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Featured Topic Article
Community-Engaged Scholarship: Is Faculty
Work in Communities a True Academic
Enterprise?
Diane C. Calleson, PhD, Catherine Jordan, PhD, and Sarena D. Seifer, MD
Abstract
Since Ernest Boyer’s landmark 1990 re-
port, Scholarship Reconsidered: Priorities
of the Professoriate, leaders in higher
education, including academic medicine,
have advocated that faculty members
apply their expertise in new and creative
ways in partnership with communities.
Such community engagement can take
many forms, including community-based
teaching, research, clinical care, and ser-
vice. There continues to be a gap, how-
ever, between the rhetoric of this idea
and the reality of how promotion and
tenure actually work in health profes-
sions schools.
The Commission on Community-En-
gaged Scholarship in the Health Profes-
sions was established in October 2003
with funding from the W.K. Kellogg
Foundation to take a leadership role in
creating a more supportive culture and
reward system for community-engaged
faculty in the nation’s health professions
schools. The authors prepared this article
to inform the commission’s deliberations
and to stimulate discussion among edu-
cators in the health professions. The au-
thors define the work that faculty en-
gage in with communities, consider
whether all work by faculty in communi-
ty-based settings is actually scholarship,
and propose a framework for document-
ing and assessing community-engaged
scholarship for promotion and tenure
decisions. They conclude with recom-
mendations for change in academic
health centers and health professions
schools.
Acad Med. 2005; 80:317–321.
The scholarship of engagement means
connecting the rich resources of the uni-
versity to our most pressing social, civic
and ethical problems, to our children, to
our schools, to our teachers and to our
cities. . . . I have this growing conviction
that what’s also needed is not just more
programs, but a larger purpose, a sense of
mission, a larger clarity of direction in the
nation’s life as we move toward century
twenty-one.
—Ernest Boyer, Scholarship Reconsidered:
Priorities of the Professoriate
Since Ernest Boyer’s landmark 1990
report,1
from which the above quote was
taken, leaders in higher education, in-
cluding academic medicine, have advo-
cated that faculty members apply their
expertise in new and creative ways in
partnership with communities.1–3
In the
Institute of Medicine’s November 2002
Report, Who Will Keep the Public
Healthy?, leaders endorsed Boyer’s work
by emphasizing the need to shift faculty
roles and rewards to support faculty
commitment to communities. It recom-
mends that academic institutions should
develop criteria for recognizing and re-
warding faculty scholarship related to
service activities that strengthen public
health practice, and that the National
Institutes of Health should increase the
proportion of its budget allocated to pop-
ulation- and community-based preven-
tion research.4
There is a gap, however, between recom-
mendations made by national commis-
sions and national governing bodies, and
the reality of how promotion and tenure
actually works in health professions
schools. Generating support in academic
health centers for faculty work in com-
munities is a challenge for both external
and internal reasons. Externally, the sur-
vival of clinical departments and their
faculty are dependent on the ability to
maintain a combination of clinical and
research revenues. Other health profes-
sions schools, including schools of public
health, are equally dependent on govern-
ment grants and contracts to sustain
themselves. Community-based activities
are often not consistent with these de-
mands for generating extramural sources
of support.
Internally, faculty roles and rewards poli-
cies can be barriers to significant and sus-
tained faculty involvement in communi-
ties.5–7
Untenured faculty are more likely
to receive promotion for publishing arti-
cles in peer-reviewed journals than for
demonstrating an active commitment to
addressing community problems.5
Fac-
ulty are thus reluctant to apply their ex-
pertise to community-based concerns.8
It
is too professionally risky.
To address these persistent challenges,
the Commission on Community-En-
gaged Scholarship in the Health Profes-
sions was established with funding from
the W.K. Kellogg Foundation in October
2003. Comprising a diverse group of
leaders from academic institutions, pro-
fessional associations, community-based
organizations, philanthropy, and govern-
ment, the commission has been charged
to take a leadership role in creating a
more supportive culture and reward sys-
tem for community-engaged faculty.
In this article, prepared to inform the
commission’s deliberations, we define the
work that faculty engage in with commu-
Dr. Calleson is assistant professor, Public Health
Leadership Program, School of Public Health,
Department of Family Medicine, University of North
Carolina at Chapel Hill School of Medicine, Chapel
Hill, North Carolina.
Dr. Jordan is director, Children, Youth and Family
Consortium, University of Minnesota, and assistant
professor of pediatrics, University of Minnesota
Medical School—Twin Cities.
Dr. Seifer is research assistant professor,
Department of Health Services, University of
Washington School of Public Health and Community
Medicine, Seattle, Washington, and executive
director, Community-Campus Partnerships for
Health, Seattle, Washington.
Correspondence should be addressed to Dr.
Calleson, Assistant Professor, Public Health
Leadership Program, CB#7469, School of Public
Health, University of North Carolina at Chapel Hill,
Chapel Hill, NC 27599-7469; telephone: (919) 966-
1769; e-mail: ͗Calleson@med.unc.edu.͘.
