Clinician-educator Tracks Research Articles

Education Research: The Current Landscape of Clinician Educator Tracks in Adult Neurology Residency Programs: A National Survey of Program Directors.

As the concept of a clinician-educator (CE) evolves and the multiple competencies of the role become better defined, there seems to be a growing need for targeted training for clinicians pursuing a career in medical education. This study aims to describe the current state of CE tracks in adult neurology residency programs and to identify the barriers to implementation, potential solutions, and program goals and outcomes. We characterized CE tracks using 2 methods. First, we reviewed the websites of all US adult neurology residency programs to determine the availability of a CE track and its characteristics. Second, we administered a 20-item survey to program directors (PDs) of all US neurology residency programs, with questions focused on track availability, characteristics, perceived benefits of CE tracks on resident career development, barriers to implementation, and ideas for national initiatives that may facilitate track development or improvement. Fifty-eight of 177 (33%) PDs responded to the survey. Combining the results of the website reviews and surveys, we found that 34 of 179 (19%) programs have CE tracks. Seventy percent of PDs felt that CE tracks are very impactful or impactful for participating residents' careers, a perception more common among PDs of programs with tracks. The greatest perceived benefit was in preparing residents for educational leadership roles. The greatest barriers to implementation were a lack of teaching faculty, a lack of resources, and limited resident time. The highest ranked idea for a national initiative that can facilitate track development was live and recorded lectures on medical education topics. Although most PDs surveyed agreed that CE tracks are impactful for preparing residents as teachers and education leaders, such tracks are available in only 19% of adult neurology residency programs. PDs report that the benefits of CE tracks extend beyond the participants, with implications for the health of the residency program and the neurology department. While some programs have significant barriers to implementation, national initiatives may help reduce the resource burden on individual programs. Future areas of study include assessing the development and outcomes of national initiatives and analyzing the outcomes associated with CE tracks.

Longitudinal Outcomes of a Resident Academic Administrator, Clinician Educator Track.

As clinician educator tracks continue to gain popularity in graduate medical education, this report aims to fill a gap in the literature by providing a 14-year update on professional outcomes of participants in a psychiatry residency academic administrator, clinician educator (AACE) track and to compare these outcomes to non-track participants. An anonymous web-based survey querying professional achievements was distributed to all graduates of a psychiatry residency training program from 2009 to 2022. Outcomes of AACE track participants and non-track participants were compared. Of 228 alumni contacted, 61% responded (n = 140). Eighty-seven percent of track participants responded (n = 74) while 41% of non-track participants responded (n = 45). Of track participants, 63% practice in academic settings with 57% having held administrative leadership roles, 49% educational leadership roles, and 39% national or regional leadership roles. Track graduates were academically engaged with 70% reporting at least one publication, 89% at least one presentation, and 93% attending at least one national meeting. In comparison, 31% of non-track participants practice in academic settings with 44% having held administrative, 29% educational, and 20% national or regional leadership roles. Thirty-nine percent have at least one publication, 75% at least one presentation, and 90% attended at least one national meeting. When compared to non-track participants, track participants were significantly more likely to have an academic affiliation and a higher number of publications and were more likely to hold national or regional leadership roles. Track participants demonstrate longitudinal career success as clinician educators and academic administrators more so than non-track participants.

Clinician-Educator Tracks in Internal Medicine: A National Survey

Clinician-Educator Tracks in Internal Medicine: A National Survey

A Qualitative Study on the Outcomes of Participation in a Longitudinal Clinician Educator Curriculum During Internal Medicine Residency.

