Growing Medical Educators from Medical Students by Supporting Self-directing Learning Opportunities Born Out of Cadaveric Dissection.

This study focuses on a subset of medical students who participated in an anatomy dissection program and undertook an additional self-directed learning (SDL) project investigating incidental findings of cadaveric pathology. The value of SDL activity is explored as a means of enhancing medical student education, particularly its student perceived value in preparing and developing them as future medical educators. It was assessed whether the project advanced student interest in medical education by analyzing their motivations for participation. The results of the study highlight the potential of SDL as an experiential learning opportunity for medical students and the role of anatomic pathology in connecting multiple domains of medical education.

"Teaching capital"- a sociological analysis of medical educator portfolios for promotion.

Medical educator portfolios (MEP) are increasingly recognized as a tool for developing and documenting teaching performance in Health Professions Education. However, there is a need to better understand the complex interplay between institutional guidelines and how teachers decode those guidelines and assign value to teaching merits. To gain a deeper understanding of this dynamic, this study employed a sociological analysis to understand how medical educators aspiring to professorships use MEPs to display their teaching merits and how cultural capital is reflected in these artefacts. We collected 36 medical educator portfolios for promotion from a large research-intensive university and conducted a deductive content analysis using institutional guidelines that distinguished between mandatory (accounting for the total body of teaching conducted) and optional content (arguing for pedagogical choices and evidencing the quality, respectively). Our analysis showed that the portfolios primarily included quantifiable data about teaching activities, e.g., numbers of students, topics and classes taught. Notably, they often lacked evidence of quality and scholarship of teaching. Looking at these findings through a Bourdieusian lens revealed that teachers in this social field exchange objectified evidence of hours spent on teaching into teaching capital recognized by their institution. Our findings highlight how institutional guidelines for MEPs construct a pedagogical battlefield, where educators try to decode and exchange the "right" and recognized teaching capital. This indicates that MEPs reflect the norms and practices of the academic field more than individual teaching quality.

Twelve tips for medical educators to optimize their curricula vitae.

A good curriculum vitae (CV) highlights medical educators' academic achievements and supports their professional goals. Many faculty struggle with timely updates and strategic formatting. These twelve tips will help medical educators optimize their CV to best showcase their strengths and accomplishments. The first three tips outline a process: identify a system to collect potential entries and schedule regular time for updates. Tips four and five detail how to tailor traditional CV formatting to best describe the work of medical educators. The next few tips offer concrete strategies and examples of CV entries to consider for inclusion. The remaining tips remind faculty to ask for help from colleagues, who can share a sample CV and identify overlooked activities. Our intention is to transform a task that can be burdensome into a process that seamlessly captures the breadth of our work as medical educators and allows for introspection and growth.

Scenario-Based e-Simulation Design for Global Health Education: Theoretical Foundation and Practical Recommendations.

Electronic simulation (e-simulation)-particularly scenario-based e-simulation (SBES)-is an increasingly used, promising educational strategy for global health education that can address gaps in training access, effectiveness, and cost. However, there is little guidance for educators on how to develop an SBES, and guidance is lacking outside the clinical context. Moreover, literature on medical education rarely uses the theoretical basis for e-simulation design and development, including for SBES. Hence, we aim to differentiate and describe the concept, design elements, and theoretical basis of SBES with examples from different topics in global health. In addition to enhancing the understanding of the potential of SBES for global health education, this manuscript also provides practical recommendations for global health educators in designing and developing SBESs based on the existing literature and authors' experiences. Overall, this manuscript will be useful for global health educators as well as other medical educators seeking to develop an SBES for similar skill sets.

General Practitioner Educators on Clinical Debrief: A Qualitative Investigation into the Experience of Teaching Third-Year Medical Students to Care.

