Fincher, Ruth-Marie E. MD; Simpson, Deborah E. PhD; Mennin, Stewart P. PhD; Rosenfeld, Gary C. PhD; Rothman, Arthur EdD; McGrew, Martha Cole MD; Hansen, Penelope A. PhD; Mazmanian, Paul E. PhD; Turnbull, Jeffrey M. MD
Section Editor(s): Guest Editors: THE COUNCIL OF ACADEMIC SOCIETIES TASK FORCE ON SCHOLARSHIP
Dr. Fincher is professor, Department of Medicine, and vice dean for academic affairs at the Medical College of Georgia School of Medicine, Augusta, Georgia; Dr. Simpson is professor, Department of Family and Community Medicine, and associate dean for educational support and evaluation at the Medical College of Wisconsin, Milwaukee, Wisconsin; Dr. Mennin is professor, Department of Cell Biology and Physiology, and assistant dean for educational development and research at the University of New Mexico School of Medicine, Albuquerque, New Mexico; Dr. Rosenfeld is professor, Department of Integrative Biology and Pharmacology, and assistant dean for educational programs, at the University of Texas Medical School, Houston, Texas; Dr. Rothman is professor and director, education office, Department of Medicine, at the University of Toronto, Toronto, Ontario, Canada; Dr. McGrew is assistant professor, Department of Family and Community Medicine, at the University of New Mexico School of Medicine, Albuquerque, New Mexico; Dr. Hansen is professor of physiology and director, Centre for Collaborative Health Professional Education at the Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada; Dr. Mazmanian is professor, Department of Preventive Medicine and Community Health, and Associate Dean for Continuing Medical Education at the School of Medicine, Virginia Commonwealth University, Richmond, Virginia; and Dr. Turnbull is professor, Department of Medicine, and vice dean for education at the University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
Correspondence and requests for reprints should be addressed to Dr. Fincher, Vice Dean for Academic Affairs, Medical College of Georgia School of Medicine, CB-1847, Augusta, GA 30912; telephone: (706)721-3529; fax: (706)721-7244; e-mail: 〈firstname.lastname@example.org〉.
In this article, we specifically address scholarship in education, focusing on teaching and other learning-related activities rather than on educational research, which may be assessed and rewarded using the same forms of evidence as basic science or clinical research. We build on Boyer's work,1 which provides a vocabulary for discussing the assumptions and values that underlie the roles of faculty as academicians, and apply the criteria of educational scholarship of Glassick et al.,2 to assess scholarly work to determine which types of work should be rewarded. Finally, we outline the organizational infrastructure needed to support scholars in education.
Innovation, development, and change in medical education at a number of medical schools have carried with them a growing appreciation of the importance of education and teaching. At these schools broader definitions of scholarship have emerged along with corresponding changes in their respective academic reward systems. Such situations are not common, however. We observe that the definition of scholarship generally applied by medical schools is unnecessarily narrow and excludes areas of legitimate academic activity and productivity that are vital to the fulfillment of the school's educational mission. According to this narrow definition, scholarship is demonstrated only by research, peer review of results, and dissemination of new knowledge. For this reason, faculty who are essential to the core educational mission of their medical schools often are not promoted because they do not engage in accepted forms of scholarship. Yet, the same faculty may conceptualize, design, implement, or evaluate new curricula, interdisciplinary courses, assessment instruments, Web-based learning materials, and high-quality course syllabi. Others may excel as course directors, teachers, and/or highly respected role models. These educational activities may extend beyond the privacy of the classroom to the public domain, where the products of faculty educational efforts may be reviewed by peers and adopted by faculty at other schools. Some educators may be invited to share their expertise with faculty in their department or at other schools, and through presentations at regional or national meetings. Nevertheless, despite the peer review and dissemination inherent in these activities, they may not meet the current promotion criteria for scholarship.
We maintain that creative teaching with effectiveness that is rigorously substantiated, educational leadership with results that are demonstrable and broadly felt, and educational methods that advance learners' knowledge do reflect “the systematized knowledge of a learned person”3 and are consistent with the traditional definition of scholarship. As scholars, these faculty must be recognized by promotion.