Despite increasing prevalence of longitudinal clinician educator tracks (CETs) within graduate medical education (GME) programs, the outcomes of these curricula and how participation in these tracks affects early career development remains incompletely understood. To describe the experience and outcomes of participating in a CET and its effects on recent internal medicine residency graduates' perceived educator skills and early career development. We conducted a qualitative study between July 2019 and January 2020 using in-depth semi-structured interviews of recently graduated physicians from 3 internal medicine residencies at one academic institution who had participated in a CET, the Clinician Educator Distinction (CED). Iterative interviews and data analysis was performed via an inductive, constructionist, thematic analysis approach by 3 researchers to develop a coding and thematic structure. Results were sent electronically to participants for member checking. From 21 (out of 29 eligible) participants, thematic sufficiency was reached at 17 interviews. Four themes related to the CED experience were identified: (1) motivation to go beyond the expectations of residency; (2) educator development outcomes from Distinction participation; (3) factors enabling curricular efficacy; and (4) opportunities for program improvement. A flexible curriculum with experiential learning, observed teaching with feedback, and mentored scholarship allowed participants to enhance teaching and education scholarship skills, join a medical education community, transform professional identities from teachers to educators, and support clinician educator careers. This qualitative study of internal medicine graduates identified key themes surrounding participation in a CET during training, including positively perceived educator development outcomes and themes surrounding educator identity formation.

The pipeline starts in medical school: characterizing clinician-educator training programs for U.S. medical students

ABSTRACT In the past forty years, clinician-educators have become indispensable to academic medicine. Numerous clinician-educator-training programs exist within graduate medical education (GME) as clinician-educator tracks (CETs). However, there is a call for the clinician-educator pipeline to begin earlier. This work aims to identify and characterize clinician-educator track-like programs (CETLs) available in undergraduate medical education (UME). We developed an algorithm of 20 individual keyword queries to search the website of each U.S. allopathic medical school for CETLs. We performed the web search between March to April 2021 and repeated the search between July and September 2021. The search identified CETLs for 79 (51%) of the 155 U.S. allopathic medical schools. The identified CETLs commonly address the clinician-educator competency of educational theory (86%, 68/79), are formally organized as concentrations or analogous structures (52%, 41/79), and span all four years of medical school (37%, 29/79). The prevalence of CETLs varies with geography and medical school ranking. We provide an overview of the current state of CETLs as assessed from institutional websites. To create a future with a sustainable output of skilled clinician-educators, UME must continue to increase the number and quality of CETLs.

Advancing our field by academically advancing pediatric rehabilitation medicine physicians.

Academic promotion is desired by many faculty practicing at academic medical institutions, but the criteria for promotion often appear opaque to many physician faculty. In nearly all cases, evidence of scholarship is required regardless of academic track. Academic advancement can be stymied by unclear expectations, lack of protected time to engage in scholarly projects, insufficient evidence of dissemination, and limited guidance, mentorship and sponsorship. In addition to being important for promotion, scholarship is an essential aspect of academic medicine because it helps inform and advance the science. Pursuing academic excellence is an important goal for pediatric rehabilitation medicine faculty members because it helps advance the care of children with disabilities and the field itself. Pediatric rehabilitation medicine faculty in the clinician educator or clinician leader tracks are encouraged to understand the criteria for advancement, seek out mentorship, scholarize their career ikigai and identify opportunities to demonstrate academic excellence.

Current status of clinician-educator tracks in internal medicine residency programmes

BackgroundResidents in internal medicine programmes lack formal training in leadership, curriculum development and clinical teaching. Residency programmes created clinician-educator tracks (CETs) to formally teach residents to become effective educators and...

Clinician-Educator Tracks for Trainees in Graduate Medical Education: A Scoping Review.

Clinician-educator tracks (CETs) appear to be increasing in prevalence in graduate medical education (GME) and may play an important role in medical education workforce development. The authors conducted a scoping review to characterize the current state of knowledge about CETs' structure, content, and outcomes. Six databases were searched in January 2018 for English-language peer-reviewed articles published through 2017 to identify articles describing CETs in GME. To be included, the CET had to target GME learners (residents/fellows), be longitudinal, have the primary aim of developing trainees into clinician-educators (CEs), and address at least one CE core competency (direct teaching, curriculum development, mentorship/advising, leadership, assessment, educational scholarship). The authors extracted and analyzed data from included articles. Of 1,434 articles identified, 19 were included in the review, representing 18 separate CETs. All but 2 CETs (11%) were specialty-specific. Most included a core curriculum with classroom-based sessions (18; 100%), workplace-based opportunities to practice skills (17; 94%), and a required scholarly project (16; 89%). Seventeen (94%) focused on skills related to direct teaching. Four (22%) identified mentoring/advising as a core curriculum focus. Five (28%) required project dissemination. Time spent in CETs varied widely (median: 166 hours; range: 8 hours/4-month period to 1,288 hours/2-year period). The most common reported outcomes were learner reactions (7; 39%) and career tracking (11; 61%). This review yields a composite picture of the current state of CETs in GME. The results highlight the paucity of outcomes data and areas for potential standardization and future research.