Phenomenon: There is a paucity of research reporting the experiences of general practitioner clinical educators. Providing education for students could lead to better clinical skills and greater job satisfaction for the educator. However, it could also result in increased stress and mental fatigue, adding to what is an already pressured situation in the current primary care climate. Clinical Debrief is a model of case-based learning with integrated supervision developed to prepare medical students for clinical practice. This study aimed to explore the experiences of general practitioners who facilitate Clinical Debrief. Approach: Eight general practitioner educators with experience of facilitating Clinical Debrief participated in semi-structured qualitative interviews. Results were analyzed using Reflexive Thematic Analysis, and four main themes were developed. Findings: Themes included: Personal enrichment: psychological "respite" and wellbeing; Professional enrichment: Clinical Debrief as a "two-way" door; Becoming a facilitator: a journey; and, Relationships in teaching: blurred boundaries and multiple roles. Insights: Being a Clinical Debrief facilitator had a transformative impact on the personal and professional lives of the GPs who participated in this study. The implications of these findings for individual GPs, their patients, and the wider healthcare system, are discussed.

Ernesto Bustamante Zuleta (1922-2021): pioneering teacher and practitioner of Colombian neurosurgery.

Ernesto Bustamante Zuleta (1922-2021) was an impactful Colombian neurosurgeon whose legacy is inextricably linked with the development of the neurosurgery specialty in Colombia. His detail-oriented approach to treatment complemented his reputation for mastery of the neurosciences. Never simply confined to the operating theater, this calm and considerate physician felt compelled to teach during his entire career. The result of his teaching made a lasting imprint on an entire generation of neurosurgeons who subsequently established a high standard of neurosurgical care in Colombia. A true pioneer, Bustamante comprehensively engaged in his field, from founding the country's first residency program in neurosurgery to successfully implementing technology in his procedures, performing many of Colombia's first neurosurgical interventions, and publishing extensively across various categories of medical science. This historical reflection highlights his enduring contributions to the field and considers his legacy through the witness testimony of many of his students and collaborators. The hope is that his contributions may be acknowledged in full, as he was a reserved person who never boasted of his own accomplishments. The authors also hope that those who did not have the opportunity to know him would be informed by the historical context of the development of Colombian neurosurgery and inspired by his conviction and altruism.

Becoming Agents of Change: Contextual Influences on Medical Educator Professionalization and Practice in a LMIC Context.

Medical educators are particularly needed in Low- and Middle-Income Countries (LMIC), where medical schools have grown rapidly in size, number, and global outlook in response to persistent health workforce shortages and increased expectations of quality care. Educator development is thus the focus of many LMIC programs initiated by universities and governments of high income countries. While signs of medical educator professionalization such as postgraduate qualifications, specialized units, and professional associations have emerged in LMIC, whether these relate to programs originating from outside LMIC contexts is unknown. This study investigated the contextual influences on the long-term impact of an international faculty development program a decade after its delivery in a LMIC context - Vietnam.Ten years after an international aid program to develop clinical skills teaching expertise in Vietnam, we conducted in-depth qualitative interviews with eight medical educators from all eight participating medical schools. Selected for their leadership potential, each participant had completed the Maastricht Masters in Health Professions Education during the program. Interview transcripts underwent thematic analysis, using the Theory of Practice Architectures as a conceptual lens to highlight the contextual influences on professional practice.Four themes were identified: Careers and Practices before, during, and after the program, Unrecognized and Unseen practice, Structural Restraints on individual advancement and collective activity, and the Cultivation of Connections through social traditions. Participants reported being in well-established teaching delivery roles. However, the absence of professionalizing discourses and material resources meant that practice was restricted and determined by institutional leadership and individuals' adaptations.Informed by the theory of practice architectures, we found that change in medical education practice will falter in contexts that lack supporting discursive, material-economic, and socio-political arrangements. While there were emerging signs of individual agency, the momentum of change was not sustained and perhaps unapparent to Western framings of educational leadership. Practice architectures offers a framework for identifying the contextual features which influence practice, from which to design and deliver sustainable and impactful interventions, and to advance context-relevant evaluation and research. Our findings suggest that faculty development delivered across diverse contexts, such as in distributed or transnational medical programs, may have more effect if informed by a practice architectures analysis of each context.

