Evolving Programs in Medical Education

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How do physicians who are enrolled in graduate-level medical education programs navigate landscapes of practice? This is the question Dorene Balmer, PhD, Samuel Rosenblatt, MD, MSEd, and Don Boyer, MD, MSEd, sought to answer through their scholarship endeavors at CHOP.

From 2016 to 2020, Drs. Balmer, Rosenblatt and Boyer followed a cohort of 11 physicians who were completing the Masters in Medical Education (MSEd) program at the University of Pennsylvania’s Graduate School of Education (GSE). In this longitudinal, qualitative study, the researchers used recursive interviewing to learn how the MSEd students were experiencing the program and how they believed the program shaped who they were as medical educators over time.

“One of the benefits of longitudinal work is allowing participants the opportunity to narrate their own growth,” says Dr. Balmer. “In hearing what they had previously shared, they were able to reflect on their growth and say how they had changed.”

Dr. Rosenblatt was also going through the program at the time, which gave the team a unique perspective. Dr. Rosenblatt served as their “curious set of eyes.” The cohort of physicians opened up to him in ways they didn’t with Drs. Boyer, the co-director of the master’s program, or Dr. Balmer.

Evolving views of their role

In preparing their manuscript — which was recently published in Medical Education — Drs. Balmer, Rosenblatt and Boyer wove together common themes from each of the interviews they’d conducted based on Etienne Wenger’s work examining landscapes of practice, the collection of communities of practice that make up one’s professional world. Ultimately, the trio found that as the physician cohort moved through the program, they engaged more broadly, and their views about their roles evolved.

Their work was also rather novel.

“Nobody’s ever really studied a group of physicians in a master’s program through time,” notes Dr. Balmer. “Instead of setting aside five years to follow one group of people, a team will usually perform a cross-sectional study. In following one group over a five-year time period, you learn a lot of things that you can’t get cross-sectionally.”

The team’s work didn’t just focus on how physicians engage with the MSEd program. Their work also examined how physicians are able to take their experiences and connections and use them to create new communities of practice upon completing the program.

In thinking about how to continue their scholarship, Drs. Boyer, Rosenblatt and Balmer have launched a new study. The new study is an off shoot of their recently published work, comparing the experiences of two different cohorts of physicians who are enrolled in the master’s program — one that experienced the program in-person and one that was partially virtual due to the COVID-19 pandemic.

New study feeds off knowledge gained from first study

This new study is being led by Dr. Rosenblatt along with Daniel Herchline, MD, MDEd, who recently completed his hospital Medicine fellowship at CHOP and also shares the team’s passion for all things medical education. The team is eager to hear about the two cohorts’ experiences.

“In collecting data, we have the previous cohort who went through the program in-person, and now, a new cohort who went through (a large portion of) the program virtually. In looking at our data, we’ll be able to get a sense of what things have been the same and what things have been different,” says Dr. Balmer. “It’s important to emphasize that different doesn’t necessarily mean worse or better.”

For a graduate-level program that has been built largely on in-person interaction, their findings will be interesting, indeed.

“We’ve always felt strongly that the in-person component of this program has been so important,” shares Dr. Boyer. “Having this new cohort who completed the first half of the program virtually and who will come together in-person for the first time this July will be different for sure. It will be very interesting to see how this translates in terms of data.”

Key take-away themes

To pivot back to their recently published study, Drs. Balmer, Rosenblatt, and Boyer have a few key takeaways they hope people will get from their work.

“The MSEd program didn’t naturally set out to create communities of practice,” says Dr. Balmer. “They are something that often come into existence when you have a group of people assembled around a shared interest. In looking at our data, once folks moved on from the community of practice that they create in a master’s program, they’re likely to fall out of touch. This doesn’t mean the community was a failure in any way. The members of the cohort will move on and create new communities of practice where they are, thus navigating their own, unique landscape of practice.”

“From the program side, I think a lot of people apply for their master’s degree and view it as a destination, but it’s really just the start,” adds Dr. Boyer. “Hopefully, through the program, we give people a lot of tools to add to the foundation they’ve built, whether that’s at the same institution they graduated from or at a new one.”

Concludes Dr. Rosenblatt, “The transferability is a huge part of what they learn. They learn how they can build a community and seek it out.”