Category: Staff Development

Building Community: Developing as an early-career medical educator + the Developing Medical Educators’ Group (DMEG)

Posted on by sarah.allsop

In this blog, one of our BMERG committee members David Hettle, an honorary senior teaching fellow and specialist registrar (SpR) in infectious diseases and medical microbiology, talks about the winding journey to becoming an educator and how the Academy of Medical Educators Early Career Educator group ‘DMEG’ can support you on this journey.

Photo by Dan Meyers on Unsplash

The route to becoming a medical educator, it is fair to say, is not clear, linear, or uniform. Indeed, medical educators may come from medicine, education, other healthcare professions, basic science or other backgrounds.1 This diversity brings with it wide variation in perceptions of what being a medical educator is.

The most recent definition available from the Academy of Medical Educators (AoME) is:

“Medical educators and clinical teachers develop, deliver, and manage teaching programmes and engage in scholarship and research into all aspects of teaching, learning and assessment. Within this definition, the daily work of medical education (MedEd) relates to the teaching of students, doctors, physician associates, vets and dentists about all aspects of patient care, the management of health services, the promotion of health and the prevention of disease.” 2

Clearly, this definition covers a vast spectrum. Individually identifying as a medical educator can range from being central to one individual’s professional identity,3 or may be a secondary identity, potentially at odds with another part of training such as clinical or academic progression. Education may also be merely an activity that professionals undertake rather than being a true part of their owned identity.4-5

The process of ‘becoming a medical educator’ has increasingly become a topic of interest as the profession learns how to support the development of educators. However, much research focusses on educators towards the end of their careers, who often view their involvement and roles as having occurred serendipitously, and have taken much of their career to finally identify as an ‘educator’.3,6

But…why does this matter?

Of course, we are all developing as educators day-by-day, but for those who see themselves at the beginning of their medical educator journey, looking forwards trying to see what the career looks like can be a huge challenge. The fear can be that it is an uncertain, meandering path, with opportunities by chance, rather than planning or good intentions.

Despite this, each year large numbers of junior doctors take time out of training and choose to undertake teaching fellowships,7,8 with numbers increasing all the time. Currently between 70-90 teaching fellows are employed across the NHS trust academies paired with the University of Bristol medical school each year. With an ever-increasing pool of potential career educators completing entry-level posts in MedEd, such as clinical teaching fellowships, there is a need for the world of MedEd to promote, drive and enhance the development of these healthcare professional educators.

Several recent publications suggest routes through which supporting the development of educators should happen including: 5,9-10

  • making teaching visible through events and activities which celebrate the significance of educators’ roles
  • creating transparent and replicable MedEd reward and development structures (such as career pathways – both stand-alone and potentially integrated with clinical training)
  • building communities within MedEd offering role-modelling, a sense of connectedness, and a forum for sharing stories, experiences and frustrations

In 2020, AoME launched the Developing Medical Educators’ Group. This is specifically aimed at those junior and early-career educators shaping their futures in the world of medical education – whether they have held formal posts in MedEd or not.

It recognises that early-career educators are often trying to balance their educator identity with their clinical identity, and that their development can be challenging to integrate in clinical settings where teaching is not always valued as highly as clinical service or research. Communities such as DMEG are therefore crucial to this group of educators, as the “future of medical education” across the UK.

Through AoME, early career educators can apply to be recognised as educators through gaining associate or membership status of the Academy.2 Such accreditation can be hugely important to progression in clinical training and in promoting the value in MedEd as a specialty.

DMEG offers a community for early-career educators, encouraging engagement from anyone interested in MedEd, guided by peers and near-peers in the same boat (or very recently in the same boat!), as those navigating the dual world of medical, dental or veterinary training with educational development. Events are offered both through AoME and directly by DMEG including:

  • DMEG debates: a monthly, live online forum debating hot topics in MedEd (most recently ‘What does the rise of AI mean for MedEd?’).
  • Medical EducaTALKS: regular podcasts exploring aspects of MedEd with senior educators.
  • DMEG conference: A yearly event, this year on 4th October – Communities of Practice in Practise – an online conference discovering the work of early-career educators + hosting workshops and keynotes exploring the world of MedEd.

