Skip to main content

Advertisement

Log in

Teacher training for rheumatology fellows: a national needs assessment of fellows and program directors

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Introduction

Teaching is an integral part of what we do as physicians, and exposure to training on how to effectively teach is not consistently implemented in the curricula within medical training.

Methods

We administered anonymous, in-person surveys to fellows and program directors (PDs) at the 2017 American College of Rheumatology national conference to evaluate fellow and PD attitudes regarding development of programs dedicated to teaching fellows on how to teach.

Results

One hundred seven of 150 fellows returned surveys (response rate 71%). About 60% demonstrated interest in pursuing a teaching-focused career. About 97% felt their teaching skills can be improved; 88% felt improved teaching skills will be valuable for their career. With 61% response rate (57/94 PD surveys), most PDs agreed their fellows could use additional instruction in teaching. About 90% noted this would be an asset for fellows’ careers. When compared, 56% of fellows reported no structured training in education during fellowship, while 64% of PDs said this type of training was available. All agreed fellow teaching skills can be improved but significantly more fellows than faculty felt confident in the fellows’ ability to give feedback (p = 0.03). Both groups identified time constraints and other faculty interest as barriers.

Conclusion

There is significant need to develop effective fellow-as-teacher programs aimed at enhancing fellows’ teaching skills, with focus on giving feedback and working within fellow and faculty time constraints. The program can help address a curriculum gap identified by fellows as well as PDs before fellowship-to-faculty transition.

Key Points

There is a notable gap between faculty physicians’ expectations to teach as clinician-educators and the lack of training dedicated to learning how to teach during medical training. Despite the fact that past clinical educators have identified instructional design and assessment as low-confidence areas, there is a paucity of structured program dedicated to developing these teaching skills during fellowship training.

With 97% fellows and 84% program directors, both groups agreed fellows could use additional instruction in teaching skills, but there was a significant discrepancy between fellow and program director perspectives regarding fellows’ ability to give feedback.

Consistent with past needs assessments in other medical specialties, lack of time and potential faculty interest were recognized as potential barriers, calling for a structured training program dedicated to education on didactics that takes into account trainee and faculty time constraints.

Our needs assessment can direct future research on analyzing effectiveness of fellow-as-teacher program implementation by focusing on improvement of fellow teaching and feedback skills.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fleming VM, Schindler N, Martin GJ, DaRosa DA (2005) Separate and equitable promotion tracks for clinician-educators. JAMA 294(9):1101–1104. https://doi.org/10.1001/jama.294.9.1101

    Article  CAS  PubMed  Google Scholar 

  2. Chen HC, Wamsley MA, Azzam A, Julian K, Irby DM, O'Sullivan PS (2017) The health professions education pathway: preparing students, residents, and fellows to become future educators. Teach Learn Med 29(2):216–227. https://doi.org/10.1080/10401334.2016.1230500

    Article  PubMed  Google Scholar 

  3. Roberts DH, Schwartzstein RM, Weinberger SE (2014) Career development for the clinician-educator. Optimizing impact and maximizing success. Ann Am Thorac Soc 11(2):254–259. https://doi.org/10.1513/AnnalsATS.201309-322OT

    Article  PubMed  Google Scholar 

  4. Gardner AK, Waters V, McLaughlin RJ (2017) What do faculty in health professions need to be competent educators? Results from a School-Wide Needs Assessment. J Allied Health 46(4):e77–e80

    PubMed  Google Scholar 

  5. The internal medicine subspecialty milestones project (2015). http://www.acgme.org/Portals/0/PDFs/Milestones/InternalMedicineSubspecialtyMilestones.pdf

  6. Horn L, Tzanetos K, Thorpe K, Straus SE (2008) Factors associated with the subspecialty choices of internal medicine residents in Canada. BMC Med Educ 8:37. https://doi.org/10.1186/1472-6920-8-37

