Sustaining the surgical educator workforce in Australia and New Zealand

Development of a cumulative teaching score for tracking surgeon performance in undergraduate medical education

Background

Surgeon educators are important in undergraduate medical education (UME). However, teaching activities are undervalued and under-recognized compared with research, resulting in poorer quantity and quality of surgeon teaching. The purpose of this study was to investigate teaching roles available to surgeons and the amount of effort involved.

Methods

A comprehensive review of all possible roles surgeons may take in UME at our institution was assembled. Delphi committee members were asked to evaluate each teaching role on the amount of effort needed per hour. Results were analyzed using descriptive statistics, and a Cronbach α of 0.60 or higher was the threshold to declare consensus.

Results

Twenty-five participants, including physicians, residents and medical students, completed the study. Consensus was reached on the amount of effort needed for each teaching role. These values were used to prototype a cumulative teaching score that can be used to qualitatively quantify surgeon teaching.

Conclusion

Surgeon teaching is important in UME, but not tracked and thus not valued. To improve the quantity and quality of surgeon teaching in UME, we need to track, reward and recognize surgeon teaching activities. The “effort score” we developed to objectively and transparently qualify teaching was able to determine the relative effort needed for each teaching activity in UME at the University of Toronto. Combining the effort score and time committed to each teaching activity will produce a cumulative teaching score for each instructor.

Tensions in integrating clinician and educator role identities: a qualitative study with occupational therapists and physiotherapists

OBJECTIVE

Clinician educators (CEs) frequently report tensions in their professional identities as clinicians and educators, although some perceive a reciprocal relationship between clinical and teaching roles. However, it is unknown if the shared meanings of clinicians' multiple job roles translate to identity verification. We sought to examine CEs' perceptions of their clinician and educator roles and the influence of their perceptions on the salience of their professional identities.

DESIGN

Qualitative individual interviews and focus groups, analysed using framework analytic approach.

SETTING AND PARTICIPANTS

23 occupational therapy (OT) and 16 physiotherapy (PT) educators from two acute hospitals and one rehabilitation unit in Singapore.

RESULTS

PT and OT CEs constructed shared meanings of their clinician and educator roles through overcoming feelings of unease and inadequacy, discovering commonalities and establishing relevance. However, shared meanings between clinician and educator roles might not necessarily lead to mutual verification of their professional identities. Individuals' cognitive flexibility and openness to additional roles, and organisations' expectations had a mediating effect on the identity integration process. Less experienced CEs reported feelings of distress juggling the competing demands of both clinician and educator roles, whereas more experienced CEs appeared to be more capable of prioritising their job roles in different situations, which could be a result of differences in adaptation to frequent interruptions in clinical setting. Emphasis on patient statistics could result in failure in achieving identity verification, leading to feelings of distress.

CONCLUSION

Faculty developers should take into consideration the episodic nature of the educator identity construction process and develop induction programmes to assist CEs in building integrated identities.