as medical educators, they face considerable obstacles during their PIF. Structural change and support are needed to increase recognition, value, promotion, and belonging for BSME to improve the satisfaction and retention of this important group of faculty.

Developing a programmatic approach to faculty development and scholarship using the ASPIRE criteria: AMEE Guide No. 165

Faculty Development (FD) has become essential in shaping design, delivery and quality assurance of health professions education. The growth of FD worldwide has led to a heightened expectation for quality and organizational integrity in the delivery of FD programmes. To address this, AMEE, An International Association for Health Professions Education, developed quality standards for FD through the development of the AMEE ASPIRE to Excellence criteria. This guide uses the ASPIRE criteria as a framework for health professions educators who wish to establish or expand approaches to FD delivery and scholarship within their institutions.

Reflective practice by health professions educators to enhance learning and teaching: AMEE Guide No. 166

Reflective practice is an essential aspect of the professional development of all health professions educators, with the intention to enhance both learning and teaching. This Guide presents an overview of reflective practice for educators and provides a practical and developmental reflective practice approach for health professions educators. The importance of structured thinking frameworks to stimulate greater understanding of both learning and teaching situations is highlighted. Medical Educator Reflective Practice Sets (MERPS) is an innovative approach for enhancing learning and teaching in health professions education that integrates lesson study and action learning. The key features of the approach are participation in three collaborative sessions, the use of structured thinking frameworks, and solution-focussed teaching in response to the identified problem. The MERPS approach is flexible and can be adapted for implementation across the continuum of health professions education, from undergraduate to postgraduate and continuing professional development.

Fast-tracking, identity formation and the formalisation of teaching in health professions education

The proliferation of education programmes goes some way towards professionalising teaching, but we mustn't let them devalue teaching by bypassing socialisation processes and professional identity formation.

Transition theory and the emotional journey to medical educator identity: A qualitative interview study

BACKGROUND

Medical academia is in crisis, with fewer people entering and growing concern at numbers leaving. While faculty development is often seen as part of the solution, there are significant issues with faculty not engaging with and resisting development opportunities. Lack of motivation may be linked to what might be called a 'weak' educator identity. We studied medical educators' experiences of career development to gain further insights into: how professional identity may develop; individuals' accompanying emotional responses to perceived identity change; and consideration of the accompanying temporal dimensions. Drawing on new materialist sociology, we explore medical educator identity formation in terms of an affective flow that places the individual within a constantly shifting assemblage of psychological, emotional and social relations.

METHOD

We interviewed 20 medical educators at various career stages, with differing strengths of medical educator self-identity. Using an adapted transition model as a basis for understanding the emotions experienced by those undergoing identity transitions, we explore the process that, for some medical educators, appears to lead to decreased motivation, ambiguous identity and disengagement, but for others results in renewed energy, a stronger and more stable professional identity and increased interest and engagement.

RESULTS

By more effectively illustrating the emotional impact of the transition process leading to a more stable educator identity, we show that some individuals, especially where the change was not sought or welcomed, express their uncertainty and distress through low mood, resistance and an attempt to minimise the significance of undertaking or increasing teaching duties.

DISCUSSION

Understanding the emotional and developmental phases of the transition to medical educator identity has several key implications for faculty development. Faculty development approaches should be alert to the individual educator's stage of transition since this will affect that individual's readiness to accept and respond to guidance, information and support. A renewed emphasis on early educational approaches that will support the transformational and reflective learning of the individual is needed, while traditional approaches emphasising skills and knowledge may be more useful in the later stages. Further testing of the transition model and its applicability to identity development in medical education is indicated.

The Effects of Coaching Pediatric Residents on Faculty Coaches' Relationships, Learning, and Professional Identity Formation

PURPOSE

Coaching programs have been implemented in medical education to improve skill development and feedback for trainees. As more faculty take on coaching roles, it is critical to understand how being a coach affects faculty as well as trainees. This study examined the effects of coaching residents on faculty members' relationships, learning, and professional identity formation (PIF), as they move through intersecting communities across landscapes of practice.

METHOD

From July 2020 to January 2021, the authors conducted a mixed-methods study of current and former coaches at 2 institutions with longitudinal pediatric resident coaching programs. They used a concurrent triangulation design in which qualitative and quantitative data were collected simultaneously and integrated during data analysis. A survey explored the impact of coaching on faculty members' learning, relationships, and PIF, and semistructured interviews further examined coaches' experiences. The interview transcripts were analyzed inductively guided by the sensitizing principles of PIF and landscapes of practice.

RESULTS

Of 43 eligible coaches, 32 (74%) completed the survey, and 18 completed interviews. Four themes emerged from the interviews. (1) Coaches' relationships supported belonging in multiple communities. (2) Coaching enabled multidimensional learning. (3) Relationships served as mechanisms of learning for coaches. (4) Coaches' relationships and learning catalyzed PIF. Furthermore, there was a significant difference in the effects of coaching on career growth by faculty rank ( P = .02). Coaches' strengthened PIF increased a sense of purpose, meaning, and professional fulfillment, and inspired new career directions. Survey data further supported these findings.

