Medical educators’ beliefs about teaching, learning, and knowledge: development of a new framework

Ottenhoff- de Jonge et al. BMC Medical Education https://doi.org/10.1186/s12909-021-02587-x (2021) 21:176 RESEARCH ARTICLE Open Access Medical educators’ beliefs about teaching, learning, and knowledge: development of a new framework Marleen W. Ottenhoff- de Jonge1*, Iris van der Hoeven1, Neil Gesundheit2, Roeland M. van der Rijst3 and Anneke W. M. Kramer1 Abstract Background: The educational beliefs of medical educators influence their teaching practices. Insight into these beliefs is important for medical schools to improve the quality of education they provide students and to guide faculty development. Several studies in the field of higher education have explored the educational beliefs of educators, resulting in classifications that provide a structural basis for diverse beliefs. However, few classification studies have been conducted in the field of medical education. We propose a framework that describes faculty beliefs about teaching, learning, and knowledge which is specifically adapted to the medical education context. The proposed framework describes a matrix in which educational beliefs are organised two dimensionally into belief orientations and belief dimensions. The belief orientations range from teaching-centred to learning-centred; the belief dimensions represent qualitatively distinct aspects of beliefs, such as ‘desired learning outcomes’ and ‘students’ motivation’. Methods: We conducted in-depth semi-structured interviews with 26 faculty members, all of whom were deeply involved in teaching, from two prominent medical schools. We used the original framework of Samuelowicz and Bain as a starting point for context-specific adaptation. The qualitative analysis consisted of relating relevant interview fragments to the Samuelowicz and Bain framework, while remaining open to potentially new beliefs identified during the interviews. A range of strategies were employed to ensure the quality of the results. Results: We identified a new belief dimension and adapted or refined other dimensions to apply in the context of medical education. The belief orientations that have counterparts in the original Samuelowicz and Bain framework are described more precisely in the new framework. The new framework sharpens the boundary between teachingcentred and learning-centred belief orientations. (Continued on next page) * Correspondence: 1 Department of Public Health and Primary Care, Leiden University Medical Centre, Hippocratespad 21, Zone V7-P, PO Box 9600, 2300 RC Leiden, The Netherlands Full list of author information is available at the end of the article © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Ottenhoff- de Jonge et al. BMC Medical Education (2021) 21:176 Page 2 of 13 (Continued from previous page) Conclusions: Our findings confirm the relevance of the structure of the original Samuelowicz and Bain beliefs framework. However, multiple adaptations and refinements were necessary to align the framework to the context of medical education. The refined belief dimensions and belief orientations enable a comprehensive description of the educational beliefs of medical educators. With these adaptations, the new framework provides a contemporary instrument to improve medical education and potentially assist in faculty development of medical educators. Keywords: Teacher beliefs, Beliefs, Conceptions of learning and teaching, Educational beliefs, Educational framework, Faculty development, Framework validation, Orientations to learning and teaching Background The beliefs medical educators hold about teaching, learning, and knowledge determine to a large extent their teaching approaches [1–5]. Because personal educational beliefs drive educators’ behaviour while teaching, these beliefs should be considered a starting point from which to improve the quality of education [6, 7]. Supporting this view, Kember and Kwan stated that fundamental changes to the quality of education rely on changes in educational beliefs [8]. Thus, obtaining more insight into those beliefs is important for the quality of education and may help us to understand why education reform can be cumbersome and faculty development often falls short of changing pedagogical practices [9]. Within the context of higher education a number of studies have explored the educational beliefs of educators and have proposed classification rubrics [2, 6, 8, 10–15]. Such classifications are useful to distinguish between beliefs in a structured way and provide insight into relevant aspects of educational beliefs. However, these classification studies have not been conducted in the field of medical education. Our study addresses a framework that can be used in learning-centred rather than teaching-centred curricula, since currently most medical curricula have adopted learning-centred approaches. We propose a beliefs framework to improve suitability in the context of contemporary medical education. Belief orientations Prior classification studies [2, 6, 8, 10, 11, 13–15] have classified beliefs as global orientations in a continuum, ranging from teaching-centred to learning-centred. While teaching-centred belief orientations focus on the transmission of defined content or knowledge, learningcentred belief orientations focus on students’ conceptual understanding and development. Light and Calkins [15] describe a classification differentiating three belief orientations: teaching-centred, intermediate, and learningcentred. However, they do not base their classification on a fixed set of ‘dimensions’, by which is meant qualitatively different aspects of beliefs. Another classification proposed by Postareff and Lindblom-Ylänne [11] distinguishes 10 different dimensions of beliefs about teaching, learning, and knowledge, structured into four groups. However, this study only differentiates the two belief orientations: teaching-centred and learningcentred. Framework of educational beliefs The pr (...truncated)