Resident-as-Teacher: Can It Be Done With an E-Learning Module?

Background Resident-as-teacher initiatives are traditionally specialty-specific and performed in-person, limiting ability to disseminate essential teaching skills to all residents. Objective The aim of this study was to develop, implement, and evaluate a resident-as-teacher interactive e-learning module on growth mindset and coaching. Methods The module was designed and implemented between August 2022 and March 2023. It was distributed to postgraduate year (PGY) 1 residents in all specialties at a large academic institution. Completion rates, Likert ratings, and answers to 2 open-ended questions were used for assessment. Descriptive statistics and 1-way analysis of variance with Sîdák correction for multiple comparisons were performed on Likert ratings. Responses to open-ended questions were evaluated using content analysis. Results The module was completed by all 277 PGY-1 residents (100%), with the evaluation completed by 276 of 277 (99.6%) residents. Mean rating of the module's relevance to the role of resident teacher was 4.06±0.90 (5-point Likert scale), with general surgery residents rating the module less favorably compared to all specialties (3.28±1.06; P<.01; 95% CI 0.26-1.30). Open-ended comments revealed that residents most liked the delivery of relevant teaching strategies and the interactive design of the module. The most common area for suggested improvement was the addition of content such as teaching in challenging situations. Time needed for design, implementation, and evaluation was 80 hours total. Conclusions An e-learning module offers an interactive platform for teaching skills and was found to be an acceptable method of instruction for residents.

The APPD Longitudinal Educational Assessment Research Network's First Decade.

ABSTRACT: In 2009, the Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN), a national educational research network, was formed. We report on evaluation of the network after 10 years of operation by reviewing program context, input, processes, and products to measure its progress in performing educational research that advances training of future pediatricians. Historical changes in medical education shaped the initial development of the network. APPD LEARN now includes 74% (148 of 201) of US Pediatric residency programs and has recently incorporated a network of Pediatric subspecialty fellowship programs. At the time of this evaluation, APPD LEARN had approved 19 member-initiated studies and 14 interorganizational studies, resulting in 23 peer-reviewed publications, numerous presentations, and 7 archived sharable data sets. Most publications focused on how and when interventions work rather than whether they work, had high scores for reporting rigor, and included organizational and objective performance outcomes. Member program representatives had positive perceptions of APPD LEARN's success, with most highly valuing participation in research that impacts training, access to expertise, and the ability to make authorship contributions for presentations and publication. Areas for development and improvement identified in the evaluation include adopting a formal research prioritization process, infrastructure changes to support educational research that includes patient data, and expanding educational outreach within and outside the network. APPD LEARN and similar networks contribute to high-rigor research in pediatric education that can lead to improvements in training and thereby the health care of children.

Understanding burnout in Pediatric residency through the lens of the 'Areas of worklife'.

BACKGROUND AND OBJECTIVES: Burnout is a widespread problem in medicine, especially among trainees. Despite this, data on effective interventions are limited. An organizational context for burnout entitled Areas of Worklife identified six areas of the work environment that can affect burnout through mismatches between individuals expectations of that area and the reality of the work environment. This study aimed to gain a deeper understanding of pediatric residents' perspectives of the Areas of Worklife to allow programs to utilize this framework in the development of future interventions. METHODS: Using qualitative methodology founded in grounded theory, we employed an iterative data collection by conducting semi-structured interviews, until data saturation was achieved, with 15 pediatric residents in 2018. We recorded interviews and transcribed them verbatim. Content analysis was conducted concurrently with data collection using constant comparison methods; the principal investigator and co-investigators worked jointly to generate codes and identify themes. RESULTS: Themes were identified for the individual Areas of Worklife that represented resident perspectives and mismatches with the work environment. Overall, patient care was a central focus connecting the areas of control, reward, values, and workload; themes in these areas concentrated on resident's ability to interact with and learn from patients. CONCLUSIONS: Residents' definitions of the Areas of Worklife can be used to identify mismatches between residents' expectations and their work environment, which can inform organizational interventions. These findings highlight the importance of a patient-focused approach to residency training, which is consistent with literature that shows patient care is a means to find meaning in their work. Resident definitions of the Areas of Worklife offer residency programs a practical approach in their battle against burnout by providing focused direction to respond to resident needs and identify tangible targets for intervention.

A step-by-step guide for mentors to facilitate team building and communication in virtual teams.

As collaborative work in medical education has increasingly moved online, team mentors have had to adapt their practices into the virtual environment. Fostering connection, communication and productivity on virtual teams requires specific skills and deliberate practice that differ from in-person teamwork. Drawing from best practices in business, education and medicine and also from our own experience as a virtual team, we present a guide for mentors to create and sustain successful virtual teams. Grounded in Tuckman's Five Stage Model of Team Development, we offer specific strategies for virtual team mentors to promote team cohesion, mitigate conflict, maintain productivity and leverage the benefits of the virtual environment.