Cultivating Future Radiology Educators: Development and Implementation of a Clinician-Educator Track for Residents

Effective and dedicated educators are critical to the preservation and advancement of the practice of radiology. The need for innovative and adaptable educators is increasingly being recognized, with several institutions granting academic promotions through clinician-educator tracks. The implementation of resident "clinician-educator tracks" or "teaching tracks" should better prepare residents aspiring to become academic radiologists focused on teaching. In this work, we describe our experience in the development and implementation of a clinician-educator track for diagnostic radiology residents at our institution.

The Graduate Medical Education Scholars Track: Developing Residents as Clinician-Educators During Clinical Training via a Longitudinal, Multimodal, and Multidisciplinary Track.

Residency clinician-educator tracks have been created; however, they have generally been limited to a single discipline or program and experienced some challenges. The Graduate Medical Education Scholars Track (GMEST), an embedded longitudinal, multimodal, multidisciplinary clinician-educator track for residents, was piloted at the Pritzker School of Medicine, University of Chicago, in academic year 2014-2015. The GMEST is a two-year experience completed during residency training. The goal is to prepare trainees for academic careers as clinician-educators with a focus on medical education scholarship. This track is designed for residents from diverse training programs with variable clinical schedules and blends a live interactive program, asynchronous instruction and discussion, and overarching multimodal mentorship in medical education. Participants are expected to complete a capstone medical education project and submit it to institutional, regional, and/or national venues. Data gathered from the 2014-2016 and 2015-2017 cohorts demonstrated that 21/22 (95%) participants were satisfied with the GMEST curriculum, felt it was important to their development as future clinician-educators, and felt it would positively influence their ability to work in medical education. Further, 18/22 (82%) participants wished to pursue a career as a clinician-educator and in medical education leadership and/or scholarship. The authors will longitudinally track graduates' future career positions, projects, publications, and awards, and cross-match and compare GMEST graduates with non-GMEST residents interested in medical education. Faculty mentors, program directors, and the Medical Education, Research, Innovation, Teaching, and Scholarship community will be asked for feedback on the GMEST.

Whither the Pulmonary Ward Attending? Preserving Subspecialty Exposure in United States Internal Medicine Residency Training.

Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine. The decline in subspecialty medicine interest can be attributed to many factors, including differences in compensation, decreased subspecialist exposure, and a changing research funding landscape. Although there has not been systematic documentation of this trend in pulmonary and critical care medicine, we have noted previously pulmonary and critical care-bound trainees switching to hospital medicine instead. With our broad, multiorgan system perspective, pulmonary and critical care faculty should embrace teaching general medicine. Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.

More Than Just A Hobby: Building an Academic Career in Global Emergency Medicine

BackgroundAs the specialty of emergency medicine (EM) continues to spread around the world, a growing number of academic emergency physicians have become involved in global EM development, research, and teaching. While academic departments have always found this work laudable, they have only recently begun to accept global EM as a rigorous academic pursuit in its own right. ObjectiveThis article describes how emergency physicians can translate their global health work into “academic currency” within both the clinician-educator and clinician-researcher tracks. DiscussionThe authors discuss the impact of various types of additional training, including global EM fellowships, for launching a career in global EM. Clearly delineated clinician-researcher and clinician-educator tracks are important for documenting achievement in global EM. ConclusionsReflecting a growing interest in global health, more of today's EM faculty members are ascending the academic ranks as global EM specialists. Whether attempting to climb the academic ladder as a clinician-educator or clinician-researcher, advanced planning and the firm support of one's academic chair is crucial to the success of the promotion process. Given the relative youth of the subspecialty of global EM, however, it will take time for the pathways to academic promotion to become well delineated.

A guide to writing peer-reviewed publications: a common program requirement and resume builder.

