Scholarly activity is a requirement for accreditation by the Accreditation Council for Graduate Medical Education. There is currently no uniform definition used by all Residency Review Committees (RRCs). A total of 6 of the 27 RRCs currently have a rubric or draft of a rubric to evaluate scholarly activity.
To develop a definition of scholarly activity and a set of rubrics to be used in program accreditation to reduce subjectivity of the evaluation of scholarly activity at the level of individual residency programs and across RRCs.
We performed a review of the pertinent literature and selected faculty promotion criteria across the United States to develop a structure for a proposed rubric of scholarly activity, drawing on work on scholarship by experts to create a definition of scholarly activity and rubrics for its assessment.
The literature review showed that academic institutions in the United States place emphasis on all 4 major components of Boyer's definition of scholarship: discovery, integration, application, and teaching. We feel that the assessment of scholarly activity should mirror these findings as set forth in our proposed rubric. Our proposed rubric is intended to ensure a more objective evaluation of these components of scholarship in accreditation reviews, and to address both expectations for scholarly pursuits for core teaching faculty and those for resident and fellow physicians.
The aim of our proposed rubric is to ensure a more objective evaluation of these components of scholarship in accreditation reviews, and to address expectations for scholarly pursuits for core teaching faculty as well as those for resident and fellow physicians.
Scholarship has long been a basic expectation of faculty members at institutions of higher learning in the United States and elsewhere. This expectation is no less assumed in academic pharmacy. A number of organizations have verbalized and enforced this precept over the years.1-3 For example, this expectation is spoken to directly in the American Council for Pharmacy Education’s Accreditation Standards and Guidelines.4 This expectation is further emphasized in the draft document of the accreditation standards to be implemented in 2016, in Standard 20. Specifically, Element 20.2 states: “The college or school must create an environment that both requires and promotes scholarship, and must also develop mechanisms to assess both the quantity and quality of faculty scholarly productivity.”5 The successful pursuit of scholarship by clinical faculty members (those engaged in both clinical practice and teaching, without regard to tenure or clinical track status) is challenging. 6-10 Thus, faculty member job descriptions or models should be designed so clinical faculty members can successfully meet all academic job expectations, including productive and meaningful scholarship.
In 2012, an AACP Section of Teachers of Pharmacy Practice task force was charged with examining this issue and providing recommendations for models for clinical faculty members that would allow the successful pursuit of scholarship. The task force gathered information relating to the current state of affairs at a number of colleges and reviewed relevant literature. This information, along with personal experiences and much discussion and contemplation, led to some general observations as well as specific recommendations. This paper reiterates the task force’s observations and recommendations and provides further detail regarding our interpretation of the findings and basis for the eventual recommendations to the section.
scholarship; clinical faculty; faculty models
There has been an increased emphasis on scholarly activities by health sciences faculty members given the importance of the promotion of public health over the last 50 years. Consequently, faculty members are required to place greater emphasis on scholarly activities while maintaining their teaching and service responsibilities. This increasing requirement of scholarly activities has placed great demands on clinical practice faculty members and it has made their management of clinical practice, teaching responsibilities, and expectations for promotion and tenure a difficult task. This retrospective literature review identifies barriers to the scholarship activities of clinical faculty members in dentistry, medicine, nursing, and pharmacy and discusses strategies for enabling faculty members to pursue scholarly activities in the current health science academic environment. The review indicates commonalities of barriers across these 4 disciplines and suggests strategies that could be implemented by all of these disciplines to enable clinical practice faculty members to pursue scholarly activities.
scholarship; promotion; practice faculty; medicine; dentistry; pharmacy; nursing
Internal medicine residents at the Ochsner Clinic Foundation stay engaged with clinical work and have difficulty initiating and completing research and publishing their scholarly activities. Commonly cited barriers include lack of knowledge about institutional research programs, lack of confidence regarding medical writing skills, lack of time, and failure to understand the value of research. The residency directors at Ochsner initiated the Consolidated Academic and Research Exposition (CARE) program to teach basic research skills and encourage residents' interest and productivity in research.