Creation of the Association of Pediatric Program Directors Faculty Development for Educators "Nuts and Bolts" Teaching Aids.

Faculty development (FD) continues to be a great need and challenge for faculty engaged in graduate medical education (GME) and such educator development should ultimately benefit learners in GME programs. As a Task Force within the Association of Pediatric Program Directors (APPD) FD Learning Community, our Educator subcommittee utilized multiple needs assessments to develop a novel educator development program called the APPD FD for Educators Nuts and Bolts (Nuts & Bolts) consisting of 1 to 2 page FD teaching aids. This paper outlines the development of these teaching aids and can be used as a reference for developing future Nuts & Bolts teaching aids. The development was based on 1) a defining framework (Glassick's criteria), 2) a clear model for evaluation of the program (Logic model), and 3) development of an assessment tool to demonstrate effectiveness of the teaching aids in FD at the local level. These 3 components help establish the scholarly nature of the FD Nuts & Bolts program. Multiple lessons learned from development of this program are presented to inform others engaged in educator program development. Detailed proposals for use of FD Nuts & Bolts for faculty improvement and plans for generating additional teaching aids are presented.

Integrating Graduates of a National Faculty Development Program Into a Community of Practice.

PURPOSE: The Educational Scholars Program (ESP) started as a national 3-year faculty development (FD) program for pediatric educators. Fourteen years later, the ESP has grown into a larger community of practice (CoP). The purpose of this study was to identify programmatic processes that serve as bridges or barriers to integrating ESP graduates into the CoP. METHODS: A cross-sectional survey was sent to 126 ESP graduates. Based on their self-reported level of engagement, graduates were categorized into 4 groups: Core, Active, Peripheral, and Outsider groups. Factors contributing to engagement with the ESP community, and the impact of varying levels of engagement on outcomes related to the organization and the graduate were ascertained. RESULTS: Half of the ESP graduates completed the survey. Thirty-five percent of the respondents were in the Core or Active groups. Almost all ESP graduates in the Core and Active groups felt a sense of belonging to the ESP community. Opportunities provided to network, collaborate, and receive mentorship were reported as highly significant influences on their decision to remain engaged. CONCLUSION: Purposeful integration of graduates of an FD program within a CoP, by allowing varying levels of involvement, enhances engagement within the CoP.

Growth mindset in competency-based medical education.

The ongoing adoption of competency-based medical education (CBME) across health professions training draws focus to learner-centred educational design and the importance of fostering a growth mindset in learners, teachers, and educational programs. An emerging body of literature addresses the instructional practices and features of learning environments that foster the skills and strategies necessary for trainees to be partners in their own learning and progression to competence and to develop skills for lifelong learning. Aligned with this emerging area is an interest in Dweck's self theory and the concept of the growth mindset. The growth mindset is an implicit belief held by an individual that intelligence and abilities are changeable, rather than fixed and immutable. In this paper, we present an overview of the growth mindset and how it aligns with the goals of CBME. We describe the challenges associated with shifting away from the fixed mindset of most traditional medical education assumptions and practices and discuss potential solutions and strategies at the individual, relational, and systems levels. Finally, we present future directions for research to better understand the growth mindset in the context of CBME.

Planning and Presenting Workshops That Work: A Faculty Development Workshop.

Introduction: Workshops are commonly used in higher education, although faculty often have little or no training in how to develop and deliver this type of teaching methodology. This publication can be used to deliver a 1-hour active learning session to faculty utilizing experiential learning as a framework. Methods: An hour-long workshop on developing and implementing effective workshops was given to five cohorts of participants in the Academic Pediatric Association's Educational Scholars Program (ESP) between 2010 and 2018, following a 2008 pilot. After a brief didactic presentation, participants developed their own workshop plans. A unique reflection in action was utilized to model effective workshop facilitation techniques. Written surveys were used to evaluate the effectiveness of the workshop. Data from the ESP graduates were used to report the percentage of respondents who conducted their own workshop postgraduation. Results: A total of 116 faculty participated in this workshop over the course of 5 years. One hundred and fourteen participants stated they found the session to be useful. The role modeling/reflection by the facilitators and the opportunity to work with others on a workshop plan were described as the most valuable aspects. Approximately 70% of scholars who responded to postgraduation surveys had conducted at least one regional, national, or international workshop. Discussion: This faculty development session implements active and adult learning principles to model and teach participants how to develop and lead an effective workshop. It also provides a mechanism for collaboration among participants to develop a workshop based on shared interests.

Academic General Pediatrics Hiring Practices and Completion of Academic General Pediatrics Fellowships.