There is growing interest in different ways to garner academic promotion in today's medical school. In response, clinician-educator tracks have burgeoned in recent years.1–3 Although extramural funding is not required for advancement in all tracks, almost all promotions still require scholarly activity. At most institutions publication in peer-reviewed journals is an essential component in this. Although seemingly straightforward, acquiring a sufficient number of peer-reviewed papers remains a significant barrier to promotion for many highly skilled, busy program directors, designated institutional officials, teachers, and academic clinicians.4–6 The Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements note that “Some members of the faculty should also demonstrate scholarship by one or more of the following…publication of original research or review articles.”7Although publication is fundamental for academic advancement, writing papers can seem difficult if not impossible for many clinical faculty, including those who focus on medical education. Publishing in peer-reviewed journals requires directed effort, yet the payoffs can be sizable. Besides climbing the academic ladder, promotions at medical schools are usually accompanied by salary increases. Other benefits include developing a greater depth of knowledge in a niche area. With such expertise comes regional, national, and even international recognition, along with opportunities to present scholarly work at conferences. Scholarship is also important to faculty's role in mentoring residents in their scholarship endeavors, a role that is required by the ACGME: “Faculty should encourage and support residents in scholarly activities.”7 Finally, and perhaps most importantly, scholarly pursuits and academic productivity may improve faculty job satisfaction.5,6,8The task of writing can seem daunting, especially for individuals who have not written before or have not written recently. As with any undertaking, begin with small steps.

Factors Impacting the Departure Rates of Female and Male Junior Medical School Faculty: Evidence from a Longitudinal Analysis

High rates of attrition have been documented nationally in assistant professor faculty of U.S. medical schools. Our objective was to investigate the association of individual level risk factors, track of academic appointment, and use of institutional leave policies with departure in junior faculty of a research-intensive school of medicine. Participants included 901 faculty newly hired as assistant professors from July 1, 1999, through December 30, 2007, at the Perelman School of Medicine at the University of Pennsylvania. The faculty affairs database was used to determine demographics, hiring date, track of appointment, track changes, time to departure, and use of work-life policies for an extension of the probationary period for mandatory review, reduction in duties, and leave of absence. Over one quarter (26.7%) of faculty departed during follow-up. Faculty appointed on the clinician educator or research tracks were at increased risk of departure compared to the tenure track (hazard ratio [HR] 1.87, confidence interval, [CI] 1.28-2.71; HR 4.50, CI 2.91-6.96; respectively). Women appointed on the clinician educator track were at increased risk of departure compared to men (HR 1.46, CI 1.04-2.05). Faculty who took an extension of the probationary period were at decreased risk of departure (HR 0.36, CI 0.25-0.52). At this institution, junior faculty on the tenure track were least likely to depart before their mandatory review compared to faculty on the clinician educator or research tracks. Female assistant professors on the clinician educator track are of significant risk for departure. Taking advantage of the work-life policy for an extension of the probationary period protects against attrition.

Recruitment and Retention in Academic Medicine—What Junior Faculty and Trainees Want Department Chairs to Know

AbstractAttracting and retaining bright and motivated physicians remains a high priority for academia. Historically, the recruitment of trainees into academia and the retention of junior faculty have been suboptimal. To learn more about the perceived obstacles that discourage the pursuit of academic careers, a Workshop on Academic Career Pathways was conducted during the 2011 Southern Regional Meetings held in New Orleans. The audience included mainly residents and fellows as well as junior and senior faculties. Speakers described career options in academic medicine focusing on the clinician-investigator and the clinician-educator tracks. Afterward, the audience was asked to identify perceived obstacles to recruitment and retention in academic medicine. The group identified 10major obstacles in 3 categories: financial challenges, personal mentoring and academic skills acquisition. This article summarizes the workshop proceedings and ends with recommendations to chairs and department leaders for improving recruitment and retention in academic medicine based on the discussion.

Clinician-Educator Pathway for Radiology Residents

Faculty clinician-educator tracks have become increasingly common at US academic medical centers. Although many radiology faculty members belong to such tracks, there is little training in radiology residencies to prepare residents to take on these roles. The authors present a summary of a novel radiology residency clinician-educator pathway developed and piloted at their institution. The key components of the pathway include protected time to work on a substantive education project and a small number of high-quality didactic lectures. Publication or presentation in some form is expected. The pathway includes regular mentorship from highly regarded clinician-educators, as well as didactic training in education techniques and skills. A formal application process was established, as were methods of evaluation during and after the experience.

