On whose shoulders we stand: lessons from Exemplar medical educators

Abstract

The hiring of educators in medical schools (faculty who study the educational process and prepare others to become educators) has been one of the most successful educational innovations ever. Starting in 1954, through a collaboration between the Schools of Medicine and Education at the University of Buffalo, the innovation has spread to over half of the medical schools in the United States and to medical schools in several other countries. Practically every medical school and specialty now hires educators to conduct faculty development, evaluate learners, and develop or revise curricula. This article focuses on lessons learned by six-first-generation educators hired in medical education. These individuals made unique contributions that improved the process of educating and evaluating future physicians. Among their most important contributions have been the use of standardized patients, faculty development to improve instruction, and the use of clinical decision making theory. In addition, these professional educators created a home and career path for other professionals and nurtured protégés to continue the work they started. Ten lessons are reported from structured interviews using a standardized protocol. These lessons will hopefully inform current and future medical educators to help them sustain the effective collaboration between medical schools and educators.

The evolving field of medical education research

“…The field's inaugural goal was to improve the quality of learning in medical schools, recognizing the great potential of incorporating basic educational principles to improve medical teaching practices [4, 5]. While this general goal remains central to today's research, it continues to evolve into more specific realms of teaching, curriculum, assessment, program evaluation, education theory, etc.…”

“…The formal inception of medical education research into various medical schools across North America and the United Kingdom began in the 1950s [4, 5, 8, 9]. These early origins hailed from two straightforward ideas: 1) the quality of medical education could be improved; and 2) the expertise needed to achieve improvement extended beyond clinical competence [4].…”

“…These early origins hailed from two straightforward ideas: 1) the quality of medical education could be improved; and 2) the expertise needed to achieve improvement extended beyond clinical competence [4]. While these were important building blocks, the field really began to expand in the U.S. in the 1960s, because of a rise in student demand, the students themselves were beginning to insist upon improved assessment and training strategies and the allocation of federal funding for innovations in medical education [5].…”

“…Early research efforts typically arose through small‐scale collaborations between Schools of Medicine and professional educators. These efforts tended to focus on local program evaluation as individual schools sought to assess the quality and effectiveness of their pre‐existing curricula [4, 5, 8]. To do so, the field's pioneers began to venture more broadly into areas of education theory, probing a variety of topics including the link between education and professional competency [10], the interaction between teacher and student [11], and the potential advantages of novel teaching and assessment methods [12, 13].…”

“…Discipline‐based academics began collaborating with the clinicians and educators in the health professions, each group providing alternative and complementary perspectives on issues inherent in teaching medicine and providing a variety of formal research techniques to allow study into the practical problems of the field with increasing rigor [16, 17]. These collaborations among traditionally detached fields were innovations in themselves and laid the groundwork for the even more diverse scope that currently encompasses the field [5].…”