How can clinician-educator training programs be optimized to match clinician motivations and concerns?

Understanding barriers, enablers and motivational factors for Australian healthcare educators teaching university students on clinical placement using the validated Physician Teaching Motivation Questionnaire

BACKGROUND

In Australia, university clinical programs rely heavily on external healthcare professionals to provide a range of authentic clinical training and professional development opportunities for students. There is, however, a limited understanding of the factors that motivate these professionals to be educators and whether this varies across different healthcare disciplines within Australia. As the demand for clinical placements continues to increase, it is critical for the ongoing success of these programs that universities identify both the barriers associated with teaching and the benefits that enhance job satisfaction.

METHODS

A two-part questionnaire was emailed to 849 external healthcare educators teaching predominantly in Medicine, Medical Imaging, and Optometry programs at Deakin University. Part-one surveyed the socio-demographics, perceived benefits, and barriers to teaching, plus the utilisation of entitlements offered by the university. Part-two was modelled on Dybowski and Harendza's validated Physician Teaching Motivation Questionnaire (PTMQ) and adapted to an Australian audience.

RESULTS

Overall, 776 out of the 849 questionnaires were considered in the final participant pool. The response rate for part-one was 19.7% (n = 153/776) and 18.3% (n = 142/776) for part-two. Across all professions, altruism was the primary source of motivation for teaching in Deakin University's healthcare programs. Medical Imaging educators placed a higher value on career-related teaching aspects compared to those in Medicine and Optometry (p < 0.003). The resources and benefits associated with teaching were generally perceived to be of minimal importance. External healthcare educators most commonly reported that there were no barriers to teaching (41.3%, n = 78) however, increased workloads and time constraints were the next most likely factors to affect teaching participation (31.8%, n = 60).

CONCLUSION

Our validated adaptation of the PTMQ successfully targeted healthcare professions not focussed on by Dybowski and Harendza. Altruistic motivation was the overarching theme for why Australian external healthcare educators contribute to teaching with some differences in career-driven motivation additionally acknowledged. Despite there being no key benefits or barriers to teaching participation, universities must remain cognisant of the factors that influence the recruitment and retention of external healthcare educators and how to optimise these for the ongoing success and sustainability of their teaching programs.

How to… support others in developing a career in clinical education research

The Incubator for Clinical Education Research (ClinEdR) is a UK-wide network, established with support from the National Institute for Health Research, to lead initiatives to build capacity in the field. A key barrier identified by this group is that many experienced educators, clinicians, and researchers, who may be committed to supporting others, have little guidance on how best to do this. In this "How to …" paper, we draw on relevant literature and our individual and collective experiences as members of the National Institute for Health Research ClinEdR incubator to offer suggestions on how educators can support others to develop successful careers involving ClinEdR. This article offers guidance and inspiration for all professionals whose role involves research and scholarship and who encounter aspiring or developing clinical education researchers in the course of their work. It will also be of interest to researchers who are starting out and progressing in the field.

Job characteristics that enrich clinician-educators' career: a theory-informed exploratory survey

Clinician educators (CEs) play a vital role in helping academic institutions achieve the missions of patient care, education and research. The driving forces that motivate pediatric CEs in professional growth and personal satisfaction remain unexplored. An exploratory survey research to investigate the job characteristics and factors that motivate CEs to pursue professional growth with personal satisfaction. Using the Job Characteristics Model (JCM) as a framework, we developed a 22-item survey comprised of the JCM derived Job Diagnostic Survey, Global Job Satisfaction scales and demographics. We collected data from January 2020 to March 2020 from self-identified pediatric CEs (with and without educational leadership roles) through a survey recruitment service. Given no data on total number of CEs in the survey pool, response rate was unknown. Job characteristics in the core job dimensions of meaningfulness, autonomy, and performance feedback, as well as, the derived Motivating Potential Score (MPS), were analyzed using descriptive statistics and regression models. From 201 respondents, including 55 education leaders, >70% were satisfied with patient care, teaching, and mentoring while <40% were satisfied with administrative and scholarly activities. Meaningfulness (in some areas), autonomy (patient care/teaching), and internal feedback (all areas) had significant effects on job satisfaction. In regression analysis, skill variety, feedback, and years of experience were associated with higher job satisfaction, and the MPS was a predictor of total job satisfaction. The JCM can be utilized to understand CE's motivations and needs within their workplace and guide professional development via job enrichment efforts.

