Factors Affecting Clinical Instructor Participation in Faculty Development Across Workplace Settings: A Scoping Review

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  In Roundtable Session: Future Directions for Faculty Development in Health Professions and Biomedical Education Abstract

Abstract

Objectives
Health professions education (HPE) programs have grown over the past two decades creating greater demand for clinical instructors (CIs), both in academic medical centers (AMC) and community healthcare centers (CHCs). CIs may take on teaching roles with limited training (Swanick, 2008). Faculty Development (FD) includes all informal and formal methods healthcare professions use to develop teaching skills. Despite available FD opportunities, many CIs do not participate (Steinert et al, 2009). Individual and contextual/organizational factors along with CIs’ positioning relative to students’ academic institution likely affect CIs’ participation (Alexandraki et al, 2023). We engaged in a scoping review (ScR) to map existing literature on FD participation to clarify key concepts, identify research gaps, and inform future organizational practices and policy. This ScR explores: 1) How individual and contextual/organizational factors contribute to or inhibit CIs’ participation in FD; 2) How do these factors differ between AMCs and CHCs?

Theoretical/Conceptual Framework
The human resource field developed the Ability Motivation and Opportunity (AMO) Framework to help organizations understand and influence employee behavior within specific contexts. In this model, organizational practices can enhance AMO factors and interact with individual attributes to drive employee behaviors (Applebaum et al, 2000).

Method
We used iterative methods to define our research question, identify and select relevant articles, chart data, summarize findings, and consult with CE’s (Levac et al, 2010). Between November 2023 and August 2024, we searched the electronic databases CINAHL, PubMed, and Web of Science using terms related to clinical teacher, FD, and health occupations. We included peer-reviewed articles between 2010 and 2024 discussing factors affecting CIs participation in FD in AMC and CHC settings. We synthesized data using conventional content analysis with the AMO framework as a sensitizing concept (Hsieh et al, 2005).

Results
The search yielded 3173 papers, of which we included 52. We identified 3 categories affecting FD participation related to AMO: intrapersonal, interpersonal, and organizational. Intrapersonal factors include motivation, beliefs, personal attributes, and professional identity. Interpersonal factors include socialization, mentorship, and role models. The organizational factors include access, program structure, and culture. While the same categories of factors affected FD participation in AMCs (n=31) and CHCs (n=14), the CIs in CHCs encounter greater challenges related to interpersonal and organizational factors. Several articles emphasized the need for organizations to build educator communities in CHCs through collaboration among clinical sites, professional organizations, and school-based FD initiatives (interpersonal factor), while also calling for the integration of teaching into institutional policies (organizational factor).

Scholarly Significance
The results of this ScR builds upon the existing literature to clarify factors impacting participation in FD, highlight potential differences in AMC vs CHC settings, and offer a framework for how organizations can foster FD participation. We described intrapersonal, interpersonal, and organizational factors relating to AMO that influence CI participation in FD. Faculty developers, education and healthcare leaders must consider how organizations can use each of these three factors to enhance AMO in their setting to foster FD participation. This includes careful attention to the organizational factors and contextual differences between AMCs and CHCs to optimize participation in each unique setting.

Authors

• Erin Green, California State University - Sacramento

• Bridget Colleen O'Brien, University of California - San Francisco

• Manon Kluijtmans, Utrecht University

• Huiju Carrie Chen, Kaiser Permanente Bernard J. Tyson School of Medicine