Looking at the forest instead of counting the trees: an alternative method for measuring faculty's clinical education efforts

Establishing an educational value unit to promote teaching in an academic unit

BACKGROUND

In academic health centers, education remains an incompletely supported and funded mandate. In an attempt to promote education and better support educational endeavors of faculty, some academic health centers and departments have conceived of a metric, the educational value unit (eVU), to begin to "quantify" teaching. What goes into this metric, its intended goals and the logistics of its implementation vary considerably among centers.

LESSONS LEARNED

This practical advice paper highlights the various lessons learned from a review of the limited published literature on eVU systems supplemented with our personal experience in implementing a successful eVU system in the Department of Pediatrics at our institution, to help guide others who may be interested in doing that same. Even in limited-resource settings, our hope is that these lessons can serve as a guide on how to better quantify and reward teaching, whether through monetary or nonfiscal incentives and recognition.

Radiology Education in the 21st Century: Threats and Opportunities

Over the past 25 years, radiology has seen tremendous growth in interpretive demands, including increasing imaging volumes and shorter turnaround times, as well as increased noninterpretive demands often targeting value-adding opportunities. These mounting pressures have led to increased burnout among radiologists nationwide and, in the academic setting, have begun to threaten the core educational mission. Despite these threats, radiology has also proven itself over the years to be a leader when it comes to innovation, and as such, no other field is better suited to confront these challenges with innovative solutions. This article explores the impact these workload trends have had on radiology education and educators, as well as opportunities to confront these challenges.

Educational Added Value Unit: Development and Testing of a Measure for Educational Activities

OBJECTIVES

University-based hospitalists educate health care professionals as an expectation, often lacking time and support for these activities. The purpose of this study was to (1) develop a tracking tool to record educational activities, (2) demonstrate its applicability and ease of completion for faculty members in different divisions, and (3) compare educational efforts of individuals from different professional pathways and divisions by using the educational added value unit (EAVU).

METHODS

Educational activities were selected and ranked according to preparation effort, presentation time, and impact to calculate the EAVU. Faculty participants from 5 divisions at 1 institution (hospital medicine, general and community pediatrics, emergency medicine, behavior medicine and clinical psychology, and biostatistics and epidemiology) completed the retrospective, self-report tracking tool.

RESULTS

A total of 62% (74 of 119) of invited faculty members participated. All faculty earned some EAVUs; however, there was a wide distribution range. The median EAVU varied by division (hospital medicine [21.7], general and community pediatrics [20.6], emergency medicine [26.1], behavior medicine and clinical psychology [18.3], and biostatistics and epidemiology [8.2]). Faculty on the educator pathway had a higher median EAVU compared with clinical or research pathways.

CONCLUSIONS

The EAVU tracking tool holds promise as a mechanism to track educational activities of different faculty pathways. EAVU collection could be of particular benefit to hospitalists, who often perform unsupported teaching activities. Additional studies are needed to determine how to apply a similar process in different institutions and to determine how EAVUs could be used for additional support for teaching, curriculum development, and educational scholarship.

Examination of a clinical teaching effectiveness instrument used for summative faculty assessment

This study explores whether a clinical teaching effectiveness (CTE) instrument provides valid scores for summative faculty assessment. The sample included all CTE instruments (n = 10,087) that learners (N = 1,194) completed to assess clinical teachers (N = 872) during 1 academic year. The authors investigated response processes (e.g., missing data, straight-line responses, level of learner), internal structure (e.g., confirmatory and exploratory factor analysis), teaching ratings by learner group (medical student or resident), and relation to other variables (e.g., correlation with global rating). Response processes identified a high prevalence of straight-line responses (same rating across all items) and differential patterns of missing data by learner group. Medical students rated their teachers higher than residents, and CTE scores had different factor structures depending on learner group. High correlation coefficients of CTE items with a single rating of overall teaching performance suggest that learners consider global performance when assessing clinical teaching performance.

Aligning compensation with education: design and implementation of the Educational Value Unit (EVU) system in an academic internal medicine department

The authors report the development of a new metric for distributing university funds to support faculty efforts in education in the department of internal medicine at the University of Kansas School of Medicine. In 2003, a committee defined the educational value unit (EVU), which describes and measures the specific types of educational work done by faculty members, such as core education, clinical teaching, and administration of educational programs. The specific work profile of each faculty member was delineated. A dollar value was calculated for each 0.1 EVU. The metric was prospectively applied and a faculty survey was performed to evaluate the faculty's perception of the metric. Application of the metric resulted in a decrease in university support for 34 faculty and an increase in funding for 23 faculty. Total realignment of funding was US$1.6 million, or an absolute value of US$29,072 +/- 38,320.00 in average shift of university salary support per faculty member. Survey results showed that understanding of the purpose of university funding was enhanced, and that faculty members perceived a more equitable alignment of teaching effort with funding. The EVU metric resulted in a dramatic realignment of university funding for educational efforts in the department of internal medicine. The metric was easily understood, quickly implemented, and perceived to be fair by the faculty. By aligning specific salary support with faculty's educational responsibilities, a foundation was created for applying mission-based incentive programs.