The Teaching Scholars Program is but a start on an interesting and worthwhile voyage—from novice to informed educator.
The Teaching Scholars Program for Educators in the Health Sciences was designed to promote the professional development of health science educators in the Faculty of Medicine at McGill University, in Montreal, Quebec, by increasing faculty members’ expertise in developing and implementing educational programs and taking on leadership roles in education.
The Teaching Scholars Program (TSP), which has been previously described,1 is a year-long program that focuses on five major themes: curriculum design and innovation, effective teaching methods and evaluation strategies, educational program evaluation, research in medical/health sciences education, and educational leadership. This program was inspired by the Teaching Scholars Program at the University of North Carolina2 and was designed to enable faculty members in the Faculty of Medicine (which includes the schools of medicine, nursing, physical and occupational therapy, and communication sciences and disorders) to enhance their educational knowledge and skills while maintaining their clinical, teaching, and research responsibilities. More specifically, the TSP aims to respond to faculty members’ needs by helping them to learn more about educational principles and methods, pursue scholarship in medical education (through curriculum development, program evaluation, and educational research), and prepare for educational leadership roles.
The TSP was developed in 1997, three years after the Faculty Development Office in the Faculty of Medicine first opened. Following a series of successful workshops and seminars that were of value in providing faculty members with knowledge and skills relevant to their roles as teachers, we realized that more intensive training, designed to enable the development of educational scholarship and leadership, was required to advance our educational mission. We were also convinced that a longitudinal program that would allow individuals to maintain many of their ongoing responsibilities would be worthwhile.
Members of the Faculty Development Office designed and implemented the TSP, which was supported by the dean of medicine and the chairs of the clinical and basic science departments. This group included the authors: the associate dean for faculty development who is a clinical psychologist by training (YS) and a medical educator who is a clinical pharmacologist (PJM), as well as colleagues from family medicine and orthopedic surgery. We had all had experience and/or training in medical education and were committed to the importance of education in a research-intensive university. The authors have both been involved in the TSP since its inception and we continue to serve as advisors to the teaching scholars.
The Teaching Scholars Program
The TSP accepts three to six faculty members annually. Since 1997, 34 faculty members from the following disciplines have graduated from this program: anesthesiology (2); dentistry (1); family medicine (4); geriatrics (1); internal medicine (2); nursing (3); obstetrics and gynecology (3); oncology (1); otolaryngology (1); palliative care (1); pediatrics (5); psychiatry (1); radiation oncology (2); and surgery (7). Three individuals are currently enrolled in the TSP and will complete the program in the fall of 2006. The majority of teaching scholars have been clinicians, involved in teaching undergraduate, graduate, and postgraduate students. Two have been basic scientists. At the time of entry, eight of the scholars held an administrative position in medical education (eg, undergraduate or postgraduate program director).
Recruitment for the TSP targets individuals from all health professions in the university and affiliated teaching hospital. Educators from all of the medical specialties, basic science departments, and schools of nursing, physical and occupational therapy, and communication sciences and disorders can apply. We circulate program descriptions to departmental chairs and divisional directors, undergraduate and postgraduate program directors, and faculty members involved in medical education. We ask potential applicants to provide a letter outlining their anticipated goals for the program, a description of their proposed educational project, and an explanation of how their involvement in the program will benefit their division or department. We also require two letters of reference, including a letter of support from the applicant’s departmental chair. The TSP selection committee includes the authors, members of the Faculty Development Office, and a representative from a basic science department, nominated by the dean. We interview all applicants and choose the teaching scholars based on their stated interest in medical education, their previous educational experience, the potential value of their educational project to both their department and the Faculty of Medicine, and the feasibility of the applicant acquiring “protected time” for the program. We also require written support from the departmental chair or divisional chief in order to ensure successful completion of the program.
The teaching scholars are expected to devote a minimum of one day a week, for the duration of one year, to complete the program. Although all of the scholars have completed the program requirements, most of them require more than a year to achieve the program objectives; “protecting” time for their course work and independent study is an ongoing challenge. As a result, we hold the TSP “graduation,” which consists of individual presentations and a celebration of excellence, 18 months after the start of the program.
The teaching scholars do not pay to participate in the program, nor do they receive a stipend for lost clinical income. However, their course work and travel to an educational meeting (or educational site of interest) are paid for by a private donation made to the Faculty of Medicine. The annual cost of this program, which includes course work, travel, and program administration by the Faculty Development Office, is approximately $25,000.
