A Scoping Review of Health Care Faculty Mentorship Programs in Academia: Implications for Program Design, Implementation, and Outcome Evaluation.

INTRODUCTION: Formal mentoring programs have direct benefits for academic health care institutions, but it is unclear whether program designs use recommended components and whether outcomes are being captured and evaluated appropriately. The goal of this scoping review is to address these questions. METHODS: We completed a literature review using a comprehensive search in SCOPUS and PubMed (1998-2019), a direct solicitation for unpublished programs, and hand-searched key references, while targeting mentor programs in the United States, Puerto Rico, and Canada. After three rounds of screening, team members independently reviewed and extracted assigned articles for 40 design data items into a comprehensive database. RESULTS: Fifty-eight distinct mentoring programs were represented in the data set. The team members clarified specific mentor roles to assist the analysis. The analysis identified mentoring program characteristics that were properly implemented, including identifying program goals, specifying the target learners, and performing a needs assessment. The analysis also identified areas for improvement, including consistent use of models/frameworks for program design, implementation of mentor preparation, consistent reporting of objective outcomes and career satisfaction outcomes, engagement of program evaluation methods, increasing frequency of reports as programs as they mature, addressing the needs of specific faculty groups (eg, women and minority faculty), and providing analyses of program cost-effectiveness in relation to resource allocation (return on investment). CONCLUSION: The review found that several mentor program design, implementation, outcome, and evaluation components are poorly aligned with recommendations, and content for URM and women faculty members is underrepresented. The review should provide academic leadership information to improve these discrepancies.

Applying multiple frameworks to establish effective virtual collaborative teams in academia: a review and recommendations.

Recently, academic health professionals have been increasing collaboration with peers at a distance for activities such as research, scholarship, and faculty development. Novel virtual technologies enable academic professional teams to overcome time and distance barriers to facilitate collaboration, but little research is available to guide academicians on how to effectively organize and manage virtual collaborative teams using these technologies. Based upon a literature review and six years of experience as a virtual collaborative team, the authors use Boyer's Scholarship of Integration paradigm to identify and critique four models for virtual collaboration. The literature search devised from the four identified models found references that had a theoretical foundation for peer virtual collaboration and have been adopted in some professional context. The authors present a review of this literature, describe the benefits for adapting these models to academic health profession contexts, and provide a reflective critique about the challenges for their adaptation in these contexts. They also provide a hypothetical scenario to exemplify the application of these models for health-care professionals along with important considerations and tips when forming new virtual peer collaborative teams or problem-solving teams who are not optimally functioning.

Building and executing a research agenda toward conducting implementation science in medical education.

BACKGROUND: Implementation science (IS) is the study of methods that successfully integrate best evidence into practice. Although typically applied in healthcare settings to improve patient care and subsequent outcomes, IS also has immediate and practical applications to medical education toward improving physician training and educational outcomes. The objective of this article is to illustrate how to build a research agenda that focuses on applying IS principles in medical education. APPROACH: We examined the literature to construct a rationale for using IS to improve medical education. We then used a generalizable scenario to step through a process for applying IS to improve team-based care. PERSPECTIVES: IS provides a valuable approach to medical educators and researchers for making improvements in medical education and overcoming institution-based challenges. It encourages medical educators to systematically build upon the research outcomes of others to guide decision-making while evaluating the successes of best practices in individual environments and generate additional research questions and findings. CONCLUSIONS: IS can act as both a driver and a model for educational research to ensure that best educational practices are easier and faster to implement widely.

Medical education scholarship: an introductory guide: AMEE Guide No. 89.

Abstract This AMEE Guide provides an overview of medical education scholarship for early career scholars, based upon a summary of the existing literature and pragmatic advice derived from the experience of its authors. After providing an introduction to the principles of scholarship and describing questions that the Guide addresses, the authors offer a conceptual description of the complementary traditions of teaching and educational discovery, and advocate for the development of educational scholars with both traditions. They then describe the attributes of effective mentor-mentee relationships and how early career scholars can identify potential mentors who can fulfill this role. In the subsequent sections, they describe the appropriate development of scholarly questions and other components of a complete scholarly plan, including how to use conceptual frameworks in guiding such plans. From here, they describe methods that align with both the teaching and discovery traditions and provide concrete examples of each. They then provide guidelines for assessing the impact of scholarship, identify the various opportunities for sharing it, and how to effectively interpret and describe it. Additionally, they provide practical advice on how appropriately to demonstrate the scholarship in a promotional packet, including the principle of reflectivity in scholarship. Finally, they address the principles of applied research ethics for educational scholarship and when to consider soliciting approval for scholarly activities by a human research board.

Local development of MCQ tests for evidence-based medicine and clinical decision making can be successful.

BACKGROUND: Guidelines for the design of multiple-choice item (MCQ) tests of evidence-based medicine (EBM) and clinical decision making (CDM) have not been published. PURPOSE AND METHODS: We describe a strategy to develop an EBM/CDM MCQ test database guided by educational theory and used psychometric analyses, including reliability, validity, and item analyses, to judge the strategy's success. RESULTS: The internal consistency reliability of tests derived from the database was in the good-to-excellent range (0.74-0.95) and test-retest reliability was fair (0.51). One test discriminated across three levels of EBM/CDM learners (discriminant validity). Tests also predictively correlated with other medical school assessments according to theory (convergent and discriminant validity). The items were infrequently misclassified, had statistics close to historical standards, and were acceptable after no more than one round of revisions. CONCLUSIONS: Our strategy for developing an EBM/CDM MCQ database was successful and tests derived from it can be flexibly sampled to assess different EBM/CDM knowledge domains and three levels of EBM/CDM learners. Assuming the availability of similar resources to support its application, this strategy should be replicable at other settings.

