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UBC Theses and Dissertations

How do medical educators think about capacity building through graduate medical educational programs? Cohen, Richard David

Abstract

Medical education in the twenty first century is a complex undertaking and is occurring in a setting of rapidly increasing change. Training students and residents to the point of clinical proficiency requires educational skills and knowledge that are rarely taught to most physicians. Academic health centers are increasingly part of a 'healthindustrial complex' which often places their educational missions in conflict with the revenue-generating requirements of patient care and research. The increasing role of commercial forces in medicine poses threats to the societal obligations of physicians such as patient and healthcare advocacy. Neither has medical education escaped the forces of globalization that have radically transformed much of the planet. Medical educational leaders are therefore going to require skills and knowledge to respond to these challenges. These are capacities that go beyond the scope of most faculty development programs, which usually provide minimal instruction in educational theory and research. Graduate programs in medical education can however satisfy many of these leaders' educational needs. The capacities that these programs will require to address these needs were conceptualized in a framework having outcomes at four levels: 1) individual 2) institutional 3) societal and 4) global. Three focus groups of North American medical educators were asked to discuss these capacities in the context of this framework. Data were also obtained from the mission statements of 21 English-language masters programs in medical education. The focus groups confirmed the importance of graduate educational training for physician-educators, emphasizing topics with individual and institutional implications such as curriculum planning, student assessment, program evaluation and educational research. There was minimal discussion about the societal and global ramifications of medical education. The only significant references to these notions emanated from the mission statements of the minority of medical educational programs located in faculties of education. When characterizing what capacities were important for graduate programs in medical education to develop, medical educators adopted an approach best understood via a framework derived from the adult educational program planning literature. They were reluctant to embrace the broader societal and global notions that have informed adult education over the past few decades.

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