Spotlight

Dr. Ruth-Marie Fincher Embraces the Challenge of Educational Scholarship

By Stuart Ruff, sruff@aamc.org and Valarie Clark, MPA, vclark@aamc.org

At the heart of every movement for change is a pioneer whose passion and persistence over time opens new opportunities for others. Such is the case with Ruth-Marie (Rhee) Fincher, M.D., and the evolution of contemporary thinking that describes educational scholarship. Dr. Fincher's leadership with the AAMC's Group on Educational Affairs (GEA) and her career focus on educational scholarship have paved the way for the academic medicine community to engage in constructive discourse and actions on this issue. She has championed change on how medical schools define, document, evaluate, reward and most importantly, value medical school faculty members' educational contributions.

A Professional Challenge Evolves into a Leadership Initiative

Dr. Fincher explains that many factors, from professional experiences to timing, influenced her leadership and advocating for educational scholarship. She speaks candidly about the frustration she felt early in her career to find mentors following a similar path—a path of improving teaching excellence in the academic medicine environment.

She recalls, "I had a conversation with the president of my health sciences university where I said that teaching should be recognized in the promotion and tenure process. He told me that teaching could not be evaluated, but if I could prove that teaching quality could be quantified and evaluated, he would make sure it counted." Dr. Fincher recognized this challenge as one with the potential to influence and change the institutional environment.

The Time Was Right

Dr. Fincher notes that, "the academic environment was fertile for growing this concept." The publication of Dr. Ernest Boyer's "Scholarship Reconsidered: Priorities of the Professoriate" and Dr. Charles Glassick's subsequent work, "Scholarship Assessed: Evaluating the Professoriate," opened a national discussion of educational scholarship encompassing more than scientific discovery (research). At the same time, medical school faculty responsibilities were changing and many were expected to earn more of their salary from grants and clinical work.

"There was a risk in many medical schools of the education enterprise taking a second seat. Boyer and Glassick's works provided traction for discussions about the quality of teaching and scholarship related to education, concepts that strengthen education, the centerpiece of the core mission of our medical schools. Therefore, teachers must be valued in every way—in the process of promotion, tenure, awards, honorific recognition, committee memberships, salaries, and so forth." Dr. Fincher reports that she navigated her own successful achievement of promotion and tenure using a clinical educator focus, "I became dedicated to helping other people who came behind me have an easier time of getting their education and teaching contributions recognized."

The Team Was Right

Dr. Fincher acknowledges that the evolution of educational scholarship is a result of risk taking and teamwork. She served on the GEA national steering Committee from 1995-1999, a time when educational scholarship was a priority on the GEA's agenda for action. "I had the privilege of being involved in a leadership sort of way with educational scholarship for more than a decade. Nevertheless, the real reason it has moved forward is the remarkable group of people who came together...I have had the wonderful fortune of being a coach, and a facilitator, and sometimes the provocateur, but certainly not the only person to make this happen."

The GEA Educational Scholarship Project

The educational scholarship project seeks to value educators by expanding the definition of educational scholarship to encourage promotion and tenure committees to "think outside the box" of traditional criteria and developing an infrastructure to support educational scholars. The project began with small group case discussions at the 1999 GEA Regional meetings. Attendees were asked to judge what aspects of educational works presented in case studies were deemed scholarly, and what comprised scholarship. The results of these discussions were published in a 1999 Academic Medicine article, Making a Case for the Teaching Scholar. A more extensive publication in Academic Medicine in September 2000, Scholarship in Teaching: An Imperative for the 21st Century, framed a broader definition.

Over the next six years, the consensus work continued, culminating in the GEA's 2006 Consensus Conference on Educational Scholarship. This conference invited representatives from the GEA and Faculty Affairs community to examine criteria for and core elements of educational scholarship, documentation of works for recognition and academic promotion, and necessary resources and infrastructure required to support educators as scholars.

The conference proceedings were published in a monograph, Advancing Educators and Education: Defining the Components and Evidence of Educational Scholarship in October 2007. A brief summary is available in the Winter 2007 Faculty Vitae article, Educational Scholarship: How Do We Define and Acknowledge It? The national conversation concluded that, "educational scholarship is any product or any education related resource that is designed for a purpose related to medical education, and that is reviewed by peers to assess quality, and is made public for others to learn from and build upon."

