응급의학에서 전국 교수개발 요구조사(CJEM, 2015)

응급의학에서 전국 교수개발 요구조사(CJEM, 2015)

A National Faculty Development Needs Assessment in Emergency Medicine

G. Mark Brown, MD*; Eddy Lang, MD*; Kamala Patel, PhD*; Andrew McRae, MD*; Brian Chung, MD†; Philip Yoon, MD†; Sandy Dong, MD‡; Danielle Blouin, MD§; Jonathan Sherbino, MD¶; Christopher Hicks, MDǁ; Glen Bandiera, MDǁ; Christine Meyers, MD**

배경

BACKGROUND

학술적 환경에서 근무하는 응급 의사는 숙련 된 임상의의 역할을 능가하는 역할을 확대합니다. 교실과 임상 환경 모두에서 전통적 "임상의 - 교육자"역할은 여전히 ​​학술적 의사 경력의 중요한 구성 요소입니다. 그러나 많은 행정, 연구, 학술 및 옹호 관련 역할이 (비록 의무는 아닐지라도) 응급 의학 분야에서 중요한 것으로 점차 확인되고 있습니다.

Emergency physicians who work in academic settings enjoy an expanding number of roles beyond that of the skilled clinician.1 The traditional “clinician-educator” role,2,3 both in the classroom and in clinical settings, is still a significant component of an academic physician’s career4-6. However, many administrative, research, scholarly, and advocacy-related roles are increasingly identified as important—if not mandatory—facets to an academic position in emergency medicine.

그러나 이러한 학문적 및 전문적 기술을 정식으로 발전시키기위한 의료 훈련 중에는 기회가 거의 없으며, 임상의는 "직무 수행 중"에 그러한 스킬을 익히거나 자신의 필요에 맞는 레지던트 수련 후 교육을 추구합니다.

Yet few opportunities exist during medical training to formally develop these academic and professional skills;2,7 instead, clinicians pick up skills “on the job” or seek post-residency training specific to their needs.

FD의 초기 형태는 기관 차원에서 제공되었으며 승진 및 테뉴어와 밀접하게 연결되었습니다. 최근에는 FD의 패러다임이 바뀌 었습니다. 개별 의학 교수진이 FD 교육을 제공하고 있으며, 내용과 형식은 포커스 그룹이나 설문 조사를 통해 교수들로부터 informed 된다. 이러한 요구 사항 평가는 FD가 해결할 수있는 지식이나 교육의 특정 격차를 식별하는 데 유용합니다.

Early forms of FD were offered at an institutional level and tied closely with promotion and tenure.2,9,10 More recently, the paradigm of FD has shifted; individual medical faculties are now offering FD curricula, the content and format of which is being informed by the faculty members themselves through focus groups and surveys.4,5,11-23 These needs assessments are useful in identifying the specific gaps in knowledge or training that FD can address.24,25

방법

METHODS

We conducted a multi-centre, cross-sectional survey of the current FD needs and interests of Canadian AEPs in order to: 

• 1) determine their current FD activities, 

• 2) provide a detailed understanding of their FD needs and interests, 

• 3) elucidate the perceived barriers to and motivation for engaging in FD, and 

• 4) identify preferred methods of delivery for FD activities.

연구 집단

Study population

The study surveyed AEPs affiliated with eight centres across Canada: The University of British Columbia, The University of Alberta, The University of Calgary, McGill University, The University of Toronto, McMaster University, Queen’s University, and Dalhousie University.

연구 도구 및 개발

Survey instrument and development

개발 단계

Survey development was conducted as an iterative process,27-29 using feedback from FD leaders and collaborating researchers, with a draft instrument piloted amongst members of the Education Committee of the Department of Emergency Medicine at the University of Calgary. 

문항 추출

Survey questions were extracted from previous FD surveys10,16,18,19,29 and evaluated by collaborating experts. The final instrument was then pilot tested in Calgary prior to national release during December 2011–June 2012.

