Introduction to the reference group: professionalisation of teachers

J. de Koning (Nijmegen, The Netherlands)

Background

There is an increased need for rationalisation and improved efficiency of medical education. This development relates to the demands of:

the society with respect to the quality of doctors and of health care
students with respect to their future professional functioning
medical doctors with respect to professional qualifications in connection with the development of medical science

In the context of these demands, medical teaching has to meet higher quality standards in addition to medical, clinical and scientific criteria.

The reference group

Professionalisation of medical teachers is in the variety of medical faculties in Europe in different stages of development. Even on a national level different approaches exist. There is no general overview of national and international policies concerning professionalisation of medical teachers.

In all countries however there is a common idea that teaching as a profession deserves more attention and further development, since it is a crucial element in the quality, efficiency, and structure of medical education.

The aim of the reference group on professionalisation of teachers is to initiate the discussion on this increasingly important topic on a European scale. In order to be able to have a relevant discussion, adequate information should be available and a multinational group of interested people should participate. In the preparation of the conference experts from three different countries were invited, i.e. Dr. Madelena Patricio, from the university of Lisbon, Portugal, Dr. Zoe Jane Playdon from the London University, UK, and Dr. Lia Fluit from the Dutch organisation for professionalisation of teachers: ODOS. It was intended to extend this group to around 20 people representing all countries in Europe.

At the MED-NET conference in Rotterdam the first steps to initiate the discussion were made through presenting information in three countries (Portugal, United Kingdom and the Netherlands respectively), and through the collection of information during a workshop (attended by 18 people from 11 different member states).

The workshop

The Discussions
According to the tradition the discussion on a European level started with the basic question: " where are we talking about?". The concept of professionalisation, its definition, its importance as well as the attitude towards it, has many different elements and may be approached from various point of views. This is illustrated by some statements:

" We live in a system where the teachers find themselves good, and they are assessed by students who either attend their lectures or stay at home".

"Teachers should be promoted on the basis of their education practice instead of their achievements in research".

"How can we make clear to teachers that they should be professionalised? It would be better to give guidelines and standards for good education practice".

These statements stimulated the discussion in two ways; firstly the supporting evidence that professional teaching is in progress became more clear, secondly the different dimensions of professionalisation that have to be considered, were identified.

The development of new ideas concerning professionalisation have been stimulated by:

scientific results from research on teaching and learning
actual evaluations of the quality of teaching
new management theories and experiences
the development and implementation of innovative educational and didactic methodologies

Concerning the characteristic aspects of professionalisation three domains could be identified:

Promotion
Teaching in medicine as a profession means that the teachers should meet a certain qualification criteria, and that there should be critical indicators, criteria and methods to assess the teaching performance. Suggestions were made to think about a teaching dossier. Demonstrating excellence in teaching has to have more impact in the curriculum vitae, and could be the reason for promotion. This implies that professional teachers have clearly defined career perspectives.

Prestige
Within the faculty organisation medical teaching in general has a low status, at least it has not a professional status. Professionalisation in this context means that the organisation should create adequate conditions to increase the status of teaching with respect to the status of research. As a consequence teachers in medicine should have more possibilities or obligations for training and education in order to qualify for the specialised profession. Additionally in taking professionalisation seriously, the assessment of teaching will become increasingly important. Dependent on the local circumstances a variety of assessment tools is available, ranging from students assessment to debriefing sessions and peer evaluation.

Payment
This factor mainly deals with the incentives for teachers to professionalise. The most important incentive at this moment is academic research. Promotion is directly related with international scientific publications. A number of faculties already introduced education awards for excellent teachers. However these awards are mostly local. It was proposed that national or even international awards should be installed. Other, more academic, incentives could be found in educational research, didactic development of courses, education congresses, and application and/or evaluation of innovative teaching technologies.

The remaining questions
As was expected the discussions did not lead to final answers. On the contrary, there remained more questions such as concerning the definition of professionalisation, the specific barriers which exists against professionalisation, the importance, the present state of the art, and the actual information needs. The crucial question providing the impetus for future activities was formulated as follows:

"How to explain to teachers as well as to faculties that teachers in medicine should professionalise?"

This question formed the basic motivation for extending the reference group to a theme committee, and reformulating the objective of this committee as: to stimulate and promote professionalisation of teachers in medicine by raising awareness concerning the issue, and by collecting and presenting structured information.

Activities

The following activities were proposed:

Formulation of a mission statement. Such statement should focus on the proposition that: "Teaching in medicine should have a professional status"
Collection of the state of the art information. This should not be restricted to the actual situation in the European countries, but also include the US, Canada and Australia. The information concerns national policies, organisations, congresses, courses, indicators for quality, incentives, etc.
Presentation of the information to the MED-NET audience via the home-page, the newsletter and/or MED-NET monographs
On the longer term the possibilities to install an international award for medical education should be considered
The committee wants to stimulate and support medical faculties to initiate projects concerning the development of criteria and guidelines for good education practice, and the organisation of European courses or modules for professionalisation of teachers

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