25 General introduction 1 In order to reach this central goal, the following primary research questions have been formulated: 1. What are the content and structure of medical educators’ beliefs about teaching and learning? 2. What is the variety of medical educators’ perspectives on being a teacher? How can this variety be clustered into educator phenotypes? 3. How are medical educators’ beliefs about teaching and learning related to the awareness of their educational identity and mission? 4. To what extent do medical educators mature in their perspectives on being a teacher over time, and which factors contribute to this maturation? Outline of research with an overview of the studies In order to answer the research questions formulated above, we performed qualitative studies, using an exploratory approach. In the study presented in Chapter 3, we included a quantitative analysis as a supportive tool to increase our understanding of the qualitative data. To obtain a broad diversity of beliefs, we recruited medical educators from two medical schools from two different continents, which therefore differed in educational and national culture and organisation. Leiden University Medical Centre (LUMC), the Netherlands, and Stanford University School of Medicine (SUSM), USA, are comparable in their emphasis on scientific education and had implemented reforms towards learningcentred education in the decade prior to the first interviews. In the period between the first interviews and the follow-up interviews (2008-2018) curriculum reform took place at LUMC. The curriculum maintained its learning-centred approach but placed more explicit emphasis on students’ active learning. In addition, an intensive faculty development programme was implemented in which almost all LUMC participants participated. At SUSM, which already had an intensive faculty development programme, no major changes had been made to the preclinical curriculum or to faculty development programmes during this interval. We intentionally chose to select educators who taught in a preclinical setting, as in this setting, learning-centred education is most clearly designed and implemented. Since beliefs about teaching and learning may vary according to the level of teaching,13,15,16 we also wanted to exclude difference in course level as an influencing factor. Another selection criterion was educators’ educational involvement and perceived excellence. The rationale for this selection is that we are specifically interested in the beliefs of the ‘best,’ most respected -and therefore influential- educators.
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