The CARE program includes 4 core components: house staff mentoring and the Resident Career Development Program, a journal club, medical writing instruction, and research engagement. Particular emphasis is given to projects that could be completed within a 1-month period and result in publication, enabling residents to use a 1-month elective rotation during their first postgraduate year. The sessions are mandatory for residents, except for those on specified rotations, including the critical care service and the night float rotation and those who are postcall.
In 2010-2011, 6 residents submitted abstracts to the Louisiana Chapter of the American College of Physicians Associates meeting; 2 abstracts were accepted for presentation. In 2011-2012, there were 14 submissions, 4 of which were accepted for presentation. In 2010-2011, there were 4 submissions to the Southern Hospitalist Conference, which increased to 7 submissions in 2011-2012. The second best presentation award at the Southern Hospitalist Conference was also earned by a resident of this institution. The program saw a 110% total increase in scholarly activity from 2010-2011 to 2011-2012.
The CARE program has been in existence for approximately 1 year. Preliminary results were tabulated based on research proposals, posters, abstracts, case reports, and presentations submitted and/or accepted at leading medical conferences over the past year as compared to the same period 1 year ago. Residents, based on the Accreditation Council for Graduate Medical Education Resident Survey responses, were more satisfied with the opportunities provided to them to participate in research or scholarly activities. Our preliminary results suggest that an organized, structured research curriculum in internal medicine residency programs is critical to promoting, initiating, and completing scholarly activity during a residency program.
Ochsner's CARE program has appreciably enhanced internal medicine residents' interest in research-related activity, resulting in a significant increase in resident-authored research papers, abstracts, posters, and case reports being accepted at leading national medical conferences.
ACGME requirements; resident research; scholarly activity
The introduction and promotion of information technology in an established medical curriculum with existing academic and technical support structures poses a number of challenges. The UNC School of Medicine has developed the Taskforce on Educational Applications in Medicine (TEAM), to coordinate this effort. TEAM works as a confederation of existing research and support units with interests in computers and education, along with a core of interested faculty with curricular responsibilities. Constituent units of the TEAM confederation include the medical center library, medical television studios, basic science teaching laboratories, educational development office, microcomputer and network support groups, academic affairs administration, and a subset of course directors and teaching faculty. Among our efforts have been the establishment of (1) a mini-grant program to support faculty initiated development and implementation of computer applications in the curriculum, (2) a symposium series with visiting speakers to acquaint faculty with current developments in medical informatics and related curricular efforts at other institution, (3) 20 computer workstations located in the multipurpose teaching labs where first and second year students do much of their academic work, (4) a demonstration center for evaluation of courseware and technologically advanced delivery systems. The student workstations provide convenient access to electronic mail, University schedules and calendars, the CoSy computer conferencing system, and several software applications integral to their courses in pathology, histology, microbiology, biochemistry, and neurobiology. The progress achieved toward the primary goal has modestly exceeded our initial expectations, while the collegiality and interest expressed toward TEAM activities in the local environment stand as empirical measures of the success of the concept.
Promotion for academic faculty depends on a variety of factors, including their research, publications, national leadership, and quality of their teaching.
We sought to determine the importance of resident evaluations of faculty for promotion in obstetrics-gynecology programs.
A 28-item questionnaire was developed and distributed to 185 department chairs of US obstetrics-gynecology residency programs.
Fifty percent (93 of 185) responded, with 40% (37 of 93) stating that teaching has become more important for promotion in the past 10 years. When faculty are being considered for promotion, teaching evaluations were deemed “very important” 60% of the time for clinician track faculty but were rated as mainly “not important” or “not applicable” for research faculty. Sixteen respondents (17%) stated a faculty member had failed to achieve promotion in the past 5 years because of poor teaching evaluations. Positive teaching evaluations outweighed low publication numbers for clinical faculty 24% of the time, compared with 5% for research faculty and 8% for tenured faculty being considered for promotion. The most common reason for rejection for promotion in all tracks was the number of publications. Awards for excellence in teaching improved chances of promotion.
Teaching quality is becoming more important in academic obstetrics-gynecology departments, especially for clinical faculty. Although in most institutions promotion is not achieved without adequate research and publications, the importance of teaching excellence is obvious, with 1 of 6 (17%) departments reporting a promotion had been denied due to poor teaching evaluations.