OBJECTIVE: Academic General Pediatrics (AGP) is a pediatric subspecialty with substantial faculty contributions in clinical care, research, education, and advocacy. However, AGP fellowship recruitment challenges exist. We aimed to describe AGP hiring practices from 2014 to 2019 and the role of fellowship training in hiring decisions. METHODS: We conducted a cross-sectional survey study of AGP Division Directors (DDs) and Fellowship Program Directors (PDs) from US-based academic institutions. Survey questions were developed iteratively and pilot-tested for content validity. Participants were identified from the Association of American Medical Colleges' directory of pediatric departments, Academic Pediatric Association's AGP Accreditation Committee's list of fellowship programs, and institutional websites. Descriptive analysis was used for close ended survey questions. Narrative responses were reviewed for trends. RESULTS: Forty-nine DDs (57%) and 22 PDs (73%) responded. All DDs reported at least one available faculty position and 73% reported filling a position with protected time. PDs reported 89 graduating fellows, 88% of whom secured an academic position with protected time. Seventy-percent of DDs and 100% of PDs reported that AGP fellows could secure an academic position with protected time, while only 22% and 1%, respectively, reported a graduating pediatric resident could secure a similar position. DDs indicated AGP fellowship trained candidates are preferable for enhancing research and education programs. CONCLUSION: AGP remains an active subspecialty and the majority of graduating fellows secured faculty positions with protected time. Further studies are needed to understand ways to improve visibility of AGP fellowships.

Influences on and Characteristics of the Professional Identity Formation of Clinician Educators: A Qualitative Analysis.

PURPOSE: Professional identity formation is the process of internalizing the ideals, values, and beliefs of a profession. In recent years, research on clinician-educator (CE) identity formation has expanded, yet gaps exist in understanding initial influences on an educator identity, sustainment throughout a career, and development of successful pathways for early CEs. This study explored the initial influences on and characteristics of the professional identity formation of CEs in an age-diverse, multispecialty population in the United States. METHOD: This was a cross-sectional qualitative study of a purposive sample of medical educators at 6 institutions across the United States between 2018 and 2019. Focus groups were conducted to obtain participants' perspectives on their career choice and subsequent formation of their professional identity as CEs. The authors used a thematic analysis of focus group data to identify themes and domains through an iterative process. RESULTS: Twelve focus groups were conducted with a total of 93 participants. Responses were categorized into 5 domains: community supportive of medical education, culture of institution and training, personal characteristics, facilitators, and professionalization of medical education. Themes highlighted the importance of role models and mentors, an affinity and aptitude for teaching and education, specific facilitators for entry into a career in medical education, the evolution from a layperson, importance of formalized training programs, and a supportive academic community. CONCLUSIONS: Clinicians experienced a variety of factors that influenced their initial career choice in medical education and subsequent professional identity formation as a CE. This study confirms and expands the current understanding of this process in an age-diverse, multispecialty population of CEs. Educators and administrators designing career development programs across the continuum of medical education should consider these aspects as they mentor and support their learners and faculty.

"PLEASE Complete Your Evaluations!" Strategies to Engage Faculty in Competency-Based Assessments.

Competency-based assessments (CBAs) have gained traction in graduate medical education and inform important learner outcomes through the continuum of medical training. Active participation in new CBAs presents challenges to faculty working in a busy clinical environment. As such, the implementation of new CBAs can be approached with intention to foster acceptance and engagement with new evaluations. This paper describes strategies utilized to implement CBAs among clinician educators during a national assessment pilot. Our methods are grounded in educational, psychological, business, ecological, communication, and information technology theory. Our primary interventions included creating a multilevel vision, engaging a dedicated work group, incorporating quality improvement methodology, and integrating technology to successfully implement the assessments. These practical and effective interventions may also be applied to the implementation of other educational innovations.

How Full Is Your Tank? A Qualitative Exploration of Faculty Volunteerism in a National Professional Development Program.

OBJECTIVE: Professional development programs (PDPs) within academic professional organizations rely on faculty volunteers, but little is known about the volunteering process and experience. Our aim was to gain insights into the initial decision to volunteer, the experience of volunteering and the decision to re-volunteer or not (ie, remain or leave as a volunteer). The study setting was a PDP of the Academic Pediatric Association, the Educational Scholars Program. METHODS: In 2014, 13 Educational Scholars Program faculty members participated in semistructured phone interviews. The authors performed a general inductive analysis of the data, inductively created codes, and analyzed coded data for emergent themes that led to the creation of a model for recruiting and sustaining volunteers. RESULTS: Four themes related to the initial volunteer decision and the decision to re-volunteer or not (self-interest and altruism, reputation of the program, relevant skill set, and doability), and 4 themes related to the experience of volunteering (emotional impact, career advancement and professional recognition, professional growth, and doability) emerged. The relationship among the themes led to the creation of a model of volunteering, involving a metaphorical volunteerism "tank" that is full when faculty initially volunteer and subsequently fills or empties as a result of dynamic interplay between the themes for each individual. CONCLUSIONS: Leaders of PDPs may find our model of volunteering beneficial for enhancing the emotional and tangible benefits and minimizing the logistical issues of volunteering. This information should contribute to success in recruiting and retaining the volunteers who are essential for developing and sustaining PDPs.

