The academic health center coming of age: helping faculty become better teachers and agents of educational change.

There is a growing appreciation of the need for educational faculty development within medical education. The authors describe the establishment and subsequent expansion of one such fellowship in medical education that arose from the cooperative efforts of Harvard Medical School, Beth Israel Deaconess Medical Center, and Mount Auburn Hospital. Three resultant fellowships are outlined that share the common goals of enhancing the skills of the faculty as educators, providing an opportunity to conduct scholarly educational research, supporting the fellows as change agents, and fostering the creation of a supportive community dedicated to enhancing the field of medical education. Curricular structure and content are outlined as well as current approaches to curricular and programmatic evaluation. The fellowships have been well received and are widely perceived as transformative for the faculty, many of whom have assumed increased roles of organizational and educational leadership. Lastly, future directions for these fellowships are presented.

Why invest in an educational fellowship program?

Expanding and refining the repertoire of medical school teaching faculty is required by the many current and changing demands of medical education. To meet this challenge academic medical institutions have begun to establish programs--including educational fellowship programs--to improve the teaching toolboxes of faculty and to empower them to assume leadership roles within both institutional and educational arenas. In this article, the authors (1) provide historical background on educational fellowship programs; (2) describe the prevalence and focus of these programs in North American medical schools, based on data from a recent (2005) survey; and (3) give a brief overview of the nine fellowship programs that are discussed fully in other articles in this issue of Academic Medicine. These articles describe very different types of educational fellowships that, nevertheless, share common features: a cohort of faculty members who are selected to participate in a longitudinal set of faculty development activities to improve participants' teaching skills and to build a cadre of educational leaders for the institution. Evaluation of educational fellowships remains a challenging issue, but the authors contend that one way to evaluate the programs' effectiveness is to look at the educational improvements that have been instigated by program graduates. The authors hope that the various program descriptions will help readers to improve their existing programs and/or to initiate new programs.

Teaching approaches that reflect and promote professionalism.

The teaching and cultivation of professionalism have long been part of medical education and have had recent special emphasis because professionalism has been identified as a core competency by the Accreditation Council for Graduate Medical Education. The author focuses on two complementary teaching initiatives that contribute to the development of professionalism in the academic environment: a resident-as-teacher program and an approach to faculty bedside teaching that mirrors and extends the lessons of the resident-as-teacher effort. These have been implemented and refined over the previous 15 years by the author and his colleagues at Mount Auburn Hospital in Cambridge, Massachusetts. The commitment to the development and refinement of residents' teaching skills serves to promulgate the fundamental elements of professionalism, with emphasis on caring and the educational well-being of the team. The author describes the elements and benefits of these approaches and shows how they can foster the development of professionalism in graduate medical education.

The educational attributes and responsibilities of effective medical educators.

Of the many roles that the academic-educator may fulfill, that of teacher is particularly challenging. Building on prior recommendations from the literature, this article identifies the skill set of teachers across the medical education continuum-characteristics of attitude and attributes, knowledge, and pedagogic skills that permit effective teaching to be linked with effective learning and understanding. This examination which characterizes teachers' attitudes, knowledge, and skills serves to reemphasize the centrality of teaching within medical education, provides direction for faculty and institutions alike in the discharge of academic responsibilities, and makes educational accountability clear. This listing of teacher attitudes and responsibilities was vetted in 2009 by medical education leaders from across North America during a national conference on faculty development.A set of recommendations concerning faculty development issues for medical teachers is offered. The recommendations are intended to establish an academic culture in medical education that values and rewards-academically and fiscally-those centrally committed to the role of teacher. The challenges of defining skills, developing and funding programs, and ongoing evaluation must be faced to achieve success in teaching throughout medical education, now and in the future. Faculty members, fellow learners, and patients deserve no less.

A national survey of medical education fellowships.

PURPOSE: The purpose of our study was to determine the prevalence, focus, time commitment, graduation requirements and programme evaluation methods of medical education fellowships throughout the United States. Medical education fellowships are defined as a single cohort of medical teaching faculty who participate in an extended faculty development programme. METHODS: A 26-item online questionnaire was distributed to all US medical schools (n=127) in 2005 and 2006. The questionnaire asked each school if it had a medical education fellowship and the characteristics of the fellowship programme. RESULTS: Almost half (n=55) of the participating schools (n=120, response rate 94.5 %) reported having fellowships. Duration (10-584 hours) and length (<1 month-48 months) varied; most focused on teaching skills, scholarly dissemination and curriculum design, and required the completion of a scholarly project. A majority collected participant satisfaction; few used other programme evaluation strategies. CONCLUSIONS: The number of medical education fellowships increased rapidly during the 1990s and 2000s. Across the US, programmes are similar in participant characteristics and curricular focus but unique in completion requirements. Fellowships collect limited programme evaluation data, indicating a need for better outcome data. These results provide benchmark data for those implementing or revising existing medical education fellowships.

The personal and professional impact of a fellowship in medical education.

BACKGROUND: Faculty development is essential to fostering excellence in medical education and desired learning outcomes. Little is known, however, about the personal and professional impact of faculty development programs on participants, learners, and institutions. We explored the perspectives of medical education fellowship graduates on their skills, self-perceptions, participation in learning communities, and reflective practice. We also explored the results of the implementation of a scholarly medical education project. METHOD: The study was a qualitative analysis of semistructured interviews with 40 faculty from multiple disciplines who, between 1999 and 2005, had completed a yearlong fellowship in medical education. RESULTS: Through qualitative analysis, we identified 11 themes. Study participants described postfellowship changes in knowledge, self-perceptions, and behaviors and institutional changes that resulted from education projects. With a foundation of principles and skills, the Fellows' confidence and identity as educators were strengthened by their sense of self-efficacy, others' perceptions of their credibility, and support from a community of peers and mentors. This change affected the graduates' professional career trajectories. CONCLUSIONS: Common themes in this and other studies suggest that enhancement of knowledge about medical education and teaching skills, protected time, a supportive learning environment, relationships with peers and mentors, validation of educational expertise by others, community building and networking, and emphasis on self-reflection and awareness are essential elements of faculty fellowships in medical education. This analysis suggests that these elements foster the evolution of identity, confidence, and self-efficacy among fellowship graduates. This personal development promotes the professional development of the medical educator.

Strategies for creating a faculty fellowship in medical education: report of a 10-year experience.

The authors present 10 strategies, plus challenges and opportunities, that have informed three well-established, yearlong medical education fellowships (defined as single cohorts of medical teaching faculty who participate in extended faculty development activities) during the period 1998 to 2008. These strategies include (1) defining an operating philosophy, values, and goals, (2) establishing a curriculum that reflects the roles and responsibilities of fellows and faculty, (3) employing a basic approach to adult learning, (4) striving to achieve a balance between stated objectives and openness of discussion, (5) creating optimum learning opportunities for the fellows to acquire and practice skills delineated in the curriculum, (6) fostering interdisciplinary communication, team development, and the creation of a learning community, (7) developing mindfulness and critical self-reflection, (8) systematically reviewing each session, (9) evaluating fellowship outcomes, and (10) planning for the future. This in-depth look presents both curricular content and process, providing a useful starting point from which those who develop and conduct educational faculty development activities at medical schools and academic medical centers may fashion and implement a local curriculum.