To report the results of a multidisciplinary, interinstitutional writing support group established to facilitate faculty scholarly productivity.
The road to scholarship can be filled with many obstacles, among them time constraints, teaching and meeting demands, student needs, office interruptions, and lack of colleagueship. The problems associated with lack of colleagueship, in particular, can be compounded for faculty who work in isolated contexts with few, if any, senior faculty to serve as mentors.
Methods of Development
The Western Writers Coercion Group evolved over a 2-year period from a small group of nursing faculty at a single institution to include, by its second year, 21 faculty from five western university campuses and three academic disciplines. The group met biweekly via teleconference with the objectives of defining and accomplishing realistic individual scholarship goals and providing a forum for the critical exchange of ideas.
The ongoing support and mentoring of the group led to significant writing outcomes in the form of manuscripts submitted for publication, abstracts submitted for conference presentation, grant proposals developed, and collegial relationships formed.
Although the benefits of group participation varied somewhat for faculty at different points in the career trajectory, they seemed to accrue at all levels of development. Group members underscored the many less quantifiable advantages of group participation: exposure to broader professional perspectives, the formation of key professional relationships, the enrichment of multidisciplinary input, and individualized assistance with time management, goal setting, and actual drafts.
The structure and experience of this group, which continues to meet regularly, might be a model to guide other groups of scholars who face geographic isolation and who struggle with balancing time and work and finding motivation for the process of writing.
scholarship; community building; writing support group
The 2009-2010 American Association of Colleges of Pharmacy (AACP) Council of Faculties Faculty Affairs Committee reviewed published literature assessing the scope and outcomes of faculty development for tenure and promotion. Relevant articles were identified via a PubMed search, review of pharmacy education journals, and identification of position papers from major healthcare professions academic organizations. While programs intended to enhance faculty development were described by some healthcare professions, relatively little specific to pharmacy has been published and none of the healthcare professions have adequately evaluated the impact of various faculty-development programs on associated outcomes.
The paucity of published information strongly suggests a lack of outcomes-oriented faculty-development programs in colleges and schools of pharmacy. Substantial steps are required toward the development and scholarly evaluation of faculty-development programs. As these programs are developed and assessed, evaluations must encompass all faculty subgroups, including tenure- and nontenure track faculty members, volunteer faculty members, women, and underrepresented minorities. This paper proposes AACP, college and school, and department-level recommendations intended to ensure faculty success in achieving tenure and promotion.
faculty development; colleges and schools of pharmacy; tenure; promotion; outcomes
Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education.
dermatology; resident; research; education; accreditation
Objectives. To implement a co-precepted advanced pharmacy practice experience (APPE) focused on traditional pharmacy faculty and administrative responsibilities and reflection opportunities.
Design. A multi-faceted, reflection-infused academic APPE was designed that exposed students to activities related to teaching, curriculum revision, scholarly writing, committee service, faculty role-modeling, mentorship and development, and school-level administrative decision-making.
Assessment. Two students completed the APPE in the first 2 semesters it was offered (1 in spring 2010 and 1 in fall 2010). Formative and summative evaluations confirmed that the students achieved the APPE goals and viewed the experience as valuable, informative, and enjoyable as expressed both in reflective journal submissions and survey comments.
Conclusion. Co-precepting by pharmacy faculty members primarily engaged in traditional faculty- and administration-related responsibilities can provide students with a robust learning experience that surpasses that which could be achieved by a single mentor.
advanced pharmacy practice experience (APPE); experiential learning; academic APPE
To establish an evidence-informed faculty development program.
Survey derived from a needs-assessment tool.
Department of Academic Family Medicine at the University of Saskatchewan, which is geographically dispersed across the province.
Full-time faculty members in the Department of Academic Family Medicine at the University of Saskatchewan.
Main outcome measures
Creation of an evidence-informed faculty development program.
The response rate was 77.3% (17 of 22). The data were stratified by 2 groups: faculty members with less than 5 years of experience and those with 5 or more years of experience. Those with less than 5 years of experience rated the following as their top priorities: teaching, developing scholarly activities, and career development. Those with 5 or more years of experience rated the following as their top priorities: administration and leadership, teaching, and information technology. Although there were differences in overall priorities, the 2 groups identified 17 out of 54 skills as important to faculty development.
