Foundations Supervisor Guide

Concept 1: Definition of Education Theories and Conceptual Frameworks

Suggested prompts:

What is an educational theory?

• A means to try and understand part of the purpose, application and interpretation of how we learn Learning is a complex behaviour, and no one theory can explain all of it
• Examples (there are obviously many more):
• Gamification theory
• Bloom’s Taxonomy (Knowledge, Comprehension, Application, Analysis, Synthesis, Evaluation)
• Community of Practice (a type of social learning theory)
• Emotional Intelligence
• Spaced repetition theory
• Deliberate Practice theory
• Constructivist Developmental framework

What is a conceptual framework?

• A smaller piece of a theory or a tool to apply to educational situations
• Kirkpatrick’s hierarchy of learning (program evaluation)
  • Reactions, Learning, Behaviour, Results/Outcomes
• RIME framework for medical trainee progression
  • Reporter, Investigator, Manager, Educator
• Miller’s pyramid (hierarchy of assessment)
  • Knows, Shows, Shows How, Does
• Kerns’ model of curriculum development
  • Problem Identification, Needs Assessment, Goals and Objectives, Educational Strategies, Implementation, Evaluations and Feedback

Key readings about this topic that a faculty supervising a trainee should read or be familiar with:

• Kaufman, D.M. (2018). Teaching and Learning in Medical Education: How Theory Can Inform Practice. In Understanding Medical Education (eds T. Swanwick, K. Forrest and B.C. O'Brien).

Concept 2: Purpose of Education Theories and Conceptual Frameworks

Suggested prompts:

• Why do we need theories and conceptual frameworks?
• How do education theory and conceptual frameworks inform our day to day practice?
  • They allow you to put on filters to understand the phenomena that you see in front of you
    • Learner in difficulty?
    • Bloom's taxonomy - are they stuck at Knowledge and can't get to application?
    • Growth mindset theory - Do they have a fixed mindset?
    • Emotional intelligence - do well on tests, but struggle to make it work in the real world when interacting with people?
  • They inform scholarship/ research
    • The best education research/ scholarship is rooted in educational theory or uses a conceptual framework

Key readings about this topic that a faculty supervising a trainee should read or be familiar with:

• Bordage G. Conceptual Frameworks to illuminate and magnify. Medical Education 2009: 43: 312–319

**pre-circulate prior to meeting for trainees to read

Concept 3: What is a Clinician Educator?

Suggested prompts:

• More than a clinician who teaches.  A Clinician Educator can be an educational consultant, troubleshooting when things go wrong
  • Have the skills to go beyond problem identification and provided solutions
  • Solutions are informed by theory
• Definition: A clinician who is active in health professional practice, applies theory to education practice, engages in education scholarship, and serves as a consultant to other health professionals on education issues. 
  • An 'educational engineer'

Key readings about this topic that a faculty supervising a trainee should read or be familiar with: 

• Sherbino J, Frank J, Snell L. Defining the Key Roles and Competencies of the Clinician Educator of the 21^st Century: A National Mixed Methods Study. Academic Medicine, Vol. 89, No. 5 / May 2014

Concept 4: How is this different than a non-clinician educator?

Suggested prompts:

• What perspectives do clinicians with expertise in medical education have that non-clinicians lack
• How do these two groups of educators benefit each other?

Clinicians who are active in practice understand at the ground level the practical realities of medical training

• An ‘applied scientist’ with insider knowledge of the health system

Non-clinician educators or education specialists have an extremely important role in medical education, complimentary and synergistic with the Clinician Educator

• Often having deeper understanding of theory and educational methodology for scholarship

CEs provide on the ground perspective, non CEs provide expertise in education

Concept 5: Teaching Philosophy

Suggested prompts:

• Who are the teachers you want emulate? What is it that they do that you feel makes them effective?  What theories and frameworks do they use?
• What education theories resonate with you in terms of your ability to teach?
• What are the common problems you see in your education practice? What theories provide a lens to better understand these problems?
• When you analyze these theories, is the scope: Macro (universal, operate at the societal level), Meso (contextual, inter-personal/systems level or Micro (contextual, individual level ie. Phenomenology ‘lived experience of an individual’)

Key readings about this topic that a faculty supervising a trainee should read or be familiar with: 

• Education Theory Made Practical. Volumes 1-3, available on www.aliem.com

Other suggested readings or resources:

• Write a draft of your answers to the Foundations Scenarios and your teaching philosophy.