영역

The five academic areas of interests were also process obtained through an iterative of faculty consultation and literature review, with the final topics refined in the pilot phase of the study. 

• Education, 

• leadership (encompassing both “administrative” and “professional” roles) and 

• research were included as the traditional categories of FD. 

• Scholarship was added to elucidate the broader role of academic communication, beyond the publishing of scientific journal articles, and including the ethical, social, and business aspects of medical practice. 

• Social accountability, as it is used here, refers to the obligation of physicians to direct their educational, research, and service activities towards addressing the health concerns of the community, region, and/or nation they have a mandate to serve.34 

Scholarship과 Social accountability

Although elements of scholarship and social accountability were included in previous surveys under traditional category headings,16,18-20,23,26 with increasing recognition that these are significant facets of an AEP’s career,7,13,21 these latter two categories were added and expanded to allow for a more comprehensive evaluation.

설문 시행

An online survey instrument, consisting of a series of multiple-response or Likert-scale questions, was implemented through Surveymonkey.com.30,31 Multiple-selection questions permitted up to five scale responses. Questions using a 5-point Likert employed descriptive anchors for each point on the scale.32,33 Demographic information was collected using drop-down boxes. Each section also contained a free-form response for additional comments or selections. The survey required 10-15 minutes to complete and was anonymous; names were optionally collected on the consent page to aid with survey administration.

설문 시행

Survey administration

Eligible faculty within each of the academic centres were approached using a modified Dillman technique.35 Subjects were initially recruited using email, where they were informed of the upcoming study and encouraged to enroll. In subsequent email contacts, links were provided to a video requesting participation in the research and to the survey itself.

자료 수집과 분석

Data collection and analysis

Responses were automatically collected/collated as the survey progressed, and are reported here as pooled data. Descriptive statistics are used to calculate rates and averages. Multiple-selection questions are reported as the percentage of respondents selecting a particular response (frequency; range 0-100%).

결과

RESULTS

인구통계

Demographics

As summarized in Table 1, the majority of participants were FRCP-certified, EM-specialized males within the first 15 years of practice. Of female respondents, over two-thirds were within the first 10 years of their careers.

현재 활동

Current activities

현재 활동 비율

The current non-clinical activities of AEPs are reported in Table 2, broken down by academic area.

인구통계 하위집단 간 비교

The major differences in the current non-clinical participation by demographic subgroups are illustrated in Figure 1.

미래 FD 관심

Interest in future FD

The need for, and interest in, FD was determined by asking AEPs which future activities they would be willing to attend (from a list of 14 possible choices). Table 3 outlines the results for each of the five non-clinical domains.

시니어 교수는 컴퓨터 스킬에 관심 

senior faculty reported greater need to develop computer skills (26.9%vs 4.8%, p <0.001)

시니어 교수는 '어려움 겪는 전공의 돕기'에 덜 관심

senior faculty reported that they were much less in need of skills to help the “resident in difficulty” (16.4% vs 42.9%, p <0.001).

여성 > 남성: 교육, 리더십, 연구

greater interest shown by females than males in pursuing educational (2.19 vs 1.87, p = 0.016), leadership (1.82 vs 1.44, p <0.01), and research activities (1.32 vs 0.99, p = 0.01). In leadership, this gender difference was independent of seniority: although female respondents to our survey were generally more junior than their male counterparts, female AEPs showed statistically greater interest in leadership activities, even when compared to males in the 0-5 year cohort (1.82 vs 1.50 activities, p = 0.037).

동기부여요인과 장애요인

Motivation for and barriers to FD

the survey explored which factors inhibit and promote participation in FD activities (Table 4).

FD 전달방식

Delivery of FD activities

The preferred timing, location, and format of future FD activities is summarized in Table 5.