Measuring teacher identity during the transition from medical school to residency.

Residents undergo professional identity formation during training, and the integration of a teacher identity into that of a clinician is part of this process. We aimed to measure the teacher identity of incoming interns of various specialties. In this cross-sectional, survey-based study, we modified a validated teacher identity scale and distributed it to residents attending orientation at a large, academic institution. A total of 297 residents took the survey, including 272 interns; 80% (218/272) of interns completed the survey and permitted use of their data. The mean score for global teacher identity was 4.16 (SD 0.67) on a 1 to 5 Likert scale. There were significant differences between interns' current self-assessed teaching abilities and their desired future performance as teachers (P < 0.001 for all domains). Male interns had higher global teacher identity scores (4.27) than female interns (4.05; P = 0.02). There were no differences in global teacher identity between interns in medical, surgical, and supportive specialties. Interns who had participated in a student-as-teacher program in medical school had higher global teacher identity (P < 0.001) than those who had not. In conclusion, teacher identity is high in incoming interns, with higher scores in men and in those who completed student-as-teacher programs in medical school.

Twelve tips for organising speed mentoring events for healthcare professionals at small or large-scale venues.

Mentors play a critical role in the development of professionals, influencing their job satisfaction, career aspirations and evolving professional identity. A variety of mentoring models exist, each with distinct benefits and challenges. Speed mentoring, based on the concept of speed dating, provides mentees with opportunities to meet multiple mentors over a short time and pose focussed career development questions. At large-scale events such as the annual AMEE (Association for Medical Education in Europe) meeting, speed mentoring sessions can successfully connect aspiring, novice and mid-career educators with international educational leaders to facilitate transfer of valuable insights for professional growth. For some mentors and mentees, this might spur ongoing communications or even longitudinal relationships. In this paper, we aim to provide strategies for planning and implementing speed mentoring events, combining insights gained from the literature and our experience of organising speed mentoring at the 2019 AMEE meeting in Vienna. These tips will be useful to a variety of professionals planning to organise speed mentoring initiatives.

An Annotated Bibliography of Key Studies in Medical Education in 2018: Applying the Current Literature to Pediatric Educational Practice and Scholarship.

Pediatric educators desire to and should strive to incorporate current educational methods and ideas into their professional practices. The overwhelming volume of medical education literature makes this difficult. This article provides an overview of 18 key articles from the 2018 literature that the authors considered impactful for the field of pediatric medical education. The author group has extensive combined leadership experience and expertise across the continuum of pediatric medical education and used an iterative, staged process to review 2270 abstracts from 13 medical education-related journals. This process aimed to identify a subset of articles that were most relevant to educational practice and scholarship and most applicable to pediatric medical education. Author pairs independently reviewed and scored abstracts and reached consensus to identify the abstracts that best met these criteria. Selected abstracts were discussed using different author pairs to determine the final articles included in this review. The 18 articles selected are summarized. The results showed a cluster of studies related to assessment, learner education and teaching, communication, and culture and climate. This review offers a summary for educators interested in remaining knowledgeable and current regarding the most relevant and valuable information in the field of medical education.

No Faculty Required: Use of a Health Literacy Low Inference Self-Assessment Measure to Promote Behavior Change.

OBJECTIVE: To determine if use of a health literacy low-inference, self-assessment measure (LISAM), promoted behavior change as measured by increased use of health literacy communication skills (HLCS). METHODS: The LISAM is a tool used by educators to self-assess their performances after giving a lecture. The tool is low inference because it self-assesses behaviors that are specific, with little room for subjectivity. Forty-four third-year medical students self-assessed HLCS using a LISAM modified to include health literacy communication skills (LISAM-HLCS).  Self-assessment followed participation in an audio recorded, standardized patient encounter and again after listening to the recording.  Students also created 3 written goals for improvement.  This session was repeated 1 week later. RESULTS: At Session 2, 71.4% of students met at least 2 of their 3 self-created objectives. The 3 most commonly created objectives were using teach-back, asking more open ended questions, and obtaining patient input into the management plan. Use of the LISAM increased HLCS use at Session 2 versus Session 1 as assessed by both students and study investigators (P < .05). CONCLUSIONS: Without faculty present, students met and adjusted objectives, catalyzing changes in HLCS. The LISAM-HLCS has the potential to empower students to improve communication skills and to reduce dependence on faculty observations.