DMEG seeks to raise the profile of developing medical educators, validate and recognise their critical and important role and ensure that facilities and resources exist for training and development of early-stage educators.

From a personal point of view, having recently been a teaching fellow, DMEG offers me a friendly community to support and continue my development. I can share challenges and new ideas and explore what the MedEd world looks like across the UK and beyond, regardless of where I am currently working, or if/when locally there are no networks or collaboratives available.

I would encourage anyone interested in MedEd, and especially those in teaching fellow posts to have a look at DMEG and see what they can offer you as an educator. By being a group for developing healthcare educators, run by developing healthcare educators, they are always open to suggestions!

Whatever your interest and however long you have been involved in MedEd, DMEG invites you to come and explore the DMEG Conference 2023: Communities of practice in practise, on 4th October 2023.

References

  1. Huwendiek S, Mennin S, Dern P, Ben-David MF, van der Vleuten C, Tonshoff B, Nikendei C. Expertise, needs and challenges of medical educators: Results of an international web survey. Med Teach 2010; 32(11): 912-8.
  2. Academy of Medical Educators. Professional Standards for medical, dental and veterinary educators, 4th edition. Cardiff: Academy of Medical Educators.
  3. Hu WCY, Thistlethwaite JE, Weller J, Gallego G, Monteith J, McColl GJ. ‘It was serendipity’: A qualitative study of academic careers in medical education. Med Educ 2015; 49(11): 1124-36.
  4. Sabel E, Archer J; Early Careers Working Group at the Academy of Medical Educators. “Medical education is the ugly duckling of the medical world” and other challenges to medical educators’ identity construction: A qualitative study. Acad Med 2014; 89(11): 1474-80.
  5. Bartle E, Thistlethwaite J. Becoming a medical educator: motivation, socialisation and navigation. BMC Med Educ 2014; 14: 110.
  6. Browne J, Webb K, Bullock A. Making the leap to medical education: A qualitative study of medical educators’ experiences. Med Educ 2018; 52(2): 216-26.
  7. Wilson S, Denison AR, McKenzie H. A survey of clinical teaching fellowships in UK medical schools. Med Educ 2008; 42(2): 170-5.
  8. Edwards LJ, Hettle D, Stocker C. (2023, July 12-14). A review of Entry-Level Medical Education Roles (ELMERs) in the United Kingdom (conference workshop). Association for the Study of Medical Education Annual Societal Meeting 2023, Birmingham, UK.
  9. Van Lankveld T, Schoonenboom J, Kusurkar RA, Volman M, Beishuizen J, Croiset G. Integrating the teaching role into one’s identity: A qualitative study of beginning undergraduate medical teachers. Adv Health Sci Educ Theory Pract 2017; 22(3): 601-22.
  10. Rees E, Guckian J, Fleming S. Fostering excellence in medical education career pathways. Educ Prim Care 2021; 32(2): 66-9.

Read more about other MedEd associations in our BMERG blog Building Community: Networking Opportunities through joining a MedEd association

Conference Report: ASME Annual Scholarship Meeting 12-14th July 2023, Birmingham UK

Posted on by sarah.allsop

“Developing a Diverse Workforce“

Continuing our conference report theme, Dr Ed Luff reflects on the Association for the Study of Medical Education Conference recently held in Birmingham, UK.

The Eastside Rooms Conference Centre, Birmingham UK

The 12th-14th of July brought the return of the Annual Scholarship Meeting (ASM) of the Association for the Study of Medical Education (ASME), which took place at the Eastside Rooms conference centre in Birmingham. The three-day programme of events saw representation from a wide range of attendees from Bristol Medical School and the Academies, presenting work at a national-level medical education conference. Presenters came from all areas within the school, from professors and lecturers to medical students and clinical teaching fellows (CTFs) to MSc and PhD students, showcasing the wide range of work conducted around medical education within Bristol Medical School.