The results of the needs-assessment tool were used to shape a dynamic, evidence-informed faculty development program with full-time faculty in the Department of Academic Family Medicine at the University of Saskatchewan. Future programs will continue to be dynamic, faculty-centred, and evidence-informed.
Facilitation of residents’ scholarly activities is indispensable to the future of medical specialties. Research education initiatives and their outcomes, however, have rarely been reported.
Since Academic Year (AY) 2006, research education initiatives, including research lectures, research problem based learning discussions, and an elective research rotation under a new research director’s supervision, have been used. The effectiveness of the initiatives was evaluated by comparing the number of residents and faculty mentors involved in residents’ research activity (Pre-initiative [2003 to 2006] vs. Post-initiative [2007 to 2011]). The residents’ current post-graduation practices were also compared. To minimize potential historical confounding factors, peer reviewed publications based on work performed during residency written by residents who graduated from the program in AY2009 to AY2011 were further compared with those of rank-to-match residents, who were on the residency ranking list during the same AYs and could have been matched with our program had they ranked it high enough on their list.
The Post-initiative group showed greater resident research involvement compared to the Pre-initiative group (89.2% [58 in 65 residents] vs. 64.8% [35 in 54], p=0.0013) and greater faculty involvement (23.9% [161 in 673 faculty/year] vs. 9.2% [55 in 595], p<0.0001). Choice of academic practice did not increase (50.8% [Post] vs. 40.7% [Pre], p=0.36). Graduated residents (n=38) published more often than the rank-to-match residents (n=220) (55.3% [21 residents] vs. 13.2% , p<0.0001, odds ratio 8.1 with 95% confidence interval of 3.9 to 17.2).
Research education initiatives increased residents’ research involvement.
Awards given to medical school faculty are one important mechanism for recognizing what is valued in academic medicine. There have been concerns expressed about the gender distribution of awards, and there is also a growing appreciation for the evolving accomplishments and talents that define academic excellence in the 21st century and that should be considered worthy of award recognition.
Examine faculty awards at our institution for gender equity and evolving values.
Recipient data were collected on awards from 1996 to 2007 inclusively at the University of Pennsylvania School of Medicine (SOM). Descriptions of each award also were collected. The female-to-male ratio of award recipients over the time span was reviewed for changes and trends. The title and text of each award announcement were reviewed to determine if the award represented a traditional or a newer concept of excellence in academic medicine.
There were 21 annual awards given to a total of 59 clinical award recipients, 60 research award recipients, and 154 teaching award recipients. Women received 28% of research awards, 29% of teaching awards and 10% of clinical awards. Gender distribution of total awards was similar to that of SOM full-time faculty except in the clinical awards category. Only one award reflected a shift in the culture of individual achievement to one of collaboration and team performance.
Examining both the recipients and content of awards is important to assure they reflect the current composition of diverse faculty and the evolving ideals of leadership and excellence in academic medicine.
faculty awards; gender equity; female-to-male ratio; leadership; excellence
To analyze up-to-date Hirsch index (h-index) data to estimate the scholarly productivity of academic radiation oncology faculty.
Bibliometric citation database searches were performed for radiation oncology faculty at domestic residency-training institutions. Outcomes analyzed included the number of manuscripts, number of citations, and h-index between 1996 and 2012. Analyses of overall h-index rankings with stratification by academic ranking, gender, and departmental faculty size were performed.
One thousand thirty-seven radiation oncologists from 87 programs were included. Overall, the mean h-index was 10.8. Among the top 10% by h-index, 38% were chairpersons, all were senior faculty, and 11% were women. As expected, higher h-index was associated with higher academic ranking and senior faculty status. Recursive partitioning analysis revealed an h-index threshold of 20 (p <0.001) as an identified breakpoint between senior vs. junior faculty. Furthermore, h-index breakpoints of 12 (p <0.001) and 25 (p <0.001) were identified between assistant professor vs. associate professor, and associate professor vs. professor levels, respectively. Multivariate analysis identified higher academic ranking, male gender, and larger departmental faculty size as independent variables associated with higher h-index.