Teaching motivators, facilitators, and barriers among dermatology volunteer clinical faculty

Volunteer clinical faculty in private practice provide important clinical teaching and mentorship to dermatology residency programs. Motivations for serving as volunteer clinical faculty in specialties such as obstetrics and gynecology, emergency medicine, and family medicine have been identified; however, there is limited data on what drives private practice physicians to volunteer to teach in dermatology residency training programs. This study examined motivators, facilitators, and barriers to serving as volunteer clinical faculty using an anonymous survey of dermatologists, Mohs surgeons, and dermatopathologists affiliated with Emory University's dermatology residency program. Among the 38 invited participants, 26 (68%) completed the survey. The types of practices represented include general dermatology (71%), Mohs surgery (23%), cosmetic dermatology (58%), and dermatopathology (27%). Traditional lectures and impromptu teaching sessions were the most utilized teaching modalities, with 14 (54%) and 11 (42%) of respondents reporting usage, respectively. Most respondents ranked altruistic statements such as "opportunity to be helpful to others" (26, 100%), "providing service to the field of dermatology" (25, 96%), and "enjoyment of teaching" (25, 96%) as important motivations. In contrast, extrinsic rewards such as career advancement and increased income were rated as least important. Significant barriers included limited time for travel and teaching and credentialing. Proposed facilitators included promoting schedule flexibility, increasing teaching supplies, and streamlining credentialing. This single-center study may have limited generalizability to other residency programs with varying characteristics. The motivators, facilitators, and barriers identified by this survey can inform dermatology residency programs on how to maximize volunteer clinical faculty recruitment, retention, and engagement, thus strengthening clinical teaching and mentorship offered.

Establishing the Need for Standardized Clinical Educator Training Programs for Medical Laboratory Professionals

BACKROUND

There is minimal, if any, training for clinical educators in medical laboratory professions. This leads to challenges with teaching, assessment and workload/training balance. Hence, the need for standardized clinical educator training.

METHOD

A survey was developed, validated and deployed to medical laboratory professionals. Responses were analyzed using SPSS. Responses from two open-ended questions-is clinical educators' training important and how is this training beneficial?-were analyzed using thematic analysis.

RESULTS

Most participants indicated that clinical educator training is important (99.4%). However, 72.4% received no formal training prior to training student. Themes from the importance of training include: Equip clinical educators, body of knowledge, standardize training and quality of training. Themes that emerged from the benefits of clinical educators training involve Training content, logistics, professional behavior and technical skills.

CONCLUSION

Clinical educators' training is crucial and valuable. Standardized training on pedagogy and other success strategies are warranted for successful clinical experiences.

Students' perception of private supplementary tutoring during medical undergraduate study in some Egyptian universities

Purpose

The current work aimed to investigate the private tutoring phenomenon among Egyptian medical faculty students.

Design/methodology/approach

The present work is a cross-sectional observational study using an online, anonymous questionnaire disseminated to Egyptian medical students and instructors via social platforms and university e-mails. All subjects involved in the survey gave informed consent to begin the questionnaire. No financial incentives were awarded to finish the questionnaire.

Findings

In total, 79.2% of the surveyed students (n = 198) admitted taking private medical courses during their medical study courses till the date of the survey. The Egyptian students, 68.4% (n = 171), markedly surpassed the non-Egyptian participants (n = 79, 31.6%). Males were nearly double the female participants (n = 162 and 88 consecutively).The highest academic-level-seeking private medical tutoring was the fifth-year students (n = 66, 26.4%).

Research limitations/implications

A large sample size is needed to strengthen the statistical power and permit the generalization over the population, so more research work in this aspect is recommended. Also, subject-specific data in private medical tutoring need to be investigated in future works. Similar global work is recommended to allow better comparison of data worldwide.

Originality/value

When conceptualizing medical education processes and developing its regulations, the dynamics of private medical instruction should be taken into account, especially concerning socioeconomic inequities and efficiency in medical school systems. This work has been the first to investigate the private tutoring phenomenon among Egyptian medical students to the authors' best knowledge.

Faculty motivations for leading clinical clerkship electives: A qualitative study

PURPOSE

Faculty are motivated to pursue clinician-educator careers out of a sense of purpose, duty, connectedness, satisfaction, and mastery. Yet, many suffer from burnout due to a lack of funding, resources, and competing clinical demands. Reasons for clinician-educator participation in unfunded educational leadership positions are underexplored. This study examined faculty members' reasons for volunteering and remaining as clerkship elective directors, an unfunded leadership position.