Once again, this year Bristol was extremely well represented at the conference, with contributions comprising 2 workshops, 15 oral presentations and 29 poster presentations, which exceeded the high bar set at last year’s conference. Huge congratulations to all those who were involved in presenting, authoring, and contributing to the work that was presented, it really highlights the excellent and high-quality work that is being conducted both locally and regionally. Work was presented by academics from within the medical school, those based at academies around the region, including both North and South Bristol, Bath, Gloucester & Cheltenham, and Swindon, as well as current undergraduate medical students and doctors completing their MSc in Teaching and Learning for Health Professionals (TLHP) and PhD.

The range of topics and areas of the curriculum covered by presenters from Bristol ranged from paediatrics to palliative care, professionalism to research paradigms, interprofessional learning and simulations on Boeing 747’s, transgender and non-binary healthcare, and gamification of sexual health. Many presentations highlighted collaboration both within the medical school, across different academies and hospital sites, as well as with outside organisations and other institutions and healthcare professionals.

This year also saw the inclusion of a new presentation format at the conference, the ‘What’s Your Point?’ sessions, where presenters were invited to start a conversation and present on a topic of interest or debate. We had a thought-provoking oral presentation on the future of medical educators, and poster presentations on classical cases/ typical presentations, promoting interprofessional education, a professionalism reporting system and engagement with teaching innovations.

ASME as a conference provides a wonderfully welcoming and inclusive environment to inspire, engage and network. It is friendly and accessible, with sessions covering the full spectrum of medical education, from admissions and widening access, through undergraduate, foundation years, and postgraduate training. There really is something for everyone and the wide range of parallel ‘pre-conference’ and ‘intra-conference’ sessions, symposia and workshops provide an opportunity for attendees to build skills and develop in areas of personal interest.

Dr Alice Middleton, CTF co-lead, based at Gloucester Academy, reflected on her experiences from the conference:

“I presented about using virtual patients to teach clinical reasoning, and was encouraged by queries and enthusiasm about the project from members of the Technology Enhanced Learning ‘TEL’ special interest group of ASME – I have joined them! I also attended the TASME prize presentation session and talked to one of the presenters after the session, we have since been emailing about potentially collaborating on a project about teaching clinical reasoning which is exciting; it was a great opportunity to link up and learn from people doing similar-but-different things in other medical schools in the UK.”

Dr Sam Chumbley, a CTF based at South Bristol Academy commented:

“This was my first ever conference, and who knew they could be so fun?! I met so many like-minded people, and everyone commented on how approachable everyone is it ASME. You can be asking a presenter a question after their talk, and then sharing a meal with them later that day. The talks were fascinating, with a heavy focus on EDI topics this year, which has empowered me to speak up when seeing colleagues or patients being discriminated. Other talks focused on topics like innovation in education, which is always exciting to hear about, and has made me less terrified of the advent of AI in education. Ultimately, ASME has set the bar very high for future conferences I will attend!”

To showcase the amazing contributions made by those within the medical school, we have created a Sway which contains information about all the work presented by those associated with Bristol Medical School.* You can view summaries of the two workshops, copies of the abstracts for the oral and poster presentations and electronic versions of all the posters too. Access the sway via this link: BRMS at ASME 2023. A collated Bristol abstracts booklet can be viewed here:

ASME-BRMS-Abstract-Booklet-2023-1

The full ASME 2023 conference brochure can be downloaded here: ASME 2023 brochure. The conference brochure contains detailed information on keynote speakers, pre and intra-conference sessions including symposia and pop-up events, parallel sessions and oral presentations. The abstracts book can be downloaded here: ASME 2023 Abstracts book. The abstracts book contains details of all abstracts included at the ASM 2023. Each individual abstract has its own page including information on the authors and presenters. This includes submissions for e-Posters, oral presentations, relevant awards, and What’s Your Point? sessions. For information about joining ASME visit: www.asme.org.uk/membership/.  