Academic Medicine, Vol. 80, No. 4 / April 2005 317
nities, consider whether all work by fac-
ulty in community-based settings is
scholarship, and propose a framework for
documenting and assessing community-
engaged scholarship for promotion and
tenure decisions. We conclude with rec-
ommendations for change in academic
health centers and health professions
schools.
Aligning Institutional Mission
with Faculty Work
If we want faculty to be involved ͓in com-
munities͔ but reward them for other ac-
tivities, we are our own worst enemies.
—Associate vice provost, public academic
health center
At the core of any discussion of faculty
roles and rewards, as noted by Boyer1
and
Sandmann et al.,9
is that faculty work
should be framed within the context of
the institution’s missions, and measures
of assessment should be developed based
on the actual “work” in which faculty are
engaged and to which they are commit-
ted. This is especially true for faculty who
are involved in community-based work
and whose institution’s mission directly
supports these activities, regardless of
whether they are all scholarly activities.
Thus, just as classroom- and hospital-
based teaching, basic science research,
and clinical care are critical to the aca-
demic health center mission, communi-
ty-based teaching, community-based re-
search, and community service are
equally valuable. In line with the Institute
of Medicine, we believe that community-
based work that benefits communities
and advances the institution’s mission
should count more significantly than it
currently does toward faculty promotion
and tenure decisions.
Several health professions schools have
codified these values in their promotion
and tenure policies, including the De-
partment of Family Medicine and the
School of Public Health at the University
of North Carolina, the University of
Washington School of Public Health and
Community Medicine, and Portland
State University.10–13
Steiner et al.14
and
Steckler et al.15
have published the lessons
learned and the strategies they used to
change promotion and tenure guidelines
in the Department of Family Medicine
and the School of Public Health, respec-
tively, at the University of North Carolina
at Chapel Hill. (The article by Steiner et
al. is in this issue of Academic Medicine.)
Portland State University (PSU) has also
published its experience with taking a
campus-wide approach to promoting
community-engaged scholarship.
Through intensive internal and external
discussions, PSU adopted a clearly articu-
lated mission and strategic plan that
guided a series of transformational events
in the 1990s, including revised promo-
tion and tenure guidelines that recognize
and reward faculty contributions to com-
munity engagement.16,17
The experiences of these and other insti-
tutions demonstrate that recognizing and
rewarding community-engaged scholar-
ship requires changes not only in the
wording of policies and procedures, but
even more importantly in institutional
culture. Such changes are only possible
when approached from multiple leverage
points simultaneously.8
Defining Scholarship
Faculty are engaged in a range of activi-
ties, not all of which should be consid-
ered scholarship. Two proposed models
can help promotion and tenure commit-
tees determine whether a given faculty
activity is “scholarship.” Glassick et al.18
proposed a model that evaluates faculty
work as scholarship based on the degree
to which a faculty member establishes
clear goals, is adequately prepared, uses
appropriate methods, has significant re-
sults, creates an effective presentation of
the work, and reflects critical activity.
Diamond and Adam19
suggest a model
for scholarship that “requires a high level
of discipline-related expertise, breaks new
ground or is innovative, can be repli-
cated, documented, peer-reviewed and
has a significant impact.”
Not all faculty work in communities
meets these definitions of scholarship. As
a junior faculty physician noted (in a ses-
sion at the 2002 annual meeting of the
Association of American Medical Col-
leges ͓AAMC͔20
), she provided clinical
care that is valued by her department
through leadership in an innovative clini-
cal program in a poor urban community,
yet she struggles to make it have a central
role in her promotion and tenure portfo-
lio. While delivering clinical service alone
is not scholarship, it is critical to advanc-
ing her medical school’s mission to pro-
vide care to the underserved. However, if
this same junior faculty member had
demonstrated innovation in clinical prac-
tice, potential for replication in other
communities, documented significant
patient outcomes, and published the
findings in a peer-reviewed journal, this
work would have met Diamond and
Adam’s definition of scholarship.
Defining Community-Engaged
Scholarship
As a result of Boyer’s effort to expand the
framework for scholarship, institutions of
higher education are using broader defi-
nitions of scholarship, encompassing a
continuum of faculty work ranging from
discovery, to the integration of discovery
with application, to work that is primar-
ily the application of faculty exper-
tise.21,22
We posit that faculty work in
communities exists along this contin-
uum. In this article, we use the term com-
munity-engaged scholarship to reflect this
range of faculty work in communities
that meets Glassick et al.’s and Diamond
and Adam’s definitions of scholarship.
Community-engaged scholarship can apply
to teaching (e.g., service–learning), research
(e.g., community-based participatory re-
search), community-responsive clinical and
population-based care (e.g., community-
oriented primary care, academic public
health practice), and service (e.g., commu-
nity service, outreach, advocacy).
