The View From the Top: Academic Emergency Department Chairs' Perspectives on Education Scholarship

Five hats of effective leaders: teacher, mentor, coach, supervisor and sponsor

BACKGROUND/AIM

Teaching, mentoring, coaching, supervising and sponsoring are often conflated in the literature. In this reflection, we clarify the distinctions, the benefits and the drawbacks of each approach. We describe a conceptual model for effective leadership conversations where leaders dynamically and deliberately 'wear the hats' of teacher, mentor, coach, supervisor and/or sponsor during a single conversation.

METHODS

As three experienced physician leaders and educators, we collaborated to write this reflection on how leaders may deliberately alter their approach during dynamic conversations with colleagues. Each of us brings our own perspective and lens.

RESULTS

We articulate how each of the 'five hats' of teacher, mentor, coach, supervisor and sponsor may help or hinder effectiveness. We discuss how a leader may 'switch' hats to engage, support and develop colleagues across an ever-expanding range of contexts and settings. We demonstrate how a leader might 'wear the five hats' during conversations about career advancement and burn-out.

CONCLUSION

Effective leaders teach, mentor, coach, supervise and sponsor during conversations with colleagues. These leaders employ a deliberate, dynamic and adaptive approach to better serve the needs of their colleagues at the moment.

Development of entrustable professional activities for emergency medicine medical education fellowships: A modified Delphi study

Background

It is essential that medical education (MedEd) fellows achieve desired outcomes prior to graduation. Despite the increase in postgraduate MedEd fellowships in emergency medicine (EM), there is no consistently applied competency framework. We sought to develop entrustable professional activities (EPAs) for EM MedEd fellows.

Methods

From 2021 to 2022, we used a modified Delphi method to achieve consensus for EPAs. EM education experts generated an initial list of 173 EPAs after literature review. In each Delphi round, panelists were asked to make a binary choice of whether to include the EPA. We determined an inclusion threshold of 70% agreement a priori. After the first round, given the large number of EPAs meeting inclusion threshold, panelists were instructed to vote whether each EPA should be included in the "20 most important" EPAs for a MedEd fellowship. Modifications were made between rounds based on expert feedback. We calculated descriptive statistics.

Results

Seventeen experts completed four Delphi rounds each with 100% response. After Round 1, 87 EPAs were eliminated and two were combined. Following Round 2, 46 EPAs were eliminated, seven were combined, and three were included in the final list. After the third round, one EPA was eliminated and 13 were included. After the fourth round, 11 EPAs were eliminated. The final list consisted of 16 EPAs in domains of career development, education theory and methods, research and scholarship, and educational program administration.

Conclusions

We developed a list of 16 EPAs for EM MedEd fellowships, the first step in implementing competency-based MedEd.

Five Key Articles on Curriculum Development for Graduate Medical Educators

Background Curriculum development is an essential domain for medical educators, yet specific training in this area is inconsistent. With competing demands for educators' time, a succinct resource for best practice is needed. Objective To create a curated list of the most essential articles on curriculum development to guide education scholars in graduate medical education. Methods We used a modified Delphi method, a systematic consensus strategy to increase content validity, to achieve consensus on the most essential curriculum development articles. We convened a panel of 8 experts from the United States in curricular development, with diverse career stages, institutions, gender, and specialty. We conducted a literature search across PubMed and Google Scholar with keywords, such as "curriculum development" and "curricular design," to identify relevant articles focusing on a general overview or approach to curriculum development. Articles were reviewed across 3 iterative Delphi rounds to narrow down those that should be included in a list of the most essential articles on curriculum development. Results Our literature search yielded 1708 articles, 90 of which were selected for full-text review, and 26 of which were identified as appropriate for the modified Delphi process. We had a 100% response rate for each Delphi round. The panelists narrowed the articles to a final list of 5 articles, with 4 focusing on the development of new curriculum and 1 on curriculum renewal. Conclusions We developed a curated list of 5 essential articles on curriculum development that is broadly applicable to graduate medical educators.

