Perspectives of Academic VA Clinician Educators: A Qualitative Analysis from a Single Facility.

Objective

As part of a quality improvement initiative focused on medical educator faculty development, we sought to explore the perspectives of clinician-educators based at a large urban Veterans Affairs Medical Center (VAMC) who navigate the workplace communities of both their VAMC and academic medical center (AMC).

Methods

Informed by the conceptual framework of Communities of Practice proposed by Lave and Wenger, we conducted semistructured interviews from 2023-2024 with 20 VAMC-based clinician-educators holding faculty appointments at the affiliated AMC. We used purposive sampling to recruit a wide range of participants capturing differences in factors such as academic rank, subspecialist versus internal medicine specialist, and formal educational positions at the AMC.

Results

We identified three themes from the interviews: professional fulfilment from mission-driven care and mentoring of trainees; facilitation of the clinician-educator role by the VAMC environment; and the impact of geographic distance on faculty integration. In the last theme, several participants highlighted how working closely within the VAMC promoted strong collegial relationships within the facility, and physical separation from the AMC led to perceptions of professional distance from medical school faculty colleagues.

Conclusions

Educating the next generation of healthcare professionals remains one of the core missions of the VA and supporting VA-based clinician-educators is critical to fulfilling this mission. Our study reveals the importance of the geographic distance between AMC and VAMC and its translation to perceptions of collegiate distance among individual VA faculty. We discuss strategies to foster connectivity between AMCs and VA facilities alongside strengthening VA-specific faculty development as potential solutions.