성년이 된 AHC: 교수들이 더 나은 선생, 변화에이전트가 되게 돕기(Acad Med, 2006)

성년이 된 AHC: 교수들이 더 나은 선생, 변화에이전트가 되게 돕기(Acad Med, 2006)

The Academic Health Center Coming of Age: Helping Faculty Become Better Teachers and Agents of Educational Change

Charles J. Hatem, MD, Beth A. Lown, MD, and Lori R. Newman, MA

의학교육을 위한 기관들은 전통적으로 교수들이 교사로서의 책임을 다할 수 있게 준비시키는 것에는 매우 적은 시간만을 할애해왔다.

Institutions committed to medical education have historically spent an inordinately small amount of time preparing their faculty members for their responsibilities as teachers.

선구자적인 예외는 the Shapiro Institute for Education and Research at Harvard Medical School (HMS) and Beth Israel Deaconess Medical Center (BIDMC)이다.

A pioneering exception to the historic indifference to medical teaching was the prescient formation of the Shapiro Institute for Education and Research at Harvard Medical School (HMS) and Beth Israel Deaconess Medical Center (BIDMC). As described by the founders:

HMS와 BIH는 교육병원과 의과대학이 clinical business과 더불어 공통의 academic mission에서도 최고 선두이자 중심적 위치를 더 효과적으로 유지하기 위하여 1996년에 joint venture를 설립하였다.

In an effort to organize a teaching hospital and a medical school in a manner that would position them to maintain more effectively their common academic mission front and center with the clinical business, HMS and the Beth Israel Hospital (BIH) created a joint venture in 1996.

 

교육과 연구를 위한 이 새로운 비영리기관은 교육과 연구가 최우선의 (그리고 유일한) 미션이다. 이 기관은 추가적인additional 그리고 구체적인 academic leadership을 제공하기 위해, 그리고 academic mission을 위한 전략기획을 수행하기 위한 joint venture를 실현enable시키려는 목적으로 설계되었다.

The new nonprofit Institute for Education and Research has education and research as its top (and only) mission. It is designed to provide additional and specific academic leadership and to enable the joint venture to undertake strategic planning for the academic mission.1

1996년 BIH는 BIDMC가 되었다. 그리고 CareGroup이라는 새로운 헬스케어 독립체entity 아래에 join하였다.

In 1996, the BIHmerged with New England Deaconess Hospital to form BIDMC. Mount Auburn Hospital (MAH), another HMS teaching hospital, joined BIDMC under the umbrella of a new health care entity, CareGroup.

이 기관의 핵심적으로 집중하는 것 중 하나는 교수개발이다.

One of the Institute’s central commitments is faculty development.

Harvard Medical System 내에서의 의학교육 펠로우십

The Fellowships in Medical Education within the Harvard Medical System

1998년의 The Rabkin Fellowship in Medical Education

The Rabkin Fellowship in Medical Education was established in 1998 in honor of Mitchell T. Rabkin, MD, CEO emeritus of the BIH.

The Rabkin Fellowship은 하버드-협력 기관의 교수들에게 열려있음

The Rabkin Fellowship is open to faculty based at all Harvard-affiliated institutions and is designed to prepare future leaders in medical education.

1999년의 The Mount Auburn Fellowship in Medical Education. Rabkin 펠로우십과 교육과정은 같으며, 2004년에 modified version이 시작되었음.

The Mount Auburn Fellowship in Medical Education was established in 1999 and follows the same curricular structure as the Rabkin Fellowship. In 2004, a modified version of the Mount Auburn Fellowship was initiated for fellows of the Academy at HMS. 

펠로우십 프로그램의 목적은... 

The goals of the fellowship programs are to

• ▪ help faculty develop and enhance their skills as educators;

• ▪ provide faculty an opportunity to conduct scholarly research or an educational project in an area of interest and importance in medical education;

• ▪ support the fellows as educational leaders and change agents within the AHC; and

• ▪ create a community of educators who continuously strive to improve the field of medical education.

최초 펀딩 소스 

The initial funding of the fellowship came from philanthropic support and from the founding institutions (BIDMC and HMS), with subsequent underwriting from MAH.

펠로우들

Fellows

2006년까지 63명의 졸업생 숫자. 다양한 과에 소속되어 있음. 초기에는 clinical faculty에 주로 집중하였으나 점차 확대됨.