Clerkship Chiefs: Introducing Students to the Role of Physician Educator.

As a Clerkship Chief, senior medical students prepare for future roles as physician leaders and future medical educators. The Clerkship Chief elective offers senior students an opportunity to work with junior students on their core clerkships. Chiefs assume an educational leadership role as they mentor and provide supplemental formative feedback to junior students in real time. As educators, Chiefs answer questions, prepare study materials and didactics, and assist clerkship students with time management. This early experience and behind-the-scenes view of medical education may influence attitudes and decisions of senior students in pursuit of education leadership.

Community, Coaching, and Action Research: Promoting Ambitious Teaching in Medical Education.

Ambitious teaching is an instructional approach enacted through central tasks of teaching that involves a fundamental shift in mindset and practice. In this approach, the teacher facilitates student learning in the context of authentic, interactive experiences by eliciting student thinking and adapting instruction accordingly. We designed the Medical Educator-Excellence in Teaching (MEET) program to promote ambitious teaching in medical education. Here, we describe the structure of MEET, the framework that informed our work, and program evaluation data. We propose MEET as a model of educator development that promotes ambitious teaching through development of educator community, focused coaching, and inquiry into practice.

Prediction of Admission Tests for Medical Students' Academic Performance.

Introduction: Medical educators are concerned about predicting standardized tests for students' academic performance in medical colleges. This study, in Saudi Arabia, attempted to analyze the predictive validity of two local standardized tests (GAT and SAAT) for students' performance in the first two years and basic and advanced science courses. This study is unique since it focuses on comparing the prediction of both tests between the two years and examining the difference in students' performance in basic and advanced science courses. Methods: Data of 650 students included GAT and SAAT scores, GPA in the first and second year, and average basic and advanced science courses validated through students' college ID. Results: Results show that both GAT and SAAT significantly predict medical students' GPA with sufficient strength (ie, R2 =27% and 28% for the first and second years). It also indicates that GAT and SAAT are significant predictors of students' academic performance in their basic and advanced science courses with an acceptable strength (ie, R2= 27% for the basic science course, and R2= 22% for advanced science course). Discussion: Based on these results, the study concludes about the necessity of having more accurate and relevant admission criteria for medical colleges.

Sources of Joy In Medical Educators as Described by the PERMA Model.

Phenomenon: Burnout is prevalent amongst long-practicing physicians. For medical educators, it has deleterious effects not only on the educator themselves, but also the students they are teaching. Though significant research has focused on factors associated with burnout, there is limited understanding of its counter: how physicians, particularly medical educators, derive joy from their work. Approach: This qualitative study included 15 highly-rated clinician educators in Internal Medicine who took part in individual semi-structured interviews. Participants were invited to discuss their sources of professional joy. After transcription, we used thematic content analysis: 50 themes were identified. Themes were then coded using the domains of the PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) model of positive psychology, assigning each theme a best fit domain. Forty-five themes were mapped into the PERMA model. Findings: When describing professional joy, highly-rated clinician educators displayed high levels of overlap with all domains of the PERMA model. Interaction with the learner was a prominent source of professional joy, particularly within Positive Emotion, Engagement, and Relationship domains. Insights: Our findings indicate that the PERMA model appropriately defines the sources of professional joy for these educators. Future research could employ this model to identify targets for interventions aimed at amplifying joy at work for this group.

Medical educators' perspectives on the barriers and enablers of teaching public health in the undergraduate medical schools: a systematic review.