METHODS

In this qualitative study, the authors conducted 17 semi-structured interviews with clerkship elective directors in March 2021. The authors conducted a thematic analysis of deidentified transcripts using motivation theories as a lens.

RESULTS

Directors' motivations to engage in this unfunded educational leadership position stemmed from their existing clinician-educator identity and a sense of purpose and duty. Directors are sustained by the satisfaction derived from witnessing the positive impact they have on learners' career development and skills building, the impact of learners on the clinical environment, as well as personal benefits in the mastery of educator skills and enhanced visibility as educators.

CONCLUSIONS

Unfunded educational leadership positions can advance clinician-educators' commitment to learners and alter the learning environment. Strategies for faculty recruitment and retention in unfunded leadership positions include ensuring meaningful contact with learners, as well as opportunities for personal career development through skills building and enhanced visibility through recognition.

Neglecting physician desires to teach at an academic medical facility: A mixed method investigation of the consequences

PURPOSE

Recent findings have suggested that physicians who spend more time participating in their most meaningful job activities (e.g. teaching) are less likely to experience burnout. The current study aimed to expound upon this finding, focusing specifically on the role of teaching in promoting meaning and preventing burnout.

METHOD

A total of 428 physicians at a large academic healthcare institution completed an online survey that included measures of burnout and other relevant variables. In the second part of this study, 20 physicians participated in interviews with the aim of expounding upon and contextualizing the findings from Part 1.

RESULTS

Results from Part 1 suggested that although meaningfulness derived from teaching was associated with reduced burnout, this association was only true for those who indicated that clinical teaching was among the most meaningful parts of being a physician. In addition, physicians were less likely to spend time working on their most meaningful job activity when it was teaching. Part 2 illustrated why teaching in the clinical environment can be so meaningful and protective against burnout.

CONCLUSIONS

Many physicians are unable to teach due to the increasing demands of medical institutions, which may contribute to the increasing levels of burnout in healthcare providers.

Structure and impact of longitudinal Graduate Medical Education curricula designed to prepare future clinician-educators: A systematic scoping review: BEME Guide No. 74

BACKGROUND

Many Graduate Medical Education (GME) programs offer clinician-educator curricula. The specific instructional methods employed and current best practices for clinician-educator curricula are unknown. We aimed to characterize the structure, curriculum content, instructional methods, and outcomes of longitudinal GME clinician-educator curricula.

METHODS

We conducted a scoping review, registered with BEME, by comprehensively searching health science databases and related grey literature from January 2008 to January 2021 for studies involving longitudinal GME curricula aimed to train future clinician-educators.

RESULTS

From 9437 articles, 36 unique curricula were included in our review. Most curricula were designed for residents (n = 26) but were heterogeneous in structure, instructional methods, and content. Several curricular themes emerged, including: 1) duration ≥ 12 months, 2) application of theory-based didactics with experiential activities, 3) independent projects, 4) exposure to faculty mentorship and educator communities, 5) strengthening competencies beyond teaching and scholarship, and 6) protected time and funding. Most outcomes were positive and focused on learner satisfaction or behavior change related to scholarly output and career tracking.

CONCLUSIONS

Curricula in our review included important skills including experiential teaching, scholarly projects, and exposure to educator communities. Future curricula should build on these competencies and include more assessment of learner and program outcomes.

Expert Veterinarians Should Be Trained Expertly: Fostering the Development of Adaptive Expertise in Veterinary Students through Faculty Development for Veterinary Educators

The field of health professions education is rapidly evolving, and with it the field of veterinary education. This discussion piece amalgamates literature across health professions education to provide a picture of what a veterinary clinician-educator is, why there is a need for veterinary clinician-educators when developing learners with adaptive expertise, and how faculty development can support the growth of clinicians into clinician-educators. It is intended to outline the best practices for fostering the development of adaptive expertise in veterinary students through faculty development for veterinary educators.

The effect of a medical student on community preceptor productivity

BACKGROUND

Medical students are increasingly being taught in community-based hospitals and clinics in addition to university-based health systems, and there is sustained interest in the question of whether medical schools should pay healthcare organizations to allow students to precept to compensate for loss of productivity by preceptors. This study aimed to inform this subject by investigating the effect of medical students on preceptor productivity.