The TSP Curriculum and Program Specifics
We expect our teaching scholars to achieve competencies in several different areas: the design, implementation, and evaluation of educational programs; medical education research; and educational leadership. Moreover, while the TSP is designed to allow each scholar to tailor activities to individual needs, all scholars participate in the following four components over the course of a year:
- two university courses, primarily in the Faculty of Education;
- a monthly seminar, specifically designed for the teaching scholars;
- an educational project, which typically consists of curriculum design and evaluation or a research study; and
- faculty-wide faculty development activities, which include workshops, seminars, and medical education rounds.
Each scholar participates in two graduate courses in the Faculty of Education or another department at McGill University. Students in these three-credit courses typically meet once a week for three hours over the course of a semester. To date, the majority of scholars have taken courses in the Faculty of Education. These courses have included: Teaching and Learning in Higher Education; Instructional Design; Cognition and Instruction; Theories of Teaching and Learning; Educational Evaluation; Educational Research Methods; Qualitative Research; and Learning and Technology. A number of these courses address the theoretical underpinnings of teaching and learning and introduce the scholars to the foundations of pedagogy. Other courses are more practical in nature and help the scholars to develop a new course or educational program. For example, the course entitled Teaching and Learning in Higher Education systematically guides the scholars through the steps of course design, from the articulation of goals and objectives to the choice of content and teaching methods and the development of appropriate evaluation tools.1
At the same time, we encourage the scholars to choose courses that address their own educational needs and pertain to their educational project. Thus, they have also taken courses in the departments of English (eg, The Meaning of Literacy), philosophy (eg, Epistemology; Phenomenology), music (eg, The History of Jazz), epidemiology (eg, Randomized Clinical Trials), and management (eg, Cross Cultural Management; The Art of Leadership). The scholars appreciate the diversity of courses available to them as well as the flexibility in course selection.
Feedback on the university courses has been consistently positive. When scholars first return from their educational courses, they often report that they are overwhelmed by the “jargon” of pedagogy. However, in no time they are using a different “language” themselves and quickly impress their departmental colleagues with their new vocabulary (eg, concept maps; formative and summative evaluation). They also report that the pedagogical content applies directly to their own courses and projects and provides them with the foundation to pursue new educational initiatives from an informed perspective. One scholar reported:
My course, Theories of Teaching and Learning, should be recommended to all teaching scholars. I now feel that I have actually been “taught” something about teaching. My course also gave me a theoretical and practical basis for my project in medical education.
Another scholar added an insightful perspective:
My course, Teaching and Learning in Higher Education, was outstanding. I was initially leery as it seemed quite “touchy-feely.” However, it contained literally everything needed to develop, teach, and assess a course. It struck a perfect balance between theory and practice.
We meet on a monthly basis with the teaching scholars as a group, to review their educational projects, to discuss issues of common interest (eg, methods of student evaluation; qualitative research methods), and to examine topics that arise from the university courses (eg, theories of teaching and learning). These two-hour meetings also facilitate the development of a “community of practice” among the scholars3 and help to promote reflection on educational issues and problems. Once a year, we hold a teaching scholars “alumni meeting” and current scholars have an opportunity to hear what previous scholars have achieved. They also learn how the graduates’ educational projects and responsibilities have evolved over time. In addition, we have incorporated educational journal clubs (where scholars review an educational article of interest to the group) and discussions with visiting speakers into the monthly seminars. Most meetings also provide opportunities for individual mentorship and peer support.
Feedback from the scholars has indicated that they appreciate the opportunity to sit behind closed doors with one another and reflect on teaching and learning, their educational projects, and their ongoing teaching encounters. One scholar noted:
The overall benefit of the program was the existence of a safe space with mentors and peers in education, where I was encouraged and supported to try new things and new ideas.
The scholars seem to particularly welcome the mutually respectful nature of the meetings, the time away from other professional responsibilities, and the support they receive from their peers. Another scholar made the following observation:
The monthly meetings provided a structure and time frame for having to complete certain steps in the program planning process. As time was a factor for me, these meetings were a motivating factor toward organizing my time and efforts. The dialogue with the other scholars was also very important and helpful, and the sense of camaraderie was particularly rewarding. I have now developed a rapport with two people in the group that will be sustained in the future.