CONCLUSIONS

Being a coach deepened faculty members' professional identities through their varied relationships, multidimensional learning, and sense of belonging in intersecting communities. This study introduces a framework to understand the factors mediating coaches' PIF and highlights how investing in coaching leads to important benefits for coaches.

Preparing Pharmacy Educators as Expedition Guides to Support Professional Identity Formation in Pharmacy Education

Objective. To provide an educator-friendly travel guide for supporting pharmacy students' lifelong journey to professional identity formation.Findings. In contrast to professionalism, which has emphasized externally visible behaviors, professional identity focuses on the internalization of the attitudes, standards, and behavioral norms of a profession, such that one "thinks, acts, and feels" like a member of that profession. Identity, whether personal or professional, is continuously developed in part during interactions with others and in response to internal and external feedback on those interactions. Educators play a critical role in helping students navigate the "provocative moments" (eg, transitions, dissonance) that accompany identity formation. To help educators travel with purpose, several identity formation theories suggest means of creating learning experiences and supporting the development of a professional identity. Additionally, guidebooks for the trip (ie, published literature) provide examples of didactic and experiential teaching approaches that can be used to promote professional identity formation. While further exploration and research are necessary, traveling this journey with colleagues can help members of the Academy succeed in sustainably and effectively infusing intentional professional identity formation within pharmacy education and training.Summary. There are myriad ways for educators to develop and support professional identity formation, which can present a challenge when defining the role that educators play in this complex, dynamic process. Educators must understand the reasoning behind various approaches and the common dialogue used to engage and support learners as their expedition guides on the lifelong journey to professional identity formation.

How learning-centred beliefs relate to awareness of educational identity and mission: An exploratory study among medical educators

INTRODUCTION

Although learning-centred education would be most effective if all medical educators held learning-centred beliefs, many educators still hold teaching-centred beliefs. A previously developed theoretical model describes a relationship between beliefs, educational identity and 'mission,' meaning that which inspires and drives educators. To increase our understanding of why educators hold certain beliefs, we explored the empirical relationship between educators' beliefs and their awareness of their educational identity and mission.

METHODS

A qualitative study was conducted using in-depth interviews with medical educators. We performed a deductive thematic analysis employing two existing models to examine educators' beliefs about teaching and learning and their awareness of their educational identity and mission.

RESULTS

Educators demonstrated both teaching-centred and learning-centred beliefs, which aligned with an awareness of their educational identity and mission. While educators who were unaware of both their identity and mission displayed teaching-centred beliefs, educators aware of their identity and mission displayed learning-centred beliefs. Those who were aware of their identity, but not their mission, displayed either teaching- or learning-centredness.

CONCLUSIONS

Medical educators' awareness of identity and mission are related to their beliefs about education. Further research is needed into whether beliefs can change over time by increasing identity and mission awareness.

Impact of an Innovative Endowed Chair Program on Medical Educator Recipients

PURPOSE

Rarely do faculty members receive endowed chairs as recognition for their work as educators. In addition to the title, endowed chairholders have traditionally received discretionary income to pursue value-added work. This study assessed the impact on recipients of receiving an endowed chair for education.

METHOD

The authors conducted a qualitative thematic analysis between 2018 and 2020, interviewing University of California, San Francisco, School of Medicine chairholders who had completed at least one 5-year term. Authors double-coded all transcripts, reconciled codes, applied social cognitive career theory during analysis, and identified themes through an iterative consensus-building approach.

RESULTS

Twenty-three of 24 (96%) eligible faculty members from 16 departments participated. Themes identified were symbolism, resources, education and educator credibility, development, and impact. The chair was a symbol that brought recognition, indicated quality, and amplified visibility and status within the institution and externally. Receiving an endowed chair conferred credibility on recipients and empowered them in the educational domain. The resources allowed chairholders the flexibility to undertake activities that were of value to them, to mentees, and to the organization. Holding the chair facilitated professional development for self and others. Chair recipients reported impact that persisted long after their term(s) concluded. A model of impact emerged, suggesting that simply possessing the chair title led to visibility and gravitas, which, combined with resources, allowed the holder to leverage opportunities in education.

CONCLUSIONS

The endowed chair is an important strategy for career development in education for the chairholder and enhances the position of education institutionally. Having a plan sharpens the focus on activities, results, and impact.