    Article  PubMed  PubMed Central  Google Scholar 

  7. Messman A, Kryzaniak SM, Alden S, Pasirstein MJ, Chan TM (2018) Recommendations for the development and implementation of a residents as teachers curriculum. Cureus 10(7):e3053. https://doi.org/10.7759/cureus.3053

    Article  PubMed  PubMed Central  Google Scholar 

  8. Fakhouri Filho SA, Feijo LP, Augusto KL, Nunes M (2018) Teaching skills for medical residents: are these important? A narrative review of the literature. Sao Paulo Med J 136(6):571–578. https://doi.org/10.1590/1516-3180.2018.0147060818

    Article  PubMed  Google Scholar 

  9. Richards JB, Kelly E, Fessler H, Roberts DH (2013) A novel survey tool to assess pulmonary and critical care fellows' attitudes regarding acquiring teaching skills during fellowship training. J Grad Med Educ 5(3):506–509. https://doi.org/10.4300/JGME-D-12-00153.1

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rivera V, Yukawa M, Aronson L, Widera E (2014) Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors. J Am Geriatr Soc 62(12):2377–2382. https://doi.org/10.1111/jgs.13187

    Article  PubMed  Google Scholar 

  11. McSparron JI, Huang GC, Miloslavsky EM (2018) Developing internal medicine subspecialty fellows' teaching skills: a needs assessment. BMC Med Educ 18(1):221. https://doi.org/10.1186/s12909-018-1283-2

    Article  PubMed  PubMed Central  Google Scholar 

  12. Data resource book (Academic year 2015-2016) http://www.acgme.org/About-Us/Publications-and-Resources/Graduate-Medical-Education-Data-Resource-Book/GraduateMedicalEducation/GraduateMedicalEducationDataResourceBook.

  13. Kumar NL, Perencevich ML, Trier JS (2017) Perceptions of the inpatient training experience: a nationwide survey of gastroenterology program directors and fellows. Dig Dis Sci 62(10):2631–2647. https://doi.org/10.1007/s10620-017-4711-y

    Article  PubMed  Google Scholar 

  14. Richards JB, McCallister JW, Lenz PH (2016) Pulmonary and critical care medicine program directors' attitudes toward training in medical education. A Nationwide Survey Study. Ann Am Thorac Soc 13(4):475–480. https://doi.org/10.1513/AnnalsATS.201601-006OC

    Article  PubMed  Google Scholar 

  15. Alpert CM, Sinha SS, Cullen MW (2019) Teaching tomorrow's teachers: an innovative model of clinician-educator development for fellows-in-training. J Am Coll Cardiol 73(22):2900–2903. https://doi.org/10.1016/j.jacc.2019.04.029

    Article  PubMed  Google Scholar 

  16. Cramer JD, Chi DH, Schaitkin BM, Eibling DE, Johnson JT (2018) Teach the teacher: training otolaryngology fellows to become academic educators. Laryngoscope 128(9):2034–2048. https://doi.org/10.1002/lary.27156

    Article  PubMed  Google Scholar 

  17. Miloslavsky EM, Degnan K, McNeill J, McSparron JI (2017) Use of Fellow as Clinical Teacher (FACT) curriculum for teaching during consultation: effect on subspecialty fellow teaching skills. J Grad Med Educ 9(3):345–350. https://doi.org/10.4300/JGME-D-16-00464.1

    Article  PubMed  PubMed Central  Google Scholar 

  18. Adamson R, Goodman RB, Kritek P, Luks AM, Tonelli MR, Benditt J (2015) Training the teachers. The clinician-educator track of the University of Washington Pulmonary and Critical Care Medicine Fellowship Program. Ann Am Thorac Soc 12(4):480–485. https://doi.org/10.1513/AnnalsATS.201501-032OT

    Article  PubMed  Google Scholar 

  19. Tofil NM, Peterson DT, Harrington KF, Perrin BT, Hughes T, Zinkan JL, Youngblood AQ, Bartolucci A, White ML (2014) A novel iterative-learner simulation model: fellows as teachers. J Grad Med Educ 6(1):127–132. https://doi.org/10.4300/JGME-D-13-00067.1