Independent study is a key component of the TSP. Originally, we expected all scholars to design and conduct a research study in medical education. However, we quickly realized that many of the scholars wanted to design a new course or curriculum for their students, residents, or peers, and that a completed research project was not feasible within the constraints of a one-year program. Thus, we modified the parameters of independent study to include an educational research project or the development and evaluation of a curricular initiative (eg, a trauma course for medical students, an orthopedics course for primary care physicians, an ambulatory rotation in medicine, co-tutoring in a basis of medicine course, and problem-based learning in surgery). To date, 22 (62%) of the scholars have focused on curriculum design and evaluation during the TSP.
The overriding goals of the educational projects are to encourage the scholars to focus on a departmental need, to buttress the principles discussed in the university courses, and to promote scholarly activity in education. A sample of the scholars’ educational projects is presented in List 1. Although many of the scholars alter their topic of study during the first few months of the program, and many find it difficult to secure time to devote to their projects, they all value the opportunity to focus on a subject that is relevant to them and their department, that enables the integration of course concepts and educational experiences, and that promotes “learning by doing.” For many, their educational project is also a critical factor in their understanding of the value of research in medical education. One scholar described the benefit of the educational project in this way:
My TSP project has been very helpful. It has allowed me to apply what I have learned in the education courses in real time, so that my learning in these courses was highly valued by both trainees and staff in the department. It was also seen as filling an important training need, and I am now viewed as a resource person in this field.
Faculty development activities
The Faculty Development Office in the Faculty of Medicine at McGill University sponsors a variety of activities designed to assist faculty members in their multiple roles (eg, educators, researchers, administrators) and to promote excellence in teaching and learning. Faculty-wide workshops and seminars form an important component of the TSP year, and teaching scholars are encouraged to participate as facilitators or participants. Sample workshop topics include: Advanced Clinical Teaching Skills; Designing Successful Workshops; Evaluating Students and Residents; Giving Feedback; Leadership Skills for Health Care Professionals; Promoting Interaction in Teaching and Learning; Teaching and Evaluating Professionalism; Teaching Technical and Procedural Skills; Teaching When There’s No Time to Teach; and Writing For Excellence in Medical Education.
All of the scholars participate in these activities, with each scholar averaging attendance at three or four workshops during the TSP year. At the beginning of the program, the scholars generally participate as small-group members; by the end of the year, the majority function as co-facilitators and participate in the design and delivery of the educational session. Feedback on this activity has demonstrated the value of witnessing what goes on behind the scenes, observing experts in action, acquiring new skills, and better understanding the process of designing a faculty development workshop. One scholar observed:
Taking part in the faculty development workshops should be viewed as an integral part of the TSP. Taking part as a facilitator is completely different from attending, and you get to apply some of the skills learned in the education courses, while gaining a better understanding of how faculty development works from the inside.
The scholars also participate in medical education rounds, which are offered four to six times a year. These two-hour rounds, which bring together faculty members interested in innovations and research in medical education, have been particularly beneficial in introducing the scholars to a community of medical educators. The remark, “I never knew so many people in our Faculty were interested in medical education,” is frequently heard after one of these sessions.1
To assess the benefits and outcomes of the TSP, all scholars complete an end-of-year questionnaire. We also survey them one year after program completion and the program advisors maintain field notes. In addition to this ongoing assessment, we conducted a follow-up survey and curriculum vitae (CV) analysis of 26 scholars in 2003, with a focus on new educational initiatives, roles and responsibilities, and scholarly activities in medical education.
Evaluation data from the first three cohorts of scholars, which have been published previously,1 were organized in response to two guiding questions: (1) what were the scholars’ and advisors’ perceptions of the program’s strengths and limitations (ie, process evaluation); and (2) were the scholars able to accomplish what they had set out to do (ie, outcome evaluation)? For the purpose of this description, we will report on new educational roles and responsibilities, new educational and scholarly activities, and perceived benefits and outcomes of the TSP. These findings are based on summaries of the one-year follow-up questionnaires completed by the scholars who participated in the program between 1997 and 2004 and the CV analysis conducted in 2003. We will also discuss perceived limitations and unanticipated outcomes of the TSP.
New educational roles and responsibilities
The CV analysis of 26 scholars who participated in the program between 1997 and 2003 showed that 15 of the teaching scholars (60%) have taken on new roles and responsibilities in medical education since completing the TSP. Two former scholars (8%) became associate deans in the Faculty of Medicine, seven (27%) became program directors at the undergraduate or postgraduate level, six (23%) were named directors of major curricular initiatives, and one (4%) took on a major leadership role in a national organization.