A Critical Review of Professional Identity Formation Interventions in Medical Education

PURPOSE

Professional identity formation (PIF) can be defined as the integration of the knowledge, skills, values, and behaviors of a profession with one's preexisting identity and values. Several different, and sometimes conflicting, conceptualizations and theories about PIF populate the literature; applying these different theories in PIF curricula and pedagogic strategies can profoundly impact the PIF of future physicians. The authors conducted a critical review of the recent literature on PIF interventions in medical education to explore the conceptualizations of and theoretical approaches to PIF that underlie them.

METHOD

The authors searched articles on PIF educational interventions published in 5 major medical education journals between 2010 and March 2021. The articles' context and findings were extracted, analyzed, and summarized to identify conceptualizations and theoretical approaches to PIF.

RESULTS

The authors identified 43 studies examining medical education interventions aimed at influencing PIF. The majority of the studies (n = 31) focused on undergraduate medical education. Reflective writing and the use of narrative reflections were the dominant modes of student activity in PIF interventions, supporting the dominant individualist approach to PIF. Less commonly PIF was understood as a socialization process or as an active process with both individually and socially focused influences.

CONCLUSIONS

Relying on reflective writing as the intervention of choice to impact PIF feeds the dominant individualist perspective on PIF. An unintended consequence of this individualist orientation is that cultural problems embedded in the profession can become burdens for individual physicians to personally bear. Future education and research into PIF should account for theoretical preferences and the impact of these preferences.

Implementing a Social Determinants of Health Curriculum in Undergraduate Medical Education: A Qualitative Analysis of Faculty Experience

PURPOSE

Following shifts that broadened the medical profession's conceptualization of the underlying drivers of health, medical schools are required to integrate curricula on health disparities and the social context of medicine into undergraduate medical education. Although previous research has focused on student experiences and outcomes in these curricula, less attention has been paid to the experiences of the physician-faculty involved. This study aimed to capture faculty insights to improve understanding of the challenges and opportunities of implementing this curricular reform.

METHOD

In-depth, semistructured interviews were conducted with 10 faculty members at one U.S. medical school in spring 2019 to capture their experiences designing and teaching a new curriculum related to the social determinants of health and health disparities. Study design, including interview guide development, was informed by the critical pedagogy perspective and social constructionist approaches to curriculum implementation. With the use of a constructivist grounded theory approach, interview transcripts were analyzed using open, thematic, and axial coding techniques. Primary themes were categorized as professional, organizational, interactional, or intrapersonal and organized into the final model.

RESULTS

Participants processed their experiences at 4 concentric levels: professional, organizational, interactional, and intrapersonal. Faculty generally embraced the movement to incorporate more discussion of social context as a driver of health outcomes. However, they struggled with the shortcomings of their training and navigating structural constraints within their school when developing and delivering content. When confronted with these limitations, faculty experienced unexpected tension in the classroom setting that catalyzed self-reflection and reconstruction of their teaching approach.

CONCLUSIONS

Findings highlight the challenges that faculty encounter when integrating social determinants of health and related curricula into undergraduate medical education. They also speak to the need for a broader conceptualization of relevant expertise and have implications for how medical schools select, train, and support medical educators in this work.

Clinician Educator Pathway for Nephrology Fellows: The University of North Carolina Experience

Nephrologists have a significant role in educating and mentoring trainees. They are considered role models and a major reason for fellows to be attracted to the specialty. Nephrology training programs not only support fellows in their teaching endeavors but also provide them with the necessary knowledge and skills required for advancing their careers as clinician educators. However, such career development tracks are limited in number and most focus on early career faculty. Here we present an overview of the various teaching opportunities for fellows at the University of North Carolina (UNC) Nephrology fellowship program and the development of a fellow-oriented clinician educator track. Our goal as part of the nephrology community is to empower the current nephrology fellows to develop fulfilling careers as nephrology clinician educators.

Faculty Development for the Twenty-First Century: Teaching the Teachers

Faculty development is a poorly understood and incompletely executed initiative in undergraduate and graduate medical and dental education programs. Despite significant change in the delivery of health care over the past several decades, the education of students and residents has followed a legacy path of business as usual. Some faculty have incorrectly assumed that content expertise transfers to teaching expertise. The insistence for robust faculty development programs on the part of accrediting and other professional organizations has created a call to action, but much work has yet to be done. It is therefore essential that leaders in these programs develop a sense of urgency to teach the teachers lest our students and residents will replicate outdated methods, unsystematically teach themselves, and fall victim to an educational system that is grossly inadequate. It is the purpose of this article to enhance undergraduate and graduate medical and dental education by offering viable change options, specifically targeted to improving historical trends by emphasizing the importance of growth mindsets, emotional intelligence, the creation of holding environments, and stimulating enthusiasm for lifelong learning as part of twenty-first century strategies for faculty development.

