Identity formation and motivation of new faculty developers: A replication study in a resource constrained university

The Value of Master's Degree Programmes in Health Professions Education: A Scoping Review

INTRODUCTION

There are increasing numbers of Master's Degree Programmes in Health Professions Education (MHPE), and the value to their students and graduates is not well understood. We conducted a scoping review to explore what is known about the value of MHPE programmes to their students and graduates.

METHODS

A scoping review was conducted using Arksey and O'Malley's five-stage framework. PubMed, CINAHL, Cochrane, BEI, ERIC and EThOs databases were searched in addition to cited reference searching. Original research with an evaluation and published in the English language were included.

RESULTS

Nineteen studies were included. Studies were based in a variety of locations on five continents, and included in-person, distance and blended learning. Students and graduates of MHPE programmes self-reported development of their pedagogical knowledge, confidence and credibility in their role as an educator, and educational scholarship. Enhanced career opportunities and opportunities for collegial interactions and networks were also reported. Important barriers included struggling with the time and financial commitments required for studying on a MHPE programme.

CONCLUSIONS

There are a variety of dimensions of value of MHPE programmes to their students and graduates. Important practical recommendations for MHPE programme providers and employers include providing opportunities for the development of networks and supporting the time and financial commitments required for studying.

Evolving from Didactic to Dialogic: How to Improve Faculty Development and Support Faculty Developers by Using Action Research

Problem: Since competency-based medical education has gained widespread acceptance to guide curricular reforms, faculty development has been regarded as an indispensable element to make these programs successful. Faculty developers have striven to design and deliver myriad of programs or workshops to better prepare faculty members for fulfilling their teaching roles. However, how faculty developers can improve workshop delivery by researching their teaching practices remains underexplored. Intervention: Action research aims to understand real world practices and advocates for formulation of doable plans through cycles of investigations, and ultimately contributes to claims of knowledge and a progression toward the goal of practice improvement. This methodology aligns with the aim of this study to understand how I could improve a faculty development workshop by researching my teaching practices. Context: In 2016, we conducted four cycles of action research in the context of mini-Clinical Evaluation Exercise (mini-CEX) workshops within a faculty development program aiming for developing teaching and assessment competence in faculty members. We collected multiple sources of qualitative data for thematic analysis, including my reflective journal, field notes taken by a researcher-observer, and post-workshop written reflection and feedback in portfolio from fourteen workshop attendees aiming to develop faculty teaching and assessment competence. Impact: By doing action research, I scrutinized each step as an opportunity for change, enacted adaptive practice and reflection on my teaching practices, and formulated action plans to transform a workshop design through each cycle. In so doing, my workshop evolved from didactic to dialogic with continuous improvement on enhanced engagement, focused discussion and participant empowerment through a collaborative inquiry into feedback practice. Moreover, these processes of action research also supported my growth as a faculty developer. Lessons Learned: The systematic approach of action research serves as a vehicle to enable faculty developers to investigate individual teaching practices as a self-reflective inquiry, to examine, rectify, and transform processes of program delivery, and ultimately introduce themselves as agents for change and improvement.

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.

Becoming Agents of Change: Contextual Influences on Medical Educator Professionalization and Practice in a LMIC Context

