Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes
Abstract
The current health care delivery model continues to fall short in achieving the desired patient safety and quality-of-care outcomes for patients. And, until recently, an explicit acknowledgment of the role and influence of the clinical learning environment on professional development had been missing from physician-based competency frameworks. In this Perspective, the authors explore the implications of the insufficient integration of education about patient safety and quality improvement by academic faculty into the clinical learning environment in many graduate medical education (GME) programs, and the important role that academic faculty need to play to better align the educational and clinical contexts to improve both learner and patient outcomes. The authors propose a framework that closely aligns the educational and clinical contexts, such that both educational and clinical outcomes are centered around the patient. This will require a reorganization of academic faculty perspective and educational design of GME training programs that recognizes that (1) the dynamic interplay between the faculty, learner, training program, and clinical microsystem ultimately influences the quality of physician that emerges from the training program and environment, and (2) patient outcomes relate to the quality of education and the success of clinical microsystems. To enable this evolution, there is a need to revisit the core competencies expected of academic faculty, implement innovative faculty development strategies, examine closely faculty's current clinical super vision practices, and establish a training environment that supports bridging from clinician to educator, training program to clinical microsystem, and educational outcomes to clinical outcomes that benefit patients.
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The transition from less granular, 'time-based' assessments to CBME and entrustment requires more direct workplace-based observations of trainees, provision of high-quality feedback, and use of highly reliable assessment tools, all of which require transformation in processes, resources, and faculty expectations.
“The transition from less granular, ‘time-based’ assessments to Competency-Based Medical Education (CBME) and entrustment requires more direct workplace-based observations of trainees, provision of high-quality feedback, and use of highly reliable assessment tools, all of which require transformation in processes, resources, and faculty expectations [13,46–48].”
This requires significant changes, such as designing GME programs that link residents with faculty over longer time periods, faculty development in coaching skills, reconsidering clinical faculty roles, and examining the balance between clinical service and education requirements.
“This requires significant changes, such as designing GME programs that link residents with faculty over longer time periods, faculty development in coaching skills, reconsidering clinical faculty roles, and examining the balance between clinical service and education requirements [13,46,52].”
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Gonzalo, J. D., Wolpaw, D. R., Krok, K. L., Pfeiffer, M. P., & McCall-Hosenfeld, J. S. (2019) · Medical Education Online · doi:10.1080/10872981.2019.1591256 · Cited by 39 · see citing works
- Authors
- Wong, B. M., & Holmboe, E. S.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Wong, Brian M.
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-04
- Volume
- 91
- Issue
- 4
- Pages
- 473-479
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2328303310
- Cited by
- 69
- References
- 13
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 7 · 2020: 10 · 2019: 12 · 2018: 5 · 2017: 12 · 2016: 2
- FWCI
- 6.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Medical Research Impacts
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Keywords
- graduate medical education, university faculty, clinical learning environment, patient safety, quality improvement, faculty development, core competencies, clinical microsystems, educational outcomes, clinical outcomes, physician professional development
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Curriculum, Education, Medical, Graduate, Faculty, Medical, Humans, Quality of Health Care, Outcome Assessment, Health Care, Quality Improvement, Patient Safety
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