Exploring the Key Influencing Factors on Teachers' Reflective Practice Skill for Sustainable Learning: A Mixed Methods Study

In 2019, the United Nations released "Education for Sustainable Development for 2030", emphasizing that sustainable learning is an important component of education for sustainable development, as it can enable learners to master the knowledge and skills required to keep learning in a variety of circumstances. To better understand teachers' sustainable learning within the context of education, this study used a comprehensive method combining quantitative analysis and qualitative analysis to examine the key factors that influence teachers' reflective practice skill through educational practice for sustainable learning. A total of 349 teachers responded to the survey. Based on the quantitative results, 10 teachers were chosen for qualitative analysis. Results showed that teaching support service, peer feedback, teacher-student interaction, and personal goal orientation were found to have a significant impact on teachers' reflective practice skill, which is beneficial for promoting sustainable learning. Interestingly, the direct impact of pedagogical self-efficacy on reflective practice skill was not observed. The following qualitative research yielded five topics on teaching support service, peer feedback, teacher-student interaction, pedagogical self-efficacy, and personal goal orientation. These topics helped to explain the results of the quantitative analysis. The findings of the proposed model were conducive to understanding the mechanism that affects teachers' reflective practice skill as well as providing practical implications for teachers' sustainable learning in educational practice.

Faculty Development for Academic Emergency Physicians: A Focus Group Analysis

Objectives: The objective is to explore academic emergency medicine physicians’ exposure to and needs regarding faculty development.

Methods: We conducted a prospective qualitative study of Society for Academic Emergency Medicine members in 2018 using focus groups selected by convenience and snowball sampling. One facilitator ensured representative engagement and responses were transcribed in real-time by an assistant after obtaining verbal consent. Results were analyzed using a grounded theory approach with a constructivist perspective. Thematic analysis was refined using the constant comparative method.

Results: Sixteen physicians participated in the focus groups, representing a diverse group of perspectives. Six themes emerged about unmet needs in faculty development: knowledge and skills, relationships, specific programs or resources, and professional benefits.

Conclusions: Members of a national academic society identified three areas of focus important to developing academicians in emergency medicine: content for faculty developers, relationship-building among members, and support from the organization as a “professional home.” Academic societies can use this to guide future programming.

Teaching the Teacher: Assessing Barriers to Identity Formation of Clinical Teachers in a Developing Country

PHENOMENON

Clinical teachers' identity formation is understudied in developing countries like Pakistan. Despite producing thousands of international medical graduates per year, Pakistani medical education is still in its infancy. The application of Western medical education methods and theories is beset by unique socio-cultural challenges. These must be identified and addressed to ease our physicians' transition from clinician to teacher and maximize their teaching output in a resource-limited setting.

APPROACH

Eight clinical teachers were interviewed from Combined Military Hospital Kharian, Punjab, Pakistan in July 2020. Semi-structured questionnaires were used, and interviews were audio-taped to generate transcripts. These were analyzed qualitatively and coded, developing themes regarding barriers to identity formation.

FINDINGS

Six themes reflected possible barriers to identity formation and fell under two domains: individual and systemic issues. At the individual level these themes were: conflicting priorities, lack of autonomy, and language barriers. Systemic issues were found to be: disconnect between educationists and teachers, the absence of incentives, and lack of institutional support.

INSIGHT

Identifying barriers to identity formation can aid clinical teachers' development and encourage discourse around providing increased institutional support to teachers to overcome said barriers. Both the individual and the institute are stakeholders in the process of identity formation and dialogue between the two can lead to improved teaching outcomes.

Embodied teacher identity: a qualitative study on 'practical sense' as a basic pedagogical condition in times of Covid-19

Worldwide, the Covid-19 pandemic has transformed teaching contexts rapidly. Studies on the effects of the Covid-19 pandemic have largely focused on students' learning and well-being. In contrast, little is known about how emergency online teaching affects teachers. The aim of this study was to examine how disrupted teaching contexts during the Covid-19 pandemic affected academic teacher identities in health science education. Interviews were conducted with 19 experienced lecturers in health science education from two universities. Interview data were analysed using systematic text condensation. The established codes were compared across interviews to identify common themes and subsequently synthesized into descriptions of the emerging phenomena. Findings indicated that a form of embodied teacher identity, i.e. internalized teaching practices turned into dispositions, constituted a basic pedagogical condition and a resource for the teachers, and that the sudden change in the teaching context caused a loss of teacher identity. This identity loss was related to an incorporated understanding and use of the teacher's sense of the classroom (subtheme 1), non-verbal feedback from students (subtheme 2) and reciprocal visual contact (subtheme 3). Data also indicated that teachers' ability to adapt their teaching to students' needs while teaching and teachers' motivation and job satisfaction may have suffered. Universities should carefully consider how to cultivate sustainable and adaptive teacher identities compatible with the increasing digitalization of learning environments. Teaching is an embodied affair, and teacher identities are sensitive to structural changes in teaching contexts.

