GP teachers' subject matter knowledge in the context of a tutorial: the preparation and delivery compared

Background: Clinical teachers use several different types of knowledge in the act of teaching. These include content knowledge (subject matter), knowledge of how to teach (pedagogy) and knowledge of learners (context). Most attention in faculty development has been on how to teach rather than what is taught. The quality of a teacher's subject matter knowledge is likely to be a critical determinant of how well a subject is presented, communicated and learned. We therefore set out to examine teachers' subject matter knowledge in the context of a general practice tutorial on grade 1 hypertension.Methods: This study is part of a larger study that employed a mixed method approach (concept mapping, phenomenological interviews and video-stimulated recall) to examine differences between clinical educators in subject matter knowledge, pedagogical knowledge and knowledge of the learning environment in the context of general practice education.Results: This paper presents the concept map data findings from the larger study as well as the parts of the phenomenological interviews that relate to subject matter knowledge and beliefs. We found that there were marked differences in the quality and elaborative structure of GP teachers' knowledge in the concept maps completed prior to the tutorials. These differences were also predictive of differences in the content presented to learners in tutorials. Teachers' beliefs about subject matter were also likely to have affected what they chose to teach about and how they presented it.Conclusions: Subject matter knowledge varies considerably between GP teachers in the context of a common and relatively simple tutorial. Differences in the quality of subject matter knowledge matter because they have a profound effect on what is learned and how it is learned. Faculty development for clinical educators needs to pay heed to the quality of subject matter knowledge in addition to its more common pedagogical focus.