184 Chapter 7 The overarching aim of this dissertation is thus to deepen our understanding of how medical educators mature over time, and how this maturation relates to their beliefs about teaching and learning. To achieve this aim, we performed qualitative studies, using an exploratory approach. We interviewed medical educators, all of whom were deeply involved in teaching, from two medical schools from two different continents, and which therefore differed in educational and national culture and organisation. Leiden University Medical Centre, the Netherlands, and Stanford University School of Medicine, CA, USA, are comparable in their emphasis on scientific education and had implemented reforms towards learning-centred education in the decade prior to the initial interviews. To gain insight into educators’ maturation, we performed follow-up interviews a decade after the initial ones with the same participants who were still available. Chapter 2 presents a study on medical educators’ beliefs about the process of teaching and learning. It proposes a framework specifically adapted to the context of medical education that describes the content and structure of beliefs about teaching, learning, and knowledge. The framework consists of a matrix and describes beliefs in terms of belief orientations (indicated in the columns in the matrix) and belief dimensions (indicated in the rows in the matrix). The belief orientations, which represent a global, composite set of beliefs about teaching, learning, and knowledge, range from teaching-centred to learning-centred. The belief orientations are defined by the dimensions which each represent a different aspect of the belief orientations regarding teaching, learning, and knowledge. Within each dimension three or four beliefs can be distinguished, ordered on a continuum from teaching-centred to learning-centred. To adapt the framework, we conducted the initial semi-structured interviews with 26 medical educators in the period of 2008-2010. We used a framework, developed in higher-education non-medical contexts, as a starting point for context-specific adaptation. The qualitative analysis consisted of relating relevant interview fragments to this framework, while remaining open to potentially new beliefs identified during the interviews. The most important adaptation from the original framework is the addition of a new belief dimension, which we labelled: ‘Creation of a conducive learning environment.’ The belief orientations that have counterparts in the original
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