What Questions Guide Investing in Our Faculty?

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.

Vitalizing the evaluation of curricular implementation: a framework for attending to the "how and whys" of curriculum evolution

As curricular reforms are implemented, there is often urgency among scholars to swiftly evaluate curricular outcomes and establish whether desired impacts have been realized. Consequently, many evaluative studies focus on summative program outcomes without accompanying evaluations of implementation. This runs the risk of Type III errors, whereby outcome evaluations rest on unverified assumptions about the appropriate implementation of prescribed curricular activities. Such errors challenge the usefulness of the evaluative studies, casting doubt on accumulated knowledge about curricular innovations, and posing problems for educational systems working to mobilize scarce resources. Unfortunately, however, there is long-standing inattention to the evaluation of implementation in health professions education (HPE). To address this, we propose an accessible framework that provides substantive guidance for evaluative research on implementation of curricular innovations. The Prescribed-Intended-Enacted-Sustainable (PIES) framework that is articulated in this paper, introduces new concepts to HPE-with a view to facilitating more nuanced examination of the evolution of curricula as they are implemented. Critically, the framework is theoretically grounded, integrating evaluation and implementation science as well as education theory. It outlines when, how, and why evaluators need to direct attention to curricular implementation, providing guidance on how programs can map out meaningful evaluative research agendas. Ultimately, this work is intended to support evaluators and educators, seeking to design evaluation studies that provide more faithful, useful representations of the intricacies of curricular change implementation.

Clinical Teacher Training for health professionals: From blended to online and (maybe) back again?

BACKGROUND

The Clinical Teacher Training (CTT) programme was originally developed as an interprofessional, blended learning programme, to support health professionals working across health services within Australia, although it has also been delivered internationally. With the disruption of COVID-19, we rapidly moved to 'online only' delivery. We sought to modify the programme, ensuring that the constructivist paradigms important for our learner experience through the original blended format were maintained in the online platform.

APPROACH

Consisting of 10 modules on a range of topics, the new CTT online only programme was facilitated online across 6 weeks with asynchronous and synchronous assessable activities, and provision of peer and facilitator feedback. The learning outcomes for each module were similar to the 'blended learning' format. The new programme was delivered three times throughout 2020 and completed by a total of 208 health professionals from across 10 metropolitan and rural health districts.

EVALUATION

The focus of our evaluation was on the programme's final 2020 iteration, for which we had ethics approval. Participants (n = 59) were from diverse health professions, across five metropolitan and rural health districts. We prioritised the learner experience in constructing our evaluation strategy. Quantitative and qualitative data were collected by post-course questionnaire and analysed using descriptive statistics and thematic analysis. Twenty participants (34%) responded to the post-course questionnaire. Participants valued the structure, topics, clear outcomes, timeframe, online resources, small group activities, feedback and the flexibility and accessibility afforded by online only delivery. However, participants identified a need for additional 'real-time' engagement in activities. Faculty were surprised by the time required to adequately facilitate online learning, and similarly, valued the real-time interactions.

IMPLICATIONS

The online only CTT programme provided an excellent, scalable framework to ensure continued provision of a relevant and accessible training resource for clinicians working in metropolitan and regional/rural health services. Learner-reported achievement of programme learning outcomes was not negatively impacted by online only delivery. Balancing these resource advantages with learner preferences and our desire to build active teaching networks, we will continue to host the majority of the programme online, while offering short face-to-face sessions within local contexts.

Influences on and Characteristics of the Professional Identity Formation of Clinician Educators: A Qualitative Analysis

PURPOSE

Professional identity formation is the process of internalizing the ideals, values, and beliefs of a profession. In recent years, research on clinician-educator (CE) identity formation has expanded, yet gaps exist in understanding initial influences on an educator identity, sustainment throughout a career, and development of successful pathways for early CEs. This study explored the initial influences on and characteristics of the professional identity formation of CEs in an age-diverse, multispecialty population in the United States.

METHOD

This was a cross-sectional qualitative study of a purposive sample of medical educators at 6 institutions across the United States between 2018 and 2019. Focus groups were conducted to obtain participants' perspectives on their career choice and subsequent formation of their professional identity as CEs. The authors used a thematic analysis of focus group data to identify themes and domains through an iterative process.

RESULTS

Twelve focus groups were conducted with a total of 93 participants. Responses were categorized into 5 domains: community supportive of medical education, culture of institution and training, personal characteristics, facilitators, and professionalization of medical education. Themes highlighted the importance of role models and mentors, an affinity and aptitude for teaching and education, specific facilitators for entry into a career in medical education, the evolution from a layperson, importance of formalized training programs, and a supportive academic community.

CONCLUSIONS

Clinicians experienced a variety of factors that influenced their initial career choice in medical education and subsequent professional identity formation as a CE. This study confirms and expands the current understanding of this process in an age-diverse, multispecialty population of CEs. Educators and administrators designing career development programs across the continuum of medical education should consider these aspects as they mentor and support their learners and faculty.