Nine of the scholars (35%) became members of our renewed Centre for Medical Education, with two involved as Core Faculty (devoting one day a week to medical education activities at the Centre) and seven as Centre Members (devoting at least one day a month to Centre activities). The Centre for Medical Education at McGill University strives to promote excellence and scholarship across the continuum of health professions education by serving as a resource for curriculum development and innovation, stimulating interest in educational research and development, advancing the field of health professional education through scholarship, and ensuring that research informs educational practice. Members of the Centre are involved in educational planning, curriculum design, and program evaluation; faculty development and educational consultations; research in health professions education; mentorship of students, residents, fellows, and colleagues; and dissemination of educational innovations and research findings.
In addition to these new roles and responsibilities, 24 of the scholars (92%) who participated in the program between 1997 and 2003 became involved in new educational committees at multiple levels, including their hospital departments, the university, regional organizations, and national societies. For example, a number of scholars became members of departmental training committees, university committees devoted to educational issues (eg, a Task Force on Teaching Dossiers), and examination committees of the Royal College of Physicians and Surgeons of Canada.
New educational and scholarly practices
Follow-up data indicated that the majority of teaching scholars continued their involvement in teaching medical students, residents, or graduate students, and they all maintained the changes that they had implemented in their teaching practices (eg, systematic formative and summative evaluations of students and residents). All of the scholars who had developed a course or program during the TSP continued to deliver their curricular initiative, with ongoing refinements and modifications. In addition, 20 scholars (80%) developed new courses, and 13 (50%) designed faculty development activities for their own departments. The majority also continued to participate in faculty-wide faculty development activities, as participants or facilitators. Sixteen scholars (62%) reported that they had become an important resource for their colleagues and were viewed as educational leaders in their own departments, as exemplified by the following comment:
The TSP has had a huge impact. I am now an informed educator and can contribute when educational issues arise in my department or at national association meetings.
Twenty-three scholars (90%) have presented aspects of their TSP educational project at a national or international educational meeting. In addition, many became regular attendees of such meetings (eg, the annual meeting of the Canadian Association for Medical Education) and continued to present their scholarly work in these settings.
Eight of the scholars (31%) applied successfully for educationally related grants during the TSP. Six (23%) received additional grants after the completion of the program, and 13 (50%) continued their involvement in educational research. Nine individuals (35%) have published their teaching scholars’ projects in peer-reviewed journals, for a total of 18 publications. Five of the scholars (19%) have pursued advanced studies following their year as a teaching scholar. One completed a masters in education, one received a masters in business administration, and another concluded a masters in public administration. One scholar registered for our newly formed masters in educational and counselling psychology, with a focus on health professions education, and one is a PhD student in philosophy. In many ways, the TSP laid the foundation for further learning and professional growth for these scholars.
Perceived benefits and outcomes
In reviewing the scholars’ year-end and follow-up questionnaires, we noted three major areas of perceived impact: increased knowledge and skills, introduction to a “community of practice,” and new career paths and opportunities.
All of the scholars reported that the TSP had an impact on them as medical educators and that the program had expanded their knowledge and skills in educational theory and techniques. One scholar observed:
The TSP provided me with insight into better teaching methods, evaluation strategies, and the foundations of educational practice. It has given me the language and confidence to pursue wider goals and continue to grow as a teacher.
Many also commented on the fact that the TSP “allowed” them to focus on developing these skills and characterized the TSP as a “transformational opportunity.” The following comment illustrates this phenomenon:
The program has certainly had an impact on me as an educator. The humbling experience of being a student has increased my awareness of the “other side.” I have a renewed appreciation for how hard it can be to figure out what the teacher wants in an assignment and how competing goals challenge the time and effort one can invest in a particular course. In addition, I have more insights into the rationale behind the teaching methods that I will now continue to use and I have aborted other methods in light of new knowledge.
One of the most significant outcomes of the TSP is exemplified by the following observation of a recent graduate:
I think that the TSP’s greatest impact is my increased awareness of the medical education community at McGill and the educational projects that are being undertaken.
Most of the scholars remarked upon the benefit of meeting “like-minded colleagues” and being introduced to a network of medical educators. One scholar noted:
I became a part of a family of educators during my year as a teaching scholar. I met many individuals, within the medical community and beyond, who will serve as resource persons for educational and non-educational matters in the future.
Another scholar made a similar comment:
I was introduced to a culture of continuing education, excellence and development, created by the Faculty Development Office, the teaching scholars, and the Faculty of Education.
