Supporting health professional educators in the workplace: A scoping review.

PURPOSE: Clinical educators frequently request additional support for educating pre-qualification health professions students despite having access to professional development programs to build education knowledge and skills. The breadth of 'additional support' options remains unclear. The aim of this review is to explore what is known about support options for health professional educators in the workplace through the lens of learning organisations. MATERIALS AND METHODS: A scoping review was conducted searching Ovid Medline, CINAHL, ProQuest and PsycINFO electronic databases from 1 January 2005 up to 21 October 2020 for studies that identified support strategies for clinical educators of pre-qualification students in the workplace. Relevant data were charted, summarised thematically and synthesised with reference to support type and implementation level. RESULTS: Fifty relevant records related to medicine, nursing and allied health clinical education were included. Twelve support themes and five cross-cutting support categories were identified across four implementation levels of healthcare systems. CONCLUSIONS: A diversity of support for clinical educators beyond professional development was identified. Future research combined with leadership and commitment from the healthcare and education sectors is needed to better understand the applicability, efficacy and resourcing of any newly integrated support to ensure it is sustainable and improves clinical educator capability.

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.

How community and organizational culture interact and affect senior clinical educator identity.

PURPOSE: The development of Educator Identity has a significant impact on well-being, motivation, productivity, and the quality of teaching. Previous research has shown that conflicting responsibilities and a challenging work environment could negatively affect the development of Clinical Educator Identity within an organization. However, there is a lack of research that identifies the factors affecting Clinical Educator Identity Formation and provides guidance on how organizations can support its development, maintenance, and advancement. METHODS: To examine the phenomenology of Professional Identity Development in experienced Senior Clinical Educators in Singaporean hospitals, the study utilized an exploratory qualitative approach. The data was collected from September 2021 to May 2022 through one-to-one interviews. Four investigators analyzed the data using constant comparative analysis to identify relevant themes. RESULTS: Eleven senior educators revealed that personal, relational, and organizational factors influenced the development of Clinical Educator Identity. The relational aspect was a vital enabler, while organizational culture was a strong barrier. The study also identified several ways in which organizations can support Educator Identity development. CONCLUSION: The study findings provide insight into how organizations can support the development of Clinical Educator Identity. The results could aid organizations in understanding the areas where they can channel resources to support Clinical Educator Identity development.

Clinical educators can supervise students without increased stress: a study of interacting factors using insights from complexity theory.

Supervising students in healthcare settings is complex and can be stressful for clinical educators. However, it is unclear how to design student placements without clinical educator stress. Using complexity theory as a lens, fuzzy set Qualitative Comparative Analysis (fsQCA) was used to explore factors associated with no increased stress for clinical educators during speech pathology (SP) placements. Factor selection was informed by the Demand- Control- Support model and existing literature. No single factor was necessary for clinical educators to experience no increased stress. Varied combinations of all factors were found in 10 paths to no increased stress. These combinations often had passing student(s); however, multiple paths included other factors that could be adjusted by clinical educators prior to placement. For example, having more than one workday per week without students was a factor in four paths to no increased stress despite other potential challenges such as a higher caseload throughput. More experienced educators, who had other supporting factors (e.g. lower caseload throughput or workplace engagement such as support from colleagues and managers), also perceived no increased stress in four paths. Student placements without increased stress for clinical educators require consideration of multiple interacting factors. Principles of complexity theory provide insight into how clinical educators uniquely respond to their individual circumstances, resulting in different experiences of student placement impact even within similar workplaces. FsQCA has highlighted practical ways clinical educators supervise students without increased stress. However, any changes for an individual clinical educator need to be considered in combination with other factors given the complexity of clinical education and healthcare settings.

Does the student-led osteopathy clinical learning environment prepare students for practice?

BACKGROUND: For many allied health disciplines, pre-professional clinical education takes place in student-led, on-campus clinic environments. In these environments, pre-professional students undertake patient care under the supervision of qualified health professionals. Literature exploring the benefits of the student-led clinical learning environment is limited and little is known about the role student-led clinics play in preparing pre-professional osteopathy students for professional practice. AIM: To explore the perceptions of osteopathy clinical educators about the role of the student-led clinic at Victoria University (VU) in preparing pre-professional students for professional practice. METHODS: A qualitative collective case study methodology was utilised to explore clinical educator perceptions. Individual interviews were conducted with clinical educators employed in the university osteopathy clinic. Interview questions were framed around the Capabilities for Osteopathic Practice which set the Australian osteopathy practice standards. Data were assessed by two of the authors using thematic analysis. RESULTS: Nine clinical educators out of 31 employed at the university clinic (29%) agreed to participate. Qualitative analysis generated three themes: perceptions of the student-led clinic (SLC) as a learning environment; clinical educator perception of their role in the SLC; and, challenges to and of the SLC environment. CONCLUSIONS: Clinical educators perceived that the student-led osteopathy clinical learning environment develops pre-professional learners to meet some, but not all, of the capabilities for professional practice as an osteopath in Australia. The environment may be improved through faculty development, fostering a proactive learning approach, addressing system-based issues, and providing opportunities to interact with other health professions.