The positive response by the health pro-
fessions to this broader conception of
scholarship has been less immediate than
in other parts of higher education. How-
ever, it has gained ground recently as
schools struggle to respond to the chang-
ing health care system and societal expec-
tations. The recent status report by the
AAMC on faculty appointment and ten-
ure, for example, indicates that medical
schools are introducing new faculty
tracks and career pathways and now rec-
ognize a broader range of scholarly activi-
ties.23
The AAMC has also sought to ad-
vance the definition of scholarship in
medical education through the develop-
ment of teaching portfolios used in pro-
motion and tenure decisions24
and
through a special issue of Academic Medi-
cine on scholarship.25
Other academic organizations are also
broadening their views of scholarship. A
1999 report of the American Dental Edu-
cation Association recommends creating
faculty tracks for educators and incen-
tives for community-based clinicians to
teach in dental schools,26
and a 2004 re-
Featured Topic Article
Academic Medicine, Vol. 80, No. 4 / April 2005318
port recommends that dental schools
encourage a broad range of faculty schol-
arship.27
The American Association of
Colleges of Nursing issued a 1999 posi-
tion statement28
on the definition of
scholarship in nursing that supports Boy-
er’s model, and provides examples of the
types of documentation needed for each
dimension of scholarship in nursing. The
Association of Schools of Public Health’s
Council of Public Health Practice Coor-
dinator’s 1999 Report, Demonstrating
Excellence in Academic Public Health
Practice,29
encourages schools of public
health to reconsider the definition and
scope of what constitutes scholarship as it
relates to public health practice as part of
the institutional mission and faculty re-
ward structures. While these discipline-
specific efforts have served to generate de-
bate and discussion, few academic health
centers or health professions schools for-
mally recognize or reward community-
engaged scholarship. A framework and
policy agenda are needed that integrates
this form of scholarship across the clinical
and public health arenas.
Assessing Community-Engaged
Scholarship
The shift initiated by Boyer regarding
how we define and conceptualize scholar-
ship has led to important discussions
regarding how to best assess scholarship
in communities using Boyer’s frame-
work.18,21,29,30
Several projects through-
out the 1990s, supported in large measure
by the American Association for Higher
Education, focused on undergraduate
education and used the term “profes-
sional service” and “outreach” to describe
the range of faculty work in communi-
ties. Most of the resulting policy state-
ments emphasize that faculty “work”
with communities should be evaluated
based on a full range of process, product,
and outcome measures and should be
framed within Glassick et al.’s or Dia-
mond and Adam’s model of scholar-
ship.18,19
With their focus at the under-
graduate level, however, these efforts
have largely been overlooked by health
professions schools.
The Association of Schools of Public
Health’s report cited above focuses on
faculty assessment of academic public
health practice and is closest to our con-
ceptualization of community-engaged
scholarship. Academic public health prac-
tice is defined as “the applied interdiscipli-
nary pursuit of scholarship in the field of
public health. The application of academic
public health is accomplished through
practice-based research, practice-based
teaching and practice-based service.”29
This work, while important, has had little
reach outside of schools of public health,
due to use of the term “public health
practice” and its limited inclusion of clin-
ical practice. Maurana et al.31
subse-
quently drew upon these prior works and
expanded to reflect a language that spans
the health professions. In their article, these
authors emphasized that “Boyer’s model of
scholarship of discovery, integration, appli-
cation, and teaching all apply to commu-
nity scholarship, but the principles, pro-
cesses, outcomes, and products may differ
in a community setting.”
Process Measures for Community-
Engaged Scholarship
The process involved in collaborating
with communities is an essential part of
the methodology of community-engaged
scholarship. The collaborative inquiry
and the relationships that form between
faculty and communities to examine and
address problems should be an essential
part of a faculty member’s assessment. In
an evaluative context, these are consid-
ered process measures.32
Process measures
would be included with the traditional
focus on products or outcomes such as
the number of publications in peer re-
viewed journals and the number of grants
obtained as a principal investigator.
Couto33
emphasizes that community-
based participatory research “requires
that students, faculty members and com-
munity partners listen to one another,
deliberate critically about common prob-
lems and issues, arrive at solutions to
mutual problems creatively in a commu-
nity setting, and work together to imple-
ment solutions.” Other authors have
made similar observations about the im-
portance of including process measures
in a faculty member’s assessment. Mau-
rana et al.31
noted that “community
scholarship requires the scholar to be
engaged with the community in a mutu-
ally beneficial partnership. Community-
defined needs direct the activities of the
community scholar.”
It is these process measures that are a
hallmark of community-engaged scholar-
ship. Process itself can have an important
effect on community health improve-
ment, leading to increased leadership and
capacity by communities for sustaining
intervention programs, and determining
whether communities will continue to
work long-term with the faculty member.
Often, community-engaged faculty are
the critical link to long-term institution-
al–community partnerships.
Process measures need a more central
place in departmental and institutional
promotion and tenure guidelines. Exist-
ing tools on collaboration, partnerships,
service–learning, and community-based
participatory research can be modified
specifically to measure process in com-
munity-based scholarship.34,35
The as-
sessment questions on community schol-
arship developed by Maurana et al.31
using Glassick et al.’s framework also
have great potential as process measures
to evaluate faculty.
Products of Community-Engaged
Scholarship
Academic products as delineated in a
faculty member’s curriculum vitae are
still considered the “gold standard” for
promotion and tenure decisions, with
peer-reviewed articles and grants gener-
ally regarded as having the highest value.
