A National Faculty Development Needs Assessment in Emergency Medicine

A comprehensive "real need" assessment, a step toward improving the quality of faculty development programs: A survey-based study in Hormozgan University of Medical Sciences

Background and Aims

Developing a framework to identify the "real" needs of faculty members, the gap between the current and desired conditions, would lead to an effective faculty development program (FDP) and improve higher education quality and health system promotion. For the first time in Iran, instead of needs assessment based on faculty members preferences or assessing needs only in a few areas, this study aimed to assess the difference between "self-rated level of skill" as the current condition and "perceived importance" as the expected condition, regarding all faculty roles and levels at Hormozgan University of Medical Sciences (HUMS).

Methods

This study used a research-made questionnaire that included 73 items within nine domains. The content validity of the questionnaire was confirmed, and Cronbach's alpha coefficient ranged from 0.86 to 0.96 for domains. The census method was applied. Participants rated their current skill level and perceived importance for professional development of each item on a 10-anchor scale. Statistical software, SPSS 19, analyzed the data using descriptive statistics and analytic tests.

Results

Significant differences existed among participants' ratings of skills and the importance of further training in various areas. Priority professional development domains were e-learning, curriculum development, personal development, program evaluation, leadership and management, student assessment, learning theories and teaching strategies, research and scholarship, and ethics and communication.

Conclusion

Additional formal training is required, especially in e-learning and curriculum development, for most faculty members at HUMS to enhance their academic performance. This study is the first needs assessment in Iran based on gaps between current and desired conditions. Conducting a "real needs" assessment before initiating an FDP is necessary for its feasibility.

Top emergency medicine faculty development papers since 2000: A Delphi study

Objectives

Faculty development is essential for academic emergency physicians to maintain clinical skills and succeed in administrative and leadership roles and for career advancement and satisfaction. Faculty developers in emergency medicine (EM) may struggle to find shared resources to guide faculty development efforts in a way that builds on existing knowledge. We aimed to review the EM-specific faculty development literature since 2000 and come to a consensus about the most useful for EM faculty developers.

Methods

A database search was conducted on the topic of faculty development in EM from 2000 to 2020. After identifying relevant articles, we performed a modified Delphi process in three rounds, using a team of educators with a range of experiences with faculty development and education research, to identify articles that would be most useful to a broad audience of faculty developers.

Results

We identified 287 potentially relevant articles on the topic of EM faculty development, 244 from the initial literature search, 42 from manual review of the references of the papers meeting inclusion criteria, and one by our study group's recommendation. Thirty-six papers met final inclusion criteria and underwent full-text review by our team. The Delphi process yielded six articles that were deemed most highly relevant over the three rounds. Each of these articles is described here, along with summaries and implications for faculty developers.

Conclusions

We present the most useful EM papers from the past two decades for faculty developers seeking to develop, implement, or revise faculty development interventions.

Faculty Development and the Emergency Medicine Educator: A National Needs Assessment

BACKGROUND

Faculty development (FD) encompasses structured programming that aims to enhance educator knowledge, skill, and behavior. No uniform framework for faculty development exists, and academic institutions vary in their faculty development programming, ability to overcome barriers, resource utilization, and achievement of consistent outcomes.

OBJECTIVE

The authors aimed to assess current FD needs among emergency medicine educators from six geographically and clinically distinct academic institutions to inform overall faculty development advancement in emergency medicine (EM).

METHODS

This cross-sectional study assessed FD needs among EM educators. A survey was developed, piloted, and distributed to faculty via each academic institution's internal e-mail listserv. Respondents were asked to rate their comfort level with and interest in several domains of FD. Respondents were also asked to identify their previous experience, satisfaction with the FD they have received, and barriers to receiving FD.

RESULTS

Across six sites, 136/471 faculty completed the survey in late 2020 (response rate of 29%): 69.1% of respondents reported being satisfied overall with the FD they have participated in, and 50.7% reported being satisfied with education FD specifically. Faculty report higher comfort levels and interest in several domains when satisfied with the education-specific FD they have received compared with those who report not being satisfied.

CONCLUSIONS

EM faculty report generally high satisfaction with the overall faculty development they have received, although only half express satisfaction with their education-related faculty development. Faculty developers in EM may incorporate these results to inform future faculty development programs and frameworks.

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.

Simulation in the Continuing Professional Development of Academic Emergency Physicians: A Canadian National Survey

INTRODUCTION

Simulation is becoming a popular educational modality for physician continuing professional development (CPD). This study sought to characterize how simulation-based CPD (SBCPD) is being used in Canada and what academic emergency physicians (AEPs) desire in an SBCPD program.

METHODS

Two national surveys were conducted from March to June 2018. First, the SBCPD Needs Assessment Survey was administered online to all full-time AEPs across 9 Canadian academic emergency medicine (EM) sites. Second, the SBCPD Status Survey was administered by telephone to the department representatives (DRs)-simulation directors or equivalent-at 20 Canadian academic EM sites.

RESULTS

Response rates for the SBCPD Needs Assessment and the SBCPD Status Survey were 40% (252/635) and 100% (20/20) respectively. Sixty percent of Canadian academic EM sites reported using SBCPD, although only 30% reported dedicated funding support. Academic emergency physician responses demonstrated a median annual SBCPD of 3 hours. Reported incentivization for SBCPD participation varied with AEPs reporting less incentivization than DRs. Academic emergency physicians identified time commitments outside of shift, lack of opportunities, and lack of departmental funding as their top barriers to participation, whereas DRs thought AEPs fear of peer judgment and inexperience with simulation were substantial barriers. Content areas of interest for SBCPD were as follows: rare procedures, pediatric resuscitation, and neonatal resuscitation. Lastly, interprofessional involvement in SBCPD was valued by both DRs and AEPs.

