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Nothman S, Kaffman M, Nave R, Flugelman MY. Survey of faculty development in four Israeli medical schools: clinical faculty development is inadequate and clinical teaching is undervalued in Israeli faculties of medicine. Isr J Health Policy Res 2021; 10:10. [PMID: 33557931 PMCID: PMC7871531 DOI: 10.1186/s13584-021-00438-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Teaching medical students is a central part of being a doctor, and is essential for the training of the next generation of physicians and for maintaining the quality of medicine. Our research reviews the training that physicians in Israel receive as teachers of clinical clerkships, and their thoughts regarding teaching students. The importance of faculty development cannot be overstated, for securing quality medicine and physician empowerment. METHODS This study was based on a survey conducted among physicians teaching at Israeli medical schools. The survey was conducted using an online questionnaire sent to clinical teachers according to lists received from the teaching units of the faculties, department heads, and other clinical teachers. Participation in the study was anonymous. FINDINGS Of 433 invited physicians, 245 (56%) from three departments (internal medicine, paediatrics, obstetrics and gynaecology) of four faculties of medicine in Israel, out of five total, completed the questionnaire. Only 35% of the physicians reported having received training for their role as teachers, most of these participated in a short course of up to 2 days. There were significant differences between the Technion and the other schools. Technion teachers without academic appointment had higher rates of pedagogic training. The same was true in regard to Technion teachers, either residents or young specialist. Significant gaps were reported between the content covered in the training and the topics the doctors felt they would want to learn. The clinicians who participated in the survey expressed that clinical teaching was less valued and more poorly remunerated than research, and that improved compensation and perceived appreciation would likely improve the quality of clinical teaching. CONCLUSIONS Of the one-third of the physicians surveyed who had received some training in clinical teaching, the training was perceived as inadequate and not aligned with their needs. There was a significant difference in rates of pedagogic training between the Technion and other medical schools. In addition, most clinical teachers surveyed felt that teaching students is inadequately valued. Due to its focus on just three disciplines, and higher relative number participants from the Technion faculty of medicine, our survey may not fully represent the activities of the faculties of medicine in Israel. Nevertheless, given the importance of clinical teaching of medical students, our findings argue for increasing faculty development and educational training of physicians in clinical settings, for recognizing the importance of teaching in academic and professional promotion processes.
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Affiliation(s)
- Simon Nothman
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel.,Department of Obstetrics and Gynaecology, Haemek Medical Center, Afula, Israel
| | - Michael Kaffman
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel.,Department of Family Practice, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| | - Rachel Nave
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel
| | - Moshe Y Flugelman
- Department of Education, Ruth and Bruce Faculty of Medicine, Technion IIT, Haifa, Israel. .,Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, 7 Michal St., Haifa, Israel.
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Abstract
Phenomenon: Universities offer a variety of voluntary faculty development to ensure quality education, but face inconsistent faculty participation. Therefore, all Dutch universities require all faculty to obtain a teaching qualification certificate. Yet, like other medical centers, University Medical Center Utrecht continued to struggle with faculty nonparticipation. It has been postulated that clinician teachers may face unique challenges with responsibilities for patient care in addition to teaching and research, challenges that cannot be overcome by merely mandating faculty development or a teaching certificate. This project was conducted to gain insight into factors that hinder faculty participation and better understand what is needed to enhance faculty engagement in their professional development as teachers. Approach: UMC Utrecht has had a teaching certificate requirement for over 20 years. In 2015-2016, we conducted a local needs assessment, gathering faculty perspectives about the teaching certification process. To convey seriousness of purpose and promote commitment to change, we formally engaged key stakeholders from the outset, obtained grant funding for the needs assessment, and had an outside consultant lead the project. Faculty who were stalled or never started were questioned via semi-structured interviews. A focus group with those actively in the process of