The effect of the Educational Scholar Program as a longitudinal faculty development program on the capability of educators as scholars

INTRODUCTION

The Educational Scholar Program (ESP) is designed and implemented as a longitudinal and institution-based faculty development program. The present study aimed to assess the effect of the ESP on educators' capabilities to undertake SoTL activities associated with their scholar role.

METHODS

This study was conducted from 2017 to 2022. The participants (n = 64) were educators in six schools of Shahid Sadoughi University of Medical Sciences. The ESP was a faculty development program that consisted of training and project-based stages. The educators experienced small-group learning, self-directed learning, and reflective assignments in the training stage. In the second stage, the educators completed a SoTL (Scholarship of Teaching and Learning) project. Learner-related outcomes based on Kirkpatrick model was assessed. The reaction of educators (satisfaction, active participation in the ESP, and the perception of mentoring sessions) was assessed by three questionnaires (Reaction level). The educators' learning was evaluated by modified essay questions and their project reports (Learning and Behavior levels). Outputs of the ESP including journal publications, abstracts presented at meetings or congresses, grant funding, awards in educational festivals, promotions, projects with ongoing implementation following the ESP, and conducting further SoTL projects after ESP were assessed quantitatively over two years after participating in the ESP (Results level). Data were summarized by descriptive statistics (mean, percentage, SD, 95% Confidence Interval (CI)). Cut-off scores of the instruments was calculated with a standard setting method which introduced by Cohen-Schotanus and Van DerVleuten. Data analyzed by One-sample t-test.

RESULTS

Sixty-four of 72 (89%) educators completed the ESP. The mean (CI) satisfaction score of educators was 42 (CI: 26.92-58.28), the active participation was 92 (CI: 80.24-103.76). The scores of the mentoring assessment from the perspective of the educators were reported at 90 (CI: 78.24- 101.76). The mean (95%CI) learning scores in the essay examination were 88 (CI: 70.36- 105.64), and project assessment were 90 (CI: 78.24- 101.76). The results showed the educators' scores in reaction and learning significantly higher than the cut-off scores. (P < 0.05). Most projects were conducted in curriculum development and assessment/evaluation domains. The number of projects with ongoing implementation over the two years following the ESP and the acquisition of grants was higher than other outputs in the results level.

CONCLUSION

The ESP, as an institute-based longitudinal program, enhanced the learner-related outcomes (in four levels of reaction, learning, behavior, and results). The creation of practical learning and supportive mechanisms influenced on the results. The outcomes of ESP indicated that the educators prepared to conduct SoTL activities in their educational community.

A developmental pathway toward leadership for educational change: the Educators' experiences of the educational scholar program

INTRODUCTION

The Educational Scholar Program (ESP) is a creative method to focus on the quality of education and the scholarship of education. This paper critically investigated how educational educators perceived the Educational Scholar Program.

METHOD

The ESP was developed according to the project-based learning method. An interdisciplinary strategy was used by participating educators from different schools, including nursing, medicine, public health, dentistry, and pharmacy. (n = 27). Semi-structured interviews explored the experiences of the participants in the ESP. A conventional content analysis approach introduced by Graneheim and Lundman was used for data analysis.

RESULTS

A theme of "a developmental pathway toward leadership for educational change" was explored into four categories: "Motivated for educational change," "collaborative learning through the application of knowledge," "tensions of change agent," and "a perceived responsibility of a change agent."

CONCLUSION

The participants perceived the ESP as a platform for improving leadership capabilities for educational change through the Scholarship of Teaching and Learning (SoTL). Using the ESP as a faculty development program to train educational leadership for change is suggested.

Is it worth it? A qualitative analysis of the impact of medical education fellowships on careers

Objectives

Medical education fellowships provide training in teaching, assessment, educational program administration, and scholarship. The longitudinal impact of this training is unknown. The objective of this study was to explore the impact of medical education fellowships on the careers of graduates.