Next year’s ASM will be held in Warwick, from the 10th-12th of July 2024, with the theme ‘Maximising Potential’. We hope that next year will bring further success for Bristol Medical School at ASME. We are also looking forward to the AMEE conference, which this year is being held in Glasgow from the 26th to the 30th of August. The best of luck to everyone who is presenting.

* We have done our best to ensure that all work presented at this event has been included here, but if you think we have missed yours and you would like it added, please get in touch.

Read Sarah Allsop’s Conference report on the June 2023 AOME-INHWE Conference here

Hot Topics: Researcher skills – 5 key learning points about Reflexive Thematic Analysis

Posted on by sarah.allsop

This blog is written for BMERG by one of our committee members Dr Grace Pearson. Grace is Bristol Medical School graduate and a current Clinical Research Fellow in Population Health Sciences. Her research interests are in undergraduate medical education, specifically curriculum development and evaluation and geriatrics education.  

Grace shares her experience and tips after attending a workshop hosted by BMERG and the School of Policy Studies on ‘Reflexive Thematic Analysis’ from the expert Qualitative researcher, Professor Virginia Braun from the University of Auckland. 

Image of a galaxy Photo by Bryan Goff on Unsplash
Image of buckets Photo by Sixteen Miles Out on Unsplash

At medical school, future doctors are taught to detect patterns in history and examination to reach a diagnosis. Moving into medical research, this scientific pattern-recognition continues in quantitative data analysis and interpretation. As a result, approaching mixed methods studies or pure qualitative research can be daunting for those of us in medical and other scientific fields – it certainly was for me.  

There are several core aspects of qualitative data analysis that I’ve never truly got to grips with, despite attending multiple training courses… Therefore, getting the chance to learn directly from a world-leading expert was an opportunity not to be missed.  

I went into this workshop wanting to learn how to analyse or ‘code’ my data and develop my themes. I came away with a much wider appreciation of the importance of exploring context, embracing subjectivity, finding latent meaning, and conceptualising what Prof Braun called ‘galaxy’ themes rather than ‘buckets’. Let me explain a bit more.  

When we first look at qualitative data during analysis, certain things can jump out at us as topics. We may think these may start to look like our themes, but if we are not careful, they can end up looking like our original questions and, because everything we connect to a particular topic ends up together ‘in a bucket’ so to speak, may have lots of conflicting ideas within them.  

Conversely, true themes are more like a galaxy with a clear core, a ‘central organizing concept’ holding together all the ideas which although may be different, just like stars and planets are in a galaxy, they remain inherently linked. 

Here are my 5 key learning points from Professor Braun’s fantastic reflexive thematic analysis (RTA) workshop, which I hope might help others to approach their own qualitative data analysis in a reassuringly robust way:  

  • Scientifically Descriptive vs Artfully Interpretive analysis: Descriptive describes and summarises the data in an ‘experiential’ or ‘realist’ manner. Interpretive tells a story, locating the data within a wider context and presents an argument in a ‘critical’ or ‘constructionist’ way. Approaches to thematic analysis (TA), range from ‘scientifically descriptive’ deductive methods such as coding reliability, to ‘artfully interpretive’ inductive methods such as reflexive TA. 
  • Small q vs Big Q: Descriptive analysis suits ‘Small q’ research questions that seek to explore or describe peoples’ experiences, understandings, or perceptions – their ‘individual reality’. Interpretive analysis suits ‘Big Q’ research questions that seek to explore the ‘wider context’, for instance influencing factors, representations, and constructions.  
  • Context and Subjectivity: Analysis occurs in the intersecting space between the researcher(s), the data, and the research question. Subjectivity is present in all 3, as all are influenced by sociocultural, disciplinary, and scholarly context – as a result, analysis is situated in context, which must be clearly communicated.  
  • Coding: codes are ‘units of analytic interest’, the smallest unit of analysis capturing a single analytic idea or facet. These can be semantic (explicit) or latent (implicit) – descriptive analysis generally uses more semantic codes, whilst interpretive analysis uses both. Codes are not ontologically ‘real’, they exist only for the researcher(s) to foster engagement with the data – they need to capture the meaning of the data along with the researchers’ interpretation, orientated towards answering the research question.   
  • Themes: a theme is a construction that captures shared or repeated meaning in the data around a ‘central organising concept’. Themes are conceptual, therefore semantic-level data may seem disparate, but it is unified by latent meaning representing diverse manifestations of the core concept (like a galaxy).  Themes sit in the analytic narrative – they must tell a story of how the data is meaningful and answers the research question.   