Exploring clinical educators' perceptions of role modeling after participating in a role modeling educational program.

INTRODUCTION: Role modeling significantly affects medical students' values, attitudes, and professional behaviors. Role modeling is a complex and multidimensional process that necessitates accurate perception and adequate knowledge and skills. However, most clinical educators do not have adequate awareness and knowledge about the positive and negative effects of role modeling. We aimed to explore clinical educators' perceptions of role modeling after participating in a role modeling educational program. METHODS: This qualitative study was conducted on eighteen clinical educators who were voluntarily participated in a three-month role modeling educational program. Data were collected using reflection paper writing and were analyzed through conventional content analysis. RESULTS: Data analysis resulted in the development of three main categories, namely closer attention to role modeling and effort for its promotion, deliberate effort to display role modeling, and creating a positive environment to increase the effectiveness of role modeling. CONCLUSIONS: Clinical educators have limited role modeling knowledge and skills, and hence, educational programs are required to improve their role modeling knowledge, attitudes, and skills. Role modeling educational programs should aim at developing educators' awareness and knowledge about role modeling, develop their reflection and self-control abilities, and sensitize them to the importance of deliberate use of role modeling.

Clinical teachers' perceptions of role modeling: a qualitative study.

BACKGROUND: Role modeling has been significantly considered in medical education in recent decades. In the clinical course, students learn necessary skills and accordingly their professional identity is formed by observing and working among clinical educators. Given the importance of the role modeling in medical education, in the present study, it was attempted to explore the clinical teachers' perceptions of being a role model for medical students using a qualitative method. METHODS: A qualitative design, based on the content analysis approach, was used to analyze the perspectives of 15 clinical teachers. Participants were chosen by purposeful sampling. Data were collected using reflection paper writing. RESULTS: During the data analysis, five main categories emerged: influencing others, developing different dimensions of student, situational self-awareness, feedback and continuous effort. CONCLUSIONS: This study will be useful to form role modeling educational programs. Encouraging clinical teachers to make continuous efforts to improve role modeling and educating time management and self-control skills can help reduce the challenges of role modeling for clinical teachers.

Reducing variations in clinical nurse educator roles: a service improvement project standardising roles and career pathways.

BACKGROUND: There is limited research evaluating the implementation and effectiveness of clinical nurse educator (CNE) roles in clinical practice. UK employers tend to use generic nursing job profiles, although the definition, expectations and implementation of nurse educator roles are interpreted differently between employers. AIM: This project intended to reduce variation and standardise job titles, job descriptions and job plans for CNEs ranging from band 5 to band 7 and identify the academic requirements and professional experience required of each band. METHODS: An evaluative service review of existing CNE roles was conducted across a large division of a major NHS hospital trust. Focus group interviews were conducted to identify CNEs' and matrons' perceptions of the role. FINDINGS: Themes identified from the coding of narrative data included: the importance of the role; variations in expectations of the role, job titles, job descriptions and plans; and a lack of career progression pathways. CONCLUSION: This service improvement project demonstrates that a standardised approach to the implementation of CNE roles can be achieved with the support of a unified senior nursing team. Clearer role definition and career progression pathways would improve job satisfaction and may help retain CNEs in post.

Teaching pediatric otoscopy skills to the medical student in the clinical setting: preceptor perspectives and practice.

BACKGROUND: Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors' clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. METHODS: A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. RESULTS: Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP's diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). CONCLUSIONS: Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

Implementing a clinical-educator curriculum to enrich internal medicine residents' teaching capacity.

INTRODUCTION: Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess the implementation of a clinical educator rotation aimed at developing residents' competencies related to clinical teaching. METHODS: A mixed-methods approach was used to develop and assess the clinical educator rotation at a teaching community hospital. Internal medicine residents who participated in the rotation and consented to the research were assigned to the clinical educator trainee (CET) group, the remaining residents were assigned to the control group. Osteopathic medical students rotating in the medicine service line were invited to participate. The study used descriptive and qualitative analyses to measure primary and secondary outcomes. RESULTS: The primary outcome measure showed a positive change in resident knowledge, skills and behaviors in communication, reflection, feedback, precepting, and facilitation. Medical student perceptions of resident teaching skills confirmed the observed changes in CETs. Some CETs continued to practice and build their capacity for teaching after completing the rotation. Qualitatively, we derived four common themes among the data; communication, professional engagement, practice-based learning, and systems-based learning. CONCLUSION: Resident teaching capacity was enriched after completing the clinical educator rotation. Other benefits included: enhanced patient communication and education, increased resident confidence, personal satisfaction with training, work life-balance and enhanced career satisfaction. Future research should focus on curricular content, faculty development, and delivery assessment. In addition, research efforts should identify appropriate emerging technologies to include in the curriculum for enhancing teaching capacity.