Collaborative faculty development transforms evaluation at a school of osteopathic medicine: an exploratory grounded theory study

Background: Faculty development (FD) initiatives for medical educators must keep pace with educators’ expanding roles and responsibilities in the 21st century to effectively support and guide professional growth. Successful initiatives will be comprehensive and systematic, rather than episodic. Our research explores the impact of a collaborative, individualized, and focused FD program. The purpose of this pilot study is: (1) to describe the innovative design and implementation of the incipient FD program at University of the Incarnate Word School of Osteopathic Medicine (UIWSOM), San Antonio, Texas; and (2) to present insights from a preliminary process evaluation of the program’s initial launch to inform and facilitate broadscale implementation.      Methods: We used a longitudinal, holistic approach to redesign the UIWSOM FD program to provide evidence-informed and experiential learning for faculty. We performed a process evaluation of the initial iteration of the FD program using an inductive qualitative research approach. We applied principles of constructivist grounded theory to analyze faculty’s responses collected during semi-structured interviews. Results: Three themes emerged from our analysis: communication, advocacy, and reciprocal learning.  We found that effective communication, advocacy for faculty success, and reciprocal value between faculty and program developers undergirded the core concept of authentic engagement.  Faculty’s perceptions of the quality of engagement of those implementing the program overshadowed the quality of the logistics.  Conclusions: Our pilot study identified authentic engagement as critical to faculty’s positive experience of this new FD initiative.  Practical implications for other health professions schools with similar FD initiatives include consideration of the relational aspects.  Future studies should expand the process evaluation to determine key factors driving perceived program success for other skill domains and amongst clinical faculty, and include a long-range outcome evaluation of the fully implemented program.

Student and Educator Experiences of an Integrated Medical Imaging Curriculum

INTRODUCTION

Medical imaging is integrated across all years in the medical programs at the Medical School, in our country. Little is known about this pedagogical approach from the perspective of those who participate in it. This study investigated how students and educators experience an integrated medical imaging curriculum.

METHODS

One-on-one interviews were conducted with nine educators and three undergraduate medical students and analyzed using a reflexive thematic approach. Educators included radiologists, non-radiologists clinicians, and scientists and health professionals from the medical program.

RESULTS

The integrated medical imaging curriculum appears to be incoherently experienced by educators and students as learning opportunities that were 'everywhere and nowhere'. Teaching events were 'repetitive and patchy' and featured a transmission-oriented pedagogy emphasizing 'exposure and absorption'. Educators expressed paradoxical views of their responsibility for teaching medical imaging reflected in this sentiment: 'I don't teach medical imaging… (but I do)'.

DISCUSSION

When medical imaging is integrated into learning resources and course work across the undergraduate program, it may lose its visibility and importance as a distinct learning area despite its crucial role in medical practice. An integrated curriculum may inadvertently separate knowing about medical imaging from learning to apply medical imaging knowledge in clinical practice.

CONCLUSIONS

Further work is required to construct an integrated medical imaging curriculum that explicitly emphasizes medical imaging learning outcomes, so they are experienced coherently and consistently by medical students and those who prepare them for practice as doctors.

The social construction of teacher and learner identities in medicine and surgery

INTRODUCTION

There are growing concerns about the quality and consistency of postgraduate clinical education. In response, faculty development for clinical teachers has improved formal aspects such as the assessment of performance, but informal work-based teaching and learning have proved intractable. This problem has exposed a lack of research into how clinical teaching and learning are shaped by their cultural contexts. This paper explores the relationship between teacher-learner identity, educational practice and the workplace educational cultures of two major specialties: internal medicine and surgery.

METHODS

This was a secondary analysis of a large dataset, comprising field notes, participant interviews, images and video-recordings gathered in an ethnographic study. The lead author embedded himself in four clinical teams (two surgical and two medical) in two different hospitals. The authors undertook a critical reanalysis of the observational dataset, using Dialogism and Figured Worlds theory to identify how teachers and postgraduate learners figured and authored their professional identities in the specialty-specific cultural worlds of surgery and internal medicine.

RESULTS

Surgery and internal medicine privileged different ways of being, knowing and talking in formal and informal settings, where trainees authored themselves as capable practitioners. The discourse of surgical education constructed proximal coaching relationships in which trainees placed themselves at reputational risk in a closely observed, embodied practice. Internal medicine constructed more distal educational relationships, in which trainees negotiated abstract representations of patients' presentations, which aligned to a greater or lesser degree with supervisors' representations.

CONCLUSIONS

Our research suggests that clinical education and the identity positions available to teachers and learners were strongly influenced by the cultural worlds of individual specialties. Attempts to change work-based learning should be founded on situated knowledge of specialty-specific clinical workplace cultures and should be done in collaboration with the people who work there, the clinicians.