The current results suggest an overall rise in scholarly citation metrics among domestic academic radiation oncologists, with a current mean h-index of 10.8, vs. 8.5 in 2008. Significant relationships exist between h-index and academic rank, gender, and departmental size. The results offer up-to-date benchmarks for evaluating academic radiation oncologist to the national average and potentially has utility in the process of appointment and promotion decisions.
Bibliometrics; Academic productivity; Publications; H-index; Radiation Oncology
Faculty productivity is essential for academic medical centers striving to achieve excellence and national recognition. The objective of this study was to evaluate whether and how academic Departments of Medicine in the United States measure faculty productivity for the purpose of salary compensation.
We surveyed the Chairs of academic Departments of Medicine in the United States in 2012. We sent a paper-based questionnaire along with a personalized invitation letter by postal mail. For non-responders, we sent reminder letters, then called them and faxed them the questionnaire. The questionnaire included 8 questions with 23 tabulated close-ended items about the types of productivity measured (clinical, research, teaching, administrative) and the measurement strategies used. We conducted descriptive analyses.
Chairs of 78 of 152 eligible departments responded to the survey (51% response rate). Overall, 82% of respondents reported measuring at least one type of faculty productivity for the purpose of salary compensation. Amongst those measuring faculty productivity, types measured were: clinical (98%), research (61%), teaching (62%), and administrative (64%). Percentages of respondents who reported the use of standardized measurements units (e.g., Relative Value Units (RVUs)) varied from 17% for administrative productivity to 95% for research productivity. Departments reported a wide variation of what exact activities are measured and how they are monetarily compensated. Most compensation plans take into account academic rank (77%). The majority of compensation plans are in the form of a bonus on top of a fixed salary (66%) and/or an adjustment of salary based on previous period productivity (55%).
Our survey suggests that most academic Departments of Medicine in the United States measure faculty productivity and convert it into standardized units for the purpose of salary compensation. The exact activities that are measured and how they are monetarily compensated varied substantially across departments.
Electronic supplementary material
The online version of this article (doi:10.1186/1472-6920-14-205) contains supplementary material, which is available to authorized users.
Faculty productivity; Salary compensation; Academia; Department of medicine; Survey
Scholarly activity as a component of residency education is becoming increasingly emphasized by the Accreditation Council for Graduate Medical Education. “Limited or no evidence of resident or faculty scholarly activity” is a common citation given to family medicine residency programs by the Review Committee for Family Medicine.
The objective was to provide a model scholarly activity curriculum that has been successful in improving the quality of graduate medical education in a family medicine residency program, as evidenced by a record of resident academic presentations and publications.
We provide a description of the Clinical Scholars Program that has been implemented into the curriculum of the Trident/Medical University of South Carolina Family Medicine Residency Program.
During the most recent 10-year academic period (2000–2010), a total of 111 residents completed training and participated in the Clinical Scholars Program. This program has produced more than 24 presentations during national and international meetings of medical societies and 15 publications in peer-reviewed medical journals. In addition, many of the projects have been presented during meetings of state and regional medical organizations.
This paper presents a model curriculum for teaching about scholarship to family medicine residents. The success of this program is evidenced by the numerous presentations and publications by participating residents.
A June 2012 site visit report from the Accreditation Council for Graduate Medical Education Clinical Learning Environment Review revealed that residents and physicians at TriHealth, Inc., a large, nonprofit independent academic medical center serving the Greater Cincinnati area in Ohio, had an opportunity to improve their awareness and understanding of the hospital's system for reporting patient safety concerns in 3 areas: (1) what constitutes a reportable patient safety event, (2) who is responsible for reporting, and (3) how to use the hospital's current reporting system.
To improve the culture of patient safety, we designed a quality improvement project with the goal to increase patient safety event reporting among residents and teaching faculty. An anonymous questionnaire assessed physicians' and residents' attitudes and experience regarding patient safety event reporting. An educational intervention was provided in each graduate medical education program to improve knowledge and skills related to patient safety event reporting, and the anonymous questionnaire was distributed after the intervention. We compared the responses to the preintervention and postintervention questionnaires and tracked monthly patient safety event reports for 1 year postintervention.