BACKGROUND: Having relevant public health content in the undergraduate medical curriculum is critical to preparing medical doctors for emerging health issues and increased public health roles. Medical educators are central to this effort. OBJECTIVE: This systematic review synthesises the most relevant and up-to-date evidence on medical educators' perspectives regarding the barriers and enablers on incorporating public health teaching in the undergraduate medical curricula. METHODS: Seven databases were searched for articles published between 1 January 2010 and 31 December 2021. Articles were included if they were available in full-text English or Indonesian language, peer-reviewed, and focused on medical educators' perspectives on teaching public health in the undergraduate medical curricula. Findings were integrated to answer the review question using thematic analysis. RESULTS: Twenty-nine articles were included in the final review. Three major themes emerged: (i) space in the medical curricula, (ii) confidence/capabilities of medical educators, and (iii) institutional support. Overcrowded curricula, lack of consensus about the scope and level of public health to incorporate into teaching, ensuring the quality and the relevance of content with what is required in real practice, as well as inadequate institutional support are major challenges in teaching public health to medical students. CONCLUSIONS: Integrating public health into other subjects is largely seen as a solution. This requires strong institutional support in the form of financial, logistic, and technical support; structured training for medical educators on how to incorporate the content into their subjects; and a recognition of the important role that public health educators play.

The "General practitioner learning stations"-development, implementation and optimization of an innovative format for sustainable teaching in general practice.

BACKGROUND: Teaching general practice in a university setting is still challenging. In our department we have developed a teaching format with content from a previous lecture-style-teaching into an interactive small group format taught by frontline general practitioners (GPs). The "GP learning stations" introduce students to the skills and attributes of a GP working in primary care in a university setting. Our main objective was to understand whether the teaching format had proven itself sustainable in a university setting over eight years. Furthermore, we wanted to better understand the role of the GP as a medical educator. METHODS: More than eight years of experience in organizational and staff expenses were collected and analyzed. In addition, the grade point average of the students' evaluation was calculated and their free text answers were categorized and evaluated descriptively. During two teach-the-teacher seminars attending GPs were asked why they teach and if they feel equipped to teach the format. RESULTS: The initially high organizational and staff expenses were significantly reduced. The recruitment of GPs, their didactic contribution, and their joint creation of content went smoothly throughout the whole period. A total of 495 students participated in the regular evaluation. The analysis yielded a grade point average of 1.9, on a scale from 1 = very good to 6 = insufficient. In the free text answers students praised the educators, the format and the practical relevance. The interactive transfer of the content, the didactic competence of the educators and the spatial environment were viewed critically. Reasons for GPs to teach were the joy to pass on knowledge and experience, and to make the work of GPs more attractive to students. Most GPs felt prepared to teach through their experience as a physician although some felt unprepared to teach through their lack of didactic knowledge. CONCLUSION: Despite reducing the costs of the format, a grade point average of 1.9 could be achieved in the long term. This supports the teaching concept of learning stations and its "mixture of discussion, scientific background and role play, combined with (…) experiences and exciting individual cases from (GPs) everyday life", hopefully making general practice more attractive to the students.

Usage of power by different types of trainers in the education of paramedics - evaluation by means of a validated questionnaire.

Objective: Emergency medical services are characterized by a high pressure to act. Dealing with trainees is a challenge. It is known, that the use of power in education subsists: power can be applied in a participative and restrictive way. We investigated the transferability of existing scales to the education system of Emergency medical service trainees. We hypothesized: a restrictive (a) and participative (b) use of power, can be demonstrated in Emergency medical service training, (c) the use of power by educators, who are responsible for theoretical learning, and instructors, who accompany trainees in real-life emergencies, are different and (d) the assessed participatory and restrictive use of power by trainers is negatively correlated. Methods: In a cross-sectional study, 206 trainees of Emergency medical service schools completed a questionnaire. The survey consists of 35 power related items regarding medical educators and practical instructors. Differences in the dimensions of power application were tested. The effect size and the correlation between power dimension were calculated. Results: The reliability of the scales was .92 (practical instructor) and .89 (medical educator) by removing one item. All subscales showed values with higher Cronbach's alpha than .68. Application of participative power differs (p<.00) between practical instructors (mean 64.7; SD 20.3) and medical educators (mean 55.3; SD 17.8). The participatory and the restrictive use of power correlated for medical educators significant negatively (r=-.48; p<.01). Conclusion: In both educator and instructor groups the use of participative power had a greater agreement that the use of restrictive techniques. The practical instructors used participative power slightly more often that did educators due to the dependency on the trainee as a team member. The context of the scales partially overlaps with other descriptions such as leadership and instructor quality.