Within a community-engaged scholar-
ship framework, the nature and scope of
scholarly productivity and its dissemina-
tion needs to be broadened. Faculty com-
mitted to community-engaged scholar-
ship need to generate products that
balance “community priorities and uni-
versity requirements for knowledge gen-
eration, transmission and application.”9
We propose three primary types of prod-
ucts of community-engaged scholarship
that together can achieve this balance:
peer-reviewed articles, applied products,
and community dissemination products.
Peer-reviewed articles. The traditionally
accepted product is usually an established
number of descriptive or empirical arti-
cles in reputable peer-reviewed journals.
These articles communicate to others in
the field lessons learned and descriptions
of innovative programs, and serve as a
vehicle for documenting research meth-
ods and findings. Therefore, this type of
product retains its importance in the
evaluation of community-engaged schol-
arship. An increasing number of peer-
reviewed journals over the last decade
have been publishing articles on service–
Featured Topic Article
Academic Medicine, Vol. 80, No. 4 / April 2005 319
learning, public health practice, and com-
munity-based participatory research.36–38
Applied products. Applied products fo-
cus on the “immediate” transfer of
knowledge into application and serve to
“strengthen collaborative ties between
academics and practice” and enables fac-
ulty to “apply disciplinary knowledge to
practice” with communities.39
Applied
products include innovative intervention
programs; policies at the community,
state, and federal levels; training materials
and resource guides; and technical assis-
tance. These are products that communi-
ties value and that can help improve
community health.8
Furthermore, as Rice
and Richlin40
argue, these applied prod-
ucts allow practice to “inform and enrich
theory.” These products can be evaluated
for evidence of scholarship by the extent
to which they require a high level of disci-
pline-related expertise, are innovative,
have been implemented or used, and
have had an impact on learners (if educa-
tional in scope), organizational or com-
munity capacity, or the health of individ-
uals or communities.18,19
Community dissemination products.
These products of community-engaged
scholarship can include community fo-
rums, newspaper articles, Web sites, and
“presentations to community leaders and
policy makers at state and national lev-
els.”31
These products provide valuable
opportunities for reflective critique by
peers both in the community and in the
academy.8
Impact and Project Outcomes of
Community-Engaged Scholarship
In community-engaged scholarship, “im-
pact” encompasses the outcomes of fac-
ulty members’ efforts to foster and sus-
tain change in communities and in the
academy. Impact occurs through the rela-
tionships faculty members develop and
sustain with communities (see the pre-
ceding process section) and the products
(see the preceding products section) that
they develop together. Measures of im-
pact in the community can include
changes in health policy, improved com-
munity health outcomes, improved com-
munity capacity and leadership, and in-
creased funding to the community for
health-related projects.21,31
For the academy, impact can be measured
by the faculty member’s effort to institu-
tionalize and sustain a community pro-
gram or curriculum with either or both
external grants and in-kind institutional
funding. This level of impact requires
committed faculty and institutional lead-
ership, since institutional systems are
generally resistant to innovation. Other
measures of impact address learners. Fac-
ulty who incorporate service–learning
into their teaching, for example, can con-
tribute to a wide range of educational out-
comes including changes in student atti-
tudes, career choice, skills, and knowledge
related to working in communities.24
The Challenge and Future of
Community-Engaged Scholarship
The challenge for faculty whose work
interfaces with communities is that
“community-based anything takes time,
length and breadth.”7
Commitment to
the process of developing relationships
with communities and working through
an iterative process of developing useful
products can take years. Further, com-
munity and institutional impacts may
take even longer to achieve and docu-
ment. These factors all conspire to limit a
faculty member’s ability to achieve and
document the requirements of most pro-
motion and tenure policies.
Outcomes, however, are important, and
faculty and communities must work to-
gether to define reasonable goals and de-
velop intermediate outcomes that can be
highlighted through each of the types of
products we describe above, while work-
ing toward achieving and documenting
sustained change. Faculty need to be up-
front with their community partners,
department chairs, and peers about the
realities of what is expected of them.
They need to negotiate and manage these
expectations.
Regarding the future of community-en-
gaged scholarship, Weiser et al.41
astutely
point out that “a university’s values are
most clearly described by its promotion
and tenure policy and by the criteria used
to evaluate faculty members.” According
to this dictum, most academic health
centers and health professions schools do
not truly value community partnerships
and the community involvement of their
faculty as central to achieving their insti-
tutional missions. Implementing the
framework described in this article will
require leadership on the part of national
associations of health professions schools
as well as individual health professions
faculty, deans, and department chairs. As
a starting point, we recommend that the
leadership of academic health centers and
health professions schools initiate a dia-
logue about the proposed framework in
relation to their institutions’ missions and
current promotion and tenure policies.
For its part, the Commission on Com-
munity-Engaged Scholarship in the
Health Professions is pursuing a number
of strategies designed to influence sup-
port for community-engaged scholarship,
including engaging key stakeholder
groups, issuing reports and recommen-
dations, writing editorials, and making
presentations.42
The commission is dis-
seminating an online toolkit that health
professions faculty can use to document
their community-engaged scholarship for
review, promotion, and tenure decisions.