Attributes of excellent clinician teachers and barriers to recognizing and rewarding clinician teachers' performances and achievements: a narrative review

BACKGROUND

Over the last 31 years, there have been several institutional efforts to better recognize and reward clinician teachers. However, the perception of inadequate recognition and rewards by clinician teachers for their clinical teaching performance and achievements remains. The objective of this narrative review is two-fold: deepen understanding of the attributes of excellent clinician teachers considered for recognition and reward decisions and identify the barriers clinician teachers face in receiving recognition and rewards.

METHODS

We searched OVID Medline, Embase, Education Source and Web of Science to identify relevant papers published between 1990 and 2020. After screening for eligibility, we conducted a content analysis of the findings from 43 relevant papers to identify key trends and issues in the literature.

RESULTS

We found the majority of relevant papers from the US context, a paucity of relevant papers from the Canadian context, and a declining international focus on the attributes of excellent clinician teachers and barriers to the recognition and rewarding of clinician teachers since 2010. 'Provides feedback', 'excellent communication skills', 'good supervision', and 'organizational skills' were common cognitive attributes considered for recognition and rewards. 'Stimulates', 'passionate and enthusiastic', and 'creates supportive environment', were common non-cognitive attributes considered for recognition and rewards. The devaluation of teaching, unclear criteria, and unreliable metrics were the main barriers to the recognition and rewarding of clinician teachers.

CONCLUSIONS

The findings of our narrative review highlight a need for local empirical research on recognition and reward issues to better inform local, context-specific reforms to policies and practices.

What Faculty Want: Academic and Community Emergency Physicians’ Perceptions of Learner Feedback

Introduction

Faculty development is often deployed by central medical schools, with little guidance from end-users. How and what faculty members can use to improve their performance requires a deeper understanding from this user group. This study aims to explore how faculty perceive learners’ feedback about their performance as educators.

Methods

This study is an explanatory mixed-method research, wherein community- and academic-based emergency medicine faculty members from nine regional hospitals were surveyed about their perceptions of various outcome measures for faculty development. Selected participants were invited to follow-up interviews. We analyzed the physicians’ perceptions toward teaching and performance feedback data based on faculty’s gender, role as academic or community physician, and work experience.

Results

The quantitative phase has 104 participants, and 15 of these were followed up with interviews. The gender of faculty does not have statistical or practical differences regarding their perceptions of learner feedback. Type of practice contains meaningful insights about the perception of learner feedback although it does not have a statistical difference. Moreover, an inverse trend exists between the physicians’ years of experience and their perceived value of learner feedback. Kruskal-Wallis test showed a significant difference in the faculty’s experience level and their perceived value for the metric “quantity of feedback commentary compared to their peer group” (H(4) = 12.21, p = 0.02), specifically between junior and senior faculty (p = 0.007). Some faculty stated that experienced faculty may perceive they have a very well-established style.

Conclusions

Diversifying feedback sources and delivery may be useful for different groups of faculty members. Junior physicians are more interested in gaining feedback about the quantity of their written feedback to students compared to more senior physicians. Learner feedback holds promise to trigger continuous improvement in community sites for those who fall behind compared to the academic sites.

Measuring the Impact of a Faculty Development Program on Clinical Educators

INTRODUCTION

An Academy of Clinical Educators (ACE) was established at the University of Newcastle, to support and build capacity among existing and prospective medical educators. ACE established a Certificate of Clinical Teaching and Supervision (CCTS) program, the final assessment of which was a reflective piece on how the course has affected participants' practice as clinical teachers or supervisors and how changes are expected to impact learner achievement. We conducted a qualitative evaluation of these to explore the impact of the CCTS on participants' teaching.

METHODS

Thirty-one participants (of 90 completers to date) consented for their written reflections to undergo qualitative thematic analysis and completed a survey exploring their preparation for, and experience of the program, and application of skills learnt.

RESULTS

Most participants reported applying the skills gained through the CCTS to their teaching practice to a large (n=23; 72%) or very large (n=5; 16%) extent. Four themes emerged from the qualitative data, aligned with the topics of the CCTS: teaching structure; feedback; orientation; and assessment. Participants described application of more structured approaches to orientation, teaching and feedback, positive student responses, and self-reported satisfaction with adopted changes.

DISCUSSION

The CCTS has motivated change in the teaching practice of participants. Although evidence presented here is limited by the self-reported nature, descriptions of actual changes in practice were detailed and specific enough to suggest they could act as a proxy for objectively measured change in behaviour and outcome.

CONCLUSION

A faculty development program delivered to clinicians with a range of teaching and education-related roles, from varied clinical disciplines and professions, can promote improved, structured teaching and feedback.

Academies in Health Professions Education: A Scoping Review

PURPOSE

Thirty years ago, academies were conceived as a sociocultural approach to revitalize the teaching mission of medical schools and to promote educators' career advancement. The academy movement has grown rapidly and now reaches a broad range of health professions education organizations. The authors conducted a scoping review to map the literature and describe the evidence that guides the formation of new academies and justifies the continuation of existing ones.