Methods

The authors performed a qualitative study with a constructivist-interpretivist paradigm using semistructured interviews in 2021. The authors used a purposeful randomized stratified sampling strategy of graduates to ensure diversity of representation (gender, region, fellowship duration, and career stage). Two researchers independently analyzed interview transcriptions using a modified grounded theory approach.

Results

The authors interviewed 10 graduates and identified three overarching concepts: motivations for pursuing fellowship, benefits of training, and drivers of career development. Graduates sought training because of their desire for growth and career preparation and at the advice of mentors. Fellowships provided knowledge and skills in a structured learning environment, supported by mentors and a collaborative community. Fellowship training shaped the careers of graduates by increasing their self-efficacy, enhancing their outcome expectations, refining their goals, and influencing their professional identity formation. They acquired expertise that prepared them for jobs, developed credibility, felt competitive in the job market, anticipated successful promotion, reached for greater goals, broadened their educational worldview, and evolved their professional identity as a result of fellowship training.

Conclusions

Fellowship training in medical education provides knowledge and skills, a structured learning environment, and important relationships that shape the careers of graduates by impacting their self-efficacy, outcome expectations, goal creation, and professional identity formation.

A workforce study of emergency medicine medical education fellowship directors: Describing roles, responsibilities, support, and priorities

INTRODUCTION

Despite emergency medicine (EM) medical education fellowships increasing in number, the position of the medical education fellowship director (FD) remains incompletely defined. The goal of this study was to characterize the roles, responsibilities, support, and priorities for medical education FDs.

METHODS

We adapted and piloted an anonymous electronic survey consisting of 31 single-answer, multiple-answer, and free-response items. The survey was distributed to FDs via listserv and individual emails from a directory compiled from multiple online resources. We used descriptive statistics to analyze data from items with discrete answer choices. Using a constructivist paradigm, we performed a thematic analysis of free-response data.

RESULTS

Thirty-four medical education FDs completed the survey, resulting in a response rate of 77%. Thirty-eight percent of respondents were female. Fifty-three percent earned master's degrees in education and 35% completed a medical education fellowship. Most respondents held other education leadership roles including program director (28%), associate/assistant program director (28%), and vice chair (25%). Sixty-three percent received support in their role, including clinical buy-down (90%), administrative assistants (55%), and salary (5%). There was no difference (χ² [2, n = 32] = 1.77, p = 0.41) between availability of support and type of hospital (community, university, or public hospital). Medical education FDs dedicated a median of 12 h per month to fellowship responsibilities, include education (median 35% of time), program administration (25%), research mentorship (15%), and recruitment (10%). Medical education FDs describe priorities that can be categorized into three themes related to fellows, fellowship, and institution.

CONCLUSION

This study provides insight into the current position and experience of medical education FDs. The results can clarify the role and responsibilities of FDs as the demand for medical education FDs increases.

Elevating Radiology Education Research Through a Dedicated Research Fellowship: Adding Professional Identity as Essential for Success

RATIONALE AND OBJECTIVES

Education research has been undervalued in radiology, with few radiology journals having dedicated space for such research and barriers to production including dedicated time, resources, grant funding, and mentorship. As radiologists, we have an opportunity to study education in our unique learning environments and create more effective ways to teach that are grounded in established education theory, solid assessment methodologies, and a focus on merit as well as worth.

MATERIALS AND METHODS

The growth of education research in our field requires a two-pronged approach; We must cultivate leaders in education research from within our specialty, and continue to submit high quality work to radiology journals to increase exposure of the reviewers and readership to education methodologies.

RESULTS

We have created the first radiology education research fellowship to this end. This manuscript details the fellowship creation process, the first education research fellow experience, and in-depth analysis of the inaugural year via a qualitative program review.

CONCLUSION

We were successful in supporting an inaugural fellow in attaining the knowledge and skills to become a productive education researcher. Beyond this, the fellowship experience was a catalyst in developing her unique professional identity as an education master which will further raise the status of education research in pediatric radiology.