METHODS

The authors analysed retrospective data on preceptor productivity and time efficiency from 17 outpatient primary care physicians over 7 months and 38,205 patient visits. Then, the authors surveyed these same physicians to assess how they believe precepting medical students affected their productivity.

RESULTS

The retrospective data analysis found that physicians see slightly more patients per half-day when accompanied by a student. In surveys, these physicians reported the same number of patients seen per half-day with or without a medical student, but more time spent in clinic with a medical student. They also reported that allowing students to document in the medical record often helped reduce/offset the lengthened workday.

CONCLUSIONS

Medical students either increase or do not change the number of patients seen per half-day but can increase preceptor time spent in clinic per day. Generally, physicians accept this increased time for the sake of promoting education and the joy of teaching. These findings can inform medical schools and healthcare organizations when negotiating financial arrangements for preceptorships in community based primary care clinics. Specifically, these findings suggest that medical students precepting do not cost the hospital organization in terms of preceptor productivity.

Survey of faculty development in four Israeli medical schools: clinical faculty development is inadequate and clinical teaching is undervalued in Israeli faculties of medicine

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.

Developing a Practical Medical Educator Training Program: Meeting A Need in Faculty Development

This article was migrated. The article was marked as recommended. Faculty who teach in medical schools typically do so because of their knowledge and expertise in their field, yet few receive training in best practices in teaching. Educator development programs that help faculty enhance their teaching skills while continuing to fulfill their existing professional responsibilities can help address this gap. Such programs may be developed and implemented locally by individuals within the institution. This guide is intended for individuals who are interested in developing educator training programs but who lack experience in program development. The article describes practical strategies for designing, implementing, and evaluating a collaborative program to teach skills and best practices in medical education. Key themes in program design, program implementation, and program evaluation and dissemination include appropriate goal setting, setting clear expectations, strong communication, and the benefits of diversity in collaboration. Educator training programs provide enhanced teaching skills and opportunities for career advancement for participants at all career stages, which in turn benefits the institution and the medical profession.

'We have different needs': Specifying support for classroom and clinical sessional educators

CONTEXT

Both classroom and clinical sessional educators are often overlooked in faculty development, even though they play an important role in student learning. Our aim was to contrast classroom and clinical sessional educators´ experiences of and perceived needs for connectedness, appreciation and support, in relation to their teaching quality. We then utilised these results to make suggestions for supporting these educators.

METHODS

The participants (11 physical therapy sessional educators: four clinical; seven clinical, and classroom) took part in three focus groups. We based the interview guide questions on previous survey results, used a critical theory research paradigm and performed thematic analysis.

RESULTS

We identified four emerging differences between physical therapy sessional educators with experience in the classroom and clinic. Classroom sessional educators needed: (a) more connectedness; (b) more appreciation; (c) more access to the learning management system, and (d) both different and similar faculty development when compared to clinical sessional educators. Differences were greater in classroom sessional educators who taught more hours. We also saw similarities in the need for feedback on teaching, orientations and communication, a better salary and clinical workplace support their role of an educator. Suggestions for context-dependent support for sessional educators were designed to address these similarities and differences.

CONCLUSIONS

Talking to various types of sessional educators about their teaching needs is the first step in providing effective faculty development. Varying needs for connectedness, appreciation, pedagogy and access to the learning management system amongst physical therapy sessional educators highlighted the need for an investment in classroom educators who teach multiple hours and want to grow as health science educators. Differences between classroom and clinical sessional educators brought to the forefront the importance of individualised, contextual faculty development and administrative or departmental action that supports sessional educators. The resulting context-dependent suggestions for improvement of support of sessional educators have the potential to improve the quality of health science teaching overall.

The Effect of Teaching Family Medicine Clerkship Students on Preceptor Productivity

INTRODUCTION

High-quality, experiential learning in outpatient settings is indispensable for medical student education; however these settings are difficult to recruit and retain. The majority of primary care physicians are employed by organizations and are under pressure to increase their relative value unit (RVU) production. Although the common perception that teaching medical students decreases productivity is unproven, it is likely a barrier for primary care physicians pursuing clinical teaching. We sought to investigate whether medical student teaching affects clinical productivity.

METHODS

We recruited 15 family medicine (FM) clerkship sites to participate in our study via email and at an in-person meeting. For each preceptor, we collected billing data in the form of current procedural terminology (CPT) codes for all patient encounters and the number of patients seen per half-day for when the preceptor had a student and when they did not. We converted CPT codes to RVU data. We compared differences in productivity for each individual preceptor, and we used a paired t test to examine collective data with and without a student.