METHOD

The authors searched MEDLINE (via Ovid), Embase (via Elsevier and Ovid), CINAHL (via EBSCOhost), and Web of Science (via Clarivate Analytics) from inception through March 6, 2020, for publications regarding academy-like organizations. They mapped the relevant literature using logic modeling as an organizing framework and included the mission, resources, activities, output, outcomes, and impact of the included academies.

RESULTS

Of the 513 publications identified, 43 met the inclusion criteria, the oldest of which was published in 2000. Most publications were either case reports or perspective/opinion pieces (26, 57.8%), while studies presenting empirical findings were less common (11, 24.4%). Publications showed that academies were diversifying and increasingly were part of a broad range of organizations, including departments, hospitals, health science campuses, and national organizations. The mission, resources, and activities were similar across academies. Evaluation studies were largely limited to process measures, and rigorous studies examining outcomes (i.e., changes in academy participants) and impact on the organization at large were rare.

CONCLUSIONS

The increase in the number of academy-related publications parallels the accelerating speed of the academy movement. To sustain this movement, rigorous studies must provide evidence that academies contribute to the revitalization of organizations' teaching mission and bring about an academic culture where educators thrive and where education is a legitimate career path.

Navigating landscapes of practice: A longitudinal qualitative study of physicians in medical education

INTRODUCTION

Despite its widespread application in medical education, belonging to a single community of practice does not reflect the overall experience of physician-educators. Knowing how physician-educators find their way among different communities of practice (ie their landscape of practice) has implications for professional development but the limited description in the literature. In this longitudinal qualitative research, we explored how physicians who pursue graduate degrees in medical education navigate their landscape of practice.

METHODS

11/29 physicians in one cohort of a masters in medical education programme were interviewed annually from 2016 (programme start) to 2020 (2 years post-graduation). We iteratively collected and analysed data, creating inductive codes and categorising coded data by mode of identification (engagement, imagination, alignment) and time. We organised narratives into time-ordered data matrices so that final analysis wove together mode, time and participant.

RESULTS

All participants consistently spoke of navigating their landscape of practice, which included the community created in the graduate programme; but that single community 'doesn't define the journey itself'. They shifted engagement from teaching individual learners to translating what they learned in the graduate programme to develop educational projects and produce scholarship. They shifted the imagination from relying on internal and external assessments to experience-inspired versions of their future self. And they shifted alignment from belonging to the graduate programme's community of practice, then belonging to different communities in their landscape of practice and ultimately focussing on communities that mattered most to them.

DISCUSSION

Physicians in a graduate programme in medical education navigated their dynamic landscape of practice by shifting how they engaged in medical education, as well as what they imagined and who they aligned with as physician-educators. Our work offers novel insights into how knowledgeability emerges through time as overlapping modes of identification.

Professional identity formation of medical teachers in a non-Western setting

INTRODUCTION

Understanding and supporting professional identity formation (PIF) among medical teachers has become increasingly important in faculty development programs. In this study, we explored medical teachers' PIF in Indonesia.

METHODS

We conducted a qualitative descriptive study using focus group discussions (FGDs) at four medical schools in Indonesia. Basic science and clinical teachers from four different schools were selected to participate. Data were transcribed, coded, and analysed to develop themes and subthemes.

RESULTS

Seventeen FGDs were completed, involving 60 basic science and 59 clinical teachers. Four major themes regarding the formation of medical teachers' professional identity emerged: an internal dialogue between intrinsic values and external influences, empowerment through early socialization, experiential workplace learning, and envisioning the future. The PIF process was similar for basic science and clinical teachers.

CONCLUSION

Our findings suggested that PIF among medical teachers in a non-Western setting is a continuous and dynamic process that is shaped by key socialization factors (e.g. role models, workplace learning, peer support), with significant influences from religious beliefs, family values, and societal recognition. Faculty development programs should consider the dynamic and continuous nature of PIF among medical teachers and encourage clinicians and basic scientists to explore their values and beliefs, realize their goals, and envision their future.

Threshold concepts in group-based mentoring and implications for faculty development: A qualitative analysis

INTRODUCTION

The literature on faculty development programs for mentors is scarce. This study examines mentors' experiences and challenges, with the aim of identifying threshold concepts in mentoring. It also discusses the implications for the faculty development of mentors.

METHODS

Semi-structured interviews solicited personal narratives and reflections on mentors' lived experiences. Data analysis was guided by the threshold concepts framework allowing for the identification of significant and transformative shifts in perspectives.

RESULTS

We interviewed 22 mentors from two Norwegian and one Canadian medical school with group-based mentoring programs. The mentoring experience involved four significant threshold concepts: focusing on students' needs; the importance of creating a trusting learning space; seeing oneself through the eyes of students; and aligning mentor and physician identities.

