Fellow As Clinical Teacher, Benign Hematology Curriculum Improves Learning and Reaction to Academic Medicine

Introduction:

The expansion of medical schools, faculty attrition, and trainees' disinterest in academia, all highlight the need to encourage the next generation of academic physicians. The published literature indicates that early academic career awareness and involvement in scholarship activities can positively influence trainees' interest in academia.

Teaching experience has been shown to positively influence interest in an academic career, trainees who can engage in educational activities, and who transform their work into educational scholarship are more likely than their counterparts to pursue the medical educator academic track. We hypothesized that heightening diverse trainees' awareness of opportunities to engage in various educational roles through the fellow as clinical teacher (FACT) may help them consider future academic positions as well as improve their medical knowledge.

Method:

We implemented a hematology FACT program that utilized an hour didactics session that is held every month focused on benign hematology curriculum. We aimed to help fellows to 1) develop as teachers, 2) improve knowledge in benign hematology, and 3) increase their career interest in educators' academic track.

After implementing the program, post-intervention surveys focusing on evaluating their reaction to the program, whether participation in the program increased their interest in academic medicine, and whether attending the program benefitted their knowledge and advanced their learning. Focusing on level 1 and 2 on the Kirkpatrick four-level educational model.

Results:

The FACT program included nine participants, all participants served as trainees and educators in the program. Participants were asked to indicate the most challenging topics in the benign hematology field to guide building the content of the curriculum. The cellular basis of hematopoiesis was noted as the most challenging for six participants. Majority of participants reported having struggles evaluating hemoglobinopathy disorders, hematologic women's health issues, bleeding disorders, and transfusion medicine challenges. Those subjects concluded majority of the curriculum content.

Post-intervention surveys were sent out to all participants after eighteen months of implementing the program, asking their feedback about the program, their reaction about the program and knowledge benefit, nine surveys were collected.

The implemented program helped improving participants' level of knowledge for hemophilia and other bleeding disorders such as Von Willebrand Disease, in most participants (7 of 9). Also, five participants reported a benefit in regards to cellular basis of hematopoiesis and hemoglobinopathy disorders.

The majority of participants (7 of 9) found that the course material was very useful and they rated the lectures to be very good to excellent. And all participants agreed on the discussed topics to be appropriate for their level of training, moreover, it improved the overall understanding and level of interest in benign hematology. All participants noted the impact of the program on augmenting their teaching skills and interest in exploring the academic medicine track.

The drawback of the program reported by participants (3 of 9) was experiencing a communication barrier and feeling restricted communicating their questions, opinions, and concerns to their co-fellow educators.

Discussion:

Implementing the fellow as clinical teacher program has been a strategy that is used to increase trainees' interest in academic careers and educators' tracks, although its barriers and impact on fellow's education is not clear. In this review, we aimed at evaluating the program from trainees' perspectives. The program was beneficial to all trainees, all served as educators at a certain time, it was appropriate for their level of training, it improved the overall knowledge for benign hematology topics, and it positively impacted their teaching skills and interest in academic medicine. With a longer follow-up time, it would be beneficial to evaluate the program's impact on the fellows' commitment towards academic medicine.

Conclusion:

Fellow as clinical teacher program could be a tool to increase hematology fellows' interest in academic educators' track, increase level of knowledge and confidence managing different challenging topics, without affecting the quality of medical education.