RESULTS

Ten preceptors at six FM clerkship sites provided reliable data. The average RVU per half-day without a student was 10.84, and it was slightly higher at 11.25 when a student was present (P=.74). The average number of patients seen per half-day without a student was 8.32 and it was slightly lower at 7.87 when a student was present (P=.58).

CONCLUSION

This study shows promising data that teaching students in the outpatient setting does not decrease preceptor productivity. This pilot study can lead to a larger-scale exploration of family medicine preceptor productivity in different settings and institutions.

"A Friendly Place to Grow as an Educator": A Qualitative Study of Community and Relationships Among Medical Student Coaches

PURPOSE

The rise of coaching programs in medical education sparks questions about ways to support physician coaches in learning new educational practices specific to coaching. How coaches learn from one another is of particular interest considering the potential value of social learning. Using communities of practice as a conceptual framework, the authors examine the sense of community and relationships among coaches in a new medical student coaching program, the value of this community, and the facilitators and barriers influencing community development.

METHOD

In this qualitative study, investigators conducted 34 interviews with physician coaches at 1 institution over 2 years (2017-2018) and observed 36 coach meetings. Investigators analyzed interview transcripts using thematic analysis and used observation field notes for context and refinement of themes.

RESULTS

Coaches described a sense of community based on regular interactions; shared commitment to medical education; and new roles with similar experiences, joys, and challenges. They valued the sense of camaraderie and support, learning from one another, and opportunities for professional growth that strengthened their identities as educators and enhanced job satisfaction. Facilitators of community included regular meetings, leadership and administrative support, and informal opportunities to interact outside of meetings. Barriers included time constraints and geographic challenges for coaches at off-site locations.

CONCLUSIONS

The sense of community among coaches was a valued and beneficial part of their coaching experience. Coaches' interactions and relationships promoted skill acquisition, knowledge transfer, professional development, and career satisfaction. Thus, incorporating support for social learning in coaching programs promotes coach faculty development.

Teacher training for rheumatology fellows: a national needs assessment of fellows and program directors

INTRODUCTION

Teaching is an integral part of what we do as physicians, and exposure to training on how to effectively teach is not consistently implemented in the curricula within medical training.

METHODS

We administered anonymous, in-person surveys to fellows and program directors (PDs) at the 2017 American College of Rheumatology national conference to evaluate fellow and PD attitudes regarding development of programs dedicated to teaching fellows on how to teach.

RESULTS

One hundred seven of 150 fellows returned surveys (response rate 71%). About 60% demonstrated interest in pursuing a teaching-focused career. About 97% felt their teaching skills can be improved; 88% felt improved teaching skills will be valuable for their career. With 61% response rate (57/94 PD surveys), most PDs agreed their fellows could use additional instruction in teaching. About 90% noted this would be an asset for fellows' careers. When compared, 56% of fellows reported no structured training in education during fellowship, while 64% of PDs said this type of training was available. All agreed fellow teaching skills can be improved but significantly more fellows than faculty felt confident in the fellows' ability to give feedback (p = 0.03). Both groups identified time constraints and other faculty interest as barriers.

CONCLUSION

There is significant need to develop effective fellow-as-teacher programs aimed at enhancing fellows' teaching skills, with focus on giving feedback and working within fellow and faculty time constraints. The program can help address a curriculum gap identified by fellows as well as PDs before fellowship-to-faculty transition.Key Points• There is a notable gap between faculty physicians' expectations to teach as clinician-educators and the lack of training dedicated to learning how to teach during medical training. Despite the fact that past clinical educators have identified instructional design and assessment as low-confidence areas, there is a paucity of structured program dedicated to developing these teaching skills during fellowship training.• With 97% fellows and 84% program directors, both groups agreed fellows could use additional instruction in teaching skills, but there was a significant discrepancy between fellow and program director perspectives regarding fellows' ability to give feedback.• Consistent with past needs assessments in other medical specialties, lack of time and potential faculty interest were recognized as potential barriers, calling for a structured training program dedicated to education on didactics that takes into account trainee and faculty time constraints.• Our needs assessment can direct future research on analyzing effectiveness of fellow-as-teacher program implementation by focusing on improvement of fellow teaching and feedback skills.

