Training of trainers on medical education reforms: a prospective multicenter French survey among intensivists

The recent reform of the second cycle of medical education in France introduced competency-based medical education (CBME) with the incorporation of several pedagogical modalities into undergraduate training and assessment, including objective structured clinical examinations (OSCEs), simulation-based teaching (SBT), and clinical reasoning (CR) instruction throughout the academic year. While these tools are central to preparing competent practitioners, their effective implementation depends on adequately trained educators. We hypothesized that training would be insufficient, notably in the recently introduced pedagogical modalities.

We conducted a national, cross-sectional survey (June-September 2023) to assess the level and adequacy of training of board-certified physicians practicing in critical care and involved in undergraduate teaching. An anonymous online questionnaire collected demographic data, teaching frequency, training characteristics, perceived adequacy and usefulness of training, preparedness, and barriers. The responses were analyzed descriptively and comparatively.

Among the 151 eligible respondents (72% male, median age 41 years, 70% working in teaching hospitals, and 44% holding an academic position), lectures remained the most common teaching modality despite CBME implementation. Only 60% of the respondents reported involvement in OSCEs. Teachers' training rates across pedagogical modalities were low and heterogeneous: 32% for OSCEs, 30% for SBT, 29% for written assessment design, 24% for lectures, and 12% for CR. Training in the SBT was more often practical, longer in duration, and rated as more useful and adequate than training in other modalities. Overall, the respondents reported moderate preparedness and frequent teaching difficulties. Prior training was associated with higher perceived preparedness and fewer difficulties when teaching students. Lack of dedicated time was the most frequently reported barrier to training (69%).

This national survey revealed insufficient and heterogeneous training of intensivist educators in all pedagogical modalities of the undergraduate curriculum. Trainers report limited preparedness and frequent challenges. Standardized, accessible, and time-protected faculty development programs are urgently needed to support CBME education.