Regional/institutional variation

고찰

DISCUSSION

이 조사는 캐나다의 응급 의사에 대한 36 % 응답자 중에는 15년 미만 경험의 교수진가 많으며, 현재의 인구 통계와 비교했을 때 여성 응답자의 비율이 높은 편이다. 연구 결과 전통적인 교육 영역, 리더십, 학술 영역에 대한 요구가 강​하지만 연구 및 사회적 책임에 FD가 필요합니다. 또한 이전 연구에서와 마찬가지로, 우리의 결과는 의료 교육이 표본 집단에서 AEP의 비 임상 의무의 핵심이며, 교육 활동에 98 % 이상이 참여하고 있음을 보여줍니다.

This survey of Canadian academic emergency physicians, with a 36% response rate significantly weighted towards faculty with under 15 years of experience, and with a higher proportion of femalerespondents when compared to current demographics,suggests that traditional domains of education, leader-ship, and scholarship remain strong, but there is agrowing need for FD in research and social account-ability. Furthermore, as in previous studies,4-6,16 ourresults show that medical education was the core of anAEP’s non-clinical duties in the population sampled,with respondents reporting over 98% participation inthis activity. 

동시에, 우리의 연구 결과는 "임상의 교육자"이상의 학술 역량에 대한 FD 지원의 필요성과도 일치합니다.이 분야의 추세는 모든 학문 영역에 해당하며, 주로 의사 소통과 사람 기술에 대한 것이다. 예를 들어, 학술 활동에 대한 AEP의 관심은 저널 간행물이나 다른 인쇄 매체를 위해 쓰는 것이 아니라 대중 연설과 구두 발표 기술 향상에 중점을 두었습니다.

At the same time, our results are also congruent with the recognized need for FD support of academic roles beyond the “clinician-educator.”5,7,13 The trend in these areas is towards the acquisition of skills translatable between all academic domains, primarily communication and people skills. For example, AEPs’ interests in scholarly activities were centered on improving public speaking and oral presentation skills, rather than writing for journal publication or other print media. 

미래의 리더십 활동을 위해, 우리는 AEP가 전략적 계획과 같은 재정적 인 주제 또는 좀 더 좁은 주제로 학습하는 것이 아니라 팀을 조장하고 팀을 관리하는 능력을 향상시키는 것을 선호한다는 것을 발견했습니다. 그 결과는 현재 대부분의 AEP가 관여하고 있는 위원회 활동보다 더욱 폭 넓은 활동에 참여하고자하는 희망을 시사합니다.

For future leadership activities, we found that AEPs preferred to improve their ability to facilitate groups and manage teams, rather than engage in learning as financial or more narrow topics, such strategic planning. The results suggest a desire to participate in a breadth of activities, more than simply the committee work that most AEPs are currently involved with.

전통적인 FD 영역에 대한 관심을 보완하기 위해 연구와 사회적 책임에 대한 FD의 필요성이 증가하고 있음을 제시합니다. 이것은 그림 3에 자세히 나와 있으며, 비 임상 활동의 현재 전반적인 참여와 각 영역의 FD 요구를 비교합니다.

Complementing the interest in the traditional FD domains, our results also suggest a growing need for FD in research and social accountability. This is detailed in Figure 3, where we compare the current overall participation in non-clinical activities with the FD needs in each domain.

고위 교수진, 여성 AEP 및 CCFP 교육 된 AEP 모두 중요한 FD 요구 사항이 있습니다.

Senior faculty, female AEPs, and CCFP-trained AEPs all have important FD needs

결과는 시니어 AEP가 축적 된 경험에도 불구하고 FD에 대한 필요성을 계속 가지고 있음을 시사한다. 경력의 진화와 함께 수석 AEP의 교육 요구에서 리더십과 사회적 책임에 이르기까지 FD 요구가 바뀌고 있습니다.

the results suggest that senior AEPs continue to have a need for FD despite their accumulated experience. With the evolution of a career, the FD needs of senior AEPs shift from educational activities towards those in leadership and social accountability.

