3.3.B. Factors in Applying the Criteria

Determination of satisfaction of applicable criteria is based on material accumulated during the appointment, reappointment or promotion review process; documentation that explicitly and tangibly supports both the quality of performance and the quantity of contributions is required.

The professional judgment of those assessing these data is the critical factor in determining whether the Clinician Educator’s accomplishments meet or surpass the standard of excellence in the overall mix of contributions.

Evaluation should be of total performance.  Taking into consideration the proportionality of contributions, appropriate weight should be given to the quality and quantity of work in the following categories:

1. Clinical Care

Excellence in clinical practice or clinical care is a requirement for those Clinician Educators whose duties include such practice.  Factors considered in assessing clinical performance may include (but are not limited to) the following:

General Clinical Proficiency:  maintains up-to-date knowledge base appropriate to scope of practice; maintains current technical/procedural proficiency; applies sound diagnostic reasoning and judgment; applies sound therapeutic reasoning and judgment; applies evidence from relevant scientific studies; seeks consultation from other care providers when appropriate; maintains appropriate clinical productivity; and demonstrates reliability in meeting clinical commitments.

Communication:  communicates effectively with patients and their families, physician peers, trainees, and other members of the health care team (for example, nurses, nurse practitioners, respiratory therapists, pharmacists); and maintains appropriate medical documentation.

Professionalism:  treats patients with compassion and respect; serves as patient advocate (puts the patient first); shows sensitivity to cultural issues; treats physician peers, trainees, and other members of the health care team (for example, nurses, nurse practitioners, respiratory therapists, pharmacists) with respect; is available to colleagues; responds in a timely manner; and respects patient confidentiality.

Systems-Based Practice:  effectively coordinates patient care within the health care system; appropriately considers cost of care in medical decision-making; participates in quality improvement activities; and demonstrates leadership in clinical program development and administration.

The Clinician Educator Line may include individuals who contribute indirectly to patient care in clinical environments that heavily emphasize technology and/or a multidisciplinary approach.  For example, a radiation physicist may play an integral role in treatment planning for individual oncology patients or a biomedical engineer may work closely with a surgeon or interventional cardiologist to develop and implement new treatment strategies.  In such cases, factors considered in assessing clinical performance may include (but are not limited to) applicable factors described above.

2. Teaching

A standard of excellence or of acceptable performance in teaching is essential for appointment, reappointment and promotion in the Clinician Educator Line.  Teaching is broadly defined to include such areas as clinical “bedside” teaching, didactic instruction, presentations, career mentoring and advising, program building, and development of written, audio, video and digital materials.  Factors considered in assessing teaching performance may include (but are not limited to) the following:  knowledge of the material; clarity of exposition; positive style of interaction with trainees; availability; professionalism; institutional compliance and ethics; effective communication skills; helpfulness in learning; ability to stimulate further education; and ability to work effectively as part of the teaching team.

Teaching is broadly defined as activities that further medical knowledge and/or promote health. Teaching may target traditional trainees, medical personnel, special interest groups or lay populations. Teaching may, for example, be of undergraduates, medical students, residents, clinical and postdoctoral fellows, nurses and ancillary staff, other physicians, or non-medical individuals or groups.

3. Administration

Administration (including what might be called institutional citizenship) may at times be a factor in appointment, reappointment and promotion decisions.  For example, many administrative duties critical to all aspects of the operation of the School of Medicine require input from, or direction by faculty and/or Clinician Educators.  Thus, Clinician Educators are encouraged to participate in administration of the School’s programs, and both the scope and the quality of administrative performance may be considered in their reappointment and promotion.  Those with significant ongoing administrative duties, such as Service Line Directors, IT Leaders, Quality Officers, Division Chiefs and others involved in the operation of Stanford Health Care and Lucile Packard Children’s Hospital, are understood to have less time for clinical care and teaching compared to colleagues without such duties (though administrative duties per se may lead to unusual opportunities for advancement of clinical medicine).  In such cases, the quality of performance may be considered in the reappointment and promotion process.  In addition, assignment to such administrative duties is at will and subject to termination upon the agreement of Stanford Health Care or Lucile Packard Children’s Hospital, as applicable, and the School of Medicine.

4. Scholarship

Scholarship is not a requirement in the Clinician Educator Line.  However, in some cases, scholarly activities will flow naturally from the Clinician Educator’s clinical responsibilities and, in turn, scholarly work may lead to innovative approaches in the care of patients, the education of trainees, and/or advances in medicine.  As such, it may be a factor in appointment, reappointment and promotion decisions; in such cases written scholarship that advances the field will almost always be required. Factors considered in assessing scholarship may include (but are not limited to) the following:  scholarly activity and productivity, impact, innovation and creativity; recognition in the field; ability to work effectively as part of a research team; effective communication with colleagues, staff and students; and professionalism, institutional compliance and ethics. Clinician Educators who engage in scholarly activities should, at a minimum, meet a standard of acceptable performance as defined in Section 3.2.E.1.

5. Principal Investigator Waivers

Clinician Educators appointed in the School of Medicine are eligible to apply for Principal Investigator waivers.  The Research Management Group’s website http://med.stanford.edu/rmg/piwaiver.html provides details on the permitted research activity, waiver eligibility criteria and request procedures.

6. Respectful Workplace

The School of Medicine is committed to providing a work environment that is conducive to teaching and learning, research, the practice of medicine and patient care.  Stanford’s special purposes in this regard depend on a shared commitment among all members of the community to respect each person’s worth and dignity.  Because of their roles within the School of Medicine, Clinician Educators, in particular, are expected to treat all members of the Stanford Community with civility, respect and courtesy and with an awareness of the potential impact of their behavior on staff, students and other faculty members.

As detailed earlier in this section, application of criteria for evaluating the quality of clinical care and teaching include specific expectations regarding a Clinician Educator’s professional behavior in the workplace.  They are reiterated here to emphasize their importance as factors in appointment, reappointment and promotion actions.

In clinical care activities, such factors relevant to evaluation of whether the standards for clinical performance have been met may include: professionalism, institutional compliance and ethics; humanism; ability to work effectively as part of the health care team; and effective communication with colleagues, staff, students and patients.

In teaching activities, such factors relevant to whether the standards for teaching have been met may include:  a positive style of interaction with students; availability; professionalism; institutional compliance and ethics; effective communication skills; helpfulness in learning; and ability to work effectively as part of the teaching team.

In addition, for those Clinician Educators who engage in scholarly activities, such factors relevant to whether the standards for scholarship have been met may include the ability to work effectively as part of a research team; effective communication with colleagues, staff and students; and professionalism, institutional compliance and ethics.

Results from the distribution of clinical excellence and teaching evaluation forms, as well as from referee letters, will aid reviewing bodies in assessing a Clinician Educator’s performance in the workplace.