PRINCIPLES, CRITERIA, AND RECOMMENDATIONS
The Group on Educational Affairs (GEA) of the Association of American Medical Colleges (AAMC) undertook a project to develop, disseminate, and facilitate the implementation of a broadened view of educational scholarship. After reviewing the evolving concepts of scholarship, the group developed four case scenarios to assess the applicability of these concepts to medical education. The cases, discussed at each of the 1999 GEA regional meetings and the 1999 meeting of the GEA and the Society of Directors of Research in Medical Education Curriculum, have been summarized4 and made available on the Internet (see 〈http://www.medlib.iupui.edu/cgea/geasclrpro.html〉). The written and oral feedback shaped development of the principles, criteria, and recommendations presented in the rest of this article. The GEA project on scholarship is predicated on the assumptions that
▪ educational scholarship can be defined;
▪ teaching and other activities supportive of learning can be scholarly;
▪ criteria, including peer review, for the assessment of scholarship in teaching and other activities supportive of learning can be refined and improved;
▪ teaching and other activities supportive of learning must be evaluated if they are to be recognized and rewarded as legitimate scholarly activities; and
▪ an organizational infrastructure for supporting educators as scholars must be developed.
Principles: Definition of Scholarship
Hansen and Roberts5 argue that scholarship is demonstrated when knowledge is advanced or transformed by application of one's intellect in an informed, disciplined, and creative manner. The resulting products must be assessed for quality by peer review and made public. In Scholarship Reconsidered,1 Boyer did not make a clear distinction between excellent teaching and teaching as scholarship. This distinction has been defined by Hutchings and Schulman,6 who argue that teaching becomes scholarship when it demonstrates current knowledge of the field and current findings about teaching, invites peer review, and involves exploration of students' learning. Essential features of teaching as scholarship include the teaching's being public, being open to evaluation, and being presented in a form that others can build upon.6 As educators who accept responsibility for fostering scholarship in teaching, we not only must recognize the relative influences of the methods we use, but also should understand the reasons some methods are more effective than others.
Applying Scholarship to Teaching
Since a sustained record of scholarship is the foundation for advancement in academia, criteria for evaluating scholarship in teaching must be defined before teaching scholars' work can be assessed. Based on the criteria gleaned from more than 130 journal editors and granting agencies, promotion and tenure guidelines, and teacher evaluation forms, Glassick et al.2 and Glassick7 distilled six criteria of scholarship that are applicable to traditional research as well as to teaching. Table 1 illustrates how Glassick's six criteria can be applied to evaluate scholarship in discovery (traditional research) and teaching.
Operationalizing the Criteria of Scholarship
Individual faculty. Teaching in various venues, including lecture, laboratory, small groups, and clinical settings, can be scholarly if appropriate evidence is presented to show that defined standards have been met. Other learning-related activities, such as advising or mentoring, developing curriculum or instructional materials, and educational administration also can be scholarly if appropriate evidence is presented. In contrast to the typical products of the scholarship of discovery (i.e., basic science, clinical, or educational research), which include grants and manuscripts that are published in the peer-reviewed literature, the products of scholarship related to education might include Web-based materials, textbook publications, curriculum units or teaching modules, continuing education presentations, curricular change, or community education. The challenge for educators is to provide the evidence that demonstrates the scholarly nature of these activities. Table 2 illustrates the kinds of evidence that can be used by educators to demonstrate that they have met Glassick et al.'s2 scholarship criteria for four common roles of educators: lecturer, preceptor in clinical settings, tutor or small-group leader or facilitator, and educational administrator. The table presents each criterion, and for each poses the associated questions that must be answered about each role to demonstrate scholarship through presentation of evidence.