Outcome assessment of medical education fellowships in emergency medicine

OBJECTIVES

Medical education fellowships in emergency medicine (EM) provide training in teaching, assessment, educational program administration, and scholarship. The longitudinal impact of this training is unknown. Our objective was to characterize the career outcomes of medical education fellowship graduates.

METHODS

We solicited curriculum vitae (CV) from graduates of U.S. EM education fellowships by email. We abstracted data from CVs with a standard instrument that included program characteristics, employment history, leadership positions, awards, and scholarly productivity. We calculated and reported descriptive statistics.

RESULTS

A total of 71 of 91 (78%) graduates participated. Thirty-three completed a 1-year fellowship and 38 completed a 2-year fellowship. Nineteen (27%) completed an advanced degree during fellowship. Median (range) graduation year was 2016 (1997-2020). The majority, 63 of 71 (89%), work in an academic setting. Graduates held leadership positions in continuing medical education, graduate medical education, and undergraduate medical education. Forty-eight (68%) served on national medical education committees. The mean ± SD number of national medical education awards was 1.27 ± 2.03. The mean ± SD number of national medical education presentations was 7.63 ± 10.83. Graduates authored a mean ± SD of 3.63 ± 5.81 book chapters and a mean ± SD of 4.99 ± 6.17 peer-reviewed medical education research publications. Ten (14%) served on journal editorial boards, 34 (48%) were journal reviewers, and 31 (44%) had received a medical education grant.

CONCLUSION

EM medical education fellowship graduates are academically productive and hold education leadership positions.

Emergency Medicine Education Research Since the 2012 Consensus Conference: How Far Have We Come and What's Next?

In 2012, the Society for Academic Emergency Medicine convened a consensus conference on the state of medical education research with goals of defining and advancing a future research agenda. Since that time, emergency medicine (EM) education research has grown significantly. A task force of EM education experts was assembled and sought to understand the current state of EM education research and future directions. Among the advances are increases in medical education fellowships, advanced degree and certification programs, faculty development programs, publication venues, and funding. These findings are discussed in light of the prior objectives from the 2012 consensus conference, and recommendations for future directions are provided.

Research Pioneers in Emergency Medicine-Reflections on Their Paths to Success and Advice to Aspiring Researchers: A Qualitative Study

STUDY OBJECTIVE

Research in basic, translational, and clinical emergency medicine has made great strides since the formalization of emergency medicine as a specialty. Our objective is to identify and analyze strategies used by emergency medicine research pioneers to inform further advancement of research in emergency medicine, particularly for aspiring researchers and those in emerging areas, using emergency medicine medical education as one example.

METHODS

This was a prospective, grounded-theory, qualitative study, using a constructivist/interpretivist paradigm. Leading basic science, translational, and clinical emergency medicine researchers who completed residency before 1995 were eligible for structured interviews. Thematic coding followed an iterative process until saturation was reached. A theoretic model was developed and analyzed.

RESULTS

Research pioneers valued advanced methodological training and mentorship. Barriers to funding were lack of recognition of emergency medicine as a specialty, absence of a research history, and lack of training and funding resources. Deliberate interventions to improve emergency medicine research included educational sessions at national meetings, external (to emergency medicine) mentor pairings, targeted funding by emergency medicine organizations, and involvement with funding agencies. Pioneers facilitate research excellence by serving as mentors and allocating funds or protected time to develop researchers. To advance emerging subfields of research in emergency medicine, pioneers recommend advanced methodological training that is specific to the area, deliberate mentorship, and the formation of research consortia to conduct generalizable outcomes-based studies.

CONCLUSION

Research pioneers in emergency medicine cite mentorship, advanced skills obtained through fellowship or graduate degrees, deliberate collaboration with experienced researchers, support from emergency medicine organizations, and forming networks as the cornerstones of success.