Expertise, needs and challenges of medical educators: Results of an international web survey

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  • 2010; 32: 912918

    Expertise, needs and challenges of medicaleducators: Results of an international websurvey

    SOREN HUWENDIEK1, STEWART MENNIN2, PETER DERN3, MIRIAM FRIEDMAN BEN-DAVID4,5y,CEES VAN DER VLEUTEN6, BURKHARD TONSHOFF7 & CHRISTOPH NIKENDEI8

    1University Childrens Hospital Heidelberg, Germany, 2University of New Mexico School of Medicine, USA,3University Freiburg, Germany, 4Centre for Medical Education, UK, 5Tel Aviv University Sackler School of Medicine, Israel,6Maastricht University, The Netherlands, 7University Childrens Hospital Heidelberg, Germany, 8University of HeidelbergMedical Hospital, Germany

    Abstract

    Background: Little is known about how medical educators perceive their own expertise, needs and challenges in relation to

    medical education.

    Aim: To survey an international community of medical educators with a focus on: (1) their expertise, (2) their need for training

    and (3) perceived challenges.

    Methods: A web-based survey comprising closed and open free-text questions was sent to 2200 persons on the mailing list of the

    Association for Medical Education in Europe.

    Results: Of the 2200 medical educators invited to participate, 860 (39%) from 76 different countries took part in the survey.

    In general, their reported areas of expertise mainly comprised principles of teaching, communication skills training, stimulation

    of students in self-directed learning and student assessment. Respondents most often indicated a need for training with respect

    to development in medical-education-research methodology, computer-based training, curriculum evaluation and curriculum

    development. In the qualitative analysis of 1836 free-text responses concerning the main challenges faced, respondents referred

    to a lack of academic recognition, funding, faculty development, time for medical education issues and institutional support.

    Conclusions: The results of this survey indicate that medical educators face several challenges, with a particular need for more

    academic recognition, funding and academic qualifications in medical education.

    Introduction

    Over the last 20 years, academic medicine has entered a

    period of uncertainty and decline, which has given rise to

    widespread alarm (Clark 2005; Sheridan 2006). An interna-

    tional campaign to revitalize worldwide academic medicine

    was launched by the British Medical Journal, the Lancet, the

    Canadian Medical Association Journal, the Dutch Journal

    of Medicine, the Medical Journal of Australia, the Croatian

    Medical Journal, the Academy of Medical Sciences and others

    (Tugwell 2004). Within this movement, the major role of

    medical education in fostering change in the quality of health

    care became apparent. In a report from the Institute of

    Medicines Committee on the roles of academic health centres

    in the twenty-first century (Cox & Irby 2006), it was observed

    that among all of the academic health centre roles, education

    will require the greatest changes in the coming decade. This

    awareness is mirrored by the increasing interest shown

    by leading medical journals in publishing special medical-

    education issues or running series on medical education

    (Tugwell 2004; Clark 2005; Golub 2005; Cox & Irby 2006).

    Astonishingly, while medical educators are aware of the

    Practice points

    . Little is known about how medical educators perceivetheir own expertise, needs and challenges in relation to

    medical education.

    . In this international web-based survey, most medicaleducators reported a need for training with respect to

    development in medical education research methodol-

    ogy and computer-based training.

    . Medical educators perceived a lack of academic recog-nition and funding as the main challenges to medical

    education.

    Correspondence: S. Huwendiek, Department of General Paediatrics, University Childrens Hospital Heidelberg, Im Neuenheimer Feld 153, D-69120

    Heidelberg, Germany. Tel: 49 6221 5638368; fax: 49 6221 5633749; email: Soeren.Huwendiek@med.uni-heidelberg.deyThis article is dedicated to our deceased colleague Miriam Friedman Ben-David, whose heartiness and vision impressed and continues to inspire

    us up to this very day.

    912 ISSN 0142159X print/ISSN 1466187X online/10/1109127 2010 Informa UK Ltd.DOI: 10.3109/0142159X.2010.497822

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  • current situation of medical education and they play a major

    role in changing and preparing medical education for the

    coming decades, very little is known about their views on their

    own situation, their needs or the challenges which they face.

    We therefore surveyed an international community of

    medical educators focusing on three aspects: (1) their exper-

    tise, (2) their need for training and (3) the challenges they

    perceived.

    Methods

    Development of the survey instrument and testing

    The questionnaire was developed based on five focus groups

    of medical educators (46 participants each). Five cognitive

    interviews were conducted to test uniformity of comprehen-

    sion with respect to the questions included. We additionally

    conducted a pre-test using the web-based questionnaire based

    on a sample of 30 medical educators. The final web-based

    questionnaire (commercial survey tool) took approximately

    20min to complete and comprised two open questions and

    34 closed questions designed to elicit medical educators views

    on their expertise, need for training and challenges.

    The first set of seven items was used to collect demo-

    graphical data: age, gender, country of residence, professional

    background, professional status, academic title and number of

    years of employment in health professions. Two further

    questions referred to medical education degree earned or

    planned and the number of years of active involvement

    in medical education. Items concerning participants work

    setting and the role played by medical education in their work

    specifically related to the organizational unit of work; the

    proportion of work devoted to medical education (including

    teaching, evaluation, administrative work, research in medical

    education), clinical work and research other than in medical

    education; the amount of time outside working hours devoted

    to medical-education activities including preparation; the

    degree of emphasis on medical education in their institution;

    and personal interest in medical education. Two questions

    addressed research output in medical education, specifically

    asking about the number of articles published as first author

    and as co-author. Expertise and educators need for training

    were also explored. Expertise was rated for 12 important

    domains of medical education using a 5-point Likert scale

    (1 very low; 5 very high): general principles of teaching,stimulating students in self-directed learning, facilitating

    problem-based learning as a tutor, technical-skills training,

    communication-skills training (e.g. giving feedback), devel-

    opment and/or usage of computer-based training, tutor

    training, mentoring, curriculum development, student

    assessment, course and curriculum evaluation and research

    methodology in medical education. A different type of

    question required respondents to select a maximum of 6 out

    of 12 areas of medical education in which they perceived a

    special need for further training. This question was followed

    by four items in which respondents used a 5-point Likert scale

    (1 very low; 5 very high) to rate their need for: experi-enced senior medical educators as role models in their

    institution, financial support for medical-education projects

    at their institute, national and international networking with

    medical educators and more recognition for their medical-

    education work in their institution. Respondents were also

    invited to provide free-text responses with regard to the three

    main problems they face as a medical educator and for which

    they feel a special need for support and/or change. In a final

    item, respondents used a 5-point Likert scale (1 very low;5 very high) to rate the extent to which they consideredthemselves to be medical educators.

    Administration of the survey

    On two occasions between August and September 2005,

    an email was sent by the office of the Association of Medical

    Education in Europe (AMEE, www.amee.org) to all addresses

    on the AMEE mailing list, comprising AMEE members and

    AMEE conference visitors (n 2200). The email contained anintroduction to the survey and a link to the web-based survey

    tool. There were no additional e-mails or phone contacts.

    Study population

    All persons on the AMEE mailing list (n 2200) were invitedto participate. AMEE has an explicit international focus, and

    the AMEE conference represents the largest international

    medical education meeting worldwide.

    Statistical analyses

    Percentages were calculated for demographical data. For age,

    involvement in medical education and working experience

    in a health profession, mean values were calculated in terms

    of number