Needs, motivations, and identification with teaching: a comparative study of temporary part-time and tenure-track health science faculty in Iceland

BACKGROUND

About 70% of teachers who instruct healthcare students are considered sessional (adjunct/temporary part-time) faculty and receive limited instruction in pedagogy. Sessional faculty may feel isolated and struggle with their teacher identity, and are often assumed to vary in their commitment, motivation, and ability to teach. However, research on teaching identity, motivations, and needs of sessional faculty is lacking. The aim of this study was to compare similarities and differences between sessional and tenure-track faculty across a health science school to guide faculty development for sessional faculty.

METHODS

We developed an online needs assessment survey, based on informal interviews and literature reviews. Seventy-eight tenure-track faculty and 160 sessional faculty completed the survey (37, 25% response rate, respectively). We used validated scales to assess intrinsic motivation, identified regulated motivation, and identification with teaching, as well as developed scales (perceived connectedness, motivated by appreciation to try new teaching method) and single items. All scales demonstrated good internal consistency. We compared sessional and tenure-track faculty using t-tests/chi-square values.

RESULTS

We found similarities between sessional and tenure-track faculty in intrinsic motivation, identified regulated motivation, and identification with teaching. However, sessional faculty perceived less department connectedness and were more motivated to improve instruction if shown appreciation for trying new teaching methods. Sessional faculty agreed more that they desired pedagogy instruction before starting to teach and that teachers should invest energy in improving their teaching. Admitting to less participation in activities to enhance teaching in the last year, sessional faculty were more interested in digital formats of faculty development.

CONCLUSION

Our comparison suggested that sessional faculty value being a teacher as part of their self, similar to tenured faculty, but desired more appreciation for efforts to improve and perceived less connectedness to their university department than tenured faculty. They also preferred digital formats for pedagogy to improve accessibility, prior to and throughout their teaching career to support their development as teachers. Using this information as a guide, we provide suggestions for faculty development for sessional faculty. Supporting sessional faculty in the health sciences should improve the quality of teaching and positively affect student learning.

Identification of training opportunities in medical education for academic faculty

Introduction: Clinician-educators are responsible for providing education to trainees in medical centers. There is no clear overview of what opportunities exist for training clinician-educators in medical education related skills and techniques. Methods: We conducted a systematic review of multiple websites and a medical educator listserve to identify medical education training opportunities for clinician-educators. We included certificate level programs or programs with comparable recognition and excluded masters programs, programs specific to one medical specialty or institution, and brief modules/sessions. We categorized results by training/focus area(s) and program details relevant for faculty. Results: We identified 53 programs. Most focus on general medical education skills (N = 19, 36%), leadership (N = 18, 34%), or learner assessment (N = 16, 30%). Fourteen programs (26%) were exclusively online, 27 (56%) exclusively in-person, and 12 (23%) require in-person and distance components. Time requirements for completion vary greatly, ranging from 1 day to 3 years, as did program costs, ranging from $327 to $15,000. Conclusions: Although training programs in medical education for clinical faculty exist, most focus on general medical education, leadership, and assessment. More programs focused on other topics, such as simulation or educational research, may be needed. Future investigations to understand the needs of this population would be valuable.

Willingness, concerns, incentives and acceptable remuneration regarding an involvement in teaching undergraduates - a cross-sectional questionnaire survey among German GPs

BACKGROUND

Worldwide, many undergraduate general practice curricula include community-based courses at general practitioners' (GPs') offices. Usually the academic general practice departments collaborate with networks of affiliated teaching practices. To successfully master the challenge of network development and extension, more information is needed about GPs' willingness to be involved in different teaching formats, important influencing factors, incentives, barriers, and the need for financial compensation.

METHODS

In this cross-sectional study a questionnaire survey was conducted among all GPs working in Leipzig and environs (German postal code area 04). In addition to descriptive statistics, group comparisons and logistic regression were performed to reveal differences between GPs with and without an interest in teaching.

