Advancing careers in medical education: ‘Practice architectures’ for success in a resource-constrained setting

Abstract

Introduction

Advancement of careers in medical education remains a challenge around the world and is under-researched in resource-constrained contexts. Using the Theory of Practice Architectures (TPA) as a conceptual lens, we investigated the emergence and subsequent development of medical education careers in a resource-constrained country.

Methods

Qualitative semi-structured interviews were conducted with a purposive sample of 14 early-career and leading medical educators from all 9 medical schools and the 1 postgraduate institute in Sri Lanka. Thematic analysis was performed, informed by the three conceptual lenses of TPA: discursive-cultural, material-economic, and socio-political.

Results

Three themes were identified: faculty development as a career-building discourse (discursive-cultural); leadership focused on creating a workforce with expertise in medical education, equal to clinical medicine specialties (material-economic); and collaborative professional networks in health professions education originating from faculty development activities (socio-political).

Conclusion

Using TPA, our findings highlight that faculty development can foster a powerful discourse for promoting academic careers in medical education. Medical education leaders can also play a critical role by establishing formal training programmes in medical education, and collaborative professional networks can improve visibility of careers in medical education, particularly when participants share expertise and resources between institutions and health professions, across the continuum of undergraduate to postgraduate training. TPA can also be used to better understand how cultural, material-economic and socio-political factors can enhance or hinder career development in different contexts, whether resource-limited or well-resourced.

Keywords:

• Staff development
• international medical education
• teacher training

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Context: The conditions (e.g. physical environment, roles and interpersonal relationships, culture) in which medical educators work and careers are established. Context may be understood at an institutional, national or regional level.

Theory of Practice Architectures: A theory on how professional practices, defined by social and ethical understanding of that profession, develop and are shaped by institutional arrangements in particular contexts. These arrangements are discursive (the way people speak and communicate), material-economic (the formal rules, or physical resources) and socio-political (the social relationships, including power hierarchies).

Additional information

Notes on contributors

Asela M. Olupeliyawa

Asela M. Olupeliyawa, MBBS, PhD, is a Professor in the Department of Medical Education and WHO Collaborating Centre for Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Wendy C. Y. Hu

Wendy C. Y. Hu, MBBS, PhD, is a Chair, and Professor of Medical Education, Associate Dean of Learning and Innovation, School of Medicine, Western Sydney University, Sydney, Australia.

Renée E. Stalmeijer

Renée E. Stalmeijer, PhD, is an Assistant Professor in the Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.