Reexamining the teaching hospital analogy: implications for professional development school research

Purpose This study revisits the long-standing analogy between Professional Development Schools (PDSs) and teaching hospitals to examine its usefulness for guiding contemporary PDS research. Although the teaching hospital comparison has been widely invoked in PDS scholarship, it has rarely been examined in relation to how teaching hospitals are actually studied, organized and experienced. This study interrogates what can be learned from teaching hospital research and practice to inform future directions for PDS inquiry, particularly related to clinical preparation, professional learning, research and evaluation. Design/methodology/approach The study employed a qualitative, multi-source design organized around three complementary levels of analysis: conceptual, experiential and interpretive. Data sources included (a) a content analysis of published teaching hospital research frequently cited in PDS scholarship, (b) semi-structured interviews with physicians trained in and/or working in teaching hospitals and (c) a focus group with teacher educators recognized for their expertise in PDSs. Analytic strategies were aligned with the distinct purposes of each data source to examine how teaching hospitals are conceptualized in research, enacted in practice and interpreted within teacher education contexts. Findings Findings indicate that similar to PDSs, teaching hospitals are best understood as complex, multi-mission learning organizations whose value cannot be captured through singular outcome measures. Teaching hospital research consistently reports mixed results across traditional performance indicators, while simultaneously emphasizing intentionally structured systems for clinical learning, mentoring, professional role development and research integration. Physician interviews highlight how these structures are experienced through sequenced clinical rotations, residency, mentoring and differentiated professional roles. Teacher educator focus group findings reveal that while the teaching hospital analogy remains aspirational and rhetorically powerful for PDS work, the analogy is often under-theorized and unevenly enacted, particularly with respect to research organization and evaluation expectations. Research limitations/implications The study draws on a selective body of teaching hospital literature and a limited number of interviews and focus group participants. Future research could expand these data sources and engage additional cross-professional perspectives to further examine how clinically oriented preparation models are studied and evaluated. Practical implications For PDS researchers and leaders, the findings suggest the need to more intentionally identify the clinical learning structures, mentoring systems and research coherence when designing and studying PDS partnerships. Insights from teaching hospital research may support more conceptually aligned and theoretically grounded PDS research agendas. Social implications By examining how teaching hospitals organize and study professional preparation, this study contributes to broader efforts to elevate teaching as a complex, research-informed profession. Making the organizational, relational and intellectual work of teacher preparation more visible may support a more informed public, policy and institutional responsibility. Originality/value Rather than extending the teaching hospital analogy uncritically, this study offers a research-informed reexamination grounded in teaching hospital literature, practitioner experiences and teacher educator sensemaking. The study contributes to a reframing that shifts attention from outcome-based comparisons toward the organizational structures, learning processes and evaluation logics that support clinically grounded professional preparation.