RESULTS

Response rate was 45.3% with 339 analyzable questionnaires. The average age was 52.0 years and 58.4% were women. Sixty-two participants stated that they were already involved in teaching undergraduates. Altogether 60.1% of all GPs and 53.5% among those who didn't teach yet were basically interested in being involved in undergraduate education. The interested GPs could imagine devoting on average 6.9 h per month to teaching activities. GPs interested in teaching were on average younger, were more actively involved in continuing education and professional associations, and more frequently had pre-existing teaching experiences. The willingness to teach differed substantially among teaching formats. GPs were more willing to teach at their own practices rather than at university venues and they preferred skills-oriented content. Comprehensive organization on the part of the university including long-term scheduling and available teaching materials was rated as most important to increase the attractiveness of teaching. Time restraints and decreased productivity were rated as the most important barriers. Interested GPs appreciated financial compensation, particularly for teaching at university venues, and demanded amounts of money corresponding to German GPs' hourly income.

CONCLUSIONS

The GPs' interest in undergraduate teaching is generally high indicating a substantial pool of potential preceptors. Recruitment strategies should consider the collaboration with institutions involved in residency and continuing education as well as with professional associations. Comprehensive organization by the responsible department should be promoted and time restraints and decreased productivity should be overtly addressed and financially compensated.

Physicians as Teachers and Lifelong Learners

INTRODUCTION

Lifelong learning requires sustained motivation for learning. Employing a motivational theory framework, we investigated the relationships of psychological need satisfaction, clinical teaching involvement, and lifelong learning of physicians at different career stages and in various medical specialties. We also examined the associations of physician lifelong learning with stress, burnout, teaching enjoyment, and life satisfaction, all of which are essential for physician well-being and, ultimately, for the provision of quality patient care.

METHODS

This was a cross-sectional study. Using survey methodology, quantitative data were collected from 202 practicing physicians in Canada. The questionnaire contained validated scales of physician lifelong learning and psychological need satisfaction, measures of clinical teaching (involvement and enjoyment), stress level, burnout frequency, and life satisfaction. Analysis of covariance and correlational analysis were performed.

RESULTS

On average, participants reported moderate to moderately high levels of lifelong learning, psychological need satisfaction, teaching enjoyment, and life satisfaction. Irrespective of career stage and specialty, physicians' psychological need satisfaction and involvement in clinical teaching were significant in relation to lifelong learning. That is, physicians who experienced greater psychological need satisfaction at work and those who were involved in clinical teaching had, on average, higher lifelong learning scores. Physician lifelong learning had significant associations with life satisfaction and teaching enjoyment but not with stress level and burnout frequency.

DISCUSSION

Fulfilling physicians' basic psychological needs at work and supporting them in their teaching roles is likely to enhance physician lifelong learning and, ultimately, quality of patient care.

A Method to Study the Effect of a Physician Assistant Student on Preceptor Productivity

PURPOSE

Guided clinical experience is a critical component of a physician assistant (PA) student's education. However, clinical precepting is strongly perceived to have deleterious effects on productivity. In this study, we sought to test a method for evaluating the effect that PA students have on clinical productivity.

METHODS

We recruited 14 family medicine preceptors and second-year PA students from 2 programs, the University of Washington (UW) and the University of Texas Health Science Center San Antonio (UT). We collected productivity data during 3 weeks of preceptor clinical practice-one week without a PA student present and 2 weeks with a PA student present (one week early in the student's family medicine clinical rotation and a second week late in the rotation). We collected preceptor demographic data, patient characteristics, and the primary outcome-relative value units (RVUs) per preceptor per half-day during the 3 data collection weeks. At the end of the study, we asked preceptors about the ease of data collection and any negative effects of the study itself on their clinical productivity.

RESULTS

No significant differences were found in preceptor demographics or in patient characteristics, numbers of patients, or RVUs per patient seen in any of the weeks or between UW and UT. In this pilot study, no significant differences were seen in RVUs per preceptor per half-day between the 3 weeks of observation or between UW and UT.

CONCLUSION

In this pilot study, the protocol was straightforward, unintrusive, and preliminarily showed no significant effects of a PA student on preceptor productivity.

Why do surgeons teach? A qualitative analysis of motivation in excellent surgical educators

INTRODUCTION

Given that teaching is so vital to the maintenance of the medical profession, it is surprising that few authors have examined the factors which motivate physicians and surgeons to engage in this activity.

AIM

It was the aim of this study to examine the factors which motivate excellent surgical educators to teach.

METHODOLOGY

Grounded theory methodology was used to analyze transcribed semi-structured interviews. The top 20 ranked surgical educators at the University of Alberta were invited to participate. In total, 15 surgeons of various specialties were interviewed.