The toolkit includes two main sections: a
planning section that focuses on the role
of mentors, developing one’s vision for
work with communities, and strategies
for documenting one’s work across the
academic missions; and a faculty portfolio
section that focuses on how to prepare a
strong career statement, curriculum vitae,
teaching portfolio, and letters from peer
reviewers and community partners.43
Finally, with support from the U. S. De-
partment of Education’s Fund for the Im-
provement of Postsecondary Education,
Community-Campus Partnerships for
Health has convened a collaborative of 10
health professions schools that are working
over the next three years to build capacity
for community-engaged scholarship.44
This paper was supported by a grant from the
W.K. Kellogg Foundation. The authors thank the
W.K. Kellogg Foundation for their deep commit-
ment to community-engaged scholarship and
their support of this work. The authors also are
thankful for the helpful suggestions of the faculty
in the UNC-Chapel Hill Department of Family
Medicine and the anonymous reviewers.
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Community engaged scholarship__is_faculty_work_in.2

  • 1. Featured Topic Article Community-Engaged Scholarship: Is Faculty Work in Communities a True Academic Enterprise? Diane C. Calleson, PhD, Catherine Jordan, PhD, and Sarena D. Seifer, MD Abstract Since Ernest Boyer’s landmark 1990 re- port, Scholarship Reconsidered: Priorities of the Professoriate, leaders in higher education, including academic medicine, have advocated that faculty members apply their expertise in new and creative ways in partnership with communities. Such community engagement can take many forms, including community-based teaching, research, clinical care, and ser- vice. There continues to be a gap, how- ever, between the rhetoric of this idea and the reality of how promotion and tenure actually work in health profes- sions schools. The Commission on Community-En- gaged Scholarship in the Health Profes- sions was established in October 2003 with funding from the W.K. Kellogg Foundation to take a leadership role in creating a more supportive culture and reward system for community-engaged faculty in the nation’s health professions schools. The authors prepared this article to inform the commission’s deliberations and to stimulate discussion among edu- cators in the health professions. The au- thors define the work that faculty en- gage in with communities, consider whether all work by faculty in communi- ty-based settings is actually scholarship, and propose a framework for document- ing and assessing community-engaged scholarship for promotion and tenure decisions. They conclude with recom- mendations for change in academic health centers and health professions schools. Acad Med. 2005; 80:317–321. The scholarship of engagement means connecting the rich resources of the uni- versity to our most pressing social, civic and ethical problems, to our children, to our schools, to our teachers and to our cities. . . . I have this growing conviction that what’s also needed is not just more programs, but a larger purpose, a sense of mission, a larger clarity of direction in the nation’s life as we move toward century twenty-one. —Ernest Boyer, Scholarship Reconsidered: Priorities of the Professoriate Since Ernest Boyer’s landmark 1990 report,1 from which the above quote was taken, leaders in higher education, in- cluding academic medicine, have advo- cated that faculty members apply their expertise in new and creative ways in partnership with communities.1–3 In the Institute of Medicine’s November 2002 Report, Who Will Keep the Public Healthy?, leaders endorsed Boyer’s work by emphasizing the need to shift faculty roles and rewards to support faculty commitment to communities. It recom- mends that academic institutions should develop criteria for recognizing and re- warding faculty scholarship related to service activities that strengthen public health practice, and that the National Institutes of Health should increase the proportion of its budget allocated to pop- ulation- and community-based preven- tion research.4 There is a gap, however, between recom- mendations made by national commis- sions and national governing bodies, and the reality of how promotion and tenure actually works in health professions schools. Generating support in academic health centers for faculty work in com- munities is a challenge for both external and internal reasons. Externally, the sur- vival of clinical departments and their faculty are dependent on the ability to maintain a combination of clinical and research revenues. Other health profes- sions schools, including schools of public health, are equally dependent on govern- ment grants and contracts to sustain themselves. Community-based activities are often not consistent with these de- mands for generating extramural sources of support. Internally, faculty roles and rewards poli- cies can be barriers to significant and sus- tained faculty involvement in communi- ties.5–7 Untenured faculty are more likely to receive promotion for publishing arti- cles in peer-reviewed journals than for demonstrating an active commitment to addressing community problems.5 Fac- ulty are thus reluctant to apply their ex- pertise to community-based concerns.8 It is too professionally risky. To address these persistent challenges, the Commission on Community-En- gaged Scholarship in the Health Profes- sions was established with funding from the W.K. Kellogg Foundation in October 2003. Comprising a diverse group of leaders from academic institutions, pro- fessional associations, community-based organizations, philanthropy, and govern- ment, the commission has been charged to take a leadership role in creating a more supportive culture and reward sys- tem for community-engaged faculty. In this article, prepared to inform the commission’s deliberations, we define the work that faculty engage in with commu- Dr. Calleson is assistant professor, Public Health Leadership Program, School of Public Health, Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. Dr. Jordan is director, Children, Youth and Family Consortium, University of Minnesota, and assistant professor of pediatrics, University of Minnesota Medical School—Twin Cities. Dr. Seifer is research assistant professor, Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, Washington, and executive director, Community-Campus Partnerships for Health, Seattle, Washington. Correspondence should be addressed to Dr. Calleson, Assistant Professor, Public Health Leadership Program, CB#7469, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7469; telephone: (919) 966- 1769; e-mail: ͗Calleson@med.unc.edu.͘. Academic Medicine, Vol. 80, No. 4 / April 2005 317