The number of patient safety event reports increased following the educational intervention; however, we saw wide variability in reporting per month. On the postintervention questionnaire, participants demonstrated improved knowledge and attitudes toward patient safety event reporting.
The goal of this unique project was to increase patient safety event reporting by both residents and teaching faculty in 6 residency programs through education. We achieved this goal through an educational intervention tailored to the institution's new event reporting system delivered to each residency program. We clearly understand that improvements in quality and patient safety require ongoing effort. The keys to ongoing sustainability include (1) developing patient safety faculty and resident experts in each training program to teach patient safety and to be role models, (2) working toward decreasing the barriers to reporting, and (3) providing timely feedback and system changes.
Education–graduate–medical; medical errors; hospital incident reporting; patient safety; quality improvement; risk management
Faculty scholarship, teaching load, and compensation can be indicators of institutional health and can impact curricular quality. Periodic data are published by the US Department of Education for all sectors of higher education, but do not list chiropractic colleges as a separate category.
To report on the scholarly output, teaching load, and compensation of the full-time faculty at one chiropractic college, and to compare those data to national and local norms.
Data on chiropractic faculty were collected from within the institution. External data were collected from the US Department of Education and US Bureau of Labor Statistics.
The chiropractic faculty assessed create about one-tenth the scholarly output, carried 2.7 times the course load of external doctoral faculty and 1.4 times the course load typical of 2-year (community) college faculty, received two-thirds the salary typical for all segments of education, and one-half the typical retirement benefits.
Results are suggestive of significant deficiencies within chiropractic education that pose risk to the future of the profession.
chiropractic; education; professional
The purpose of this report was to describe the development, implementation, and outcomes from 3 complementary programs to facilitate the development of faculty members. The Faculty Development Committee (FDC) at the University of Tennessee developed 3 new complementary programs: the Individual Faculty Development Program to encourage faculty members to assess and identify their own specific developmental needs; the Seed Research Grant Program to fund scholarly activities by faculty; and the Technology Support Program to foster financial support of technology upgrades crucial for meeting the research, education, and service needs of faculty members. Eighteen faculty members participated in the Individual Faculty Development Program during the first 2 academic years and all provided positive feedback about their experiences. The Seed Research Grant Program funded 6 projects during its inaugural year. Limited outcome data from these 2 programs are extremely favorable relative to grant submissions and publications, and enhanced educational offerings and evaluations. The Technology Support Fund was initiated in the 2005-2006 academic year. The 3 faculty development programs initiated are offered as examples whereby faculty members are given a high degree of self-determination relative to identifying programs that will effectively contribute to their growth as academicians. Other colleges of pharmacy are encouraged to consider similar initiatives to foster individual faculty development at this critical period of growth within academic pharmacy.
faculty development; research; technology
Little is known about how well faculty at teaching hospitals role-model behaviors consistent with cost-conscious care.
We aimed to evaluate whether residents and program directors report that faculty at their program consistently role-model cost-conscious care, and whether the presence of a formal residency curriculum in cost-conscious care impacted responses.
Cost-conscious care surveys were administered to internal medicine residents during the 2012 Internal Medicine In-Training Examination and to program directors during the 2012 Association of Program Directors in Internal Medicine Annual Survey. Respondents stated whether or not they agreed that faculty in their program consistently role-model cost-conscious care. To evaluate a more comprehensive assessment of faculty behaviors, resident responses were matched with those of the director of their residency program. A multivariate logistic regression model was fit to the outcome variable, to identify predictors of responses that faculty do consistently role-model cost-conscious care from residency program, resident, and program director characteristics.
Responses from 12,623 residents (58.4 % of total sample) and 253 program directors (68.4 %) from internal medicine residency programs in the United States were included.
The primary outcome measure was responses to questionnaires on faculty role-modeling cost-conscious care.
Among all responses in the final sample, 6,816 (54.0 %) residents and 121 (47.8 %) program directors reported that faculty in their program consistently role-model cost-conscious care. Among paired responses of residents and their program director, the proportion that both reported that faculty do consistently role-modeled cost-conscious care was 23.0 % for programs with a formal residency curriculum in cost-conscious care, 26.3 % for programs working on a curriculum, and 23.7 % for programs without a curriculum. In the adjusted model, the presence of a formal curriculum in cost-conscious care did not have a significant impact on survey responses (odds ratio [OR], 1.04; 95 % Confidence Interval [CI], 0.52–2.06; p value [p] = 0.91).