대조적으로, 여성 AEP는 FD가 그들의 리더십 기술을 개발할 필요성을 더 많이 표명했습니다. 리더십에 대한 FD의 욕구 증가에 기여한 요인으로는 리더십 활동 및 직책에서 여성에 대한 과소 대표가있다 (그림 1).

In contrast, female AEPs expressed greater need for FD to develop their leadership skill-set. A likely contributor to the increased desire for FD in leadership is the reported underrepresentation of women in leadership activities/positions (Figure 1).

FD 활동은 관련성이 높고 편리해야합니다.

FD activities need to be relevant and convenient

과거 FD의 필요성은 종종 임상의에 의해 과소 평가되었고, FD의 이점은 인식되지 못했다 .2,39 그러나 이 연구는 AEP가 FD 참여에 가치를 발견한다는 것을 보여준다.

In the past, the need for FD was frequently underestimated by clinicians, and the benefits of FD equally unrecognized.2,39 However, this study illustrates that AEPs find value in FD participation.

미래 FD 활동의 내용을 묘사하는 것의 중요성은 잘 알려져 있습니다 : 

• AEP는 FD에 참여할 것인지 아닌지 고려할 때 가장 중요한 요소로 주제subject matter를 꼽았다 (Likert 응답 : 5/5). 

• 편리함 또한 매우 중요했습니다. 대부분의 AEP는 주중, 특히 "업무 시간"에 FD 활동에 참석하기를 원했습니다. 이것은 AEP가 저녁 교대에 preponderance가 있음을 생각하면 직관적입니다.

the importance of delineating the content of future FD activities is well understood: AEPs rated subject matter as the most important factor when considering whether or not to participate in FD (Likert response: 5/5). Convenience was also of great importance. Most AEPs preferred to attend FD activities on weekdays, particularly during “business hours.” This is intuitive, when AEPs have a preponderance of evening shifts.

한계

LIMITATIONS

또한이 조사는 전국적으로 950 개 이상의 AEP에 실시되었으며, 그 중 36 %가 응답을 보였으며 이는 결과가 표본 추출 편향에 영향을받을 수 있으며 전국에 걸쳐 FD interest를 대표하지 않음을 의미합니다. 이것은 참여율이 낮았던 시니어 교수들의 FD가 과소 평가 된 것을 반영 할 수 있습니다. (20년 이상 경력 교수의 응답률은 16%로 가장 낮았다). 더욱이 이 낮은 응답률을 해석 할 때 FD 설문에 대한 응답자가 FD 참여에 더 관심을 가질 가능성이 높다고 주장 할 수 있습니다. 따라서 이러한 결과는 미래에 참여할 의사가 있는 교수들의 필요와 관심을 (과대)반영 할 가능성이 높으며 참가 의사가없는 사람들의 견해에 덜 편향되어있다. 

In addition, the survey was administered to over 950 AEPs nationally, of which 36% responded, meaning that the results may be affected by sampling bias and not represent FDinterests across the country. This may reflect an under-appreciation of FD by senior faculty, whose participation was lowest (those with 20+ years seniority had a 16% response rate, compared with the most junior faculty, who had a 67% response rate) or simply greater survey burnout. Moreover, when interpreting this low response rate, it may be argued that respondents to a FD survey were more likely to have an interest in FD participation. Hence, these results are more likely to be reflective of the needs and interests of future participants and less biased by the views of those with no intention to participate. 

마지막으로, 낮은 응답률 (RR)은 다른 다중 센터 연구와 유사합니다. Farley 등 16)은 대략 같은 수의 사람들 (대략 950 명)을 대상으로 25 %의 RR (36 % RR과 비교)을 조사했다. Dent 등 26)은 58 %의 RR을 가지고 있었지만, 이는 Australian College가 후원 한 회원 설문 조사였으며, 설문 조사는 우리보다 훨씬 짧았으며 연구를 완료하기위한 재정적 인센티브가 제공되었는데,이 모두가 높은 RR을 보인다. Huwendiek et al.의 유럽 의학 교육자에 대한 연구 23)는 우리보다 훨씬 광범위한 범위를 가지고 있었고 (종합 의학 능력과 수십 개의 국가가 포함됨), 응답자의 수가 더 많았지 만 RR은 훨씬 낮았다 우리 (4.8 %)보다.

