Exploring Quality and Requirements in Faculty Development Related to Teaching.

BACKGROUND: Little is known about medical school requirements for faculty development related to teaching (FDT) in medical education. This study examined the national landscape and local faculty perceptions of their own institution's FDT requirement. METHODS: An electronic survey was disseminated to Faculty Affairs Offices in US medical schools to assess FDT requirements. A second survey was distributed to faculty within one medical school to gauge faculty perceptions related to existing FDT requirements. RESULTS: Responses were received from approximately 33% of US medical schools and 36% of local faculty. Few responding medical schools had formal FDT requirements. There was a wide range variation of hours and activities necessary to satisfy existing requirements and consequences for noncompliance. For respondents from schools that did not have a requirement, many saw value in considering a future requirement. Many local faculty agreed that the FDT requirement improved their teaching skills. When asked to share other thoughts about the FDT requirement, several qualitative themes emerged. CONCLUSION: This study helps establish a national benchmark for the status of FDT requirements in medical education and revealed information on how to optimize and/or improve such requirements. The authors offer five recommendations for schools to consider regarding FDT.

A Pilot Study Assessment of Medical Student Knowledge and System Citizenship Attitudes Pertaining to Health Systems Science.

Background and Purpose: Health system science (HSS) has been described as the third pillar of medical education. We introduced a new health system science and interprofessional practice (HSSIP) curriculum, and measured students' HSS knowledge and attitudes concerning health system citizenship. Methods: This pilot study involved first-year (M1) and fourth-year (M4) medical students in two cohorts across 2 years. Only M1 students in the second cohort participated in the new HSSIP curriculum. We compared student performance on a new National Board of Medical Examiners (NBME) HSS subject exam, and student attitudes toward system citizenship via a new attitudinal survey. Results: Fifty-six eligible fourth-year students (68%) and 70 (76%) study eligible first-year students participated in the study. NBME HSS exam performance by M4 students was statistically significantly higher than M1 students for both cohorts, with moderate to large effect sizes. Exam performance for M1 students not experiencing the HSS curriculum was higher than for M1 students who received HSS curricular content. Attitudes toward HSS by M4 versus M1 students were statistically significantly different on several survey items with moderate effect sizes. Scale internal consistency for the HSS attitude survey was strong (0.83 or higher). Discussion: There were differences among M4 and M1 medical students concerning knowledge of and attitudes toward HSS, with performance on the NBME subject exam similar to a national sample. Exam performance by M1 students was likely impacted by class size and other factors. Our results support the need for increased attention to HSS during medical education. Our health system citizenship survey has potential for further development and cross-institutional collaboration.

A Simple and Sustainable Exercise to Enhance Student Self-Reflection on Error-Making, Focus Support, and Guide Curricular Design.

Problem: Self-reflection is a critical component of professional development and clinical practice, but medical students' ability to self-reflect is typically limited. While inadequate self-reflection impacts future clinical decision-making, it may also adversely impact current learning through an inability to identify learning-behavior deficits. This may be exacerbated by common use of multiple-choice questions (MCQ) where incorrect responses provide less insight than other measures for students, faculty, or academic support. To address this, an Error Reflection Method (ERM) was developed to help students focus on 'why' they got an MCQ wrong rather than 'what' they got wrong, thereby promoting self-reflection and a learning-focus on assessment. Understanding students' learning-behavior deficits could also enrich engagement with academic support services and guide curricular design. Intervention: The ERM is a list of 10 common types of exam errors that were either 'test-taking' (unwitting) errors or 'learning-behavior' errors that reflected learning deficits. The ERM is simple, transferable, and sustainable, allowing longitudinal and regular monitoring of individual and collective error-making to focus support and guide curricular development. Context: Undergraduate medical students at the Virginia Tech Carilion School of Medicine, USA, used the ERM in formative assessment review sessions in pre-clinical years to select an error type that best described the cause of each incorrect response. Impact: Initial findings suggest the ERM is robust and associated with improved student performance and curricular development. Analysis of 3,775 student-identified errors showed the error types in the ERM described 96% of errors students made. Learning-behavior errors were more common (76%), but surprisingly, 19% were test-taking errors, allowing academic support to focus on test-taking skills in a population previously thought of as consummate test-takers. The most common error type reported was 'the content looked familiar but I couldn't answer the question' (32%); which we suggest is consistent with shallow learning. This finding has helped steer recent curricular development toward active and applied learning techniques. Lessons Learned: By formally and regularly identifying learning deficits, students may be more capable of addressing them and improve summative exam performance. As well as focusing academic support, understanding common student errors has been useful in guiding curricular design and content delivery. Further potential of the ERM may be realized in faculty development and directing assessment culture toward a learning focus.

Utilization and Perceived Effectiveness of a Web-Based Faculty Development Seminar for International Medical Science Educators.

The goal of this study was to examine the utilization and perceived effectiveness of the International Association of Medical Science Educators (IAMSE) Webcast Audio Seminar Series (WAS) by participants at the individual and institutional levels. The Webcast Audio Seminar Series User Survey (WASUS) included multiple quantitative and qualitative measures of user perceptions of their experiences and overall quality. Data was collected using a 42-item survey that examined user identification, utilization, and perceived effectiveness of the IAMSE WAS as a faculty development tool. Quantitative measures were summarized using descriptive statistics, including frequencies, means, and standard deviations. Qualitative data was investigated using an iterative, inductive thematic coding method. Qualitative themes were summarized and applied to quantitative trends as explanatory mechanisms with the intent to provide a more nuanced narrative of the data. The survey was sent to all 2012-2017 WAS participants which provided a cross-sectional snapshot of WAS user perceptions over a substantial period of time. Fifty-two participants responded. Survey participants were asked to rate WAS sessions on twelve different quality components. Quality ratings were explored by user subscription types and user experiences with other web-based conferences. Users rated the WAS program very highly on all components from 2012 to 2017. The high level of perceived quality by users is likely an important reason why WAS participation has continued to grow since its implementation. Since the quality ratings were consistently high over a 5-year period in which the number of users also grew and organizers continue to add new interactive features for users, it is expected that this growth is sustainable.

Interprofessional Service Learning in Medical Education: a Year-Over-Year Assessment of Student Feedback.

Community service learning has been extolled as an effective vehicle for interprofessional education based upon studies assessing the short-term impact of these experiences on positive team behaviors and communication skills. Through this study, the authors explore year-over-year student impressions of an interprofessional service learning program to determine whether the short-term successes detailed in prior studies are sustainable over time. Course evaluations were collected from 168 first-year medical students (M1) at Virginia Tech Carilion School of Medicine (VTCSOM) over a 4-year period beginning in 2013 and ending in 2017. All 238 current and former VTCSOM students were also prospectively surveyed and 87 (37%) responses were received. Study results indicate that first-year medical students consistently find interprofessional service learning opportunities to be valuable with regard to improving understanding of the roles of other health professionals, as well as helping to generate positive team behaviors. However, as students progress through their medical education and beyond, they may perceive the skills learned and obstacles encountered through these opportunities to be less generalizable to a clinical setting. These findings add to a growing body of evidence supporting the efficacy of service learning in interprofessional education. However, they also suggest that a potential divide may exist between the intended goals of these experiences at an administrative level and the team-based behaviors and communication skills that clinical students and practicing physicians use to navigate interprofessional conflict in the workplace.