Responses from residents and program directors indicate that faculty at US teaching hospitals were not consistently role-modeling cost-conscious care. The presence of a formal residency curriculum in cost-conscious care did not impact responses. Future efforts should focus on placing more emphasis on faculty development and on combining curricular improvements with institutional interventions to adapt the training environment.
cost-conscious care; high-value ; role-modeling; resident; program director; residency program; teaching hospitals; faculty; medical education
Learning to perform pelvic and breast examinations produces anxiety for many medical students. Clerkship directors have long sought strategies to help students become comfortable with the sensitive nature of these examinations. Incorporating standardized patients, simulation and gynecologic teaching associates (GTAs) are approaches gaining widespread use. However, there is a paucity of literature guiding optimal approach and timing. Our primary objective was to survey obstetrics and gynecology (Ob/Gyn) clerkship directors regarding timing and methods for teaching and assessment of pelvic and breast examination skills in United States medical school curricula, and to assess clerkship director satisfaction with current educational strategies at their institutions.
Ob/Gyn clerkship directors from all 135 Liaison Committee on Medical Education accredited allopathic United States medical schools were invited to complete an anonymous 15-item web-based questionnaire.
The response rate was 70%. Pelvic and breast examinations are most commonly taught during the second and third years of medical school. Pelvic examinations are primarily taught during the Ob/Gyn and Family Medicine (FM) clerkships, while breast examinations are taught during the Ob/Gyn, Surgery and FM clerkships. GTAs teach pelvic and breast examinations at 72 and 65% of schools, respectively. Over 60% of schools use some type of simulation to teach examination skills. Direct observation by Ob/Gyn faculty is used to evaluate pelvic exam skills at 87% of schools and breast exam skills at 80% of schools. Only 40% of Ob/Gyn clerkship directors rated pelvic examination training as excellent, while 18% rated breast examination training as excellent.
Pelvic and breast examinations are most commonly taught during the Ob/Gyn clerkship using GTAs, simulation trainers and clinical patients, and are assessed by direct faculty observation during the Ob/Gyn clerkship. While the majority of Ob/Gyn clerkship directors were not highly satisfied with either pelvic or breast examination training programs, they were less likely to describe their breast examination training programs as excellent as compared to pelvic examination training—overall suggesting an opportunity for improvement. The survey results will be useful in identifying future challenges in teaching such skills in a cost-effective manner.
Electronic supplementary material
The online version of this article (doi:10.1186/s12909-016-0835-6) contains supplementary material, which is available to authorized users.
Pelvic examination; Breast examination; Obstetrics and gynecology clerkship; Undergraduate medical education; Medical students
In September 2011, the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, began offering a combined BScPhm/PharmD program to third-year students and postbaccalaureate graduates. Learning consisted of in-class teaching and Advanced Pharmacy Practice Experience (APPE) rotations.
To explore preceptors’ expectations and perceptions of student performance in the APPE rotations of the new combined degree program.
A survey was distributed via email to 132 pharmacists from the Toronto Academic Health Science Network who had acted as preceptors for the combined degree program in academic year 2011/2012. The 17 questions were designed to gather information on preceptors’ demographic characteristics and their expectations and evaluations of the combined-program students. Responses were analyzed qualitatively for common themes and quantitatively using sums and means. Survey responses were compared to identify alignment and discrepancies between preceptors’ expectations and evaluations of students.
The survey response rate was 48% (63/132). Most respondents (46 [73%]) were from a teaching hospital, and the same proportion (46 [73%]) reported being preceptors for a direct patient care rotation. Forty-four (70%) of the respondents expected students to be at the level of traditional PharmD students, hospital residents, or advanced-level Structured Practical Experience Program students, and 35 (80%) of these 44 respondents reported that their students met or exceeded expectations. According to survey responses, 31% of respondents (18/58) ranked students at the corresponding level of performance on the faculty’s assessment form, while 62% (36/58) ranked students at a higher level (5 respondents did not complete the question). Only one-third of respondents felt that they personally had received adequate training before taking on preceptor duties for combined-program students.