As of June 2006, the three fellowships in medical education have graduated 63 physicians. The fellows represent a variety of clinical disciplines . At their inception in 1998 the fellowships focused on the clinical faculty, however, have always been open to all faculty who teach in both the preclinical and clinical years, as well as in graduate and continuing medical education.

다양한 경력(신임교수, 10년 이상 유경험자 등.)

Class size (2~8명). 이상적으로는 6명

Some fellows have participated in the program during the early stages of their careers, whereas others have had over 10 years of teaching experience. Class sizes have ranged from two to eight. It is our view that the ideal number for interactive seminars and effective group development is six.

선발절차와 제출서류 

The fellows are chosen through a competitive process, which begins with a request for applications. Candidates are required to submit

• ▪ a personal statement outlining the applicant’s interest in teaching and/or academic leadership, and defining personal and/or professional goals in pursuing this year-long course of study;

• ▪ a question or project to be undertaken during the fellowship;

• ▪ a letter of support from the department or division chief;

• ▪ a current curriculum vitae (CV); and

• ▪ letters of reference.

펠로우들이 해야 하는 것들과 제공되는 것들

• The medical education fellows are required to undertake an analytic study, an educational project, or research focusing on an important issue in medical education.

• Fellows each select a mentor in addition to the fellowship faculty to help guide their project’s development.

• The fellows also provide additional support and peer review for each others’ projects over the course of the year.

• Finally, the fellows summarize their projects in written reports and formal presentations at a concluding symposium.

 

약 20%의 시간을 할애하게 됨

The fellowship is structured to occupy and compensate 20% of a fellow’s time.

교육과정 구조

Curriculum Structure

펠로우십 세미나는 세 장소에서 열림. (외부) 초청 전문가, 지원 인력

The fellowship seminars are conducted at three sites: the Center for Education at BIDMC, the MAH, and HMS. 

Invited experts ...

Staff support ...

 

진행 기간 및 주요 활동 내용

• The fellows at the BIDMC and MAH meet weekly for 10 months (September through June) at separate sites for two- hour seminars during the academic year.

• The program at HMS meets monthly for two-hour seminars also for 10 months of the academic year. The medical education curriculum was added to the existing Academy fellowships at HMS in 2004–05.

• Previously the Academy fellowships were designed to support junior faculty projects, but did not have a component dedicated to ongoing seminars in medical education.

• In 2004– 05 the fellowship directors began to meet monthly with the HMS Academy fellows using core elements of the Rabkin and Mount Auburn Fellowship curricula.

여러 개의 (의학교육 연구 관련) 세미나에 참석함

Fellows from all three programs come together for a number of seminars. A majority of these are dedicated to medical education research principles taught by local and national experts.

 

이전 펠로우와 현재 펠로우와의 만남

In addition, past and present fellows convene twice a year to reflect and discuss challenging issues in medical education. The past fellows also serve as project consultants for the current fellows.

교육과정 내용

Curriculum Content

•  ▪ the historic evolution and financing of medical education;

•  ▪ the skills needed for curriculum development, design, and evaluation;

•  ▪ the application of adult learning theories to the clinical setting;

•  ▪ the enhancement of teaching skills needed at the bedside, ambulatory, operating room, and classroom arenas, including exercises in peer review, lecturing, and small-group and case- based discussion;

•  ▪ mentoring;

•  ▪ the skills needed for educational administration and leadership;

•  ▪ the relevance of the humanities to medical education;

•  ▪ research in medical education;

•  ▪ writing for publication;

•  ▪ sources of educational funding;

•  ▪ the role of technology/simulation in medical education; and

•  ▪ the skills of self-reflection and self- renewal.

경험학습이 핵심 요소

Experiential learning is a key component of the fellowship. Fellows ....

• conduct and report on master clinician–teacher observations,

• are videotaped and given feedback on lecturing techniques,

• engage in role plays providing difficult feedback to learners,

• lead case-based discussions,

• conduct peer reviews, and

• submit written reports of memorable teaching and learning experiences.

서로 존중하는 분위기의 교수-학습 공동체를 만들기 위해서 노력함. 서로 피드백을 주고 받는 안전한 환경을 만들어줌.

