Milestones as a Guide for Academic Career Development.

BACKGROUND AND OBJECTIVES: Faced with a limited supply of applicants for faculty positions, increasing demands for residency faculty, and a growing number of programs, our program has increasingly filled ranks with recent residency graduates with broad scope but limited experience and training in academics. These early-career clinicians often require further mentorship as they seek advancement in clinical skills and development of teaching and scholarly activity skill sets. METHODS: To educate our recent residency graduates in teaching/scholarly activity skills, and to provide a career trajectory, we created a process to guide their maturation with milestones using the six core competencies from the Accreditation Council for Graduate Medical Education. The milestones consist of four levels of clinician/academician maturation. Each competence has goals and activities for each level of development. We validated the milestones using our physician faculty assessing time spent in academic medicine and academic rank. RESULTS: Faculty of higher academic rank scored higher in all competencies than faculty of lower academic rank. Correlation between systems-based practice and years in academics demonstrated statistical significance, and all other categories showed nonsignificant associations. CONCLUSIONS: The milestones are consistent with faculty academic development and career progression, and may serve as a guide for career advancement and as a guideline for professional progression for residency clinicians. Further testing for validation in other family medicine programs is necessary, but preliminary findings indicate this milestone project may be of service to our profession.

Same Content, Different Methods: Comparing Lecture, Engaged Classroom, and Simulation.

BACKGROUND AND OBJECTIVES: There is a push to use classroom technology and active teaching methods to replace didactic lectures as the most prevalent format for resident education. This multisite collaborative cohort study involving nine residency programs across the United States compared a standard slide-based didactic lecture, a facilitated group discussion via an engaged classroom, and a high-fidelity, hands-on simulation scenario for teaching the topic of acute dyspnea. The primary outcome was knowledge retention at 2 to 4 weeks. METHODS: Each teaching method was assigned to three different residency programs in the collaborative according to local resources. Learning objectives were determined by faculty. Pre- and posttest questions were validated and utilized as a measurement of knowledge retention. Each site administered the pretest, taught the topic of acute dyspnea utilizing their assigned method, and administered a posttest 2 to 4 weeks later. Differences between the groups were compared using paired t-tests. RESULTS: A total of 146 residents completed the posttest, and scores increased from baseline across all groups. The average score increased 6% in the standard lecture group (n=47), 11% in the engaged classroom (n=53), and 9% in the simulation group (n=56). The differences in improvement between engaged classroom and simulation were not statistically significant. CONCLUSIONS: Compared to standard lecture, both engaged classroom and high-fidelity simulation were associated with a statistically significant improvement in knowledge retention. Knowledge retention after engaged classroom and high-fidelity simulation did not significantly differ. More research is necessary to determine if different teaching methods result in different levels of comfort and skill with actual patient care.