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.
• 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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Fleming VM, Schindler N, Martin GJ, DaRosa DA (2005) Separate and equitable promotion tracks for clinician-educators. JAMA 294(9):1101–1104. https://doi.org/10.1001/jama.294.9.1101
Chen HC, Wamsley MA, Azzam A, Julian K, Irby DM, O'Sullivan PS (2017) The health professions education pathway: preparing students, residents, and fellows to become future educators. Teach Learn Med 29(2):216–227. https://doi.org/10.1080/10401334.2016.1230500
Roberts DH, Schwartzstein RM, Weinberger SE (2014) Career development for the clinician-educator. Optimizing impact and maximizing success. Ann Am Thorac Soc 11(2):254–259. https://doi.org/10.1513/AnnalsATS.201309-322OT
Gardner AK, Waters V, McLaughlin RJ (2017) What do faculty in health professions need to be competent educators? Results from a School-Wide Needs Assessment. J Allied Health 46(4):e77–e80
The internal medicine subspecialty milestones project (2015). http://www.acgme.org/Portals/0/PDFs/Milestones/InternalMedicineSubspecialtyMilestones.pdf
Horn L, Tzanetos K, Thorpe K, Straus SE (2008) Factors associated with the subspecialty choices of internal medicine residents in Canada. BMC Med Educ 8:37. https://doi.org/10.1186/1472-6920-8-37
Messman A, Kryzaniak SM, Alden S, Pasirstein MJ, Chan TM (2018) Recommendations for the development and implementation of a residents as teachers curriculum. Cureus 10(7):e3053. https://doi.org/10.7759/cureus.3053
Fakhouri Filho SA, Feijo LP, Augusto KL, Nunes M (2018) Teaching skills for medical residents: are these important? A narrative review of the literature. Sao Paulo Med J 136(6):571–578. https://doi.org/10.1590/1516-3180.2018.0147060818
Richards JB, Kelly E, Fessler H, Roberts DH (2013) A novel survey tool to assess pulmonary and critical care fellows' attitudes regarding acquiring teaching skills during fellowship training. J Grad Med Educ 5(3):506–509. https://doi.org/10.4300/JGME-D-12-00153.1
Rivera V, Yukawa M, Aronson L, Widera E (2014) Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors. J Am Geriatr Soc 62(12):2377–2382. https://doi.org/10.1111/jgs.13187
McSparron JI, Huang GC, Miloslavsky EM (2018) Developing internal medicine subspecialty fellows' teaching skills: a needs assessment. BMC Med Educ 18(1):221. https://doi.org/10.1186/s12909-018-1283-2
Data resource book (Academic year 2015-2016) http://www.acgme.org/About-Us/Publications-and-Resources/Graduate-Medical-Education-Data-Resource-Book/GraduateMedicalEducation/GraduateMedicalEducationDataResourceBook.
Kumar NL, Perencevich ML, Trier JS (2017) Perceptions of the inpatient training experience: a nationwide survey of gastroenterology program directors and fellows. Dig Dis Sci 62(10):2631–2647. https://doi.org/10.1007/s10620-017-4711-y
Richards JB, McCallister JW, Lenz PH (2016) Pulmonary and critical care medicine program directors' attitudes toward training in medical education. A Nationwide Survey Study. Ann Am Thorac Soc 13(4):475–480. https://doi.org/10.1513/AnnalsATS.201601-006OC
Alpert CM, Sinha SS, Cullen MW (2019) Teaching tomorrow's teachers: an innovative model of clinician-educator development for fellows-in-training. J Am Coll Cardiol 73(22):2900–2903. https://doi.org/10.1016/j.jacc.2019.04.029
Cramer JD, Chi DH, Schaitkin BM, Eibling DE, Johnson JT (2018) Teach the teacher: training otolaryngology fellows to become academic educators. Laryngoscope 128(9):2034–2048. https://doi.org/10.1002/lary.27156
Miloslavsky EM, Degnan K, McNeill J, McSparron JI (2017) Use of Fellow as Clinical Teacher (FACT) curriculum for teaching during consultation: effect on subspecialty fellow teaching skills. J Grad Med Educ 9(3):345–350. https://doi.org/10.4300/JGME-D-16-00464.1
Adamson R, Goodman RB, Kritek P, Luks AM, Tonelli MR, Benditt J (2015) Training the teachers. The clinician-educator track of the University of Washington Pulmonary and Critical Care Medicine Fellowship Program. Ann Am Thorac Soc 12(4):480–485. https://doi.org/10.1513/AnnalsATS.201501-032OT
Tofil NM, Peterson DT, Harrington KF, Perrin BT, Hughes T, Zinkan JL, Youngblood AQ, Bartolucci A, White ML (2014) A novel iterative-learner simulation model: fellows as teachers. J Grad Med Educ 6(1):127–132. https://doi.org/10.4300/JGME-D-13-00067.1
Rosenbaum ME, Rowat JA, Ferguson KJ, Spengler E, Somai P, Carroll JL, Vogelgesang SA (2011) Developing future faculty: a program targeting internal medicine fellows' teaching skills. J Grad Med Educ 3(3):302–308. https://doi.org/10.4300/JGME-D-10-00109.1
Backes CH, Reber KM, Trittmann JK, Huang H, Tomblin J, Moorehead PA, Bauer JA, Smith CV, Mahan JD (2011) Fellows as teachers: a model to enhance pediatric resident education. Med Educ Online:16. https://doi.org/10.3402/meo.v16i0.7205
Kempainen RR, Hallstrand TS, Culver BH, Tonelli MR (2005) Fellows as teachers: the teacher-assistant experience during pulmonary subspecialty training. Chest 128(1):401–406. https://doi.org/10.1378/chest.128.1.401
Pascoe JM, Nixon J, Lang VJ (2015) Maximizing teaching on the wards: review and application of the One-Minute Preceptor and SNAPPS models. J Hosp Med 10(2):125–130. https://doi.org/10.1002/jhm.2302
Kirkpatrick D, Kirkpatrick J (2006) Evaluating training programs: the four levels. Berrett-Koehler Publishers
Sturman N, Rego P, Dick ML (2011) Rewards, costs and challenges: the general practitioner's experience of teaching medical students. Med Educ 45(7):722–730. https://doi.org/10.1111/j.1365-2923.2011.03930.x
McCullough B, Marton GE, Ramnanan CJ (2015) How can clinician-educator training programs be optimized to match clinician motivations and concerns? Adv Med Educ Pract 6:45–54. https://doi.org/10.2147/AMEP.S70139
Gerrity MS, Pathman DE, Linzer M, Steiner BD, Winterbottom LM, Sharp MC, Skochelak SE (1997) Career satisfaction and clinician-educators. The rewards and challenges of teaching. The Society of General Internal Medicine Career Satisfaction Study Group. J Gen Intern Med 12(Suppl 2):S90–S97. https://doi.org/10.1046/j.1525-1497.12.s2.13.x
Passo MH (2006) The role of the clinician educator in rheumatology. Curr Rheumatol Rep 8(6):469–473
Levinson W, Rubenstein A (2000) Integrating clinician-educators into Academic Medical Centers: challenges and potential solutions. Acad Med 75(9):906–912
Thomas PA, Diener-West M, Canto MI, Martin DR, Post WS, Streiff MB (2004) Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine. Acad Med 79(3):258–264
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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
- Fellows as teachers
- Fellowship training
- Medical education
- Teacher training