Evidence in the learning organization.

BACKGROUND: Organizational leaders in business and medicine have been experiencing a similar dilemma: how to ensure that their organizational members are adopting work innovations in a timely fashion. Organizational leaders in healthcare have attempted to resolve this dilemma by offering specific solutions, such as evidence-based medicine (EBM), but organizations are still not systematically adopting evidence-based practice innovations as rapidly as expected by policy-makers (the knowing-doing gap problem). Some business leaders have adopted a systems-based perspective, called the learning organization (LO), to address a similar dilemma. Three years ago, the Society of General Internal Medicine's Evidence-based Medicine Task Force began an inquiry to integrate the EBM and LO concepts into one model to address the knowing-doing gap problem. METHODS: During the model development process, the authors searched several databases for relevant LO frameworks and their related concepts by using a broad search strategy. To identify the key LO frameworks and consolidate them into one model, the authors used consensus-based decision-making and a narrative thematic synthesis guided by several qualitative criteria. The authors subjected the model to external, independent review and improved upon its design with this feedback. RESULTS: The authors found seven LO frameworks particularly relevant to evidence-based practice innovations in organizations. The authors describe their interpretations of these frameworks for healthcare organizations, the process they used to integrate the LO frameworks with EBM principles, and the resulting Evidence in the Learning Organization (ELO) model. They also provide a health organization scenario to illustrate ELO concepts in application. CONCLUSION: The authors intend, by sharing the LO frameworks and the ELO model, to help organizations identify their capacities to learn and share knowledge about evidence-based practice innovations. The ELO model will need further validation and improvement through its use in organizational settings and applied health services research.

Beyond the dual degree: development of a five-year program in leadership for medical undergraduates.

The current state of physician leadership education consists mainly of executive degree programs designed for midcareer physicians. In 2004, the authors proposed that, by educating medical students in physician leadership and integrating this with a business management or public health degree program, graduates, health care organizations, and communities would benefit sooner. Given the lack of program models to guide program integration and development, the authors began a one-year inquiry to build a model leadership curriculum and integrate leadership education across degree programs. The qualitative inquiry resulted in several linked tasks. First, the authors identified a feasible method for concurrently delivering all three program components (MD degree, Leadership Curriculum, and MBA or MPH degree) during a five-year plan. Second, the authors chose a competency-based educational framework for leadership and then identified, adapted, and validated existing leadership competencies to their context. Third, the authors performed an extensive program alignment to identify existing overlaps and opportunities for integration within and across program components. Fourth, the authors performed a needs analysis to identify educational gaps, subsequently leading to redesigning two courses and to designing three new courses. A description of the Leadership Curriculum is also provided. This inquiry has led to the development of the Boonshoft Physician Leadership Development Program, which provides physician leadership education integrated with medical education and education in business management or public heath. Future program initiatives include developing leadership student assessment tools and testing the link between program activities and short- and long-term outcome measures of program success.

A preliminary report of an educational intervention in practice management.

BACKGROUND: Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. METHODS: After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills) and the residents' evaluation of the curriculum. RESULTS: The mean correct on the knowledge test for this group of residents was 74% (n = 12) and 91% (n = 12) before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12), and 3.65 after (n = 12) the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree). The residents rated the curriculum consistently high. CONCLUSIONS: This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education.

A locally created EBM course for faculty development.

International EBM workshops have significant barriers and lack focus on institutional needs. The authors describe a local EBM curriculum and report its effectiveness and participant satisfaction. Local EBM experts devised an EBM course designed to improve faculty understanding of EBM skills and concepts. Retention of EBM concepts was assessed with a 10-item EBM knowledge test administered before and after the course. Participants were also asked to self-assess five EBM skills immediately after and nine months after the course. They also filled out a satisfaction survey. In total, 61% of the participants completed the course. The EBM knowledge test showed a significant change in scores for EBM concepts. The participants' self-assessed EBM skills remained high at nine months. Participants rated most course variables highly. It is concluded that a locally developed EBM faculty curriculum can succeed if scholars define institutional needs, receive broad institutional support, use proven educational methodologies and avoid scheduling conflicts.

Teaching EBM facilitation using small groups.

The problem-centered, learner-focused, small-group process (PLS) is used by faculty to train learners in evidence-based medicine (EBM). Few affordable and accessible courses exist to train faculty in the PLS process. The results of a novel course to train faculty in the PLS process are described. The course was a one-day workshop consisting of five small group sessions with two facilitators. The participants were seven clinicians and four medical librarians. The initial small-group session was a discussion of concepts and principles related to successful facilitation skills; the subsequent four small groups reinforced these concepts and principles with role-playing and case scenarios using different steps in the EBM process. The course, including the use of the PLS process, scored highly on participant evaluations. The authors conclude that the introductory course effectively taught the PLS process for use in EBM facilitation.