Stephen Abrahamson of UCLA discussed in his 1996 review article on medical education that medical education since World War II was increasingly short changed due to competing research and clinical priorities (1). In response to this “short changing,” many schools developed teaching scholars programs. In 1974, both the U.S. Federal Government and the Robert Wood Johnson Foundation helped fund parallel teaching scholars programs in family medicine programs. From 1974 to 2006, several major universities participated: University of California Los Angeles, University of Michigan, University of Pennsylvania, Yale University, University of North Carolina, University of Washington, University of Chicago, and Johns Hopkins University. Many of these programs expanded from Family Medicine to other medical school departments and health sciences disciplines with the emphasis of studying health care policy and studying patient care research (2). Although these programs were very successful, these programs did not have the major goal of directly improving teaching and encouraging scholarship of education in the health sciences.
Across the U.S. and Canada, numerous universities developed programs to directly address improving teaching and encouraging scholarship of education in the health sciences. These programs developed through various venues. Many schools developed formal faculty development programs and established formal offices of medical education. Some universities formed Medical Education Scholars Programs (MESP) (3). Other universities formed programs called “Academies” (4) and other universities referred to their faculty development programs as “grassroots programs” (5). Dartmouth University reported indirectly developing scholar-like programs by developing the supporting infrastructure to “accelerate” educational research productivity (6).
A search of the medical education literature revealed that numerous universities initiated formal Teaching Scholars Programs which were most often formed within specific departments, most often within departments of internal medicine. The medical education literature contains reports on such programs at several universities: Harvard, USCF, McGill, UCLA, University of Michigan, University of Washington, Johns Hopkins, and University of Iowa. Teaching Scholars Programs were also developed by the University of Utah in pediatrics, by the Medical College of Georgia in nursing, and by Harvard University in dentistry. Numerous other universities developed similar programs but did not report these in the medical education literature.
Reviewing these programs revealed that the programs reported common goals:
Enhancing teaching methods
Promoting education research
Promoting the scholarship of teaching
Enhancing curriculum development
Enhancing assessments development
Promoting advising and mentoring
Promoting executive leadership skills (7)
Reviewing these programs revealed that the programs had similar outcomes:
Increases in enthusiasm for teaching
Increases in educational research
Increases in publications of educational abstracts, editorials, chapters, and books
Increases in presentations about education at professional association meetings (8)
The University of Michigan also reported increases in promotions, education awards, new educational responsibilities, and new educational programs (3).
Teaching Scholars Programs and similar programs reported variations in funding from having no direct funding as presently exists at WVU, to investing $21,000 per scholar as reported at the University of Michigan (3). Programs also reported variations in amounts of grant monies. Many universities reported having no formal grants whereas the combined Teaching Scholars Program and Biomedical Infomatics Program at University of Washington reported having $1.2 million in grants (9).
Teaching Scholars Programs reported variance in faculty-release time from 1-hr weekly sessions at the main campus of WVU, monthly sessions at the University of Iowa (10), and one half day per week sessions at the University of Michigan (3).
A review of the medical education literature revealed discussions about what should be considered “scholarly” work. Simpson (Medical College of Wisconsin) and Fincher (University of Georgia) reported in their “Project on Scholarship” that the Graduate Education Association of the Association of American Medical Colleges used a traditional definition for scholarly works as consisting of “goals, methods, results, and effective communication” (11). In a second paper, Simpson and Fincher maintained “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 are consistent with the traditional definition of scholarship” (12).
Report on the Teaching Scholars Program at West Virginia University
In 1999, Dr. Rashid Khakoo (Assistant Vice President for Health Sciences Faculty Development), Dr. Donald Fidler, and a committee of teachers from preclinical and clinical faculty programs from the schools of dentistry, medicine, nursing, and pharmacy developed a cross-discipline Health Sciences Teaching Scholars Program. Beginning in 1999, the first eight scholars met face-to-face on a weekly basis from 8:00 a.m. to 12:00 noon from September to May. Throughout the program, classes varied from 8 to 11 scholars per year. A 4-hr weekly program posed a challenge to many participating faculty members due to their clinical responsibilities, but financial reimbursement to members’ departments was helpful. In 2003, due to financial limitations, the main campus in Morgantown downsized to 1-hr weekly sessions.
