To teach or not to teach? Assessing medical school faculty motivation to teach in the era of curriculum reform.

BACKGROUND: Medical schools have undergone a period of continual curricular change in recent years, particularly with regard to pre-clinical education. While these changes have many benefits for students, the impact on faculty is less clear. METHODS: In this study, faculty motivation to teach in the pre-clinical medical curriculum was examined using self-determination theory (SDT) as a framework. Basic science and clinical faculty were surveyed on factors impacting their motivation to teach using validated scales of motivation as well as open-ended questions which were coded using self-determination theory (SDT) as a guiding framework. RESULTS: Faculty reported that teaching activities often meet their basic psychological needs of competence, autonomy, and relatedness. Professors were more likely than associate professors to report that teaching met their need for autonomy. Faculty were more motivated by intrinsic as compared to external factors, although basic science faculty were more likely than clinical faculty to be motivated by external factors. Motivating and de-motivating factors fell into the themes Resources, Recognition and Rewards, Student Factors, Self-Efficacy, Curriculum, Contribution, and Enjoyment. The majority of factors tied to the faculty's need for relatedness. Based on these findings, a conceptual model for understanding medical school faculty motivation to teach was developed. CONCLUSIONS: Assessing faculty motivation to teach provided valuable insights into how faculty relate to their teaching roles and what factors influence them to continue in those roles. This information may be useful in guiding future faculty development and research efforts.

Medical Histopathology Laboratories: Remote Teaching in Response to COVID-19 Pandemic.

The COVID-19 pandemic required the rapid conversion of medical school curricula to virtual instruction. Prior to the crisis, histopathology teaching laboratories at UT Health San Antonio included completion of an Individual Laboratory Quiz before the laboratory session, a Team Application Exercise released and completed during the laboratory session with guidance from faculty, and a graded Team Laboratory Quiz at the end of the laboratory session. Adaptation of this interactive, in-person activity to a fully online platform included releasing the Team Application Exercise earlier to provide ample time for students to work virtually with their teams, conducting laboratory sessions using Microsoft Teams, with 5 to 6 teams led by a single instructor, and requiring the Team Laboratory Quiz to be taken individually for ensuring quiz security and test integrity. For incentivizing collaboration while completing the Team Application Exercise, the final score was either the student's individual score on the Team Laboratory Quiz or their team's average, whichever was higher. Comparison of student scores on the modified Team Laboratory Quiz to Team Laboratory Quiz scores using the earlier laboratory format prior to COVID-19 showed a significant decline; however, scores on other weekly quizzes or examinations were unaffected. Students welcomed the early release of Team Application Exercise and easier access to faculty but indicated that the modified Team Laboratory Quiz decreased peer-teaching and learning experience and increased anxiety. Faculty indicated the loss of personal interaction with students as a major theme. These data suggest that novel pedagogical approaches are required for online histopathology instruction to accommodate differences in learning styles while maintaining the benefits of team collaboration.

What Do Pediatric Residents Gain From an Experience in Juvenile Justice? A Qualitative Analysis of Community-Based Learning.

BACKGROUND: Training in advocacy and community pediatrics often involves the use of community site visits. However, data on the specific knowledge, skills, and attitudes gained from these experiences are limited. In this study we used qualitative analysis of written narratives to explore the response of residents to a juvenile justice experience. METHODS: Pediatric residents participated in a week-long experience in the juvenile probation department and completed a written narrative. Narratives were analyzed using grounded theory to explore the effects of this experience on residents' views of youth in the juvenile justice system. RESULTS: Analysis of 29 narratives revealed 13 themes relating to 5 core concepts: social determinants of behavior, role of professionals and institutions, achieving future potential, resolving discrepancies, and distancing. A conceptual model was developed to explore the interactions of these concepts in the resident view of youth in the juvenile justice system. Of the themes only 3 (23%) were related to content explicitly covered in the assigned reading materials. CONCLUSIONS: Several important concepts emerged as elements of this experience, many of which were not covered in the explicit curriculum. Variability in attitudinal response to the experience raised important questions about the influence of the ideological framework of the learner and the hidden curriculum on the learning that occurs in community settings. We propose a theoretical model that delineates the factors that influence learning in community settings to guide educators in planning these types of experiences.

Childhood Poverty and Its Effect on Health and Well-being: Enhancing Training for Learners Across the Medical Education Continuum.

OBJECTIVE: Childhood poverty is unacceptably common in the US and threatens the health, development, and lifelong well-being of millions of children. Health care providers should be prepared through medical curricula to directly address the health harms of poverty. In this article, authors from The Child Poverty Education Subcommittee (CPES) of the Academic Pediatric Association Task Force on Child Poverty describe the development of the first such child poverty curriculum for teachers and learners across the medical education continuum. METHODS: Educators, physicians, trainees, and public health professionals from 25 institutions across the United States and Canada were convened over a 2-year period and addressed 3 goals: 1) define the core competencies of child poverty education, 2) delineate the scope and aims of a child poverty curriculum, and 3) create a child poverty curriculum ready to implement in undergraduate and graduate medical education settings. RESULTS: The CPES identified 4 core domains for the curriculum including the epidemiology of child poverty, poverty-related social determinants of health, pathophysiology of the health effects of poverty, and leadership and action to reduce and prevent poverty's health effects. Workgroups, focused on each domain, developed learning goals and objectives, built interactive learning modules to meet them, and created evaluation and faculty development materials to supplement the core curriculum. An editorial team with representatives from each workgroup coordinated activities and are preparing the final curriculum for national implementation. CONCLUSIONS: This comprehensive, standardized child poverty curriculum developed by an international group of educators in pediatrics and experts in the health effects of poverty should prepare medical trainees to address child poverty and improve the health of poor children.