RESULTS

There were five main factors which motivate surgeons to teach. These were: (1) a sense of responsibility to teach future physicians (2) an intrinsic enjoyment of teaching (3) the need to maintain and expand one's own knowledge base (4) watching students develop into competent practicing physicians and playing a role in their success, and (5) fostering positive lifelong professional relationships with learners.

DISCUSSION

This is the first study in surgery to use an explorative qualitative methodology. This framework of motivating factors can be used to guide professional development activities. The framework represents motivating factors for those known to be effective teachers only. We plan to use this information to engage more surgeons in teaching by providing a basis for promoting education as part of a busy surgical practice.

Evaluation of an international educational programme for health care professionals on best practice in the management of a perinatal death: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE)

BACKGROUND

Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global public health concerns. Careful clinical management after these deaths is required, including appropriate investigation and assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An educational programme for health care professionals working in maternal and child health has been designed to address these needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE). The programme has a major focus on stillbirth and is delivered as six interactive skills-based stations. We aimed to determine participants' pre- and post-programme knowledge of and confidence in the management of perinatal deaths, along with satisfaction with the programme. We also aimed to determine suitability for international use.

METHODS

The IMPROVE programme was delivered to health professionals in maternity hospitals in all seven Australian states and territories and modified for use internationally with piloting in Vietnam, Fiji, and the Netherlands (with the assistance of the International Stillbirth Alliance, ISA). Modifications were made to programme materials in consultation with local teams and included translation for the Vietnam programme. Participants completed pre- and post-programme evaluation questionnaires on knowledge and confidence on six key components of perinatal death management as well as a satisfaction questionnaire.

RESULTS

Over the period May 2012 to May 2015, 30 IMPROVE workshops were conducted, including 26 with 758 participants in Australia and four with 136 participants internationally. Evaluations showed a significant improvement between pre- and post-programme knowledge and confidence in all six stations and overall, and a high degree of satisfaction in all settings.

CONCLUSIONS

The IMPROVE programme has been well received in Australia and in three different international settings and is now being made available through ISA. Future research is required to determine whether the immediate improvements in knowledge are sustained with less causes of death being classified as unknown, changes in clinical practice and improvement in parents' experiences with care. The suitability for this programme in low-income countries also needs to be established.

An Innovative Use of Case Conference to Teach Future Educators in Addiction Psychiatry

Objective An innovative course was developed for fellows enrolled in the Yale School of Medicine Addiction Psychiatry program to educate them in key principles of adult learning, apply these principles in a case conference presentation, and to improve skills in providing and receiving feedback. Methods An initial training module on educational skills was followed by individual mentorship to prepare a case presentation. A feedback module provided space to learn and practice skills in feedback delivery. Results The program showed positive results and improved confidence levels of the participants in presenting and providing/receiving feedback. Conclusions Implementing a course designed to improve teaching and feedback skills is feasible in a 1-year Addiction Psychiatry fellowship.

Job burnout and organizational justice among medical interns in Shanghai, People's Republic of China

BACKGROUND

New challenges are occurring in the medical education in Mainland China, and the main risk is the loss of excellent physician candidates. This is due to lack of respect; a large, strong labor force; relatively low remuneration; unstable relationships between patients and doctors; pressures from the public media; and the possible existence of organizational injustice within the hospital. The study reported here looked at one of the in-hospital risks, psychological job burnout and organizational justice, to identify the possible internal cause-effect relationship at the two major general hospitals both affiliated to Shanghai Jiao Tong University School of Medicine.

OBJECTIVE

The aim of the reported study was to analyze the related factors associated with job burnout in Chinese medical interns in Shanghai and to provide some suggestions to better their occupational development.

METHODS

A total of 135 medical interns were investigated and assessed by the Organizational Justice Scale and the Maslach Burnout Inventory - General Survey.

RESULTS

There was a statistically significant negative correlation between organizational justice and job burnout (r=-0.298, P=0.000), suggesting the existence of job burnout among the participant interns. In particular, emotional exhaustion and cynicism were statistically more significant; the comparison between the N group (from Nanjing) and S group (Shanghai) showed significant difference in participation and reduced professional efficacy (P<0.05), with reduced professional efficacy in N group more significant than in S group, and participation in S group more significant than in N group.

CONCLUSION

Job burnout existed among Chinese medical interns, and was associated with fewer complaints and lower professional efficacy. Organizational justice should be promoted more, and school authorities should pay more attention to outside "non-home" interns. Finally, it is essential that the medical interns themselves establish reasonable judgment of their valuable profession.