Ultimately, due to time constraints, the program was revised as a combination of an online web course via the SOLE (Secure Online Environment Program) with 1 hour of face-to-face meeting time per week from September to May. Although the program lost 75% of its discussion time, the asynchronous online discussions helped to focus thinking and discussions about the subject matter beyond the classroom hours. More importantly, access to online materials occurred before, during, and after the program and reinforced scholars’ learning.
For faculty members who presented the Teaching Scholar Program modules, the experience of facilitating an online version of a previously face-to-face session for scholars provided a welcome opportunity for online teaching. Many of those presenters gained significant web development skills.
In 2003 and 2004, the Teaching Scholars Program expanded to include the two branch campuses in Charleston and the Eastern Panhandle of West Virginia. The format was altered to fit the different environments of the branch campuses, creating 4-hr monthly sessions.
In 2005, the Teaching Scholars Program developed a 1-week summer program consisting of full-day sessions for six consecutive days. Faculty members from all three WVU campuses and applicants from other universities were invited to participate in the summer program. The summer program opened the Teaching Scholars Program to faculty members during a time of less course loads and also opened the program to individuals outside of the University, which provided additional funding for future development.
Web-based programs were essential for assuring and maintaining similar content experiences for the four programs. The three campus programs also developed a required second year. During the second year, scholars collaborated to implement and continue research projects which they designed during their first year of courses.
Use of the online hybrid program provided many interesting results. First, participation increased due to the wider reach of the Internet. For example, faculty from Charleston and Eastern campuses no longer needed to drive several hours to Morgantown to participate. The use of predistributed materials online facilitated preparation for sessions and made future access to materials more convenient. Keeping the 1 hour weekly and the 4-hr monthly face-to-face sessions provided the “human touch” often missing in distance education. In addition, the nature of online access allowed greater flexibility and practicality for busy clinical faculty.
Information about the WVU Teaching Scholars Programs is presented in the Appendix.
Evaluation of WVU Health Sciences Teaching Scholars Program
The directors developed two major assessments for the program: 1) online surveys of each learning session from all campuses, and 2) longitudinal surveys to assess the continuing performances of the scholars during their post-program educational careers
Online Surveys of the Individual Learning Sessions
Online surveys were done immediately after each weekly or monthly session with an 87% return rate. Our administrator sends frequent emails to the entire class to remind them to answer the anonymous online surveys within a week of the session. Each session was assessed for eight measures:
The objectives were clearly stated
The objectives were met
The facilitator/lecturer was knowledgeable about the topic
The facilitator/lecturer’s passion for the topic and teaching methods held my attention
The facilitator/lecturer was respectful to participants
The workshop was useful for my role as being a health educator
The teaching methods used by the facilitator/lecturer were a useful demonstration of excellent teaching methods
This presentation inspired me to try to make changes in my teaching
The averaged results of the total year’s sessions are shown in Table 1.
Longitudinal Survey of the Scholars Who Graduated From the WVU Health Sciences Teaching Scholars Program
Former scholars received surveys by mail and were asked to rate measures about the degree they were or were not impacted by their participation in the teaching scholars program (Table 2). Former scholars returned the surveys by mail in a manner to assure anonymity as required by the IRB. Scholars rated the measures by using a scale where 1 = decrease or no increase, 2 = no present increase but predict future increase, 3 = slight increase, 4 = moderate increase, and 5 = large increase. At the time of this publication, 22 (or 44%) of 50 scholars had submitted their anonymous surveys.
Scholars from the earliest graduation class (1999) ranked three measures higher whereas scholars from the two most recent graduation classes (2004 and 2005) ranked 10 measures higher of skills they implemented in teaching (Table 3).