obtaining their certificate discussed perceived challenges in the process and recommended solutions. Faculty who obtained their teaching certificate completed an anonymous evaluation form. All evaluation comments and transcripts were thematically analyzed using open and axial coding. A literature review was performed to contextualize our findings and identify potential solutions. We compared our initial themes to these findings and found key challenge/solution categories, which we subsequently developed into a novel framework. Findings from the study and literature review were organized using this framework and shared with different stakeholders, all of whom engaged in problem-solving. Ideas and potential solutions were incorporated into a final report with recommendations for improving faculty support and provided to the institutional leadership. Findings: Of 23 faculty teachers approached, 8 (34.8%) agreed to be interviewed; 7 of 25 (28.0%) participated in the focus group; and 83 of 156 (53.2%) completed the evaluation. From the transcripts and evaluation comments, three themes emerged related to context and barriers: (a) skill development versus certification; (b) workplace priorities and culture, and (c) visibility and feasibility of the teacher's role. Triangulation of these themes with the literature revealed four challenge/solution categories - Competence, Context, Community, and Career. This 4-C framework facilitated communication of findings, structured the development of an action plan in response to the findings, and assured implementation of new initiatives for faculty support beyond competence development. Insights: Simply adopting requirements for faculty development may be insufficient and even invoke resistance. Improving faculty participation in faculty development and the quality of education requires institutional attention to not just faculty Competence needs, but also the factors of Context, Community, and Career that together comprise the culture experienced by faculty teachers. With institutional buy-in and commitment to change, the 4-C framework can help focus institutional attention on existing gaps in all four domains and guide the development of comprehensive solutions.
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Affiliation(s)
- Lisette van Bruggen
- Center for Research and Development of Education, University Medical Center, Utrecht, Netherlands
| | - Olle Ten Cate
- Center for Research and Development of Education, University Medical Center, Utrecht, Netherlands
| | - H Carrie Chen
- Department of Pediatrics, School of Medicine, Georgetown University, Washington, DC, USA
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Benning NH, Haag M, Knaup P, Krefting D, Rienhoff O, Suhr M, Hege I, Tolks D. Digital teaching as an instrument for cross-location teaching networks in medical informatics: opportunities and challenges. GMS J Med Educ 2020; 37:Doc56. [PMID: 33225048 PMCID: PMC7672385 DOI: 10.3205/zma001349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/26/2020] [Accepted: 10/01/2020] [Indexed: 05/07/2023]
Abstract
The increasingly digitized healthcare system requires new skills from all those involved. In order to impart these competencies, appropriate courses must be developed at educational institutions. In view of the rapid development of new aspects of digitization, this presents a challenge; suitable teaching formats must be developed successively. The establishment of cross-location teaching networks is one way to better meet training needs and to make the necessary spectrum of educational content available. As part of the Medical Informatics Initiative, the HiGHmed consortium is establishing such a teaching network, in the field of medical informatics, which covers many topics related to the digitization of the health care system. Various problem areas in the German education system were identified that hinder the development of the teaching network. These problem areas were prioritized firstly according to the urgency of the solution from the point of view of the HiGHmed consortium and secondly according to existing competencies in the participating societies. A workshop on the four most relevant topics was organized with experts from the German Society for Medical Informatics, Biometry and Epidemiology (GMDS), the Society for Medical Education (GMA) and the HiGHmed consortium. These are: recognition of exam results from teaching modules that are offered digitally and across locations, and their integration into existing curricula; recognition of digital, cross-location teaching in the teachers' teaching load; nationwide uniform competencies for teachers, in order to be able to conduct digital teaching effectively and with comparable quality; technical infrastructure to efficiently and securely communicate and manage the recognition of exam results between educational institutions. For all subject areas, existing preliminary work was identified on the basis of working questions, and short- and long-term needs for action were formulated. Finally, a need for the redesign of a technologically supported syntactic and semantic interoperability of learning performance recording was identified.
