Blatt, Benjamin MD; Plack, Margaret PT, EdD; Suzuki, Mari MD; Arepalli, Sruthi; Schroth, Scott MD, MPH; Stagnaro-Green, Alex MD, MHPE
Dr. Blatt is professor of medicine, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Dr. Plack is professor of physical therapy, Department of Physical Therapy and Health Care Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Dr. Suzuki is a first-year resident, Department of Internal Medicine, New York Hospital Queens, Flushing, New York.
Ms. Arepalli is a fourth-year medical student, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Dr. Schroth is senior associate dean for academic affairs and associate professor of medicine, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Dr. Stagnaro-Green is senior associate dean for education, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Correspondence should be addressed to Dr. Blatt, CLASS Clinical Skills Center, The George Washington University School of Medicine and Health Sciences, 900 23rd St. NW, Suite 6216, Washington, DC 20037; telephone: (202) 994-8598; fax: (202) 994-0328; e-mail: firstname.lastname@example.org.
The recruitment and retention of junior faculty is a daunting process, especially given the challenges presently confronting academic medicine.1,2 New faculty are entering a revenue-driven environment focused on clinical productivity and grant procurement at a time when health care reform legislation promises to transform the practice of clinical medicine. In addition, they are fulfilling the educational core mission of an academic health center—training the next generation of clinicians.3,4 Faculty physicians must negotiate this complex landscape while sometimes receiving lower income than their colleagues in clinical practice.
To generate interest in careers in academic medicine, experts recommend early exposure, clarification of misperceptions, and delineation of clear career pathways.5–7 Medical students—who are in the process of considering, testing, and exploring career options—are an obvious group to target. Interestingly, the pathway to a career as a clinician or funded researcher is relatively well delineated, as medical schools and national organizations offer students opportunities to participate in student interest groups and research experiences. Few avenues exist, however, for students interested in medical education to become actively involved with medical educators beyond the classroom. The lack of a clear pathway to a career as a clinician–educator is particularly troubling given the current national-level focus on curriculum reform, competency-based education, and innovative pedagogical techniques—all of which require trained professionals for successful design and implementation.
Perhaps the most common way in which students are exposed to medical education careers is through involvement as representatives on curriculum committees. This exposure is limited in scope, though, and typically includes few students in a given class. Other approaches include summer medical education leadership programs8 and medical schools’ structured scholarly concentrations (SCs) or track systems. SCs, some of which span all four years of medical school, enable students to elect longitudinal experiences in education, research, global health, and other areas, depending on their interests.9 Initially, most SC programs focused on basic or clinical research, but a number of schools have recently implemented SCs in other domains, including medical education.10–13
A venue with rich potential for exposing medical students to careers in medical education is the annual medical education conference, which is a principal source of educational scholarship, networking, collaboration, and information sharing. Attendance at such a conference offers students opportunities for career-specific learning, skill development, role models, positive and encouraging learning environments, and networking, all of which can have a positive effect on career choice.6 To harness the March 2011 Northeast Group on Educational Affairs (NEGEA) annual retreat’s career-building potential for medical students, we incorporated a student track, with an array of events in which they could become actively involved.
For students who attend a school with a medical education SC, participating in a student track of a medical education conference fits nicely with their concentration. Because most SCs require scholarly products, a conference student track complements the SC by providing a means for students to present their work, thus fulfilling the peer-review and dissemination elements of scholarship. In addition, a student track enables students to acquire experience, knowledge, and skills through participation in activities specially designed for and focused on them. For students who attend schools without medical education SCs (the vast majority), a student track may serve as the only introduction to careers in medical education.
In this article, we describe how we instituted the NEGEA conference’s first student track and provide guides for building future student tracks based on our experience and the constructs of social cognitive career theory (SCCT). This theory, which was developed in nonmedical fields, has emerged in the medical literature as a useful means for anchoring career-building efforts in medicine.7 To the best of our knowledge, no other student career-building program nested within a medical education conference has been described in the literature.
The NEGEA Student Track
The March 2011 NEGEA annual retreat theme was international medical education, and most events occurred over a Friday and Saturday. In keeping with NEGEA tradition, the conference took place in the facilities of the sponsoring university—The George Washington University School of Medicine and Health Sciences (GW)—to enable educators to become familiar with other universities within the region and help minimize costs. With the consent of the NEGEA Steering Committee, in 2010–2011, three GW faculty (B.B., A.S.G., W.S.S.) and 10 GW student volunteers (including M.S. and S.A.) formed the GW Student Track Planning Committee to recruit student participants from the region and to develop, implement, and evaluate a special student track at the conference. The goal of the track was to build interest in careers in academic medicine and energize the conference through faculty–student interactions.
Design of the student track
To facilitate student exploration of a career in medical education, we designed the student track to engage students in the standard conference activities (plenaries, workshops, networking) as well as in activities developed exclusively for students, such as question-and-answer sessions with plenary speakers and opportunities to serve as apprentice poster judges (Chart 1).
Recruitment of participants
To recruit students to participate in the track, we placed an announcement on the conference Web site and e-mailed the NEGEA listserv and local branches of the American Medical Student Association. In addition, two faculty members (B.B., W.S.S.) contacted colleagues at other institutions and asked them to identify and invite interested students. We found this to be our most effective recruitment method. Finally, NEGEA Steering Committee members also recruited students. To encourage and facilitate student attendance, we offered students the following incentives: a reduced conference registration fee ($50), free housing (through GW students willing to lodge guests), and free meals.
