Teaching the Teacher: Novel Faculty Development for VA Hospitalists
Background: The US Department of Veterans Affairs (VA) is the largest educator of health professions trainees in the country, but the roles and responsibilities of the modern clinician educator are increasingly challenging and complex. Most VA academic hospitalists with access to professional and faculty development receive it through academic affiliates. Many VA hospitalists lack this option, and teaching within the VA is unique given its specific health system, clinical environments, and patient population.
Observations: Teaching the Teacher is a facilitation-based educational series for inpatient hospitalists at VA medical centers that is tailored to self-reported needs and provides faculty development through the lens of VA medicine. The transition from in-person to synchronous virtual programming allowed for wider dissemination of the program, and to date, 10 VA hospitalist sections across the country have participated in the series.
Conclusions: VA clinicians want and deserve dedicated training to optimize their confidence and skills in their roles as health professions educators. Teaching the Teacher is a pilot faculty development program that has met success based on its goal of meeting the specific needs of VA clinician educators in hospital medicine. It has the potential to serve as a model for clinical educator onboarding and to allow for the rapid spread of best teaching practices among clinical educators.
Teaching the Teacher
Teaching the Teacher began at a single VA institution as a series of in-person, discussion-based faculty development workshops. The series met a local need for collaborative professional development in clinical education for hospitalists and specialists who round with health professions learners on the inpatient wards. Both novice and experienced clinicians participated in the series with positive feedback. Based on the results of the national needs assessment, the program has since expanded to other sites with support from the VHA Hospital Medicine Program Office. The project’s overarching goal was to facilitate sharing of best practices across VA sites and create a network of local and national VA educators that participants could continue to access even after course completion.
Teaching the Teacher is structured into 5 facilitated hour-long sessions that can be completed either daily for 1 week or weekly for 1 month at the discretion of each institution. Each session is dedicated to a subject identified on the needs assessment as being highest yield. The hospitalist needs assessment also identified the preference for targeted faculty development that is relevant specifically to VA clinicians. To meet this need, Teaching the Teacher delivers its content through the unique lens of VA medicine. The educational mission of the VA is threaded throughout all presentations, and tips to maximize teaching in the VA’s unique clinical environments are embedded into each hour. Examples include discussions on how to incorporate veteran patients into bedside teaching, handling challenging patient-practitioner interactions as they pertain to patients, and the use of VA resources to find and teach evidence-based medicine.Each session includes a set of learning objectives; within that framework, facilitators allow participants to guide the nuances of content based on their individual and institutional priorities. The pandemic continues to shape much of the course content, as both hospitalists and their trainees grapple with mental health challenges, decreased bedside teaching, and wide variations in baseline trainee competence due to different institutional responses to teaching during a pandemic.12,16 Content is regularly updated to incorporate new literature and feedback from participants and prioritize active participation. Continuing medical education/continuing educational units credit is available through the VA for course completion.
In the first session on modern learners, participants discuss the current generation of health professions trainees, including how personality characteristics and COVID-19 have impacted their learning experiences, and strategies to improve our ability to teach them successfully (Table 2). 
The course was originally designed to be in person, but the COVID-19 pandemic forced a shift to online format. To achieve a high-quality learning environment, the course implemented best practices in virtual synchronous instruction, including setting expectations for participation and screen use at the beginning of the series and optimizing audiovisual technology.17 During each seminar, the use of breakout rooms, polling, and the chat function fostered and sustained engagement.17 After each seminar, participants received a recording of the session, a copy of the materials reviewed, and links to referenced readings.17 The course preserved the interactive aspect of the curriculum through both these previously described techniques and our novel approaches, such as facilitated live interactions with online VA resources.
The pandemic also had an impact on curriculum content, as facilitation of online learning was a new and necessary skill set for instructors and participants. To meet this evolving need, additions in content addressed best practices in synchronous and asynchronous online learning, and augmented discussions on navigating asynchronous learning modalities such as social media. A virtual format allowed for dissemination of this course across the country and for recruitment of new course facilitators from remote sites. The team of instructors included academic hospitalist faculty from 3 VA institutions.