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Affiliation(s)
- Nils-Hendrik Benning
- Heidelberg University Hospital, Institute of Medical Biometry and Informatics, Heidelberg, Germany
- HiGHmed Consortium, Working Group Teaching, Heidelberg, Germany
- *To whom correspondence should be addressed: Nils-Hendrik Benning, Heidelberg University Hospital, Institute of Medical Biometry and Informatics, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany, E-mail:
| | - Martin Haag
- Heilbronn University of applied sciences, GECKO Institute for Medicine, Informatics and Economics, Heilbronn, Germany
- German Society for Medical Informatics, Biometry and Epidemiology, WG Technology-based Teaching and Learning in Medicine, Germany
- Gesellschaft für Medizinische Ausbildung (Society for Medical Education), Committee on Digitization - Technology-Assisted Learning and Teaching, Erlangen, Germany
| | - Petra Knaup
- Heidelberg University Hospital, Institute of Medical Biometry and Informatics, Heidelberg, Germany
- HiGHmed Consortium, Working Group Teaching, Heidelberg, Germany
| | - Dagmar Krefting
- HiGHmed Consortium, Working Group Teaching, Heidelberg, Germany
- University Medical Center Göttingen, Department of Medical Informatics, Göttingen, Germany
- University of Applied Sciences Berlin, Berlin, Germany
| | - Otto Rienhoff
- HiGHmed Consortium, Working Group Teaching, Heidelberg, Germany
- University Medical Center Göttingen, Department of Medical Informatics, Göttingen, Germany
| | - Markus Suhr
- HiGHmed Consortium, Working Group Teaching, Heidelberg, Germany
- University Medical Center Göttingen, Department of Medical Informatics, Göttingen, Germany
| | - Inga Hege
- Gesellschaft für Medizinische Ausbildung (Society for Medical Education), Committee on Digitization - Technology-Assisted Learning and Teaching, Erlangen, Germany
- University of Augsburg, Medical School, Medical Education Sciences, Augsburg, Germany
| | - Daniel Tolks
- Gesellschaft für Medizinische Ausbildung (Society for Medical Education), Committee on Digitization - Technology-Assisted Learning and Teaching, Erlangen, Germany
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
- Leuphana University Lüneburg, Center for Applied Health Sciences, Lüneburg, Germany
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Affiliation(s)
- Patricia S O'Sullivan
- P.S. O'Sullivan is professor, Medicine and Surgery, University of California, San Francisco School of Medicine, San Francisco, California
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Philibert I. The International Literature on Teaching Faculty Development in English-Language Journals: A Scoping Review and Recommendations for Core Topics. J Grad Med Educ 2019; 11:47-63. [PMID: 31428259 PMCID: PMC6697281 DOI: 10.4300/jgme-d-19-00174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/01/2019] [Accepted: 05/23/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND With increasing physician mobility, there is interest in how medical schools and postgraduate medical education institutions across the world develop and maintain the competence of medical teachers. Published reviews of faculty development (FD) have predominantly included studies from the United States and Canada. OBJECTIVE We synthesized the international FD literature (beyond the US and Canada), focusing on FD type, intended audience, study format, effectiveness, differences among countries, and potential unique features. METHODS We identified English-language publications that addressed FD for medical faculty for teaching and related activities, excluding US and Canadian publications. RESULTS A search of 4 databases identified 149 publications, including 83 intervention studies. There was significant growth in international FD publications for the most recent decade, and a sizable number of studies were from developing economies and/or resulted from international collaborations. Focal areas echo those in earlier published reviews, suggesting the international FD literature addresses similar faculty needs and organizational concerns. CONCLUSIONS The growth in publications in recent years and a higher proportion of reporting on participant reactions, coupled with less frequent reporting of results, transfer to practice, and impact on learners and the organization, suggest this is an evolving field. To enhance international FD, educators and researchers should focus on addressing common needs expressed by faculty, including curriculum design and evaluation, small group teaching, assessing professionalism and providing feedback. Future research should focus on approaches for developing comprehensive institutional FD programs that include communities of learning and practice and evaluating their impact.
