Realist evaluation of faculty development for medical educators : what works for whom and why in the long-term

Purpose: Realism is a perspective in which entities exist independently of being perceived or independently of our theories about them. The realist framework with its principle of explanatory causation was used for an in-depth exploration of faculty development (FD) since, despite the widespread investment in FD, the evidence that it enhances the effectiveness of teaching in the long-term is still limited. The study aimed to develop realist theories that explain the connections between contexts (C), mechanisms (M) and outcomes (O) to find out what works for whom and why in FD. Methods: Purposive sampling was used to select two medical schools from each of the four UK regions (total 8 of the 33 UK medical schools) for interview of a faculty development coordinator and a medical educator at each school. Sixteen interviews were carried out. Data were coded and summarized under contexts, mechanisms, and outcomes (CMO) to derive realist theories. Results: We identified contexts that facilitated FD mechanisms of engagement, motivation, positive perception and professionalization, which led to educators’ outcomes of improved confidence, competence, credibility and career progression. Conclusion: Four realist theories, which support the effectiveness of FD in the long-term, were derived, enabling recommendations for FD stakeholders