Preceptors’ perceptions of the rotation and their expectations of students varied widely and were influenced by prior teaching and learning experiences. There was a disconnect between preceptor-specific expectations and preceptors’ final evaluations of students. Training to standardize the expected level of performance and additional training for preceptors would further enhance the APPE rotations of the combined degree program.
pharmacy; preceptors; students; expectations; practical experience; pharmacie; précepteurs; étudiants; attentes; expérience pratique
An appropriate balance between teaching, scholarship, and service is important for a faculty member to have a satisfying and successful career. The relative emphasis on each area normally changes during the course of a career. Although some level of scholarly output is an ongoing and fundamental expectation of all faculty members, this activity is too often given low priority, particularly among faculty members in practice areas who may have a minimal background in research and large demands on their time for teaching and clinical service. Addressing this issue requires establishing a shared commitment between administrators and faculty members, as well as identifying or developing education programs that will ensure research competence for practice faculty members. This paper provides insights into the role that scholarship and research should have for all pharmacy faculty members and provides suggestions for how to better advance this critical component within academic pharmacy.
peer-review; scholarship; research; faculty
Because of the aging demographics nearly all medical specialties require faculty who are competent to teach geriatric care principles to learners, yet many non-geriatrician physician faculty members report they are not prepared for this role.
To determine the impact of a new educational intervention designed to improve the self-efficacy and ability of non-geriatrician clinician-educators to teach geriatric medicine principles to medical students and residents.
Forty-two non-geriatrician clinician-educator faculty from17 academic centers self-selected to participate in a 3-day on-site interactive intensive course designed to increase knowledge of specific geriatric medicine principles and to enhance teaching efficacy followed by up to a year of mentorship by geriatrics faculty after participants return to their home institutions. On average, 24% of their faculty time was spent teaching and 57% of their clinical practices involved patients aged over 65 years. Half of all participants were in General Internal Medicine, and the remaining were from diverse areas of medicine.
Tests of geriatrics medical knowledge and attitudes were high at baseline and did not significantly change after the intervention. Self-rated knowledge about specific geriatric syndromes, self-efficacy to teach geriatrics, and reported value for learning about geriatrics all improved significantly after the intervention. A quarter of the participants reported they had achieved at least one of their self-selected 6-month teaching goals.
An intensive 3-day on-site course was effective in improving self-reported knowledge, value, and confidence for teaching geriatrics principles but not in changing standardized tests of geriatrics knowledge and attitudes in a diverse group of clinician-educator faculty. This intervention was somewhat associated with new teaching behaviors 6 months after the intervention. Longer-term investigations are underway to determine the sustainability of the effect and to determine which factors predict the faculty who most benefit from this innovative model.
geriatric care; clinician educators; curriculum development
As a consequence of the German Transfusion Act and the corresponding Hemotherapeutic Guidelines of the German Medical Association, the National Advisory Committee Blood approved a recommendation (votum 29) in 2003 to specify students’ training in transfusion medicine, hemotherapy, and hemostasis. The objective of this study was to assess the current status of teaching in these fields.
A questionnaire-based evaluation was performed at the medical schools in Germany (n = 34). Responses were analyzed by descriptive criteria, except for weekly semester hours of teaching.
Responses were obtained from 30 medical faculties (88%). Among them, 18 had conducted votum 29 (12 ‘completely’, 6 ‘essentially’), while 7 had done so only ‘in part’ and 5 ‘not at all’. 13 of 30 sites (43%) reported that no faculty-related curriculum in transfusion medicine and hemostasis (hemotherapy) exists. At 28 of 30 medical schools (93%), teaching in transfusion medicine, hemotherapy, and hemostasis is integrated into cross-curricular topics of interdisciplinary programs, including lectures. The corresponding semester hours of teaching per week ranged from 0.5 to 12 h/week.
Votum 29 is incompletely established. Consequently, academic teaching in transfusion medicine, hemotherapy, and hemostasis requires structural and conceptual improvement to fulfill legal specifications and regulatory constraints.
Transfusion medicine; Hemotherapy; Hemostasis; Curricula; Academic training