We strive to create a respectful “learning and teaching community” committed to the goals of better teaching. The fellowship provides a safe environment in which the fellows give and receive feedback

 

HMS와 협력병원의 다른 교수개발 프로그램도 있지만, 주로 개별 강의, 워크숍, 3주과정, 멘토링 등으로 구성되어 있다. The Rabkin, Mount Auburn, and Academy fellowships은 HMS교수만을 위하여 설계된, 1년에 걸쳐 정기적으로 진행되며, 방대한 읽기reading과 계획된 교육활동, 교육 프로젝트 수행 등으로 구성된 독립적 프로그램

Other educational faculty development opportunities within HMS and its affiliated hospitals exist, but are predominately individual lectures, workshops, three-week courses, and mentoring. The Rabkin, Mount Auburn, and Academy fellowships, however, are the only stand-alone offerings designed solely for HMS faculty that meet regularly for the entire academic year and involve extensive readings, planned curricular activities, and completion of a required educational project.

교육과정 평가

Curricular Evaluation

 

• 펠로우십 디렉터들은 매 세션 이후 만나서 debrief하고 이후 진행될 세미나에 대해서 계획을 세우며, 세션간 연관성을 가지게 하는 개념을 찾고, 펠로우의 니즈에 따라 교수계획을 설계함
  The fellowship directors meet after each session to debrief and plan upcoming seminars with particular attention to identifying connecting concepts between the sessions and designing teaching plans that meet the needs of the fellows.

• 펠로우들에게 커리큘럼에 대한 피드백을 계속 요청하기도 하지만, 일년에 두 세션은 프로그램에 대한 심층적 성찰과 펠로우의 personal and professional development에 대한 영향을 논의함.
  In addition to soliciting ongoing feedback from the fellows about the curriculum, two sessions during the year are devoted to eliciting in-depth reflections about the program and its impact on the fellows’ personal and professional development.

• 각 펠로우와 정기적으로 미팅을 잡아서 펠로우십 경험에 대한 피드백을 받고, 추가적 성찰을 위한 시간을 가짐. 프로젝트에 대한 심층적 토론
  Regularly scheduled meetings with each fellow throughout the year afford additional opportunities to garner feedback on the fellowship experience, provide time for further reflection, and allow for in-depth discussion of the fellow’s project.

• 이 미팅들은 펠로우가 change agent가 되는 과정에서 겪는 어려움을 상담해주고 서포트해주는 기회이기도 함.
  These meetings are also natural opportunities to provide support and counsel to the fellow regarding the challenges of being a change agent in an academic environment.

프로그램 평가

Programmatic Evaluation

2004년부터 ongoing evaluation study를 수행

In 2004, the program directors began an ongoing evaluative study of the fellowship in medical education. The goal of the study is to examine the outcomes of the fellowship, including its personal and professional impact, using both qualitative and quantitative methods.

펠로우십 이후

After the Fellowship

기관 차원에서 교육과 관련된 중요한 역할을 맡게 되었으며, 트레이닝의 효과도 있을 것.

The fellows have assumed significant institutional educational roles after the completion of fellowship training, which we feel is due in part to that training.

Challenges

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Acad Med. 2006 Nov;81(11):941-4.

The academic health center coming of age: helping faculty become better teachers and agents of educationalchange.

Hatem CJ1, Lown BA, Newman LR.

Author information

• 1The Academy Center for Teaching and Learning, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. chatem@mah.harvard.edu

Abstract

There is a growing appreciation of the need for educational faculty development within medical education. The authors describe the establishment and subsequent expansion of one such fellowship in medical education that arose from the cooperative efforts of Harvard Medical School, Beth Israel Deaconess Medical Center, and Mount Auburn Hospital. Three resultant fellowships are outlined that share the common goals of enhancing the skills of the faculty as educators, providing an opportunity to conduct scholarly educational research, supporting the fellows as change agents, and fostering the creation of a supportive community dedicated to enhancing the field of medical education. Curricular structure and content are outlined as well as current approaches to curricular and programmatic evaluation. The fellowships have been well received and are widely perceived as transformative for the faculty, many of whom have assumed increased roles of organizational and educational leadership. Lastly, future directions for these fellowships are presented.

PMID:

 

17065851

 

[PubMed - indexed for MEDLINE]