Some examples of recommended resources for getting started using reflexive thematic analysis 

  • https://www.thematicanalysis.net/  
  • Braun, V, & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. SAGE. 
  • Braun, V, & Clarke, V. (2022). Thematic analysis: A practical guide. SAGE. 
  • Braun, V, & Clarke, V. (2021). Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches. Counselling and Psychotherapy Research, 21(1), 37-47. https://doi.org/https://doi.org/10.1002/capr.12360 
  • Braun, V, & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328-352. https://doi.org/10.1080/14780887.2020.1769238 

More about Professor Braun https://profiles.auckland.ac.nz/v-braun

Virginia “Ginny” Braun is a New Zealand psychology academic specialising critical psychology of health and gender. She is internationally recognised for expertise in qualitative methodologies, and particularly the now widely utilised method of (reflexive) thematic analysis – developed in collaboration with Victoria Clarke (UWE).

Building Community: Networking Opportunities through joining a MedEd association

Posted on by sarah.allsop
Sarah Allsop

Joining one of the many Medical Education Associations can be a great way of meeting like minded people in the discipline and building collaborations. In this blog Sarah Allsop highlights a few of the available networks you can join.

Photo by Roman Kraft on Unsplash

Networking and national work can be a fantastic opportunity of medical educators to learn, develop and share their ideas with increased reach and impact. One of the ways of doing this is by joining one of the Medical Education Associations. For the UK, three of the main associations working in Medical Education are listed below, but there are many associations around the world:

  • The Association for the Study of Medical Education (ASME)
  • The Association for Medical Education in Europe (AMEE)
  • The Academy of Medical Educators (AoME)

To start with you may simply want to join an association, to get linked in with their publications, discounts to their events or to undertaking training or accreditation. Each association offers a slightly different emphasis so it is worth having a look at their websites to consider which might be the best fit for you and your work, and of course you can join as many associations as you want. There are often discounted memberships for students and those in low-income situations aiming to make joining more inclusive.

Once you are a member, there are also calls to be involved in the committees which can further help to facilitate work on policies and strategic aspects of medical education. Watch out for these calls via social media and on association websites. We will also post about opportunities we spot right here on the BMERG blog too, so subscribe to get the latest news direct to your inbox, and follow us on twitter @BristolUniBMERG.

Which are your favourite #MedEd Associations to be part of? Add your thoughts in the comments section below!

Launching Bristol Medical School Educator and Researcher Profiles

Posted on by sarah.allsop

As part of our objective to ‘Innovate and Inspire’, this page is dedicated to showcasing not only the work of these individuals, but also a bit about their journey and their top tips for working in the discipline.

We will be adding a new profile every month to our educator and researcher profiles page, and our first profile spotlight is….

Annie Noble-Denny

Annie is the Director of BMERG, which she conceptualised as part of her vision to build the infrastructure needed to enhance the educational research portfolio at Bristol Medical School. She is the currently the School Education Director for Bristol Medical School and the Programme Director for the Teaching and Learning for Healthcare Professional Programmes (bristol.ac.uk/tlhp). 

Read Annie’s profile here

 

If you want to nominate someone from Bristol Medical School to feature on these pages contact us at brms-bmerg@bristol.ac.uk.

Hot Topics: Researcher skills – Creating your database search strategy

Posted on by sarah.allsop

This blog is kindly written for BMERG by one of our amazing subject librarians, Richard Kielb. Richard takes us through some top tips around searching databases whilst undertaking your research, and some tips for breaking down the process.