Questioning skills of clinical facilitators supporting undergraduate nursing students.

AIMS AND OBJECTIVES: To report on a study investigating questioning skills of clinical facilitators who support the learning of undergraduate nursing students. BACKGROUND: The ability to think critically is integral to decision-making and the provision of safe and quality patient care. Developing students' critical thinking skills is expected of those who supervise and facilitate student learning in the clinical setting. Models used to facilitate student learning in the clinical setting have changed over the years with clinicians having dual responsibility for patient care and facilitating student learning. Many of these nurses have no preparation for the educative role. This study adapted a comparative study conducted over fifteen years ago. DESIGN: Descriptive online survey including three acute care patient scenarios involving an undergraduate nursing student. Participants were required to identify the questions they would ask the student in relation to the scenario. METHODS: A total of 133 clinical facilitators including clinical teachers, clinical educators and preceptors from five large partner healthcare organisations of one Australian university participated. RESULTS: The majority of questions asked were knowledge questions, the lowest category in the cognitive domain requiring only simple recall of information. Facilitators who had undertaken an education-related course/workshop or formal qualification asked significantly more questions from the higher cognitive level. CONCLUSION: The study provides some evidence that nursing facilitators in the clinical setting ask students predominantly low-level questions. Further research is needed to identify strategies that develop the capacity of facilitators to ask higher level cognitive questions. RELEVANCE TO CLINICAL PRACTICE: Clinical facilitators should undertake targeted education that focuses on how to frame questions for students that demand application, analysis, synthesis and evaluation.

Exploring failure to fail in pre-registration nursing.

Failing a student nurse can be a challenging task for mentors in the learning environment. It is often an unpleasant experience for all involved. However, mentors have a duty to uphold the reputation of the nursing profession and be the gatekeepers of the profession and the Nursing and Midwifery Council (NMC) professional register. Failing a student who is not meeting the required competence in the learning environment is a way of safeguarding the nursing profession and the future workforce. This article will look at the mentor's role when a student nurse is identified as not meeting competencies in the learning environment. The article explores the importance of following process when identifying weak students and the role that clinical educators and university staff have in supporting mentors when a student is deemed to be failing their learning experience.

"Pet things" and "penny drops"-Factors influencing clinicians' teaching of pelvic anatomy.

Pelvic anatomy is considered challenging to teach and learn, partly because its complexity can make it difficult to conceptualize. Educational researchers recognize the value of a spiraling curriculum to develop clinically orientated anatomy knowledge for health professionals, but most studies have focused on the preclinical years. It is unclear how the complexities of pelvic anatomy are taught in the clinical setting by clinician educators. Understanding pelvic anatomy teaching from the perspectives of clinician educators is important because of their critical role in supporting medical students to become knowledgeable, safe practitioners. This study sought to examine factors that influence clinician educators' teaching of pelvic anatomy to medical students during clinical placement. Using established qualitative research methods, this exploratory study used semi-structured interviews with 10 participants from obstetrics/gynecology (n = 4) and urology (n = 6) in Australia. Interviews were transcribed, and data were analyzed using a reflexive thematic analysis framework. Two overarching factors were identified as influencing clinician educators' teaching: (1) how they defined the scope of knowledge, and (2) pedagogical understanding. Scope of knowledge was underpinned by patient safety considerations and guided by past experience and student aspirations. Pedagogical understanding also relied on experience and encompassed multiple teaching strategies, including approaches informed by sensitivities surrounding pelvic anatomy. Multiple factors influence how clinician educators define the scope of pelvic anatomy knowledge required of medical students. Clinician educators' awareness of syllabus and teaching approaches can enable them to support students to attain threshold concepts such as three-dimensional spatial relationships and sociocultural sensitivities associated with pelvic anatomy.

Support for Clinical Nurse Educators: Imparting Key Leadership Skills.

Clinical nurse educators (CNEs) are expert clinical nurses tasked with supporting the orientation and professional development of nurses on clinical units, yet CNEs themselves often do not receive a formal orientation to support their role transition. CNEs at a large academic medical center participate in a quality improvement program aimed at developing communication skills for difficult conversations, feedback, and debriefing. Findings highlight some of the interpersonal communication challenges CNEs encounter, which endorse the need for a formal CNE orientation and mentoring program.

A Call for Formalized Training of Surgical Educators.