  • 2. nities, consider whether all work by fac- ulty in community-based settings is scholarship, and propose a framework for documenting and assessing community- engaged scholarship for promotion and tenure decisions. We conclude with rec- ommendations for change in academic health centers and health professions schools. Aligning Institutional Mission with Faculty Work If we want faculty to be involved ͓in com- munities͔ but reward them for other ac- tivities, we are our own worst enemies. —Associate vice provost, public academic health center At the core of any discussion of faculty roles and rewards, as noted by Boyer1 and Sandmann et al.,9 is that faculty work should be framed within the context of the institution’s missions, and measures of assessment should be developed based on the actual “work” in which faculty are engaged and to which they are commit- ted. This is especially true for faculty who are involved in community-based work and whose institution’s mission directly supports these activities, regardless of whether they are all scholarly activities. Thus, just as classroom- and hospital- based teaching, basic science research, and clinical care are critical to the aca- demic health center mission, communi- ty-based teaching, community-based re- search, and community service are equally valuable. In line with the Institute of Medicine, we believe that community- based work that benefits communities and advances the institution’s mission should count more significantly than it currently does toward faculty promotion and tenure decisions. Several health professions schools have codified these values in their promotion and tenure policies, including the De- partment of Family Medicine and the School of Public Health at the University of North Carolina, the University of Washington School of Public Health and Community Medicine, and Portland State University.10–13 Steiner et al.14 and Steckler et al.15 have published the lessons learned and the strategies they used to change promotion and tenure guidelines in the Department of Family Medicine and the School of Public Health, respec- tively, at the University of North Carolina at Chapel Hill. (The article by Steiner et al. is in this issue of Academic Medicine.) Portland State University (PSU) has also published its experience with taking a campus-wide approach to promoting community-engaged scholarship. Through intensive internal and external discussions, PSU adopted a clearly articu- lated mission and strategic plan that guided a series of transformational events in the 1990s, including revised promo- tion and tenure guidelines that recognize and reward faculty contributions to com- munity engagement.16,17 The experiences of these and other insti- tutions demonstrate that recognizing and rewarding community-engaged scholar- ship requires changes not only in the wording of policies and procedures, but even more importantly in institutional culture. Such changes are only possible when approached from multiple leverage points simultaneously.8 Defining Scholarship Faculty are engaged in a range of activi- ties, not all of which should be consid- ered scholarship. Two proposed models can help promotion and tenure commit- tees determine whether a given faculty activity is “scholarship.” Glassick et al.18 proposed a model that evaluates faculty work as scholarship based on the degree to which a faculty member establishes clear goals, is adequately prepared, uses appropriate methods, has significant re- sults, creates an effective presentation of the work, and reflects critical activity. Diamond and Adam19 suggest a model for scholarship that “requires a high level of discipline-related expertise, breaks new ground or is innovative, can be repli- cated, documented, peer-reviewed and has a significant impact.” Not all faculty work in communities meets these definitions of scholarship. As a junior faculty physician noted (in a ses- sion at the 2002 annual meeting of the Association of American Medical Col- leges ͓AAMC͔20 ), she provided clinical care that is valued by her department through leadership in an innovative clini- cal program in a poor urban community, yet she struggles to make it have a central role in her promotion and tenure portfo- lio. While delivering clinical service alone is not scholarship, it is critical to advanc- ing her medical school’s mission to pro- vide care to the underserved. However, if this same junior faculty member had demonstrated innovation in clinical prac- tice, potential for replication in other communities, documented significant patient outcomes, and published the findings in a peer-reviewed journal, this work would have met Diamond and Adam’s definition of scholarship. Defining Community-Engaged Scholarship As a result of Boyer’s effort to expand the framework for scholarship, institutions of higher education are using broader defi- nitions of scholarship, encompassing a continuum of faculty work ranging from discovery, to the integration of discovery with application, to work that is primar- ily the application of faculty exper- tise.21,22 We posit that faculty work in communities exists along this contin- uum. In this article, we use the term com- munity-engaged scholarship to reflect this range of faculty work in communities that meets Glassick et al.’s and Diamond and Adam’s definitions of scholarship. Community-engaged scholarship can apply to teaching (e.g., service–learning), research (e.g., community-based participatory re- search), community-responsive clinical and population-based care (e.g., community- oriented primary care, academic public health practice), and service (e.g., commu- nity service, outreach, advocacy). The positive response by the health pro- fessions to this broader conception of scholarship has been less immediate than in other parts of higher education. How- ever, it has gained ground recently as schools struggle to respond to the chang- ing health care system and societal expec- tations. The recent status report by the AAMC on faculty appointment and ten- ure, for example, indicates that medical schools are introducing new faculty tracks and career pathways and now rec- ognize a broader range of scholarly activi- ties.23 The AAMC has also sought to ad- vance the definition of scholarship in medical education through the develop- ment of teaching portfolios used in pro- motion and tenure decisions24 and through a special issue of Academic Medi- cine on scholarship.25 Other academic organizations are also broadening their views of scholarship. A 1999 report of the American Dental Edu- cation Association recommends creating faculty tracks for educators and incen- tives for community-based clinicians to teach in dental schools,26 and a 2004 re- Featured Topic Article Academic Medicine, Vol. 80, No. 4 / April 2005318