A Systematic Scoping Review on Portfolios of Medical Educators.

BACKGROUND: Heralded as a teaching, assessment and reflective tool, and increasingly as a longitudinal and holistic perspective of the educator's development, medical educator's portfolios (MEP)s are increasingly employed to evaluate progress, assess for promotions and career switches, used as a reflective tool and as a means of curating educational activities. However, despite its blossoming role, there is significant dissonance in the content and structure of MEPs. As such, a systematic scoping review (SSR) is proposed to identify what is known of MEPs and its contents. METHODS: Krishna's Systematic Evidenced Based Approach (SEBA) was adopted to structure this SSR in SEBA of MEPs. SEBA's constructivist approach and relativist lens allow data from a variety of sources to be considered to paint a holistic picture of available information on MEPs. RESULTS: From the 12 360 abstracts reviewed, 768 full text articles were evaluated, and 79 articles were included. Concurrent thematic and content analysis revealed similar themes and categories including: (1) Definition and Functions of MEPs, (2) Implementing and Assessing MEPs, (3) Strengths and limitations of MEPs and (4) electronic MEPs. DISCUSSION: This SSR in SEBA proffers a novel 5-staged evidence-based approach to constructing MEPs which allows for consistent application and assessment of MEPs. This 5-stage approach pivots on assessing and verifying the achievement of developmental milestones or 'micro-competencies' that facilitate micro-credentialling and effective evaluation of a medical educator's development and entrust-ability. This allows MEPs to be used as a reflective and collaborative tool and a basis for career planning.

Understanding the dimensions of a strong-professional identity: a study of faculty developers in medical education.

BACKGROUND: Faculty developers are regularly involved in training medical educators to enhance their teaching excellence through workshops and other formats. By exemplifying professional and institutional values, faculty developers may profoundly impact how other educators perceive their own professional identity. OBJECTIVE: The objective of this study was to understand how the professional identity of faculty developers is formed. DESIGN: A qualitative approach was used, with a semi-structured interview. The sample consisted of 10 medical educators. A deductive thematic analysis based on Bolivar et al. (2004a) model of professional identity formation for medical educators was carried out. RESULTS: Self-image was impacted favorably through social recognition from students and peers, and the belief of having demonstrated professional competence through job assignments and enrollment in different leadership positions. The social relations to the center or department in which the faculty developer participates were strongly related to job satisfaction. Expectations about the future of the profession included positive attitudes toward change brought by generational differences. Regarding the process of construction of professional identity, life stories and dissimilar professional careers converge in the same educational setting. Faculty developers regularly resort to self-reflection, with a desire to continue learning and developing. They are resilient and purposeful, even in negative experiences that they have faced as identity crises. They share an awareness in building a legacy for the patients, their families, and the community through nurturing new generations of health-care practitioners. CONCLUSIONS: The interviewed faculty developers have a strong-professional identity that is characterized by a stable sense of self, strong behavioral repertoire, and key associations with a community of practice.

The development of clinical thinking in trainee physicians: the educator perspective.

BACKGROUND: An important element of effective clinical practice is the way physicians think when they encounter a clinical situation, with a significant number of trainee physicians challenged by translating their learning into professional practice in the clinical setting. This research explores the perceptions of educators about how trainee physicians develop their clinical thinking in clinical settings. It considers what educators and their colleagues did to help, as well as the nature of the context in which they worked. METHOD: A qualitative approach was used in this study with in depth interviews carried out with educators as key informants. Rich data derived from 15 interview transcripts were analysed thematically in a rigorous and iterative process. RESULTS: Three broad and overlapping themes were identified: working in an educationally minded culture; proximity of the educator to the trainee physician; and trajectory of the trainee physician. The departments in which these educators worked emphasised the importance for the education of trainee physicians. All members of the team were responsible for education of the team, and all members, particularly senior nurses, were able to give feedback upon the trainee physicians' progress. Educators described working side by side with their trainee physician and frequently being in close proximity to them which means that the educator was both easily accessible and spent more time with their trainee physicians. They described a trajectory of the trainee physicians through the placement with close monitoring and informal assessment throughout. CONCLUSION: Recommendations are made as to how trainee physicians can be supported to develop their clinical thinking. Educators and managers can analyse their own and their department's practice and select the recommendations relevant to their local circumstances in order to make change. This study adds the educator perspective to a body of literature about the importance of context and supportive learning environments. As such the discussion is applicable to the education of other health professionals.

Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine.

Objectives Violence against medical trainees confronts medical educators and academic leaders in perinatal medicine with urgent ethical challenges. Despite their evident importance, these ethical challenges have not received sufficient attention. The purpose of this paper is to provide an ethical framework to respond to these ethical challenges. Methods We used an existing critical appraisal tool to conduct a scholarly review, to identify publications on the ethical challenges of violence against trainees. We conducted web searches to identify reports of violence against trainees in Mexico. Drawing on professional ethics in perinatal medicine, we describe an ethical framework that is unique in the literature on violence against trainees in its appeal to the professional virtue of self-sacrifice and its justified limits. Results Our search identified no previous publications that address the ethical challenges of violence against trainees. We identified reports of violence and their limitations. The ethical framework is based on the professional virtue of self-sacrifice in professional ethics in perinatal medicine. This virtue creates the ethical obligation of trainees to accept reasonable risks of life and health but not unreasonable risks. Society has the ethical obligation to protect trainees from these unreasonable risks. Medical educators should protect personal safety. Academic leaders should develop and implement policies to provide such protection. Institutions of government should provide effective law enforcement and fair trials of those accused of violence against trainees. International societies should promulgate ethics statements that can be applied to violence against trainees. By protecting trainees, medical educators and academic leaders in perinatology will also protect pregnant, fetal, and neonatal patients. Conclusions This paper is the first to provide an ethical framework, based on the professional virtue of self-sacrifice and its justified limits, to guide medical educators and academic leaders in perinatal medicine who confront ethical challenges of violence against their trainees.

Professional Culture in Medical Schools: A Medical Educator Interpretation.

Besides sharing knowledge, values, and attitudes, the members of a profession share a way of understanding how to perceive life, also known as professional identity. The formation of this identity is related to the acquisition of multiple roles, responsibilities, and collaboration, defining their professional culture. The medical educator is a professional who is committed to student development, who is a leader in his field, and who is active in academic or clinical activities, demonstrating the commitment to the community. The objective of this study was to explore the professional culture through the perception of the medical educator identity. A qualitative method was implemented by applying a content analysis strategy. A sample of 39 medical educators participated in structured interviews. Answers transcription was analyzed unitizing assumptions, effects, enablers, and barriers through the professional culture model: individualism, balkanized, collegiality per project, and extended collaboration. The definition of the medical educator was associated with 44% to individualism, 31% balkanized, 13% collegiality per project, and 13% extended collaboration. Generally, contributions from Basic Science educators are more individual, and the projects in the university are part of the operation planned for the short and medium term. Clinical Science educators are used to working in medical specialty groups, and some of them are involved in strategical social projects that provide care for the community. A cultural change transitioning from a highly autonomous strategy toward meaningful collaborative projects can help physicians and health professionals to develop a shared vision of what it means to be a medical educator. The medical school should provide a sense of collegial community environment to set common goals and expectations with adequate resources, and leadership is the standard.

Learning about dental trauma for medical students.

The literature identifies that medical students receive little or no formal dental trauma assessment and management teaching during medical school. The result of this is that many medical doctors are unaware of the urgency of emergency dental trauma care for patients. To bridge this important gap in medical education, medical educators should look to introduce basic dental trauma teaching into undergraduates' final year of medical school. This initiative would benefit medical doctors in either general medical practice or specialties that assess and manage trauma. This opinion article aims to present the authors' reasons for strongly supporting dental trauma teaching being included and suggests an e-learning approach for its integration into the medical education curriculum.