Clinician-Educator Tracks for Residents: Three Pilot Programs

Over the past 30 years, clinician-educators have become a prominent component of medical school faculties, yet few of these individuals received formal training for this role and their professional development lags behind other faculty. This article reviews three residency tracks designed to build skills in teaching, curriculum development and assessment, education research, and career development to meet this need. The residency clinician educator tracks at University of Michigan, Baylor College of Medicine, and University of California Davis are described in detail, with particular attention to their common elements, unique features, resource needs, and graduate outcomes. Common elements in the tracks are faculty mentorship, formal didactics, teaching opportunities, and an expectation of scholarly productivity. Essential resources include motivated faculty, departmental support, and a modest budget. Favorable outcomes include a high percentage of graduates in clinical faculty positions, teaching programs created by the residents, positive effects on recruitment, and enhancement of faculty identity as clinician educators. Clinician-educator tracks in residency present a viable means to address the training needs of clinical track faculty. The programs described in this article provide a model to assist other departments in developing similar programs.

‘So you want to be a clinician-educator …’: Designing a clinician-educator curriculum for internal medicine residents

Background: Despite a growing demand for skilled teachers and administrators in graduate medical education, clinician-educator tracks for residents are rare and though some institutions offer ‘resident-as-teacher’ programs to assist residents in developing teaching skills, the need exists to expand training opportunities in this area.Methods: The authors conducted a workshop at a national meeting to develop a description of essential components of a training pathway for internal medicine residents. Through open discussion and small group work, participants defined the various roles of clinician-educators and described goals, training opportunities, assessment and resource needs for such a program.Results: Workshop participants posited that the clinician-educator has several roles to fulfill beyond that of clinician, including those of teacher, curriculum developer, administrator and scholar. A pathway for residents aspiring to become clinician educators must offer structured training in each of these four areas to empower residents to effectively practice clinical education. In addition, the creation of such a track requires securing time and resources to support resident learning experiences and formal faculty development programs to support institutional mentors and leaders.Conclusion: This article provides a framework by which leaders in medical education can begin to prepare current trainees interested in careers as clinician-educators.

Junior faculty's perspectives on mentoring.

The prevalence and characteristics of mentorship among junior faculty in clinician-scientist and clinician-educator tracks were evaluated. Comprehensive improvement strategies are needed.

Promotion Criteria for Clinician-Educators in the United States and Canada

Clinician-educators have concerns about their ability to be promoted and the criteria used by medical school promotion committees. To discover the criteria and methods that medical school promotion committees use to make decisions about the promotion of clinician-educators. In June 1996 we mailed a questionnaire to chairpersons of all medical school promotion committees in the United States and Canada. Of 142 schools surveyed, 115 (81%) responded; 45% of respondents had a clinician-educator promotion track. On a scale from 1 (minimally important) to 7 (extremely important), the mean importance ratings of aspects of clinician-educators' performance were the following: teaching skills (6.3), clinical skills (5.8), mentoring (5.7), academic administration (5.3), developing educational programs (5.3), nonresearch scholarship (5.1), clinical research (4.8), service coordination (4.7), and education research (4.5). Methods to evaluate each aspect of performance were rated by respondents for importance and frequency of use. The 4 most important methods for evaluating teaching were awards, peer evaluation, learner evaluation, and teaching portfolio; 70% or more of schools used these frequently or always. The 4 most important methods of evaluating clinical skills were peer evaluation, awards, trainee evaluation, and objective measures, which were used frequently or always by 78%, 65%, 58%, and 29% of schools, respectively. Clinician-educators were expected to have fewer peer-reviewed publications to be promoted than investigators (5.7 vs 10.6, P<.001). Schools with separate clinician-educator tracks differed little in survey responses from schools without such tracks. Most, but not all, promotion committees now assign high importance to the special contributions of clinician-educators and use a variety of methods to assess these, regardless of whether they have a separate clinician-educator promotion track.