Concept 6: Applying Education Theory to Educational Problems

Suggested prompts:

• Choose 2 of the Educational Scenarios and apply 3 education theories with the view to proposing a solution to the problem. Which theories you apply will depend on your epistemology.  For this prompt, pre-circulate the Consultation Deck of Cases document to the Fellows.  Have them each choose 2 cases (ideally different ones) and find 3 theories that could inform a solution.  This exercise is critical to get our Fellows up to speed with a handful of theories to be able to further explore through the other tasks in this unit and the other units.
• Define Epistemology (our beliefs about knowledge, what can be known?), Objectivism (an absolute truth exists, knowledge is objective and neutral) or ‘Positivism’ (knowledge is based on observation and experiment), and Constructivism aka ‘Subjectivism’ (the reality we see is constructed by our social, historical and individual contexts – no shared truth exists)
• What is a social construct (an organized perception of reality that is created, shared and modified over time by members of a social group – exists within a particular temporal or spatial group)

Key readings about this topic that a faculty supervising a trainee should read or be familiar with:

• Consulting in Med Ed handout
• Education Theory Made Practical. Volumes 1-3, available on www.aliem.com

Also discuss:

• Wrap up of Foundations Intro and documents to be submitted for completion
• Planning ahead for Foundations Capstone, in particular remind fellow of the requirement to attend a Med Ed Conference and to plan ahead for opportunities/dates

Concept 7: Communities of Practice

Suggested prompts:

• What is a community of practice? A collaborative, informal network that supports professional practitioners in their efforts to develop shared understandings of engage in work-relevant knowledge.  More than dissemination – engagement in new ideas.
• What are the key elements of a CoP? Community is organic, self-selected with no specific affiliation. Practice – requires some expertise/skills, with a range from novice to expert.  Domain – work collectively to solve new problems and disseminate information.
• What are the benefits of a CoP? Improved problem solving, enhanced global expertise, opportunities to participate in new projects, possibility of being involved in things outside your own track or arc of scholarship

Key readings about this topic that a faculty supervising a trainee should read or be familiar with:

• Confessore S. 1997. Building a learning organization: communities of practice, self-directed learning, and continuing medical education. Journal of Continuing Education in the Health Professions. 17(1): 5-11.
• Ranmuthugala G, JJ Plumb, FC Cunningham, A Georgiou, JI Westbrook and J Braithwaite. 2011. How and why are communities of practice established in the healthcare sector? A systematic review of the literature. BMC Health Services Research.  11(273).
• Sherbino S, L Snell, D Dath, S Dojeiji, C Abbott and JR Frank. 2010. A national clinician-educator program: a model of an effective community of practice.  Medical Education Online.6(15).
• Wenger EC and WM Snyder. 2000. Communities of practice: the organizational frontier.  Harvard Business Review. 139-43

Concept 8: Educational Consultation

Suggested prompts:

What are the 9 principles of an effective CE consultation?

1. Clarify/determine the question
2. Determine the customer – the ‘real customer’ (teacher, learner, administrator)
3. Define the CE’s role(s) – take over or provide suggestions
4. Look at the needs – original question may be from another related issue
5. Use education frameworks and evidence – don't reinvent the wheel
6. Communicate with all stakeholders
7. Remember there are multiple perspectives
8. Document the process – important for analysis
9. Reflect on the consultation (successes or failures) aka program evaluation

What are the elements of a CE consultation?

• Consult request
• Data gathering
• Education diagnosis & prescription
• Recommendation
• Implementation (often iterative)
• Evaluation and FU

What are the pitfalls of an education consultation?

• Not clarifying the real question
• Not clarifying the role of the CE
• Not gathering the data yourself
• Little communication
• Recommendations not related to overall goals or institutional culture
• Recommendations that are not specific or feasible
• CE is the wrong person (bias, lack of expertise or experience)
• Inability to effect change
• Lack of follow-up

Key readings about this topic that a faculty supervising a trainee should read or be familiar with:

• Keely E, S Dojeiji and K Myers. 2001. Writing effective consultation letters: 12 tips for teachers. Medical Teacher. 24(6):585-92 
• Salerno SM, FP Hurst, S Halvorson and DL Mercado. 2007. Principles of Effective Consultation:  An Update for the 21st-Century Consultant. Archives of Internal Medicine. 167(3): 271-5
• Sherbino J, L Snell L and JR Frank. Defining the competencies of a 21st-century clinician educator: a national needs assessment. Academic Medicine. [Article not yet published.]
• Sherbino S, L Snell, D Dath, S Dojeiji, C Abbott and JR Frank. 2010. A national clinician-educator program: a model of an effective community of practice.  Medical Education Online.6(15).