Introduction

The role of the clinician educator (CE) has expanded over the last decade. The traditional skill set was focused on teaching,¹ with most faculty development (FD) programming focused on enhancing these skills.^2,3 CEs now have a need to develop other core competencies such as curricular development, assessment, and more.⁴ FD plays a vital role in acquiring these necessary skills. Although the last decade has seen a rise in FD programs for CEs,^5,6 gaps remain in understanding what competencies are represented in educational resources.

MedEdPORTAL, a MEDLINE-indexed, free, peer-reviewed, open access journal supported by the Association of American Medical Colleges since 2005, addresses the need for accessible, high-quality curricula. With an acceptance rate of 26%,⁷ it offers ready-to-use, standardized educational resources including FD for CEs. The platform was designed to address the issue of “reinventing the wheel” for medical educators. For academic leaders balancing multiple responsibilities, access to well-developed and peer-reviewed FD resources is essential. However, the extent to which MedEdPORTAL addresses the current broad spectrum of FD domains for CEs is currently unknown. Identifying existing gaps could help encourage potential authors to develop and submit curricula, helping to ensure educators continue to benefit from the MedEdPORTAL resources.

Our objectives were to identify the trends in FD domain publications in MedEdPORTAL and highlight current gaps where further resources are needed.

Methods

Four FD experts (A.A., K.F., C.N., A.D.), based on their experience as institutional leads in FD, and their service to the Alliance for Academic Internal Medicine (AAIM) Faculty Development Initiative (FDI) Task Force, led this review. Planning meetings were held to develop search criteria, finalize a review rubric, establish a shared mental model of project goals, and train reviewers.

A search of MedEdPORTAL using the terms “faculty” or “development” published from January 2005 through December 2022 yielded 2133 articles. Searches using “professional development” and “identity formation” did not identify any additional publications. All 4 authors collaboratively reviewed 10 articles to create a shared mental model for inclusion. Inclusion criteria were defined as publications conducted in the United States with a primary target audience of CEs across all medical specialties. Exclusion criteria included publications where the primary learner audience was trainees or faculty in dental, nursing, pharmacy, podiatry, and other nonphysician fields.

Authors A.D. and A.A. reviewed FD publications from 2005 to 2014, while K.F. and C.N. reviewed those from 2015 to 2022. Articles identified from the original search were entered into Microsoft Excel. Inclusion decisions were made independently with differences reconciled collaboratively between the pairs of authors. Included abstracts were then reviewed with a rubric assessing FD domains, medical specialty, and target learner audience (undergraduate medical educators, graduate medical educators for residents and fellows, and faculty educators; online supplementary data Figure 1). The rubric domains were based on the AAIM FDI Task Force’s comprehensive framework, which groups FD topics under 6 domains (Table).⁸ It did not assess publication or curriculum quality. Full article text review was used if discrepancies existed. A post hoc interrater reliability of 92% was calculated using the rate of agreement about article inclusion or exclusion. Rubric submissions underwent descriptive analysis.

TableDomains of Faculty Development Resources

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This study was considered to have exempt status by the Charleston Area Medical Center Institutional Review Board for the protection of human subjects.

Results

A broad search of MedEdPORTAL for articles addressing CE professional development, or FD, from January 2005 to December 2022 returned 2133 articles. Our article selection process is described in the Figure. A total of 275 articles met the final criteria for inclusion. The domain of teaching and learning was the most represented (38.2% of publications, 105 of 275). Other domains addressed were evaluation, assessment, and feedback (28.7%, 79 of 275); personal and professional development (24.4%, 67 of 275); leadership, administration, and organizational development (18.2%, 50 of 275); instructional design and curriculum development (16.7%, 46 of 275); and scholarly activity (12.4%, 34 of 275; online supplementary data Figure 2). The trend of FD-specific publications varied over the years (online supplementary data Figure 3). Most publications incorporated multiple educational domains with the most common overlap being teaching and learning with evaluation, assessment, and feedback. Pediatrics and internal medicine (IM) were the most represented specialty-specific publications. Most (67.3%, 185 of 275) of the publications were not targeted to one specialty and could be used by any specialty without modifications to the material. There was a wide variety in the end target audiences with overlap in some publications: 43.6% (120 of 275) with no specific audience, 28.4% (78 of 275) GME residency educators, 25.1% (69 of 275) undergraduate medical educators, 18.5% (51 of 275) faculty, and 8.4% (23 of 275) GME fellows.

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Discussion

Our review of MedEdPORTAL publications revealed a growing yet uneven body of FD resources across the 6 domains over the past 17 years with the lowest number of publications in scholarly activity and highest in teaching and learning.

The highest number of published FD resources was in 2013 and 2014. The Accreditation Council for Graduate Medical Education (ACGME) formalized the required use of Milestones for trainee assessment in 2013,⁹ which may have contributed to an increase in FD publications, specifically in the evaluation, assessment, and feedback domain. It is unknown if MedEdPORTAL made any changes in advertising or policy that may have contributed.

Most resources focused on the teaching and learning domain (38.2%, 105 of 275), aligning with existing literature. A systematic review of FD resources in family medicine (FM) showed that 65% (30 of 46) of the publications focused on teaching skills.¹⁰ A review for FD published in 2020 also showed that most of the articles focused on teaching improvement.² Our study highlights a notable gap in scholarly activity, with only 12.4% (34 of 275) of resources addressing this domain despite its importance in academic promotion.¹¹ A recent review of FD programs for author development revealed only 20 publications that described formal instruction on scholarly writing.¹² Furthermore, the domain of leadership, administration, and organizational development also remains underrepresented despite the emphasis from new ACGME CE Milestones.¹³

Most of the FD resources identified were concentrated in pediatrics (17.1%, 47 of 275) and IM (10.5%, 29 of 275), followed by emergency medicine and FM. One hundred eighty-five of 275 (67.3%) of the resources had unspecified specialty. This data aligns with prior data from 2016 showing IM, FM, and pediatrics as leading contributors to FD literature.³ Underrepresentation from other specialties may result from publications directed to specialty-specific journals. The impact of cross-specialty versus specialty-specific FD resources is unknown and warrants further investigation. Fellowship faculty were the least represented target audience (8.4%, 23 of 275), while 43.6% (120 of 275) articles had an unspecified target audience.

While this review of MedEdPORTAL was extensive, there are several limitations. With the focus on MedEdPORTAL only, it did not assess resources published elsewhere. Future studies reviewing PubMed and academic society driven FD resources using domain-based framework would offer more insight. This review did not assess the quality or impact of curricula. Finally, we did not calculate interrater reliability during the study, although several iterations of review were conducted to solidify a shared mental model, and a post hoc interrater reliability was calculated.

Our study highlights critical gaps in FD resources, particularly in scholarly activity, leadership, administration, and organizational development, and instructional design and curriculum development, requiring targeted curriculum development by leaders in GME. Further studies of MedEdPORTAL to analyze topics within each domain and measure publication quality will provide additional insights.

Conclusions

Our review of MedEdPORTAL found the FD domains of scholarly activity, and leadership, administration, and organizational development to be least represented. It also highlighted gaps in resources for specialties outside of IM and pediatrics, and for fellowship educators.