  • 3. port recommends that dental schools encourage a broad range of faculty schol- arship.27 The American Association of Colleges of Nursing issued a 1999 posi- tion statement28 on the definition of scholarship in nursing that supports Boy- er’s model, and provides examples of the types of documentation needed for each dimension of scholarship in nursing. The Association of Schools of Public Health’s Council of Public Health Practice Coor- dinator’s 1999 Report, Demonstrating Excellence in Academic Public Health Practice,29 encourages schools of public health to reconsider the definition and scope of what constitutes scholarship as it relates to public health practice as part of the institutional mission and faculty re- ward structures. While these discipline- specific efforts have served to generate de- bate and discussion, few academic health centers or health professions schools for- mally recognize or reward community- engaged scholarship. A framework and policy agenda are needed that integrates this form of scholarship across the clinical and public health arenas. Assessing Community-Engaged Scholarship The shift initiated by Boyer regarding how we define and conceptualize scholar- ship has led to important discussions regarding how to best assess scholarship in communities using Boyer’s frame- work.18,21,29,30 Several projects through- out the 1990s, supported in large measure by the American Association for Higher Education, focused on undergraduate education and used the term “profes- sional service” and “outreach” to describe the range of faculty work in communi- ties. Most of the resulting policy state- ments emphasize that faculty “work” with communities should be evaluated based on a full range of process, product, and outcome measures and should be framed within Glassick et al.’s or Dia- mond and Adam’s model of scholar- ship.18,19 With their focus at the under- graduate level, however, these efforts have largely been overlooked by health professions schools. The Association of Schools of Public Health’s report cited above focuses on faculty assessment of academic public health practice and is closest to our con- ceptualization of community-engaged scholarship. Academic public health prac- tice is defined as “the applied interdiscipli- nary pursuit of scholarship in the field of public health. The application of academic public health is accomplished through practice-based research, practice-based teaching and practice-based service.”29 This work, while important, has had little reach outside of schools of public health, due to use of the term “public health practice” and its limited inclusion of clin- ical practice. Maurana et al.31 subse- quently drew upon these prior works and expanded to reflect a language that spans the health professions. In their article, these authors emphasized that “Boyer’s model of scholarship of discovery, integration, appli- cation, and teaching all apply to commu- nity scholarship, but the principles, pro- cesses, outcomes, and products may differ in a community setting.” Process Measures for Community- Engaged Scholarship The process involved in collaborating with communities is an essential part of the methodology of community-engaged scholarship. The collaborative inquiry and the relationships that form between faculty and communities to examine and address problems should be an essential part of a faculty member’s assessment. In an evaluative context, these are consid- ered process measures.32 Process measures would be included with the traditional focus on products or outcomes such as the number of publications in peer re- viewed journals and the number of grants obtained as a principal investigator. Couto33 emphasizes that community- based participatory research “requires that students, faculty members and com- munity partners listen to one another, deliberate critically about common prob- lems and issues, arrive at solutions to mutual problems creatively in a commu- nity setting, and work together to imple- ment solutions.” Other authors have made similar observations about the im- portance of including process measures in a faculty member’s assessment. Mau- rana et al.31 noted that “community scholarship requires the scholar to be engaged with the community in a mutu- ally beneficial partnership. Community- defined needs direct the activities of the community scholar.” It is these process measures that are a hallmark of community-engaged scholar- ship. Process itself can have an important effect on community health improve- ment, leading to increased leadership and capacity by communities for sustaining intervention programs, and determining whether communities will continue to work long-term with the faculty member. Often, community-engaged faculty are the critical link to long-term institution- al–community partnerships. Process measures need a more central place in departmental and institutional promotion and tenure guidelines. Exist- ing tools on collaboration, partnerships, service–learning, and community-based participatory research can be modified specifically to measure process in com- munity-based scholarship.34,35 The as- sessment questions on community schol- arship developed by Maurana et al.31 using Glassick et al.’s framework also have great potential as process measures to evaluate faculty. Products of Community-Engaged Scholarship Academic products as delineated in a faculty member’s curriculum vitae are still considered the “gold standard” for promotion and tenure decisions, with peer-reviewed articles and grants gener- ally regarded as having the highest value. Within a community-engaged scholar- ship framework, the nature and scope of scholarly productivity and its dissemina- tion needs to be broadened. Faculty com- mitted to community-engaged scholar- ship need to generate products that balance “community priorities and uni- versity requirements for knowledge gen- eration, transmission and application.”9 We propose three primary types of prod- ucts of community-engaged scholarship that together can achieve this balance: peer-reviewed articles, applied products, and community dissemination products. Peer-reviewed articles. The traditionally accepted product is usually an established number of descriptive or empirical arti- cles in reputable peer-reviewed journals. These articles communicate to others in the field lessons learned and descriptions of innovative programs, and serve as a vehicle for documenting research meth- ods and findings. Therefore, this type of product retains its importance in the evaluation of community-engaged schol- arship. An increasing number of peer- reviewed journals over the last decade have been publishing articles on service– Featured Topic Article Academic Medicine, Vol. 80, No. 4 / April 2005 319
