title: Pulmonary and Critical Care Medicine Program Directors' Attitudes toward Training in Medical Education. A Nationwide Survey Study.
abstract: BACKGROUND
  Many pulmonary and critical care medicine (PCCM) fellows are interested in improving their teaching skills as well as learning about careers as clinician educators. Educational opportunities in PCCM fellowship programs designed to address these interests have not been well characterized in U.S. training programs.
  
  
  OBJECTIVE
  We aimed to characterize educational content and structure for training fellows to teach in PCCM fellowship programs. We evaluated three major domains: (1) existing educational opportunities, (2) PCCM program directors' attitudes toward the importance of teaching fellows how to teach, and (3) potential components of an optimal teaching skills curriculum for PCCM fellows.
  
  
  METHODS
  We surveyed program and associate program directors who were members of the Association of Pulmonary and Critical Care Medicine Program Directors in 2014. Survey domains included existing teaching skills content and structure, presence of a formal medical education curriculum or clinician educator track, perceived barriers to teaching fellows teaching skills, and open-ended qualitative inquiries about the ideal curricula. Data were analyzed both quantitatively and qualitatively.
  
  
  RESULTS
  Of 158 invited Association of Pulmonary and Critical Care Medicine Program Directors members, 85 program directors and associate directors responded (53.8% response rate). Annual curricular time dedicated to teaching skills varied widely (median, 3 h; mean, 5.4 h; interquartile range, 2.0-6.3 h), with 17 respondents (20%) allotting no time to teaching fellows to teach and 14 respondents (17%) dedicating more than 10 hours. Survey participants stated that the optimal duration for training fellows in teaching skills was significantly less than what they reported was actually occurring (median optimal duration, 1.5 h/yr; mean, 2.1 h/yr; interquartile range, 1.5-3.5 h/yr; P < 0.001). Only 28 (33.7%) had a formal curriculum for teaching medical education skills. Qualitative analyses identified several barriers to implementing formal teaching skills curricula, including "time," "financial resources," "competing priorities," and "lack of expert faculty."
  
  
  CONCLUSIONS
  While prior work has demonstrated that fellows are interested in obtaining medical education skills, PCCM program directors and associate directors noted significant challenges to implementing formal educational opportunities to teach fellows these skills. Effective strategies are needed to design, implement, sustain, and assess teaching skills curricula for PCCM fellowships.
authors.affiliation: 1 Division of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Jeremy B
authors.identifier: http://orcid.org/0000-0002-8922-1955
authors.initials: JB
authors.lastname: Richards
authors.affiliation: 2 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Jennifer W
authors.identifier: http://orcid.org/0000-0002-2710-7268
authors.initials: JW
authors.lastname: McCallister
authors.affiliation: 3 Division of Pulmonary Critical Care, and Sleep Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lenz
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D003479:Curriculum; D004503:Education, Medical, Graduate; D004635:Emergency Medicine / Q000193:education*; D005257:Fellowships and Scholarships; D006282:Health Personnel; D006801:Humans; D010465:Perception; D015272:Pulmonary Medicine / Q000193:education*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000592:standards*; D014481:United States
keywords: clinician educator; curriculum; fellowship training; graduate medical education; perception