#18 How to Flex your MedEd Scholarship Muscles

September 13, 2022 | By Era Kryzhanovskaya

With Dr. Bernice Ruo

Listen as our esteemed guest Bernice Ruo MD FACP (University of California San Diego, SGIM Teach Faculty) discusses the tips and tricks to becoming an effective MedEd scholar! Dr. Ruo provides practical tips to getting started and gaining momentum as a MedEd scholar as well as ways to promote MedEd scholarly activity amongst trainees.  

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Credits

• Producer/Writer/Hosts: Era Kryzhanovskaya MD / Molly Heublein MD
• Show Notes/Cover Art/Infographics: Charlotte Chaiklin MD
• CME:  Molly Heublein MD
• Editor (audio): Clair Morgan of Nodderly
• Guest: Bernice Ruo MD FACP

CME Partner: VCU Health CE

Show Segments

• Intro
• Guest one-liner
• Guest pick of the week
• Guest area for growth 
• Guest best piece of advice
• Era and Molly’s picks of the week 
• Case from Kashlak Memorial Hospital 
• Brief history of MedEd scholarship 
• How to engage in MedEd scholarship 
• How to overcome barriers to MedEd scholarship
• How to improve your MedEd skillset
• MedEd scholarship for residents
• Mentorship for MedEd scholarship 
• Recipe to becoming a MedEd scholar
• Take home points 
• Outro

MedEd Scholarship Pearls

1. When becoming a MedEd scholar, start small and make what you do count twice. 
2. Mentorship is important. Sometimes having multiple mentors can be beneficial if a mentee is struggling to find the “right fit” with a single mentor.
3. Promote MedEd scholarship amongst trainees by guiding them through the process of writing clinical vignettes. 
4. Dr. Ruo’s recipe for MedEd scholarship: do what you love, work on multiple projects at once, work in teams, find a good mentor, be persistent, and do not take rejection personally. 

How to be a MedEd Scholar Notes

Case from Kashlack Memorial Hospital

Corey is a second year attending in Hospital Medicine. In addition to being the best hospitalist and generalist that she can be, Corey has an academic interest in transitions of care and teaching learners about safe transitions of care.  She helped with a QI project when she was a resident around instituting discharge timeouts.  Besides presenting that work at her institution’s QI symposium, she really hasn’t had much dissemination of that initiative.  Corey is meeting with Dr Ruo to discuss what she can do to publish or spread the word about her hardwork and dig into her academic interests around transitions of care further. 

The History of MedEd Scholarship

MedEd scholarship has been around for decades given the tripartite mission of academic medical centers (caring for patients, teaching students and residents, and doing research) but has become more formalized in the past 25 years.  Traditionally, universities have utilized promotion tracks in which researchers are separate from clinicians.  However, recently many universities have created a clinical educator track to promote medical education scholarship.  In this same timeframe of about 20-25 years, medical education fellowships have become more widely available.  These fellowships are often 1-2 years in duration and incorporate formal coursework in the form of a masters in public health, masters in health professionals education, or a masters in education (Sherbino 2014).

Engaging in MedEd Scholarship

Per Dr. Ruo, start small. To get started, consider getting involved in regional meetings and volunteering. This is a great way to learn about ongoing research and education projects for potential collaboration or ideas for projects at your home institution. 

Clinically speaking, Dr. Ruo recommends keeping a list of interesting cases that could be written up as a clinical vignette. Dr. Ruo then utilizes these cases to mentor medical students on how to write clinical vignettes. 

Consider writing up QI projects, like the transitions of care project Corey worked on, for a regional meeting in order to share what was done. Small initiatives that work and help are worth sharing. During the presentation, individuals from other institutions may come up to you and talk about collaborating on future larger initiatives. Presenting at regional meetings helps build your network and disseminate your work (Wang 2019). 

How to Overcome Barriers to MedEd Scholarship 

Most common barrier is time. For most individuals, initially it is unpaid time that is usually spent on scholarly activity. Time, persistence, and a little bit of thick skin is required when you begin the journey to becoming a MedEd scholar. 

Create realistic goals

Scholarly activities do not necessarily require large chunks of time. You can work on projects in small pieces instead of trying to conquer one huge task. 

For example, Corey may start by writing an abstract about her transitions of care project to present at a regional meeting. Next, Corey can read about other individuals in their region with similar interests to reach out to for collaboration on the next step of the project. Corey could also consider creating a workshop about transitions of care. According to Dr. Ruo, one does not have to be an “expert” to create an effective workshop. A lot of times just being interested, conducting a good literature review, and polling individuals about tips on a particular topic can help one create an effective workshop (Spagnoletti 2013). After conducting a workshop, individuals will often ask you to give a talk about the particular topic and in essence, you become the expert. Workshops also provide an opportunity to expand your network. 

Make projects count twice

Dr. Ruo’s advice to maximize on a project like the QI initiative Corey worked on in residency: 

• Do not let projects die within your department. Make sure to at least share your project with others in different departments within your institution. 
• Write up an abstract about your project to share at a regional meeting.
• Consider the next steps of a project. How can you build on what you have already done?

All projects start from small ideas and pilot studies that then get improved upon via larger enhanced projects and collaboration with others. Small ideas can be the instigating flame for larger projects that burn very bright.