Academic Advancement of Educators

Effective systems for promoting educational scholarship and advancing educators includes well-informed medical school and university faculty promotion committees, and effective tools for documentation and peer review of scholarly work in education. Engagement of Group on Faculty Affairs (GFA) members in the consensus dialogue has been essential in providing clear, detailed information about educational scholarship to faculty affairs deans, who can then inform members of Promotion and Tenure (P&T) committees. As the number of educators successfully promoted by these standards increases, they will bring their own expertise to the table as members of P&T committees.

How would Dr. Fincher describe an ideal P&T system? She responds, "An ideal P&T system would recognize educational scholarship in a way that is equivalent and parallel to recognition of clinical, bench or translational research. Such a system would need to realize there is relatively little grant funding for educational research and even less for educational scholarship. Faculty who are recognized for their educational contributions would be members of the promotion and tenure committee."

Tools for Documenting Scholarship and Scholarly Work in Medical Education

Dr. Deborah Simpson popularized the "three P's" of educational scholarship: an education Product that is Peer-reviewed and made Public. The traditional peer review process of scientific discovery relies on publication in peer-reviewed journals and does not address the full range of scholarship resulting from educational work. One method of addressing the need for peer review of educational materials is MedEdPORTAL, a resource of peer-reviewed medical education products that extends across the continuum of medical education to address the needs of medical educators. A proponent and user of MedEdPORTAL, Dr. Fincher believes that educational scholarship and MedEdPORTAL are "inextricably related." There is discussion about MedEdPORTAL transitioning to a repository of the materials it peer reviews and publishes. MedEdPORTAL staff will send complimentary resources upon request.

Critical to the review for promotion of educators is the Educator Portfolio, a documentation of teaching, curricular materials and learner outcomes. Dr. Fincher notes that "in many schools, the portfolio is another opportunity for those who have made education the centerpiece of their career to display their educational contributions, including quantity, quality, evidence of a scholarly approach to educational activities, and scholarship. There is no 'perfect' portfolio but the portfolio should be an accurate reflection of that person's contributions to the education mission."

Moving the Core Mission of Medical Education Forward

Dr. Fincher summarizes the importance of medical schools recognizing and rewarding educational scholarship, "We all have a central core mission of teaching. Embracing the principles of educational scholarship improves teaching. It fosters innovation in teaching, and helps to advance the field of medical education to enhance students' and residents' learning. Ultimately quality education makes better doctors who take better care of patients. To me, it is just logical that all schools adopt these principles—because in doing so they are helping to move forward the common agendas of all medical schools."

References

1. Boyer EL. Scholarship Reconsidered: Priorities of the Professoriate. San Francisco: Jossey-Bass, 1990.

2. Glassick CE, Huber MT, Maeroff GI. Scholarship Assessed: Evaluation of the Professoriate, San Francisco, CA: Jossey-Bass, 1997.

3. Fincher RM, Simpson DE, Mennin SP Rosenfeld GC, Rothman A, McGrew MC, Hansen PA, Mazmanian, P E, Turnbull JM.
Scholarship in Teaching: An Imperative for the 21st Century. Acad Med. 2000;75(9):887-894.

4. Fincher RM, and Work JA. Perspectives on the Scholarship of Teaching. Medical Education. 2006; 40(4):293-295.

5. Simpson, DE and Fincher, RM. Making the case for the teaching scholar. Acad Med. 1999;74(12):1296-1299.

6. Simpson D, Hafler J, Brown D, Wilkerson L. Documentation Systems for Educators Seeking Academic Promotion in U.S. Medical Schools. Acad Med. 2004;79:783-790.

7. Simpson D, Fincher RM, Hafler JP, Irby DM, Richards BF, Rosenfeld GC, Viggiano TR. Advancing Educators and Education: Defining the Components and Evidence of Educational Scholarship. Proceedings from the Association of American Medical Colleges Group on Educational Affairs Consensus Conference on Educational Scholarship, 9-10 February 2006, Charlotte, NC. Washington DC: AAMC 2007.

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