Current training curricula for future surgeons do not prioritize teaching residents how to teach. With increased expectations but decreased opportunities to operate, developing efficient and effective educators is a pressing necessity. In this article, we discuss the need to formalize the role of the surgical educator, and future directions to implement better training paradigms for surgical educators.

The IUSM Medical Education Scholarly Concentration: Training Medical Students to Become Future Clinical Educators.

Indiana University School of Medicine - Bloomington launched the Medical Education Scholarly Concentration in 2020. This application-based enrichment program trains medical students to become effective clinical educators through pedagogical coursework, introduction to education research methods, and the development of a scholarly concentration product for publication.

Clinical Educators' Teaching Approaches and Attributes in Laboratory Medicine.

The quality of clinical experiences for students in health care professions relies heavily on clinical educators. Hence the quest to be informed on qualities that make great clinical educators in medical laboratory professions as well as teaching methods. A 48-question survey was developed, validated, and distributed to laboratory professionals in the American Society for Clinical Pathology database. Four questions pertaining to teaching and evaluation as well as clinical educators' attributes were evaluated in the study. Responses were analyzed using the Statistical Package for the Social Sciences. Descriptive statistics were performed with the P value set at .05. The results revealed that communication and motivation to teach were most valued among clinical educators and empathy was the least valued attribute. Educators reported on different approaches to teaching and evaluating students. Clinical educators could benefit from training that highlights these attributes and teaching methods for great clinical experiences both for educators and students.

The Impact of COVID-19 on the Laboratory Professionals' Clinical Education: a Qualitative Study.

A 48-question survey was developed and disseminated to laboratory professionals. This survey sought the perspective of clinical educators on a variety of topics, including two open-ended questions on the impact COVID-19 had on student clinical rotations and the ensuing policy changes. Of 207 clinical sites that participated in the survey., Some terminated student clinical rotations without offering any other training alternative. Others employed a number of strategies such as shortening the length of clinical rotations, taking fewer students, transitioning to an online learning platform, or delaying training until a future date. Some mandated regular illness checks, symptom checks, and COVID-19 testing when available. Clinical educators expressed concern over the lack of continuity of student clinical training, policy changes related to COVID-19 and student training that were deemed to diminish the quality of the students' clinical education. With terminated, delayed or shortened clinical rotations at many sites, in combination with staff and supply shortages, clinical educators were concerned about the overall quality of clinical education the students were receiving. In addition to these concerns, the reduction of student graduates during the pandemic decreased the number of applicants for job vacancies exasperating a pre-pandemic problem.

Establishing the Need for Standardized Clinical Educator Training Programs for Medical Laboratory Professionals.

BACKROUND: There is minimal, if any, training for clinical educators in medical laboratory professions. This leads to challenges with teaching, assessment and workload/training balance. Hence, the need for standardized clinical educator training. METHOD: A survey was developed, validated and deployed to medical laboratory professionals. Responses were analyzed using SPSS. Responses from two open-ended questions-is clinical educators' training important and how is this training beneficial?-were analyzed using thematic analysis. RESULTS: Most participants indicated that clinical educator training is important (99.4%). However, 72.4% received no formal training prior to training student. Themes from the importance of training include: Equip clinical educators, body of knowledge, standardize training and quality of training. Themes that emerged from the benefits of clinical educators training involve Training content, logistics, professional behavior and technical skills. CONCLUSION: Clinical educators' training is crucial and valuable. Standardized training on pedagogy and other success strategies are warranted for successful clinical experiences.

Evaluating Clinical Educators' Competence in an East Asian Context: Who Values What?

Background: How to evaluate clinical educators is an important question in faculty development. The issue of who are best placed to evaluate their performance is also critical. However, the whos and the hows of clinical educator evaluation may differ culturally. This study aims to understand what comprises suitable evaluation criteria, alongside who is best placed to undertake the evaluation of clinical educators in medicine within an East Asian culture: specifically Taiwan. Methods: An 84-item web-based questionnaire was created based on a literature review and medical educational experts' opinions focusing on potential raters (i.e., who) and domains (i.e., what) for evaluating clinical educators. Using purposive sampling, we sent 500 questionnaires to clinical educators, residents, Post-Graduate Year Trainees (PGYs), Year-4~6/Year-7 medical students (M4~6/M7) and nurses. Results: We received 258 respondents with 52% response rate. All groups, except nurses, chose "teaching ability" as the most important domain. This contrasts with research from Western contexts that highlights role modeling, leadership and enthusiasm. The clinical educators and nurses have the same choices of the top five items in the "personal qualities" domain, but different choices in "assessment ability" and "curriculum planning" domains. The best fit rater groups for evaluating clinical educators were educators themselves and PGYs. Conclusions: There may well be specific suitable domains and populations for evaluating clinical educators' competence in East Asian culture contexts. Further research in these contexts is required to examine the reach of these findings.