title: Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes.
abstract: The current health care delivery model continues to fall short in achieving the desired patient safety and quality-of-care outcomes for patients. And, until recently, an explicit acknowledgment of the role and influence of the clinical learning environment on professional development had been missing from physician-based competency frameworks. In this Perspective, the authors explore the implications of the insufficient integration of education about patient safety and quality improvement by academic faculty into the clinical learning environment in many graduate medical education (GME) programs, and the important role that academic faculty need to play to better align the educational and clinical contexts to improve both learner and patient outcomes. The authors propose a framework that closely aligns the educational and clinical contexts, such that both educational and clinical outcomes are centered around the patient. This will require a reorganization of academic faculty perspective and educational design of GME training programs that recognizes that (1) the dynamic interplay between the faculty, learner, training program, and clinical microsystem ultimately influences the quality of physician that emerges from the training program and environment, and (2) patient outcomes relate to the quality of education and the success of clinical microsystems. To enable this evolution, there is a need to revisit the core competencies expected of academic faculty, implement innovative faculty development strategies, examine closely faculty's current clinical super vision practices, and establish a training environment that supports bridging from clinician to educator, training program to clinical microsystem, and educational outcomes to clinical outcomes that benefit patients.
authors.affiliation: B.M. Wong is assistant professor of medicine, Department of Medicine, staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, and associate director, Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada. E.S. Holmboe is senior vice president, Milestones Development and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois, and professor adjunct of medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Wong
authors.forename: Eric S
authors.initials: ES
authors.lastname: Holmboe
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005180:Faculty, Medical; D006801:Humans; D017063:Outcome Assessment, Health Care; D061214:Patient Safety; D058996:Quality Improvement; D011787:Quality of Health Care