Books on shelves
Photo by Paul Melki on Unsplash

When it comes to research, different search strategies are needed dependent on the nature and context of your work. Sometimes you may just need a book or a few relevant articles on a subject, and in this situation a quick search of your local library catalogue can often be sufficient. For more detailed research, it is likely to be more important to be able to carry out a comprehensive review of the literature, and this will usually require an advanced search using bibliographic databases.

So what is a bibliographic database? A database will allow you to search across very large numbers of academic sources simultaneously. Most of these sources will be academic journals, but some databases will include book chapters, conference proceedings, systematic reviews etc.

Different subjects will be supported by particular databases, so it will be important to identify the ones that are most relevant for you. Medical education would be a good example of a topic which would cross over more than one subject, so you would need to consider searching in databases recommended for both Medicine and Education as well as others with a multi-disciplinary focus.

Which databases you choose to use will depend very much on the topic you are researching and also what resources you have access to as an individual or a member of an institution. Many databases are not free to access and can be extremely expensive, but they are often provided by library services in organisations such as Universities and in the NHS.

Although the various databases have search interfaces that look quite different, the basic principles listed below will generally apply to all of them. Some of the functionality and ‘wildcard’ symbols etc might be slightly different, but there are usually help pages and guides available that will help indicate how it all works.

There are four basic stages to the database searching process:

  • Break your question down to its main concepts
  • Decide on the relevant search terms
  • Combine your search terms
  • Review your results

Breaking your question down to its main concepts

For clinical questions you may have come across the PICO formula to identify your concepts, and you can consider doing something similar for your medical-education topic. The social science framework called SPICE can be useful:

S – Setting Where does the research happen?
P – Population Who is your research focused on? Is your population defined by age, gender, ethnicity etc?
I – Intervention What are you investigating? Is it the use of technology or participation in a particular educational programme?
C – Comparator Are you comparing anything with your main intervention?
E – Evaluation Appraising the value, validity, or effectiveness of the intervention.

As with PICO you do not necessarily need to have a concept for every SPICE element.

Decide on the relevant search terms

Next you will need to consider what terms to search in relation to all of the different concepts. Include likely variations in terms in order to carry out a comprehensive review and to avoid missing any papers which are relevant to your topic. It will be important to factor in all synonyms, related terminology and any variations in spelling (particularly UK/US).

Keyword searching, also known as free-text searching, is where you will look for exact matches for your search terms in the titles and abstracts of journal articles. It is also useful to include searches in any controlled vocabulary offered by your chosen database, for example resources like Medline, ERIC and Cinahl offer ‘Subject Headings’, which make it easier to locate papers on a specific subject. Each article listed in the database is assigned a number of Subject Headings which represent what topics it covers. The advantage of this is that all of the articles on the same subject will be given the same subject heading, independent of the terminology used by the individual authors.

Combine your search terms

The Boolean search operators (OR, AND, NOT) can be used to combine your searches effectively.

  • Use OR to combine searches about the same concept – synonyms, related terms, variant spellings (e.g. Vitamin C OR ascorbic acid). This will broaden your search.
  • Use AND to combine searches about different concepts (e.g. caffeine AND asthma). This will narrow your search.
  • Use NOT to exclude terms from your search. This can be useful if you are retrieving some irrelevant content but use an element of caution as this can also remove useful material that may have mentioned the excluded term.

Review your results

Critically appraise your results (are they relevant to your research topic?) and decide if you need to make any changes to your search strategy. When you have run your search, you will often find that you either have more or fewer results than you were expecting.

  • Too many? Look for ways to make your search more specific. Can you add concepts? Are there valid ways to limit your results (publication date range, age group, language etc)?
  • Too few? Look for ways to make your search more general. Are there any terms that could be removed? Would broader search terms be useful?

Setting ‘limits’ can also be helpful as many of the databases will provide a series of in-built limits and filters, so it can be useful to investigate the options available.

Remember that your local Librarian will be more than happy to answer any questions you might have about using bibliographic databases and finding information more generally! At the University of Bristol you can find your subject specific librarian at: www.bris.ac.uk/library/subject-support/