Modeling lifelong learning: exploring clinical teachers' skill development through the master adaptive learner lens

Clinical teachers must continuously learn new skills to support evolving needs of learners in complex clinical environments. The Clinician Educator Milestones published by the Accreditation Council on Graduate Medical Education delineate the skills needed, yet guidance for how to develop skills is lacking. The master adaptive learner (MAL) framework outlines a process for expertise development, but whether clinical teachers apply this to their own teaching skills development is unclear. The authors explored, through the MAL lens, how master clinical teachers develop their skills and what factors drive changes in their teaching.

The authors conducted a multisite, interview-based, qualitative study of master clinical teachers, using a cocreated definition to inform selection of participants. They developed and refined a semi-structured interview guide and collected demographics through an online survey between February and June 2024. Two authors analyzed the data using thematic analysis through an iterative process.

Twenty-nine clinical teachers participated, representing 11 specialties. The authors identified 4 main themes: (1) master clinical teachers intentionally change and improve their teaching over time; (2) internal and external factors drive change, including learner feedback, reflection, and humility; (3) formal and informal mechanisms enable teachers to change and improve, including faculty development, role modeling, and practice; and (4) changes encompass what and how they teach, with increasing emphasis on learner-centered approaches. The data suggest a master adaptive approach to teacher development-identifying gaps in knowledge through reflection and seeking professional development opportunities (planning), engaging with such opportunities (learning), analyzing feedback after experimenting (assessing), and adopting successful approaches (adapting).

Master clinical teachers describe an active, intentional process to development of teaching skills that maps on the MAL framework. Institutions should support the expansion of faculty development efforts to explicitly promote this approach and address barriers to professional development of clinical teachers.