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Irby DM, O'Sullivan PS. Developing and rewarding teachers as educators and scholars: remarkable progress and daunting challenges. Med Educ 2018; 52:58-67. [PMID: 28771776 DOI: 10.1111/medu.13379] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/10/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
CONTEXT This article describes the scholarly work that has addressed the fifth recommendation of the 1988 World Conference on Medical Education: 'Train teachers as educators, not content experts alone, and reward excellence in this field as fully as excellence in biomedical research or clinical practice'. PROGRESS Over the past 30 years, scholars have defined the preparation needed for teaching and other educator roles, and created faculty development delivery systems to train teachers as educators. To reward the excellence of educators, scholars have expanded definitions of scholarship, defined educator roles and criteria for judging excellence, and developed educator portfolios to make achievements visible for peer review. Despite these efforts, the scholarship of discovery continues to be more highly prized and rewarded than the scholarship of teaching. These values are deeply embedded in university culture and policies. CHALLENGES To remedy the structural inequalities between researchers and educators, a holistic approach to rewarding the broad range of educational roles and educational scholarship is needed. This requires strong advocacy to create changes in academic rewards and support policies, provide a clear career trajectory for educators using learning analytics, expand programmes for faculty development, support health professions education scholarship units and academies of medical educators, and create mechanisms to ensure high standards for all educators.
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Affiliation(s)
- David M Irby
- Department of Medicine, UCSF, San Francisco, California, USA
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Prediger S, Harendza S. Analysis of educational research at a medical faculty in Germany and suggestions for strategic development - a case study. GMS J Med Educ 2016; 33:Doc71. [PMID: 27990467 PMCID: PMC5135420 DOI: 10.3205/zma001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 07/07/2016] [Accepted: 07/29/2016] [Indexed: 06/06/2023]
Abstract
Background: Evidence-based medical education is playing an increasingly important role in the choice of didactic methods and the development of medical curricula and assessments. In Germany, a growing number of educational research projects has accompanied an ongoing change in the medical education process. The aim of this project was to assess medical education research activities at one medical faculty to develop procedural recommendations for the support and development of best evidence medical education. Methods: Using a newly developed online questionnaire, the 65 institutes and departments of the medical faculty of Hamburg University at Hamburg University Medical-Center (UKE) were asked to report their medical education research and service projects, medical education publications, medical education theses, financial support for educational projects, and supportive structures that they would consider helpful in the future. The data were grouped, and a SWOT analysis was performed. Results: In total, 60 scientists who were involved in 112 medical education research publications between 1998 and 2014 were identified at the UKE. Twenty-five of them had published at least one manuscript as first or last author. Thirty-three UKE institutions were involved in educational service or research projects at the time of the study, and 75.8% of them received internal or external funding. Regular educational research meetings and the acquisition of co-operation partners were mentioned most frequently as beneficial supportive structures for the future. Conclusion: An analysis to define the status quo of medical education research at a medical faculty seems to be a helpful first step for the development of a strategy and structure to further support researchers in medical education.
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Affiliation(s)
- Sarah Prediger
- University Hospital Hamburg-Eppendorf, III. Medical Clinic, Hamburg, Germany
| | - Sigrid Harendza
- University Hospital Hamburg-Eppendorf, III. Medical Clinic, Hamburg, Germany
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Chiapponi C, Dimitriadis K, Özgül G, Siebeck RG, Siebeck M. Awareness of ethical issues in medical education: an interactive teach-the-teacher course. GMS J Med Educ 2016; 33:Doc45. [PMID: 27275510 PMCID: PMC4894361 DOI: 10.3205/zma001044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/30/2015] [Accepted: 12/21/2015] [Indexed: 05/28/2023]
Abstract
PURPOSE We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course. METHOD Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism. RESULTS We found a significant self-perceived increase in the participants' ability to identify and describe ethical issues and students' dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students' perspectives and teachers' and students' behaviors. In addition, participants' feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. CONCLUSION Ethics of education is an important issue for medical teachers. Teachers' self-perceived competence can be increased by working on case vignettes in small groups.
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Affiliation(s)
- Costanza Chiapponi
- Hospital of the University of Magdeburg (OvGU), Department of General, Visceral and Vascular Surgery, Magdeburg, Germany
| | | | - Gülümser Özgül
- Hospital of Aalen, Department of Gynaecology, Aalen, Germany
| | | | - Matthias Siebeck
- Hospital of the University of Munich (LMU), Department of General, Visceral, Vascular and Transplantation Surgery, Munich, Germany
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