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Characteristics of academic medicine change agents as revealed by 4th-year medical students’ reflections-on-practice

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Abstract

Problem

At present, formal training in adult learning principles, educational theories, and educational methods is not a core objective of most medical school curricula. As academic medical centers aim to develop the next generation of medical educators, students must be provided an opportunity to learn educational principles, engage in supervised teaching activities, and develop experiences in academic medicine to foster interest early in their development as educators.

Intervention

We developed a longitudinal medical education elective for fourth-year medical students, which was comprised of attending five seminars, leading 15 teaching sessions, formulating a medical education project, and writing a reflective essay. The seminars covered the history of medical education in the USA, adult learning theory and teaching principles, use of various teaching strategies and formats, construction and organization of curricula, effective models of evaluation and feedback provision, and principles of educational research.

Context

This exploratory quasi-experiment incorporated a concurrent mixed methods data collection approach via pre- and post-seminar surveys and narrative reflection essay document analyses.

Impact

Learners revealed favorable changes in their self-efficacy and self-perceived knowledge and attitudes towards medical education. A qualitative analysis of the reflective essays revealed five thematic categories (learning impacts, medical educator growth, leadership growth, medical school reflections, and future professional plans) and thirteen sub-categories. Students found many opportunities to implement high-quality educational projects, expressed commitment to pursuing teaching careers, and felt better equipped to assume a leadership role as change agents in academic medicine.

Lessons Learned

Findings are likely relevant to critical stakeholders who advocate for the inclusion of formal educational skills training into medical education curricula.

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Acknowledgements

The authors are grateful for the organizational and curricular support provided by Latha Chandran, Alex Mechaber, Laurence Gardner, Paul Mendes, S. Barry Issenberg, and Henri Ford. The authors are also indebted to Dr. Chandran for the helpful reviews and feedback. Countless faculty, staff, and students at both the Miami campus and the regional campus helped with logistical support. Finally, the authors would like to highlight the contributions from the Division of Innovations in Medical Education within the Educational Development Office (EDO) at the University of Miami Miller School of Medicine (UMMSM). This research was conducted when the lead author (Green) was still with the EDO at UMMSM.

Author information

Authors and Affiliations

  1. Division of Innovations in Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA

    David Green

  2. University of Miami Miller School of Medicine, Miami, FL, USA

    Gauri Agarwal & Daniel M. Lichtstein

  3. Department of Surgery, University of Texas Southwestern, Dallas, TX, USA

    Chase B. Knickerbocker

  4. Sidney Kimmel College Medicine, Thomas Jefferson University, ChristianaCare and A.I. duPont Hospital for Children, Wilmington, DE, USA

    Michael Maguire

  5. Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA

    Gabriel E. Shaya

Authors
  1. David Green
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  2. Gauri Agarwal
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  3. Daniel M. Lichtstein
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  4. Chase B. Knickerbocker
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  5. Michael Maguire
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  6. Gabriel E. Shaya
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Corresponding author

Correspondence to David Green.

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Ethical Approval

University of Miami’s IRB ID: 20190045 and was approved on 1/14/2019.

Conflict of Interest

The authors declare no competing interests.

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Appendices

Appendix 1

Summary of seminar topics.

  • Seminar 1: History of medical education, characteristics of good teachers, small group teaching, problem-based learning

  • Seminar 2: Team-based learning, clinical teaching

  • Seminar 3: Writing learning objectives, writing multiple choice clinical vignette questions, developing an OSCE

  • Seminar 4: Providing feedback, mentorship, RIME model

  • Seminar 5: Educational scholarship and group discussion of planned curricular projects with peer feedback

Appendix 2

Examples of educational projects.

  • Creation of TBL session on developmental and child psychiatry

  • PBL case revision

  • Procedure lab on Suturing/knot tying and IUD insertion for OB clerkship

  • Website developed to assist students with use of medical interpreters: https://medical-student-language-access-training.webnode.com/

  • Student developed pressure injury curriculum in Geriatrics clerkship

  • Student developed and implemented Video Based Empathy small group communication skills lab

  • Student developed video guide for formal oral case presentations

  • Team based learning session on nutrition counseling for Family medicine clerkship

  • Pregnancy options counseling session for the OB-GYN clerkship that included discussions about options for termination of pregnancy

  • Communication lab on responding to pages as an intern for the Senior Bootcamp Course

  • Guide to the surgical correlates to anatomy dissection for the Anatomy course.

  • PPT and skills session on the ophthalmologic exam for Academic Societies trainers.

  • Team based learning session on pediatrics surgery for the Surgery clerkship

  • Guide and teaching session for the oral exam topics in the Obstetrics and Gynecology clerkship

  • “Racial Disparities in Pediatrics” session implemented in Pediatrics clerkship

  • “Racial Disparities in Obstetrics-Gynecology” session implemented in Obstetrics-Gynecology clerkship

  • “Contraception” session in Obstetrics-Gynecology clerkship

  • “Cultural Competency OSCE” submitted to Racial Justice Task Force as proposal

  • POCUS session on “Right upper quadrant ultrasound imaging”

  • “Telehealth visit guidelines education and physical exam via telehealth” guidelines

  • IPE workshop session

  • Peer mentoring on “Writing a case report”

  • “Gynecologic Malignancies” session in Obstetrics-Gynecology

  • Workshop on “Maternal Health Outcomes with Every Mother Counts”

  • “AKI/Hyponatremia” Team Based learning

  • OSCE on “Opioid-use disorder”

  • TBL session on “Healthcare policy education”

  • TBL on “Eating Disorders”

  • CBL on “Postpartum hemorrhage”

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Green, D., Agarwal, G., Lichtstein, D.M. et al. Characteristics of academic medicine change agents as revealed by 4th-year medical students’ reflections-on-practice. Med.Sci.Educ. 32, 91–102 (2022). https://doi.org/10.1007/s40670-021-01498-2

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  • DOI: https://doi.org/10.1007/s40670-021-01498-2

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