How to improve your MedEd skillset 

If a resident or early career attending knows they are interested in MedEd, they may choose to do a MedEd fellowship or a masters. In Ruo’s expert opinion, it is not absolutely necessary to pursue a fellowship or master’s program because one can pursue MedEd coursework or attend a faculty development program to further develop MedEd skills. The curricula taught during medical education faculty development programs often overlap with that taught in MedEd fellowships or master’s programs.  

The Society of General Internal Medicine sponsors the TEACH  program for junior faculty. In SGIM TEACH, junior faculty receive year-long mentoring, develop a teaching portfolio, and participate in workshops specifically focused on medical education. Other faculty development programs include the Harvard Macy Institute Program for Educators in Health Professions, Stanford Faculty Development Program, and AAMC Faculty Development Program.  

MedEd scholarship for residents 

Residency programs can create opportunities for residents to learn and practice teaching skills. 

At Dr. Ruo’s institution, third year residents learn about different models of presenting and precepting in the ambulatory setting. After learning about the various models, the third year residents practice precepting an intern in the outpatient setting as an attending physician observes. To learn more about precepting in the outpatient setting check out the curbsiders TEACH episode about teaching in the ambulatory world: Precepting Potpourri (PIPP-SNAPPS-OMP). 

Giving chief residents the opportunity to teach in medical school classes and seminars is another way to promote MedEd experience. 

Providing workshops and conferences for residents that focus on basic medical education topics like how to create a good learning climate, teach clinical reasoning, utilize the various types of bedside teaching models, be a good mentor or mentee, and/or effectively give feedback can help expose residents to MedEd early in their careers (Heflin 2003). 

Mentorship for MedEd scholarship 

Everyone agrees mentorship is very important. However, creating a structure with assigned mentors can be challenging as a mentor-mentee relationship requires finding a good fit. A mentee may need to try working with a few different mentors before finding the best fit or may have multiple mentors if no single mentor provides all the guidance needed. The benefits of having several mentors include having a variety of projects to collaborate on and being exposed to different perspectives (Farrell 2004). 

Dr. Ruo’s recipe to becoming a successful MedEd scholar 

• Do what you love. The process of MedEd scholarship can be challenging and slow; however, if you are interested in what you are doing it makes the process more enjoyable.  
• Work on several projects at once as projects are often in different phases and some will or will not succeed.
• Work in teams.
• Find a good mentor.
• Be persistent.
• Do not take rejection personally. Rejection and failure happens to all of us. It is part of the natural process. 

Tips for continued improvement as a MedEd scholar 

Dr. Ruo recommends working on many projects at once aka “spinning tops”. Attending workshops to learn new skills, meet new colleagues, and expand your network also results in continued improvement as a MedEd scholar. 

Instead of making specific goals like publishing one or two projects each year, Dr. Ruo recommends having multiple active projects in the works in different stages to avoid quiet phases where there are no scholarly activities to spend time on.  For example, when a manuscript is submitted and being reviewed for publication, you can turn attention to mentoring medical students and residents with clinical vignette write ups.  

Guiding mentees with publication 

Mentors can help choose the target journal for each clinical vignette submission based on novelty and importance in the field. Almost always, there is a home for the publication of scholarly projects but target journals and conferences should be selected wisely. Being ambitious is perfectly acceptable with the knowledge that there are always back up options for the publication and presentation of scholarly works.  

Tips for working on multiple projects

Everyone has their own unique approach to being a part of multiple scholarly projects. Breaking down a bigger task by identifying small goals and small steps can be helpful when getting the ball rolling. Craving out dedicated time is important. For example, setting aside an hour each week to accomplish a small task can be useful. Creating small realistic goals can help create momentum as getting started is half the battle in participating in scholarly activity as a busy clinician. 

MedEd scholarship take home points

When becoming a MedEd scholar, Dr. Ruo recommends that you do what you love, work in teams, be persistent, and find a good mentor along the way. 

Links

1. Dr. Benice Ruo’s pick of the week: Deep by James Nestor
2. Era’s pick of the week: Healthy Kitchens, Healthy Lives 
3. Molly’s pick of the week: Clinical Problem Solvers Antiracism in Medicine 
4. SGIM TEACH program: SGIM TEACH 
5. Harvard Macy Institute Program for Educators in Health Professions: Harvard Macy Educators Course 
6. Stanford Faculty Development Program: ​​Stanford Faculty Development
7. AAMC Faculty Development Program: AAMC Faculty Development  
8. Curbsiders TEACH Precepting in the Ambulatory World: Precepting Potpourri (PIPP-SNAPPS-OMP). 

Goal

Listeners will recognize the steps necessary to start a career as an academic clinician educator with a focus on scholarship. 

Learning objectives

After listening to this episode listeners will…  

1. Recognize the challenges and opportunities in the academic educator world for early career faculty.
2. Describe the most commonly used approaches to produce scholarly work (in the broad sense) in academic medicine and health professions education.
3. Distinguish opportunities to jump start a career in medical education research or scholarship production in academics.
4. Identify ways to promote MedEd scholarship amongst trainees. 

Disclosures

Dr Bernice Ruo reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Ruo B, Heublein M, Kryzhanovskaya E, Chaiklin C. “#18 How to flex your MedEd scholarship muscles.” The Curbsiders Teach Podcast. http://thecurbsiders.com/teach September 13, 2022.