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 has 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 beyond original scientific discovery. 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. So much so, that there was traction provided to generate discussions about the concept that we believe teaching forms 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." Once Dr. Fincher navigated her own successful achievement of promotion and tenure using a clinical educator focus, she says, "I became dedicated to helping other people who came behind me have an easier time of getting their education and teaching works - works that really made a contribution to the field -- 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." Dr. Fincher, Vice Dean for Academic Affairs and Professor from the Medical College of Georgia was the 2006 recipient of the AAMC Merrel Flair Award in Medical Education.
The GEA Educational Scholarship Project
The educational scholarship project sought to expand the definition of educational scholarship to encourage promotion and tenure committees to "think outside the box" of traditional criteria. The project began with small group case discussions at the 1999 GEA regional meetings. Attendees were asked to judge about what aspects of these educational works presented in the case studies were deemed scholarly, and what comprised scholarship. The results of these discussions were published in Academic Medicine in September 2000.
Over the next six years, the consensus work continued, culminating in a 2006 conference. The GEA Consensus Conference on Educational Scholarship examined 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 in October 2007 titled "Advancing Educators and Education: Defining the Components and Evidence of Educational Scholarship." 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 GFA members in the consensus dialogue ahs 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 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. Ideally, faculty would be recognized for their educational contributions by membership on the promotion and tenure committee."
Tools for Documenting Scholarship and Scholarly Work in Medical Education
Dr. Deborah Simpson recognizes educational scholarship by three P’s: an educational Product that is Peer reviewed and Published. The traditional peer review process of scientific discovery, one that relies upon ranking of peer-reviewed journals, does not address the full range of scholarship resulting from educational work. The AAMC is addressing this need for peer review of educational materials through the development of MedEdPORTAL, an resource of peer reviewed medical education products that extend 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.” Recently, MedEdPORTAL has transitioned to become its own repository of the materials it peer reviews and makes public, so it will no longer be necessary to contact an author of a product to get access to it.
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. There is no perfect portfolio - no right or wrong - but the portfolio should be an accurate reflection of that person's contributions to the education mission. "Dr. Fincher emphasized that the ultimate goal of using portfolios links high quality educational scholarship to better patient care, and that this outcome happens indirectly through better, more effective teaching and learning.
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."