A growing awareness of a community of educators, and an increasing sense of belonging to this community, was noted by most of our teaching scholars.
Eighteen of the scholars (70%) observed that the TSP helped them to embark upon a new career path and develop new domains of academic activity. As one graduate commented, “I came in to the program wanting to learn more about teaching and learning. At the end, I was committed to education as a career goal.” Another graduate affirmed that “the TSP facilitated an important change in my career. Were it not for this program, I would have likely left academic medicine.” Others noted that the TSP reinforced their commitment to medical education and they left the program with a sense of “renewed energy and dedication.” A number of scholars also highlighted how the TSP increased their feelings of “confidence and expertise,” as exemplified in the following quote:
The TSP allowed me to expand my knowledge in a field that had little attraction for me at the beginning of my career. I am now “turned on” to medical education and hope to continue to contribute here at McGill as well as in my own discipline.
A scholar who has left McGill to take on a leadership role in a national organization indicated that:
The McGill Teaching Scholars Program has been an incredible transformational opportunity for me. Although my career plans have changed since the time I completed the program, the TSP is allowing me to have a greater impact on the national scene than would have otherwise been possible.
We believe that the following sentiment best captures the overall experience of many of our scholars:
The TSP provided me with an opportunity to work closely with dedicated and supportive experts in the field of medical education; to learn from four other like-minded scholars from other departments; to take formal courses in education, all of which have increased my confidence in improving my teaching ability and satisfaction throughout my academic career; and to develop a project from an original idea and see it through to completion. I now find myself on a new education track for the future that I did not think was possible before entering the TSP.
The Faculty of Medicine has clearly benefited from the skills and expertise acquired by the teaching scholars, many of whom have become agents of change. The TSP has also had several unanticipated consequences at an organizational level. For example, interest in the TSP among residents and fellows has led to the development of a Postgraduate Fellowship in Health Sciences Education. This year-long program is modeled after the TSP and is designed to prepare McGill postgraduate trainees for educational roles in academic medicine. More specifically, it aims to enhance participants’ knowledge and expertise in educational principles and practices and develop skills and expertise in health sciences education research. Since 2003, we have welcomed five postgraduate fellows, many of whom participate in the same education courses as the teaching scholars. The TSP scholars’ participation in university courses, given by members of the Faculty of Education, has also opened channels of communication that have led to the development of a masters in educational and counselling psychology, with a focus on health professions education.
The Teaching Scholars Program at McGill resembles many others4–6 in its emphasis on independent study, peer support, and the maintenance of ongoing responsibilities. Our program also aims to move beyond the improvement of teaching skills by providing a foundation for educational leadership and scholarship. It is novel in that our scholars can apply from all schools and departments in the Faculty of Medicine, teach at all levels of the educational continuum, participate in university courses, and are encouraged to attend an “outside” conference or course. The program’s major limitation is time, both in terms of the scholars’ time and the length of the program. As one scholar commented, “The program was over just as we were getting into our stride.” Ideally, we would like to be able to increase the scholars’ time commitment to the program, allocate more resources to help each scholar design and implement a research study in medical education, and ensure dissemination of scholarly findings, both through verbal presentations and written publications. However, this program (as all others) needs to match the culture and context of the organization in which it operates, and the year-long commitment is a significant one for the members of our Faculty of Medicine.
In looking ahead, we intend to continue to build on the TSP’s strengths and encourage our teaching scholars to pursue scholarship in medical education by promoting the scholarship of teaching, discovery, integration, and application.7 We also hope to maintain this “community of practice” and support our scholars in their evolution from novice to informed educator. Sir William Osler once observed, “It goes without saying that no man can teach successfully who is not at the same time a student.” In many ways, this is the strength of our program.
The authors gratefully acknowledge the Henry and Berenice Kaufmann Foundation for financial support of the Teaching Scholars Program; Drs. Louise Nasmith and Larry Conochie for their initial involvement in this year-long program; Dr. Cynthia Weston and colleagues in the Faculty of Education for contributing to the scholars’ development; Dr. Susan Lieff for her insightful observations of the McGill Teaching Scholars Program; Ms. Maureen Leaman for administrative support and collection of the evaluation data; and participating teaching scholars, for their commitment to excellence in teaching and learning. For further information about our Teaching Scholars Program for Educators in the Health Sciences, please contact ([email protected]) or visit the program’s Web site at (http://www.medicine.mcgill.ca/facdev/).