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



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.


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.


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.


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.

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Correspondence to Pankti Reid.

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Of note: Part of this manuscript (data herein) has previously been published as an abstract at the national American College of Rheumatology meeting with the following references:

Reid P, Miloslavsky E, Dua A. Needs Assessment of a Structured Program for Fellows as Teachers: Rheumatology Program Directors’ Perspective [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10).

Reid P, Miloslavsky E, Dua A. Needs Assessment of a Structured Teaching Program for Fellows as Teachers: Rheumatology Fellows’ Perspective [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10).

Part of the Topical Collection entitled ‘Empowering Medical Education to Transform: Learnings from an international perspective

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Reid, P., Miloslavsky, E.M. & Dua, A. Teacher training for rheumatology fellows: a national needs assessment of fellows and program directors. Clin Rheumatol (2019). https://doi.org/10.1007/s10067-019-04829-2

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  • Clinician-educator
  • Fellow-as-teacher
  • Fellows as teachers
  • Fellowship training
  • Medical education
  • Rheumatology
  • Teacher training