Medical educators are particularly needed in Low- and Middle-Income Countries (LMIC), where medical schools have grown rapidly in size, number, and global outlook in response to persistent health workforce shortages and increased expectations of quality care. Educator development is thus the focus of many LMIC programs initiated by universities and governments of high income countries. While signs of medical educator professionalization such as postgraduate qualifications, specialized units, and professional associations have emerged in LMIC, whether these relate to programs originating from outside LMIC contexts is unknown. This study investigated the contextual influences on the long-term impact of an international faculty development program a decade after its delivery in a LMIC context - Vietnam. Ten years after an international aid program to develop clinical skills teaching expertise in Vietnam, we conducted in-depth qualitative interviews with eight medical educators from all eight participating medical schools. Selected for their leadership potential, each participant had completed the Maastricht Masters in Health Professions Education during the program. Interview transcripts underwent thematic analysis, using the Theory of Practice Architectures as a conceptual lens to highlight the contextual influences on professional practice. Four themes were identified: Careers and Practices before, during, and after the program, Unrecognized and Unseen practice, Structural Restraints on individual advancement and collective activity, and the Cultivation of Connections through social traditions. Participants reported being in well-established teaching delivery roles. However, the absence of professionalizing discourses and material resources meant that practice was restricted and determined by institutional leadership and individuals' adaptations. Informed by the theory of practice architectures, we found that change in medical education practice will falter in contexts that lack supporting discursive, material-economic, and socio-political arrangements. While there were emerging signs of individual agency, the momentum of change was not sustained and perhaps unapparent to Western framings of educational leadership. Practice architectures offers a framework for identifying the contextual features which influence practice, from which to design and deliver sustainable and impactful interventions, and to advance context-relevant evaluation and research. Our findings suggest that faculty development delivered across diverse contexts, such as in distributed or transnational medical programs, may have more effect if informed by a practice architectures analysis of each context.

Becoming outstanding educators: What do they say contributed to success?

Aspiring medical educators and their advisors often lack clarity about career paths. To provide guidance to faculty pursuing careers as educators, we sought to explore perceived factors that contributed to the career development of outstanding medical educators. Using a thematic analysis, investigators at two institutions interviewed 39 full or associate professor physician faculty with prominent roles as medical educators in 2016. The social cognitive career theory (SCCT) informed the interview guide. Investigators developed the codebook and performed iterative analysis using qualitative methods. Extensive team discussion generated the final themes. Eight themes emerged related to preparation, early successes, mentors, networks, faculty development, balance, work environment, and multiple identities. Preparation led to early successes, which served as "launch points," while mentors, networks, and faculty development programs served as career accelerators to open more opportunities, and a supportive work environment was an additional enabler of this pathway. Educators who reported balance between work and outside interests described boundary setting as well as selectively choosing new opportunities to establish boundaries in mid-career. Participants described multiple professional identities, and clinician and educator identities tended to merge and reinforce each other as careers progressed. This study revealed common themes describing trajectories of success among medical educators. These themes aligned with the SCCT, and typically replayed and spiraled over the course of the educators' careers. These findings resonate with other studies, lending credence to an approach to career development that can be shared with junior faculty who are exploring careers in medical education.

Faculty development: From rubies to oak

Introduction: Faculty development has played a significant role in health professions education over the last 40 years. The goal of this perspective is to present a portrait of faculty development in Medical Teacher since its inception and to highlight emerging trends moving forward.Method: All issues of Medical Teacher were reviewed, using the search terms faculty development, staff development, professional development, or in-service training for faculty. The search yielded 286 results of which 145 focused specifically on faculty development initiatives, reviews, or frameworks.Findings: This review demonstrated a significant growth in publications related to faculty development in Medical Teacher over the last 40 years, with a primary focus on teaching improvement and traditional approaches to faculty development, including workshops, short courses and other structured, group activities. The international nature of faculty development was also highlighted.Recommendations: Moving forward, it is suggested that we: broaden the scope of faculty development from teaching to academic development; expand our approaches to faculty development, to include peer coaching, workplace learning and communities of practice; utilize a competency-based framework to guide the development of faculty development curricula; support teachers' professional identities through faculty development; focus on organizational development and change; and rigorously promote research and scholarship in faculty development.

Becoming a Clinical Teacher: Identity Formation in Context

PURPOSE

Most clinical teachers have not been trained to teach, and faculty development for clinical teachers is undermined by poor attendance, inadequate knowledge transfer, and unsustainability. A crucial question for faculty developers to consider is how clinicians become teachers "on the job." Such knowledge is important in the design of future workplace-based faculty development initiatives. The authors conducted a scoping review of research on the relationship between becoming a clinical teacher and the clinical environments in which those teachers work.