Infrastructure needed to foster, assess, and reward scholarship in teaching and other activities supportive of learning. Developing the evidence associated with educational scholarship requires that departments, medical schools, universities, and professional organizations provide mechanisms to support the creation, critical review, and dissemination of educational scholars' works. Without this organizational infrastructure, faculty will continue to struggle as educators and scholars who advance knowledge within the field of medical education. Infrastructure support to advance knowledge within medical education, including scholarship in teaching, requires local institutions and national organizations to provide resources equivalent to those that support traditional basic science and clinical research. Medical schools and professional organizations have mechanisms to support peer-reviewed research, but parallel mechanisms for peer review of teaching scholarship are highly variable, particularly if the scholarly products are instructional videotapes, CD-ROMs, course syllabi, or teaching, rather than manuscripts.8
Advancing teaching scholarship requires a systematic examination of the degree to which each medical school and professional organization has the infrastructure to support faculty as educators. Bolman and Deal9 outline four “frames,” or perspectives, from which to analyze organizations based on extensive review of the organizational development literature and their broad-based consultation experiences. We believe that educators can use this frame approach to assess the adequacy of the infrastructures in their respective medical schools and their professional organizations to support teaching and education-related activities as scholarship. Based on that assessment, educators can target key features within a frame to address current needs, as Bolman and Deal report that omissions in any single frame will limit the ability of organizations and individuals to advance toward achieving their potential. Examples of features within each frame (discussed below) are provided in List 1 from both medical-school and professional-organization perspectives following an overview of the four-frame model.
Frame 1: Structural. The structural frame of a medical school and its associated academic health science center may be ascertained by viewing their organizational charts and institutional policies and procedures. These diagrams and documents indicate the positions, roles, and reporting lines of faculty, potential resources available to support teaching scholarship, and their relationships to the formal structures associated with undergraduate, graduate, and continuing education. Using the structural frame to examine organizations reveals the degree to which mechanisms are available for critical review of scholarship in teaching and to disseminate teaching products to advance knowledge in the field.
Frame 2: Human resources. The human resources frame is a way to view key variables of people's knowledge, skills, attitudes, and energy that either make or break an organization. People, in this frame, are seen as an investment toward achieving the organization's priorities. Analyzing medical schools and academic societies from the human resources frame allows educators to assess the extents to which these organizations support continuous advancement of their faculty members' knowledge, skills, and behaviors as educators.
Frame 3: Political frame. As resources within medical schools and our professional organizations become more constrained, educators must actively direct or informally influence decisions that determine priorities and resource allocations. From a political perspective, educators must utilize their power if they are to make progress within organizations that will support scholarship in teaching. Clinician and basic science educators must serve as members of formal and informal policy-setting groups, serve as members/chairs on key academic, clinical, and administrative committees, and form coalitions with other educators to effectively advocate changes needed to enhance the quality of education. Bolman and Deal argue that the political frame assumes that an organization's goals are not set from the top, but through an ongoing process of negotiation and interaction among the key players. Educators must become key players who effectively negotiate within the organization.
Frame 4: Symbolic. An organization's symbolic activities communicate its values, who its members are, and how these members are to participate in the organization. The symbolic frame focuses on the use of these symbolic activities to disclose what the organization communicates about its values and culture through its traditions, stories, myths, and rituals. Consider, for example, how publicly and how prominently educators' activities and accomplishments are displayed in our medical schools and by their academic societies. The content of meetings of departments, the faculty council, executive committees, and deans, and the content of college publications and events reveal what is valued by our medical schools. Educators must use these symbolic forms of communication to emphasize that education is a valued part of our medical schools and academic societies.
Through a systematic application of the criteria of Glassick et al. to four typical educator roles, we have illuminated the questions that faculty must ask of their work and their colleagues' work as educators to ascertain scholarship in education, particularly in teaching. Most medical schools and professional organizations lack the infrastructure to enable educators to answer these questions and thereby to put education, especially teaching, on the same level as research and other types of scholarly activities. We must evolve continuously our organizational structures, human resources activities, political coalitions, and symbols to support scholarship in education. We must create more forums for the peer review of educational materials, curricular innovations, assessment tools and instruments, standardized patient cases, and other products of educational scholarship. Our universities, medical schools, academic health science centers, and professional organizations are vital components of this infrastructure, for without them, we have no community of education scholars with whom we can share, collaborate, and exchange our work as we seek to advance the quality of education provided to our future physicians and biomedical scientists.