CONCLUSIONS

Simulation-based CPD programs are becoming common in Canadian academic EM sites. Our findings will guide program coordinators in addressing barriers to participation, selecting content, and determining the frequency of SBCPD events.

Faculty Sim: Implementation of an Innovative, Simulation-based Continuing Professional Development Curriculum for Academic Emergency Physicians

BACKGROUND

Maintaining and enhancing competence in the breadth of emergency medicine (EM) is an ongoing challenge. In particular, resuscitative care in EM involves high-risk clinical encounters that demand strong procedural skills, effective team leadership, and up-to-date clinical knowledge. Simulation-based medical education is an effective modality for enhancing technical and nontechnical skills in crisis situations and has been effectively embedded in undergraduate and postgraduate medical curricula worldwide. To our knowledge, there are few existing systematic department-wide simulation programs to address continuing professional development (CPD) for practicing academic EM faculty.

DEVELOPMENT PROCESS

We developed our novel, simulation-based CPD program following Kern's six-step model. Based on the results of a multimodal needs assessment, a longitudinal curriculum was mapped and tailored to the available resources. Institutional support was provided in the form of a departmental grant to fund a physician program lead, monthly session instructors, and operating costs.

OUTCOMES

CPD simulation sessions commenced in January 2017. Our needs assessment identified two key types of educational needs: 1) crisis resource management skills and 2) frequent practice of high-stakes critical care procedures (e.g., surgical airways). Simulation sessions involve two high-fidelity simulated resuscitations and one skills lab per day. To date, 21 sessions have been delivered, reaching 161 practicing EPs. Feedback from our faculty has been positive.

REFLECTIVE DISCUSSION

We have successfully introduced a curriculum of monthly simulation-based CPD based on the educational needs of our EPs. Future work will include more detailed program evaluation linked to clinical outcomes and program expansion to support nearby institutions.

Faculty development in the age of competency-based medical education: A needs assessment of Canadian emergency medicine faculty and senior trainees

OBJECTIVES

The Royal College of Physicians and Surgeons of Canada (RCPSC) emergency medicine (EM) programs transitioned to the Competence by Design training framework in July 2018. Prior to this transition, a nation-wide survey was conducted to gain a better understanding of EM faculty and senior resident attitudes towards the implementation of this new program of assessment.

METHODS

A multi-site, cross-sectional needs assessment survey was conducted. We aimed to document perceptions about competency-based medical education, attitudes towards implementation, perceived/prompted/unperceived faculty development needs. EM faculty and senior residents were nominated by program directors across RCPSC EM programs. Simple descriptive statistics were used to analyse the data.

RESULTS

Between February and April 2018, 47 participants completed the survey (58.8% response rate). Most respondents (89.4%) thought learners should receive feedback during every shift; 55.3% felt that they provided adequate feedback. Many respondents (78.7%) felt that the ED would allow for direct observation, and most (91.5%) participants were confident that they could incorporate workplace-based assessments (WBAs). Although a fair number of respondents (44.7%) felt that Competence by Design would not impact patient care, some (17.0%) were worried that it may negatively impact it. Perceived faculty development priorities included feedback delivery, completing WBAs, and resident promotion decisions.

CONCLUSIONS

RCPSC EM faculty have positive attitudes towards competency-based medical education-relevant concepts such as feedback and opportunities for direct observation via WBAs. Perceived threats to Competence by Design implementation included concerns that patient care and trainee education might be negatively impacted. Faculty development should concentrate on further developing supervisors' teaching skills, focusing on feedback using WBAs.

Faculty Mentoring Practices in Academic Emergency Medicine

BACKGROUND

Mentoring is considered a fundamental component of career success and satisfaction in academic medicine. However, there is no national standard for faculty mentoring in academic emergency medicine (EM) and a paucity of literature on the subject.

OBJECTIVES

The objective was to conduct a descriptive study of faculty mentoring programs and practices in academic departments of EM.

METHODS

An electronic survey instrument was sent to 135 department chairs of EM in the United States. The survey queried faculty demographics, mentoring practices, structure, training, expectations, and outcome measures. Chi-square and Wilcoxon rank-sum tests were used to compare metrics of mentoring effectiveness (i.e., number of publications and National Institutes of Health [NIH] funding) across mentoring variables of interest.

RESULTS

Thirty-nine of 135 departments completed the survey, with a heterogeneous mix of faculty classifications. While only 43.6% of departments had formal mentoring programs, many augmented faculty mentoring with project or skills-based mentoring (66.7%), peer mentoring (53.8%), and mentoring committees (18%). Although the majority of departments expected faculty to participate in mentoring relationships, only half offered some form of mentoring training. The mean number of faculty publications per department per year was 52.8, and 11 departments fell within the top 35 NIH-funded EM departments. There was an association between higher levels of perceived mentoring success and both higher NIH funding (p = 0.022) and higher departmental publications rates (p = 0.022). In addition, higher NIH funding was associated with mentoring relationships that were assigned (80%), self-identified (20%), or mixed (22%; p = 0.026).

CONCLUSIONS

Our findings help to characterize the variability of faculty mentoring in EM, identify opportunities for improvement, and underscore the need to learn from other successful mentoring programs. This study can serve as a basis to share mentoring practices and stimulate conversation around strategies to improve faculty mentoring in EM.