  • 4. learning, public health practice, and com- munity-based participatory research.36–38 Applied products. Applied products fo- cus on the “immediate” transfer of knowledge into application and serve to “strengthen collaborative ties between academics and practice” and enables fac- ulty to “apply disciplinary knowledge to practice” with communities.39 Applied products include innovative intervention programs; policies at the community, state, and federal levels; training materials and resource guides; and technical assis- tance. These are products that communi- ties value and that can help improve community health.8 Furthermore, as Rice and Richlin40 argue, these applied prod- ucts allow practice to “inform and enrich theory.” These products can be evaluated for evidence of scholarship by the extent to which they require a high level of disci- pline-related expertise, are innovative, have been implemented or used, and have had an impact on learners (if educa- tional in scope), organizational or com- munity capacity, or the health of individ- uals or communities.18,19 Community dissemination products. These products of community-engaged scholarship can include community fo- rums, newspaper articles, Web sites, and “presentations to community leaders and policy makers at state and national lev- els.”31 These products provide valuable opportunities for reflective critique by peers both in the community and in the academy.8 Impact and Project Outcomes of Community-Engaged Scholarship In community-engaged scholarship, “im- pact” encompasses the outcomes of fac- ulty members’ efforts to foster and sus- tain change in communities and in the academy. Impact occurs through the rela- tionships faculty members develop and sustain with communities (see the pre- ceding process section) and the products (see the preceding products section) that they develop together. Measures of im- pact in the community can include changes in health policy, improved com- munity health outcomes, improved com- munity capacity and leadership, and in- creased funding to the community for health-related projects.21,31 For the academy, impact can be measured by the faculty member’s effort to institu- tionalize and sustain a community pro- gram or curriculum with either or both external grants and in-kind institutional funding. This level of impact requires committed faculty and institutional lead- ership, since institutional systems are generally resistant to innovation. Other measures of impact address learners. Fac- ulty who incorporate service–learning into their teaching, for example, can con- tribute to a wide range of educational out- comes including changes in student atti- tudes, career choice, skills, and knowledge related to working in communities.24 The Challenge and Future of Community-Engaged Scholarship The challenge for faculty whose work interfaces with communities is that “community-based anything takes time, length and breadth.”7 Commitment to the process of developing relationships with communities and working through an iterative process of developing useful products can take years. Further, com- munity and institutional impacts may take even longer to achieve and docu- ment. These factors all conspire to limit a faculty member’s ability to achieve and document the requirements of most pro- motion and tenure policies. Outcomes, however, are important, and faculty and communities must work to- gether to define reasonable goals and de- velop intermediate outcomes that can be highlighted through each of the types of products we describe above, while work- ing toward achieving and documenting sustained change. Faculty need to be up- front with their community partners, department chairs, and peers about the realities of what is expected of them. They need to negotiate and manage these expectations. Regarding the future of community-en- gaged scholarship, Weiser et al.41 astutely point out that “a university’s values are most clearly described by its promotion and tenure policy and by the criteria used to evaluate faculty members.” According to this dictum, most academic health centers and health professions schools do not truly value community partnerships and the community involvement of their faculty as central to achieving their insti- tutional missions. Implementing the framework described in this article will require leadership on the part of national associations of health professions schools as well as individual health professions faculty, deans, and department chairs. As a starting point, we recommend that the leadership of academic health centers and health professions schools initiate a dia- logue about the proposed framework in relation to their institutions’ missions and current promotion and tenure policies. For its part, the Commission on Com- munity-Engaged Scholarship in the Health Professions is pursuing a number of strategies designed to influence sup- port for community-engaged scholarship, including engaging key stakeholder groups, issuing reports and recommen- dations, writing editorials, and making presentations.42 The commission is dis- seminating an online toolkit that health professions faculty can use to document their community-engaged scholarship for review, promotion, and tenure decisions. The toolkit includes two main sections: a planning section that focuses on the role of mentors, developing one’s vision for work with communities, and strategies for documenting one’s work across the academic missions; and a faculty portfolio section that focuses on how to prepare a strong career statement, curriculum vitae, teaching portfolio, and letters from peer reviewers and community partners.43 Finally, with support from the U. S. De- partment of Education’s Fund for the Im- provement of Postsecondary Education, Community-Campus Partnerships for Health has convened a collaborative of 10 health professions schools that are working over the next three years to build capacity for community-engaged scholarship.44 This paper was supported by a grant from the W.K. Kellogg Foundation. The authors thank the W.K. Kellogg Foundation for their deep commit- ment to community-engaged scholarship and their support of this work. 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