Overall, 35 students attended, representing over 20% of the 160 conference registrants. (The other attendees included two residents; the rest were faculty.) Participating students had an average age of 26 years (range 22–37 years), and the majority were female (n = 26; 74%). One student track participant was a premedical student from Cornell University; the rest were medical students representing all years of study (10 [28%] first year, 5 [14%] second year, 8 [23%] third year, and 11 [31%] fourth year). Participating medical students attended Columbia University College of Physicians and Surgeons, GW, Howard University College of Medicine, Jefferson Medical College of Thomas Jefferson University, Stony Brook University School of Medicine, Touro College of Osteopathic Medicine, Tufts University School of Medicine, University of Connecticut School of Medicine, University of Massachusetts Medical School, University of Medicine and Dentistry of New Jersey, Warren Alpert Medical School of Brown University, and Yale University School of Medicine.
Guides for Planning Student Tracks
In considering how we might enhance future student tracks, we reflected on our experience and drew from SCCT. Below, we offer guides for recruiting and designing student tracks and share lessons learned. Although our focus is on medical education, we believe the suggestions they present will be useful for educators planning conference-based student tracks in any field.
A guide to recruiting participants
The recommendations in the following guide are generalized from our experience and participant input regarding recruiting students:
* Solicit student participation early in planning committee activities. Enlist students in important roles in designing and implementing the student track.
* Design the conference to be low cost for students and, if possible, provide free student housing and meals.
* Emphasize opportunities to engage with faculty and students from other institutions in a nonthreatening, learner-centered environment
* Identify and target students with a special interest in the conference topics. (Most of our attendees had prior interest in medical education.)
* Target other students by emphasizing the general value of a medical education conference. (We emphasized the usefulness of teaching, leadership, and medical education research skills to any academic career.)
* Make personal and direct contact with faculty at other institutions to tell them about the student track and ask them to identify and invite interested students. (This was our most successful means of recruitment.)
A guide to designing student tracks
As we considered ways to maximize the potential long-term impact of a student track, we looked to SCCT. SCCT has long history in nonmedical fields and has built an evidence base to support its effectiveness in predicting career choice and success.5 Because of its predictive value, SCCT can be used to guide the development and estimate the long-term career influence of a student track such as ours.
SCCT contends that the interaction of personal characteristics with the environment results in experiences that can affect future career choices and work performance. These experiences exert their effect through influencing self-efficacy (the belief in one’s ability to succeed) and outcome expectations (the belief that a career choice will lead to valued outcomes).5,14,15 SCCT proposes that four factors can strengthen self-efficacy and outcomes expectations: personal success experience, exposure to successful role models, social and verbal persuasive communications, and positive emotional reactions (as would be elicited by a supportive learning climate).5,7 To promote career building through a medical education conference, it then follows that planners should aim to fully incorporate each of these factors into the student track experience. In Table 1, we present a guide for planners. In it we populate each of the four factors with features that, from our experience, we believe will help planners realize this goal.
Other considerations for designing effective student tracks
In reflecting further on our experience with the NEGEA student track, we identified concerns that should be addressed when creating a new program. First, although our track addressed the four SCCT factors, it is unclear whether it addressed them optimally. Many students’ comments indicated that they would have liked the conference to have provided them with more opportunities to develop self-efficacy and interact with faculty role models. Planners of future student tracks should consider ways to maximize these opportunities and to evaluate their quantity and quality.
Second is a concern about barriers, which, as noted by Lent and colleagues,16 prevent students from pursuing educational exposures and may influence career choices. Although we recognized the need to provide a low-cost conference with housing and food included, we did not address financial and other barriers to career choice and progression beyond the conference. Student track planners should consider including programming that addresses these barriers. Also, studies are needed to clarify the barriers and supports that may most influence the decision to choose a career in medical education.
Third, as our student track was a one-time event without built-in follow-up, it could not offer the reinforcing benefits of a continuity experience. Without reinforcement, the inspiration that students glean from attending a conference may dissipate when they return to their home institutions. SCCT theorists emphasize the importance of continuity for effective career building.5,7 Continuity provides repeated exposure to opportunities that SCCT deems critical to optimizing student career interest.6 From such exposure comes the chance for in-depth understanding of the scope of a medical education career, clarification of potential misperceptions, and bonding with role models.6,17 Continuity experiences can also promote ongoing goal setting, which is an important predictor of career choice.6,17
Considering the value of continuity through mentoring,18 we recommend that future student tracks be designed as springboards for participants’ further development in medical education at their home institutions. Continuity may be arranged through faculty advisor relationships with medical educators, perhaps the very educators that sponsored their attendance at the conference. It may also be promoted by participation in formal students-as-teachers programs, which as of 2010 were offered by 43% of medical schools.19 Better still is the continuity provided when a student track is integrated with a medical school SC in medical education. In doing so, the annual conference student track can become part of a comprehensive model to support students in their journey toward a medical education career. Ideally, SC student participation should be yearly and progressive, with increasing involvement in medical education conferences as students advance through their concentration. For example, first-year medical students could focus on gleaning information and skills from conference workshops and from others’ scholarship, while more advanced medical students might focus on their own scholarship through submitting and presenting posters, workshops, and papers.
In conclusion, our experience suggests that a student track nested in an annual conference may be of value in illuminating the pathway toward a career in medical education. For students, as for educators, the annual conference provides an avenue for scholarship as well as a venue to connect with others and establish an identity within the community of practice of academic medicine.
Acknowledgments: The authors wish to thank Ms. Laura Abate for her help in researching the literature. The authors also wish to thank the NEGEA Steering Committee (Elza Mylona, PhD, chair)—without their help the student track and this article would not have been possible.
Other disclosures: None.
Ethical approval: Not applicable.
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