의학교육 펠로우십 전국 설문(Med Educ Online. 2011)

의학교육 펠로우십 전국 설문(Med Educ Online. 2011)

A national survey of medical education fellowships 

Britta M. Thompson1*, Nancy S. Searle2, Larry D. Gruppen3, Charles J. Hatem4 and Elizabeth A. Nelson5

1Assistant Dean for Medical Education and Director, Office of Educational Development and Support, University of Oklahoma College of Medicine, Oklahoma City, OK, USA; 2Director, Academy of Distinguished Educators and Director, Office of Professional Development, Baylor College of Medicine, Houston, TX, USA; 3Josiah Macy Jr. Professor of Medical Education and Chair, Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA; 4Harold Amos Professor of Medicine, Director of Medical Education at Mount Auburn Hospital and Director of the Center for Teaching and Learning at Harvard Medical School, Boston, MA, USA; 5Senior Associate Dean of Medical Education, Baylor College of Medicine, Houston, TX, USA

많은 의과 대학 및 병원이 교수진의 중요한 교육 기술을 개발하고 향상시키기 위해 워크샵이나 세미나를 후원합니다 (1). 의학 학생, 레지던트 및 동료뿐만 아니라 동료 및 환자의 교육에 관련된 사람들에게 교육, 교육 장학금 및 교육 지도력의 역량은 필수적입니다. 의사 부족에 대한 요구를 충족시키기 위해 의대는 등록을 늘리고 새로운 학교가 개발되었으므로 (3) 숙련 된 의학 교육자와 의사의 필요성이 절실합니다 (4).

Many medical schools and hospitals sponsor workshops or seminars to develop and enhance important educational skills of faculty members (1). Competency in teaching, educational scholarship and educational leadership is vital to those involved in the education of not only medical students, residents and fellows, but also colleagues and patients (2). To meet the demands of the doctor shortage, medical schools have increased their enrolment and new schools have been developed (3), thus the need for trained medical educators and physicians is imperative (4).

Hatem은 가르치는 것과 환자를 보는 것은 서로 유사한 기술을 활용한다고 제안하면서, 학습자 / 환자의 요구를 이끌어 내고, 의제를 설정하고, 문제를 식별하기 위해 진단 접근법을 사용하고, 피드백과 의사 소통에 의존하고, 결과를 평가하는 것 등을 예로 들었다.

Hatem (10) proposed that teaching and doctoring utilize a similar skill set, such as eliciting a learner’s/patient’s needs, setting an agenda, using diagnostic approaches to identify problems, relying on feedback and communication, and evaluating outcomes.

Methods

We developed a 26-item questionnaire that asked participants to report on the characteristics of their medical education fellowships,

From a list of topics (see Table 2), participants were asked to indicate the extent to which each topic was primary, secondary, tertiary or not a programme focus.

A link to the online questionnaire was sent via e-mail in November 2005, and again in 2006 to allow schools to update their data or respond for the first time. The questionnaire was sent to one medical education contact at each of 127 US medical schools from a list provided by the Association of American Medical Colleges. Instructions directed the contact to have the individual who was most knowledgeable about the faculty development the programme complete questionnaire. 

Follow-up reminders were sent one and two months later. During the first administration, 72 schools completed the survey. During the second administration, an additional completed 48 schools and 33 schools updated their information. In 2009 we updated information on only the total number of fellows who had graduated from each programme, via phone or e-mail.

결과

Results

2006 년 말 127 개의 미국 의과 대학 중 120 개 (94.5 %)가 설문지를 작성했습니다. 응답 한 의과 대학의 거의 절반이 교육 펠로우십을 보유한다고 보고했다 (n 55, 45.8 %). 1970 년대에는 3 개의 펠로우십이 시작되었지만 1980 년대에는 없었고 1990 년대에는 20 명, 2000 년대에는 27 개가 있었고, 다섯 곳의 학교는 질문에 응답하지 않았습니다 (그림 1).

At the end of 2006, 120 of 127 US medical schools (94.5 %) completed the questionnaire. Almost half of the responding medical schools reported having an educational fellowship (n 55, 45.8%). Three fellowships were started in the 1970s, none in the 1980s, 20 in the 1990s and 27 in the 2000s, with five schools not responding to the question (Fig. 1). 

휄로우 십 프로그램 당 평균 접촉 시간 수는 64 시간이었고, 10 시간에서 584 시간까지였습니다. 

각 프로그램의 평균 기간은 10.5 개월이며 1 개월 미만에서 48 개월 미만 범위입니다.

The median number of contact hours per fellowship programme was 64, ranging from ten to 584 hours. The median duration of each programme was 10.5 months, with a range of less than one month to 48 months.

프로그램의 절반 이상이 휄로우에게 학술 프로젝트를 완료하고 발표 할 것을 요구했습니다. 일부에서는 저널을 작성하거나 (성찰적 글쓰기), 커리어 개발 계획을 세우거나, 학습 계약을 개발하거나, 커리큘럼을 실시하거나, 교육 라운드를 통해 교육 주제를 발표하도록 했다 (표 2).

Over half of the programmes required fellows to complete and present or publish a scholarly project. Few (25 percent or less) required fellows to write a journal (reflective writing), create a career development plan, develop a learning contract, implement a curriculum or present educational topics at grand rounds sessions (Table 2).