Lastly, though low, the response rate (RR) is comparable to other multi-centre studies. Farley et al.16 surveyed approximately the same number of people (roughly 950), with a 25% RR (vs our 36% RR). Dent et al.26 had a 58%RR, although this was the Australian College’s sponsored survey of its members, its survey was far shorter than ours, and financial incentives were provided for completing the study, all of which may account for the higher RR. Huwendiek et al.’s study23 of European medical educators had a purview much broader than ours (both in terms of multidisciplinary medical faculty and dozens of countries included), and thus it had a higher overall number of respondents, yet its RR was far lower than ours (4.8%).

결론

CONCLUSIONS

조사 된 8 개 센터에서 지역 및 제도적 이질성이 분명 해졌고, 이는 지역 문화 / 관행을 반영하거나 선택 편견의 증거가 될 수 있습니다. 그러나 이는 일반적으로 교수 구성의 인구통계학적 차이와 관련이 없으며, 기관적 이질성(예 : 모든 학계 전반에서 어느 정도의 센터가 필요성을 갖지 못했는지)에 일관성은 없었습니다.

Across the eight centres surveyed, both regional and institutional heterogeneity was evident, which may reflect local culture/practices or be evidence of selection bias. However, this typically did not correlate with demographic differences between faculties, nor was there consistency in the institutional heterogeneity (i.e., no one centre had more or less need across all the academic domains).

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CJEM. 2016 May;18(3):161-82. doi: 10.1017/cem.2015.77. Epub 2015 Sep 9.

A National Faculty Development Needs Assessment in Emergency Medicine.

Brown GM1, Lang E1, Patel K1, McRae A1, Chung B2, Yoon P2, Dong S3, Blouin D4, Sherbino J5, Hicks C6, Bandiera G6, Meyers C7.

Author information

1

*University of Calgary,Calgary,AB.

2

†University of British Columbia,Vancouver,BC.

3

‡University of Alberta,Edmonton,AB.

4

§Queen's University,Kingston,ON.

5

¶McMaster University,Hamilton,ON.

6

ǁUniversity of Toronto,Toronto,ON.

7

**McGill University,Montreal,QC.

Abstract

OBJECTIVES:

Emergency physicians who work in academic settings enjoy an expanding number of roles beyond that of the skilled clinician. Faculty development (FD) encompasses the broad range of activities that institutions use to renew skill-sets and assist faculty members in these multiple roles. This study seeks to define the current FD needs and interests of Canadian academic emergency physicians (AEPs).

METHODS:

An online survey was administered to 943 AEPs in eight centers across Canada to determine their current FD activities, provide a detailed understanding of their FD needs and interests, elucidate the perceived barriers to and motivation for engaging in FD, and identify preferred methods of delivery for FD activities.

RESULTS:

This national, cross-sectional survey was completed by 336 respondents. It shows that need for FD is universally high, particularly in traditional domains of scholarship, leadership and education (79%, 80%, 87% overall interest, respectively). However, the study also suggests that there is increasing need for FD in areas where current participation is lowest, namely research and social accountability (12% and 13% more interest, respectively). Senior and junior faculty evince equivalent overall FD interest (p>0.05), whereas female AEPs expressed greater overall FD needs in leadership (1.82 vs 1.44 activities, p=0.003) than males. Continued participation in FD activities is best promoted by offering relevant topics, at convenient times and locations.

CONCLUSIONS:

This study reports the first comprehensive national FD needs assessment of Canadian academic emergency physicians.

KEYWORDS:

Faculty Development; Needs Assessment; Survey

PMID:

 

26350557

 

DOI:

 

10.1017/cem.2015.77