CONCLUSION

Taking on a mentor role can provoke personal and professional dilemmas while also sparking growth. The trajectories of developing as a mentor and as a professional physician may be seen to mutually validate, mirror and reinforce each other. Faculty development programs designed specifically for mentors should aim to stimulate reflection on previous learning experiences and strive for a successful alignment of the distinct pedagogical and clinical content knowledge required to fulfill various professional roles.

Faculty development using a virtual community of practice: Three-year outcomes of the Academic Life in Emergency Medicine Faculty Incubator program

INTRODUCTION

The Academic Life in Emergency Medicine (ALiEM) Faculty Incubator program is a longitudinal, 1-year, virtual faculty development program for early- and mid-career faculty members that crosses specialties and institutions. This study sought to evaluate the outcomes among 3 years of participants.

METHODS

This cross-sectional survey study evaluated postcourse and 1-year outcomes from three graduated classes of the ALiEM Faculty Incubator program. The program evaluation survey was designed to collect outcomes across multiple Kirkpatrick levels using pre/post surveys and tracking of abstracts, publications, speaking opportunities, new leadership positions, and new curricula.

RESULTS

Over 3 years, 89 clinician educators participated in the program. Of those, 59 (66%) completed the initial survey and 33 (37%) completed the 1-year survey. Participants reported a significant increase in knowledge (4.1/9.0 vs. 7.0/9.0). The number of abstracts, publications, and invited presentations significantly increased after course completion and continued postcourse. A total of 37 of 59 (62.7%) developed a new curriculum during the course and 19 of 33 (57.6%) developed another new curriculum after the course. A total of 29 of 59 (49.2%) began a new leadership position upon course completion with 15 of 33 (45.5%) beginning another new leadership position 1 year later.

DISCUSSION

The ALiEM Faculty Incubator program demonstrated an increase in perceived knowledge and documented academic productivity among early- and mid-career medical educators.

Physicians' viewpoints on faculty anatomists and dissection of human bodies in the undergraduate medical studies

BACKGROUND

Studies abound regarding the views of faculty anatomists and medical students on the importance of anatomy and the dissection of human bodies, but very little is known about the views of practicing physicians.

METHODS

A survey was distributed among physicians and surgeons practicing in Spain in order to find out their views on the practice and consequences of human dissection by undergraduate students of medicine. The most relevant definition to qualify faculty anatomists of medical schools was also requested. Responses were repeatedly clustered into characteristic subgroups for analysis.

RESULTS

In total, 536 physicians and surgeons belonging to 36 different specialties in seven Spanish hospitals responded to the survey. The results highlighted two main facts. Firstly, faculty anatomists were perceived as teachers, above any other professional identity (namely: physician, biologist or scientist); nonetheless, the ascription of identities varied between specialties (p=0.009); and it also depended on whether the respondents had dissected in their undergraduate degree (p=0.03) and on the respondent's gender (p=0.03). Secondly, physicians and surgeons confirmed that dissecting human cadavers serves the undergraduate student not only for acquiring anatomical knowledge, but also essential skills and attitudes, including professionalism.

CONCLUSIONS

The results strongly suggest that dissection practice should be reinforced and enriched in undergraduate medical school. As this is important in itself, the results of the study could also help with the development of strategies to alleviate the current shortage of adequately trained anatomists for medical degrees.

AUTHENTIC RESEARCH IN THE CLASSROOM INCREASES APPRECIATION FOR PLANTS IN UNDERGRADUATE BIOLOGY STUDENTS

Engaging students in authentic research increases student knowledge, develops STEM skills, such as data analysis and scientific communication, and builds community. Creating authentic research opportunities in plant biology might be particularly crucial in addressing plant awareness disparity (formerly known as plant blindness), producing graduates with botanical literacy, and preparing students for plant-focused careers. Our consortium created four CUREs (course-based undergraduate research experiences) focused on dual themes of plant biology and global change, designed to be utilized by early and late-career undergraduates across a variety of educational settings. We implemented these CURES for four semesters, in a total of 15 courses, at four institutions. Pre- and post-course assessments used the Affective Elements of Science Learning Questionnaire and parts of a "plant blindness" instrument to quantify changes in scientific self-efficacy, science values, scientific identity, and plant awareness or knowledge. Qualitative assessment also queried self-efficacy, science values, and scientific identity. Data revealed significant and positive shifts in awareness of and interest in plants across institutions. Quantitative gains in self-efficacy and scientific identity, however, were only found at two of four institutions tested. This project demonstrates that implementing plant CUREs can produce affective and cognitive gains across institutional types and course levels. Focusing on real-world research questions that capture students' imaginations and connect to their sense of place could create plant awareness while anchoring students in scientific identities. While simple interventions can alleviate plant awareness disparity, implementing multiple CUREs per course, or focusing more on final CURE products, could promote larger and more consistent affective gains across institutions.