고찰

Discussion

우리의 결과는 특히 1990 년대와 2000 년대의 의학 교육 펠로우 십에 대한 관심이 증가하고 있음을 나타냅니다. 우리는 이러한 관심이 의학 교육에서 요구되는 많은 변화와 교육 교육 지도자의 필요성 증가에 대한 대응이라고 제안합니다. 흥미롭게도, 2011년 봄, 비공식적 인 후속 조치를 통해 펠로우십을 시작하고자하는 관심을 표명한 11개 학교 중  9개는 펠로우십을 시작하지 않았으며, 나머지 둘은 프로그램에 등록하지 않았습니다. 이 학교들은 장애요인으로 관리의 변화, 경기 침체 또는 교수 시간 부족, 보호 된 시간에 지불하는 비용 등을 언급했습니다.

Our results indicate an increasing interest in medical education fellowships, especially in the 1990s and 2000s. We suggest this interest is in response to many of the changes required in medical education and the growing need for trained educational leaders. Interestingly, through an informal follow-up in spring 2011 of the 11 schools which had indicated interest in initiating a fellowship, nine had not started a fellowship and the other two had few enroll in the programme. These schools cited either a change in administration, economic downturn or lack of faculty time or funds to pay for protected time as barriers.

우리의 데이터에 따르면 펠로우십에는 공통된 요소가 있음을 알 수 있습니다. 각자 비슷한 그룹의 개인을 봉사하고 비슷한 목적을 가지고 있습니다. 그러나 유사점이 존재하지만, 우리는 길이와 완성 요구 사항에 큰 차이가 있음을 지적했습니다. 일부 프로그램은 10 시간의 연락 시간 만 필요로하고 다른 프로그램은 500 시간 이상을 필요로합니다. 마찬가지로 일부 펠로우쉽은 한 달 이내에 완수 될 수 있고 나머지는 4 년이 걸릴 수 있습니다. 우리의 연구 결과에 따르면 동료에게 요구되는 프로젝트는 복잡성이 다양했다. 그러나 대부분은 학술적 프로젝트가 필요했습니다.

Our data suggest that fellowships have common elements: each serves similar groups of individuals and has a similar focus. But while similarities exist, we noted vast differences in the length and completion requirements. Some programmes require only ten contact hours while others involve over 500; similarly, some fellowships can be completed in less than a month while others take four years. Our results suggested that the projects required of fellows varied in complexity; however, most required a scholarly project.

대부분의 프로그램은 teaching에 중점을 두었지만, 절반 이하에서만 교과 과정을 설계하거나 구현하는 것을 요구했고, 성찰이 교사 교육 및 의사 발달의 중요한 부분으로 지적되었음에도, 불구하고 성찰적 작문은 거의 없었다. 이 결과는 각 펠로우십이 해당 기관의 시간, 전문 지식, 금전적 제약에 맞추어 교수진의 현지 요구 사항을 충족 시키도록 설계되었다는 견해를지지합니다.

Even though most programmes focused on teaching, less than half required fellows to design or implement a curriculum and few required reflective writing, even though reflection has been indicated as an important part of teacher education and physician development (11). These results support the view that each medical education fellowship is designed to meet the local needs of the faculty (12), tailored to the time, expertise and monetary constraints of the institution.

우리의 결과는 펠로우십에 대한 평가 결과는 제한적으로만 수집되었음을 시사합니다.

Our results suggest that limited evaluation outcomes were collected by fellowships.

우리는 커리큘럼을 공유하고, 효과적인 결과 측정 방법을 개발하고, 기관들간에 데이터를 수집하는 것이 의학 교육 펠로우십 중 국가 가이드라인이나 "베스트 프랙티스"를 확립하는 데 도움이 될 것이라고 제안한다.

We propose that sharing curricula, developing valid outcome measures and collecting data across institutions could help establish national guidelines or ‘‘best practices’’ among medical education fellowships.

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Med Educ Online. 2011 Apr 4;16. doi: 10.3402/meo.v16i0.5642.

A national survey of medical education fellowships.

Thompson BM1, Searle NS, Gruppen LD, Hatem CJ, Nelson EA.

Author information

1

Office of Educational Development and Support, University of Oklahoma College of Medicine, Oklahoma City, OK 73126-0901, USA. Britta-Thompson@ouhsc.edu

Abstract

PURPOSE:

The purpose of our study was to determine the prevalence, focus, time commitment, graduation requirements and programme evaluation methods of medical education fellowships throughout the United States. Medical education fellowships are defined as a single cohort of medical teaching faculty who participate in an extended faculty development programme.

METHODS:

A 26-item online questionnaire was distributed to all US medical schools (n=127) in 2005 and 2006. The questionnaire asked each school if it had a medical education fellowship and the characteristics of the fellowship programme.

RESULTS:

Almost half (n=55) of the participating schools (n=120, response rate 94.5 %) reported having fellowships. Duration (10-584 hours) and length (<1 month-48 months) varied; most focused on teaching skills, scholarly dissemination and curriculum design, and required the completion of a scholarly project. A majority collected participant satisfaction; few used other programme evaluation strategies.

CONCLUSIONS:

The number of medical education fellowships increased rapidly during the 1990s and 2000s. Across the US, programmes are similar in participant characteristics and curricular focus but unique in completion requirements. Fellowships collect limited programme evaluation data, indicating a need for better outcome data. These results provide benchmark data for those implementing or revising existing medical education fellowships.

KEYWORDS:

faculty development; medical education; medical faculty

PMID:

 

21475643

 

PMCID:

 

PMC3071874

 

DOI:

 

10.3402/meo.v16i0.5642