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rosenbaum ME, Rowat JA, Ferguson KJ, Spengler E, Somai P, Carroll JL, Vogelgesang SA (2011) Developing future faculty: a program targeting internal medicine fellows' teaching skills. J Grad Med Educ 3(3):302–308. https://doi.org/10.4300/JGME-D-10-00109.1

    Article  PubMed  PubMed Central  Google Scholar 

  21. Backes CH, Reber KM, Trittmann JK, Huang H, Tomblin J, Moorehead PA, Bauer JA, Smith CV, Mahan JD (2011) Fellows as teachers: a model to enhance pediatric resident education. Med Educ Online:16. https://doi.org/10.3402/meo.v16i0.7205

  22. Kempainen RR, Hallstrand TS, Culver BH, Tonelli MR (2005) Fellows as teachers: the teacher-assistant experience during pulmonary subspecialty training. Chest 128(1):401–406. https://doi.org/10.1378/chest.128.1.401

    Article  PubMed  Google Scholar 

  23. Pascoe JM, Nixon J, Lang VJ (2015) Maximizing teaching on the wards: review and application of the One-Minute Preceptor and SNAPPS models. J Hosp Med 10(2):125–130. https://doi.org/10.1002/jhm.2302

    Article  PubMed  Google Scholar 

  24. Kirkpatrick D, Kirkpatrick J (2006) Evaluating training programs: the four levels. Berrett-Koehler Publishers

  25. Sturman N, Rego P, Dick ML (2011) Rewards, costs and challenges: the general practitioner's experience of teaching medical students. Med Educ 45(7):722–730. https://doi.org/10.1111/j.1365-2923.2011.03930.x

    Article  PubMed  Google Scholar 

  26. McCullough B, Marton GE, Ramnanan CJ (2015) How can clinician-educator training programs be optimized to match clinician motivations and concerns? Adv Med Educ Pract 6:45–54. https://doi.org/10.2147/AMEP.S70139

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gerrity MS, Pathman DE, Linzer M, Steiner BD, Winterbottom LM, Sharp MC, Skochelak SE (1997) Career satisfaction and clinician-educators. The rewards and challenges of teaching. The Society of General Internal Medicine Career Satisfaction Study Group. J Gen Intern Med 12(Suppl 2):S90–S97. https://doi.org/10.1046/j.1525-1497.12.s2.13.x

    Article  PubMed  PubMed Central  Google Scholar 

  28. Passo MH (2006) The role of the clinician educator in rheumatology. Curr Rheumatol Rep 8(6):469–473

    Article  Google Scholar 

  29. Levinson W, Rubenstein A (2000) Integrating clinician-educators into Academic Medical Centers: challenges and potential solutions. Acad Med 75(9):906–912

    Article  CAS  Google Scholar 

  30. Thomas PA, Diener-West M, Canto MI, Martin DR, Post WS, Streiff MB (2004) Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine. Acad Med 79(3):258–264

    Article  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pankti Reid.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Of note: Part of this manuscript (data herein) has previously been published as an abstract at the national American College of Rheumatology meeting with the following references:

Reid P, Miloslavsky E, Dua A. Needs Assessment of a Structured Program for Fellows as Teachers: Rheumatology Program Directors’ Perspective [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10).

Reid P, Miloslavsky E, Dua A. Needs Assessment of a Structured Teaching Program for Fellows as Teachers: Rheumatology Fellows’ Perspective [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10).

Part of the Topical Collection entitled ‘Empowering Medical Education to Transform: Learnings from an international perspective

Electronic supplementary materials

ESM 1

(DOCX 880 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reid, P., Miloslavsky, E.M. & Dua, A. Teacher training for rheumatology fellows: a national needs assessment of fellows and program directors. Clin Rheumatol 39, 673–680 (2020). https://doi.org/10.1007/s10067-019-04829-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-019-04829-2

Keywords

Navigation