Interestingly, scholars from the earliest graduation class (1999) ranked three measures higher whereas scholars from the two most recent graduation classes (2004 and 2005) ranked 16 measures higher of knowledge and skills they implemented in improving their academic careers. Although the “n” was small (three graduates of eight from 1999 and four graduates of 16 from 2004 and 2005), we did not see a trend that early graduates implemented more of what they learned by the fact that they had more years of time since graduation to implement what they learned. The trend appears to be quite the opposite. We surmise that since we began requiring an informal second year for scholars in 2003 and also strongly encouraged more participation in on-going projects, our more recent graduates are applying more of what they learned. We shall continue to collect data to further assess how scholars perform over the years post graduation.
It was interesting that when we correlated the preferred format of the program with the year scholars participated (Table 4), the six scholars who selected that the program should be fours hours per week were all scholars who were in the program when the program was 4 hours per week. The scholars who selected that we should have online programs were scholars who participated in the program when the online programs were most utilized. Most scholars prefer the 1-hr weekly (or perhaps 4 hours once per month) with online programs. We inadvertently left off the choice for “four hours 1 day per month” and shall include that in our future surveys.
The directors of the Teaching Scholars Program used the online surveys of individual learning events to make decisions about including or excluding topics and in giving feedback to teachers about their organization and teaching performances during the sessions. It is difficult to compare the scores from early years with scores from later years since less favored topics were dropped and new and often experimental “cutting-edge” topics were initiated. Throughout the many changes in the curriculum, the average scores for individual teaching sessions throughout the years remained high (above 4.43 out of 5.00).
In longitudinally assessing the self-assessment of careers of our former scholars, we found scholars expressed higher scores about valuing and enjoying topics but expressed lower scores about implementing what they learned. Although scholars reported modest gains about what they actually implemented, they expressed that their future plans include wishes to implement what they learned. This suggests that it is essential for teaching scholars programs to continue to keep in touch with scholars beyond graduation to further stimulate and nurture scholars’ educational interests.
Since the surveys were IRB exempted with the requirement that we not be able to identify individual scholars, our study suffers from the weakness that we could not compare specific scholars’ answers with what we know about their careers. For example: we do not know how junior faculty compare with senior faculty in implementing what they learned. We anecdotally know that during the immediate years after completing the program, a few scholars dropped out of academia whereas several other scholars began vigorously presenting faculty development seminars at WVU and at state and national educational society meetings. Many former scholars became very active as teachers/facilitators in the WVU Teaching Scholars Program. Many other scholars commented that they became more confident in accepting teaching assignments and in initiating new teaching projects due to learning specific skills from the Teaching Scholars Program.
Our study suffers from the weakness that we do not have a control group of comparable faculty members who did not participate in the teaching scholars program to compare with the results about our scholars’ careers.
At the 2006 Association of American Medical Colleges (AAMC) meeting, Donald Fidler, M.D., F.R.C.P.(I), from WVU, Susan Lieff, M.D., Med, F.R.C.P., from the University of Toronto, Ontario, Canada, and Yvonne Steinert, Ph.D., from McGill University presented “Teaching Scholars Program: Faculty Development for Educators in the Health Professions.” Each presenter presented similar data as contained in this article about their own teaching scholars programs. Although the similarities were striking, the processes of developing the programs and the exact structures of the programs were highly specific to the educational and cultural environments of their respective universities. All three programs had similar positive outcome studies.
Our future plans include surveying other Health Science Teaching Scholars Programs in the U.S. and Canada to more broadly examine format, topic, and administrative issues.
Many university health science centers have approached faculty development through various methods. Establishing formal teaching scholars programs is one of several creative and effective methods for health science centers to focus on the quality of education and the scholarship of education. Using combinations of online instruction with face-to-face interactions is very helpful in developing teaching scholars programs in which health science program faculty members are active in clinical and research duties and in which programs are spread out across multiple campus sites or health care delivery sites. It is essential for programs to have flexibility to adapt to ever-changing funding, cultural, and educational environments.
Note: IRB ruled that the research component was exempt from IRB review under Title 45, Part 46.101(b) (2) of the Code of Federal Regulations as use of survey data in such a manner as to prevent the identification of individual human subjects.