METHOD

In June 2017, using the scoping review design described by Levac et al (2010), the authors searched 12 databases. They subjected the articles discovered to four phases of screening, using iteratively developed inclusion/exclusion criteria. They charted data from the final selection of articles and used thematic analysis to synthesize findings.

RESULTS

Thirty-four research reports met the inclusion criteria. Most (n = 24) took an individualist stance toward identity, focusing on how teachers individually construct their teacher identity in tension with their clinician identities. Only 10 studies conceptualized clinical teacher identity formation as a social relational phenomenon, negotiated within hierarchical social structures. Twenty-nine of the included studies made little or no use of explicit theoretical frameworks, which limited their rigor and transferability.

CONCLUSIONS

Clinicians reconciled their identities as teachers with their identities as clinicians by juggling the two, finding mutuality between them, or forging merged identities that minimized tensions between educational and clinical roles. They did so in hierarchical social settings where patient care and research were prioritized above teaching.

The International Literature on Teaching Faculty Development in English-Language Journals: A Scoping Review and Recommendations for Core Topics

BACKGROUND

With increasing physician mobility, there is interest in how medical schools and postgraduate medical education institutions across the world develop and maintain the competence of medical teachers. Published reviews of faculty development (FD) have predominantly included studies from the United States and Canada.

OBJECTIVE

We synthesized the international FD literature (beyond the US and Canada), focusing on FD type, intended audience, study format, effectiveness, differences among countries, and potential unique features.

METHODS

We identified English-language publications that addressed FD for medical faculty for teaching and related activities, excluding US and Canadian publications.

RESULTS

A search of 4 databases identified 149 publications, including 83 intervention studies. There was significant growth in international FD publications for the most recent decade, and a sizable number of studies were from developing economies and/or resulted from international collaborations. Focal areas echo those in earlier published reviews, suggesting the international FD literature addresses similar faculty needs and organizational concerns.

CONCLUSIONS

The growth in publications in recent years and a higher proportion of reporting on participant reactions, coupled with less frequent reporting of results, transfer to practice, and impact on learners and the organization, suggest this is an evolving field. To enhance international FD, educators and researchers should focus on addressing common needs expressed by faculty, including curriculum design and evaluation, small group teaching, assessing professionalism and providing feedback. Future research should focus on approaches for developing comprehensive institutional FD programs that include communities of learning and practice and evaluating their impact.

Strengthening Teachers' Professional Identities Through Faculty Development

Although medical schools espouse a commitment to the educational mission, faculty members often struggle to develop and maintain their identities as teachers. Teacher identity is important because it can exert a powerful influence on career choice, academic roles and responsibilities, and professional development opportunities. However, most faculty development initiatives focus on knowledge and skill acquisition rather than the awakening or strengthening of professional identity. The goal of this Perspective is to highlight the importance of faculty members' professional identities as teachers, explore how faculty development programs and activities can support teachers' identities, and describe specific strategies that can be used in professional development. These strategies include the embedding of identity and identity formation into existing offerings by asking questions related to identity, incorporating identity in longitudinal programs, building opportunities for community building and networking, promoting reflection, and capitalizing on mentorship. Stand-alone faculty development activities focusing on teachers' identities can also be helpful, as can a variety of approaches that advocate for organizational change and institutional support. To achieve excellence in teaching and learning, faculty members need to embrace their identities as teachers and be supported in doing so by their institutions and by faculty development.

Along the Axes of Difference: Setting Scholarship and Practice Agendas for Faculty Development

The rise of academic clinical education programs underlines the growing influence of faculty development on how health care is taught and therefore practiced. Research to date has outlined the rapid rise of these postgraduate qualifications and their impact on their graduates' professional identities. Given the scale and nature of the change, it is worth considering these programs from a broader perspective. "Axes of difference" are invoked to chart the tensions and intersections between various social identities that form distinctive features of clinical education. Six axes are described: patients-clinicians, trainees-trainers, classrooms-clinics, uniprofessional-interprofessional, local-global, and teachers-clinicians. These reveal a range of complexities about faculty development, which can inform both practice and scholarship agendas.