Academic standards and scholarship

S. Mennin

“We believe that it is time to move beyond the tired old ‘teaching versus research’ debate and give the familiar and honorable term ‘scholarship’ a broader, more capacious meaning, one that brings legitimacy to the full scope of academic work. Surely, scholarship means engaging in original research. But the work of the scholar also means stepping back from one’s investigation, looking for connections, building bridges between theory and practice, and communicating one’s knowledge effectively to students.”

Boyer 1990

Introduction

Academic standards are what the academy and society mutually agree upon as benchmarks of quality that shape and frame the roles, responsibilities and actions of the professoriate. Education and the scholarship of education are not neutral. They are political, social and historical (Freire 1993) and involve choices about setting the agenda for what and how future health professionals will learn and whom they will serve, and how teachers will live and work in the academic world. Scholarship is a cornerstone of university life that can guide the future of medical education and the development of teachers in the health professions. In most parts of the world, opportunity for academic advancement is limited.

Standards, like culture, are slow to adapt to changing circumstances. There continues to be a need for adaptive change in medical education, to modernize curricula to be more socially responsible, incorporate other pedagogies, introduce early and sustained clinical experiences, promote viable community-based education and use new technologies in the learning/assessment process. At the same time, strained economies and the migration of health professionals are pushing already overburdened health systems to adapt. The pressures on faculty and staff to do more with less are greater than ever before. Monetary pressures have pushed academic medical centre leaders to adopt values and fiscal policies more attuned to the entrepreneurial world of business than to the primary goals of health, learning and scholarship. There is a danger that the core values of learning and scholarship are being subjugated to a profit-oriented world. The internet, diseases without borders, conflicts and other international events emphasize the essential role of collaboration in the face of complex regional and transnational issues. The call for international or global standards in medical education that respect regional cultural integrities grows stronger.

Brazil, India, Australia, the United States, many parts of Africa and Asia have published national requirements and standards for the implementation of core (standard) competencies for medical education. Paradoxically, one observes in medical curricula less attention and time devoted to discussion, reflection and problem solving related to failure of healthcare systems and the millions of people who are without access to basic attention and healthcare.

Double standard: Research, patient care and teaching

“The scholarly enterprise of teaching includes the creative development of innovative pedagogic practices and course materials, and aims to encourage independent learning and critical thinking. Scholarly teaching requires enthusiastic, intellectually engaged faculty who are well informed about the latest advances in their disciplines.”

Marks 2000

There is a double standard: one for research and patient care and another one for education. Research and patient care have clear, well-established rules, expectations and standards and formal preparation for professional roles and responsibilities. The ability to generate outside funding from research and/or clinical care confers influence and status in academic and political processes. The culture of research and patient care is highly developed and almost universally accepted. Not so for scholarly work in education. Unlike research and patient care activities, teachers in the health professions rarely receive formal preparation for the teaching–learning process, education and assessment of learners. Poor teaching performance is tolerated, whereas poor quality in research and substandard patient care are not. Peer review is well established for research and patient care activities, yet still remains relatively undeveloped in teaching and other educational activities. Teachers at medical schools are well aware that the rewards and recognition for research and patient care are substantive and those for teaching and education much less so.

The absence of a common language in education and related shared values presents a major barrier to the coherent integration of scholarship and teaching. Few teachers can accurately describe how people learn, what is known about the development of expertise or the application of basic concepts and approaches to assessing learners. Even fewer can formulate and pursue research questions related to health professions education. It is a disturbing observation that those who are entrusted with the care and preparation of their successors are ill-informed about contemporary approaches to learning, teaching and education. We profess, but are we professional?

Professionalizing teaching

It is time to professionalize teaching and education; to have agreed-upon standards for teaching that are part of, rather than separate from, scholarly work and to hold teaching to the same high standards as research and patient care. How can this be done? Broadening the definition of scholarship to include the scholarship of discovery, application, integration and teaching (Boyer 1990) makes it feasible to articulate and reward all forms of excellence and to support an enriched culture for education and teaching in health professions schools.

Broadening the definition of scholarship

“What we urgently need today is a more inclusive view of what it means to be a scholar – a recognition that knowledge is acquired through research, through synthesis, through practice and through teaching.”

Boyer 1990

The traditional academic definition of scholarship applied by health professions schools to the work of the professoriate is exclusive; reserved only for those who conduct research and publish in peer reviewed journals. Large areas of legitimate academic activity and productivity vital to fulfilling the educational mission in the health professions are excluded by this definition. The work of the professoriate essential to the success of educational change and innovation is at risk of failing to be recognized because it lies outside the purview of the traditionally accepted forms of scholarship. A broader and more inclusive definition of scholarship goes beyond the discovery of new ways of knowing and new knowledge to include integration, application and teaching. It enables educators to pose important questions (Table 46.1) (Boyer 1990, Glassick et al 1997). This broader approach to scholarship is inclusive, establishing criteria for and recognizing the value of teaching as part of the merit and promotion process at a time when changes in education are needed (McGaghie 2009).

Table 46.1

Four arenas of scholarship

Category of scholarship	Description	Questions posed
Discovery	Knowledge for its own sake	What is known? What is yet to be found?
Integration	Making connections across disciplines, illuminating data in a real way, interpreting, drawing together and bringing new insight to bear on original work	How do these findings fit together … with what is already known?
Application	Engagement with society to apply what is known	How can what is known be responsibly applied to consequential problems? How can it be helpful to individuals, society and institutions?
Teaching	To make accessible and to participate in the transformation of what can be known with others	How can what is known be shared? How can what is known be transformed?

From Boyer EL: Scholarship Reconsidered: Priorities of the Professoriate. The Carnegie Foundation for the Advancement of Teaching. San Francisco,1990, Jossey-Bass.