Transforming Reflexive teachers to Reflective teachers: Faculty Development for Clinical Teachers
Subha Ramani, MBBS, MPH, MMEd, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
Introduction
In the changing world of medicine, clinical teachers need to perform time-efficient ambulatory and inpatient teaching, while their own clinical workload keeps increasing. Most academic medical faculty receive little or no explicit training in teaching and thus ill-prepared for the demands of teaching. Will faculty development boost morale and help clinical teachers succeed at their teaching tasks?
Statement of the problem and program objectives
The Department of Medicine (DOM) clinical faculty at Boston University teach medical students, residents and fellows in busy outpatient and inpatient settings. Most are busy clinicians and / or researchers, untrained in teaching, yet expected to be superlative teachers. A core group of DOM faculty discussed the need for a program to improve teaching skills of faculty and promote teacher and learner satisfaction with clinical teaching in the department. We applied the principles of educational change described by Mennin and Kaufman (Figure 1)
Objectives of the program/intervention:
1) To identify the educational needs of faculty and organize educational workshops in response to their needs;
2) To design a curriculum for a “teach the teachers” program for Department of Medicine (DOM) faculty;
3) To promote educational scholarship and leadership.
Figure 1 Mennin and Kaufman’s strategies for change
Description of the project/intervention
We propose a model for faculty development in clinical teaching for Department of Medicine faculty. Program planning occurred in three stages. Stage 1: During a day-long retreat of the Section of General Internal Medicine (GIM) faculty in May 2003, educational needs were explored using focus group discussions and questionnaires. Stage 2: A day long educational retreat was organized for clinical faculty in the DOM. Using small group discussions on key clinical teaching topics and questionnaires, educational needs were explored. Stage 3: Using above data, a faculty development steering committee is currently discussing an ongoing educator development program for the DOM.
Program Development Steps are detailed in Figure 2 below:
Findings to date/Evaluation to date
Our preliminary data are promising and suggest that clinical educators in the Department of Medicine want to improve their teaching skills and receive feedback on their teaching. Both GIM and DOM faculty had similar educational needs:
• Dedicated time for teaching in outpatient and inpatient settings;
• Observation of teaching sessions by senior or peer faculty with debriefing and feedback;
• Ongoing faculty development workshops on teaching skills development;
• Faculty mentoring for clinician educator faculty.
DOM Retreat questionnaires included 4 key questions. Responses to these questions are listed below:
Key lessons learned so far and next steps
We believe that the DOM educational retreat represents a new awareness of teachers’ needs in enhancing their teaching skills, receiving feedback on their teaching and mentoring. Based on the information from our questionnaires, members of the steering committee proposed to the Department Chairman a list of ongoing activities for educator development:
• Ongoing educator development seminars, workshops, grand rounds and retreats
• Observation of teaching by peer or senior faculty with feedback on teaching.
• Formal review of trainee evaluations by a mentor with feedback
• Teaching faculty time management skills
• Incentives for teaching activities
Questions
1) What is the best model for ongoing educator development?
2) What are the best indicators of a successful faculty development program?
3) How can teaching outcomes be measured?
4) What is the best recipe for a faculty mentoring program?
Literature cited
- Beckman TJ, Ghosh, AK, Cook DA, Erwin PJ and Mandrekar JN (2004). How Reliable Are Assessments of Clinical Teaching?: A Review of the Published Instruments. Journal of General Internal Medicine;19(9):971-977.
- Gelula MH, and Yudkowsky R (2002). Microteaching and standardized students support faculty development for clinical teaching. Academic Medicine;77(9):941,.
- Gruppen LD, Frohna AZ, Anderson RM, and Lowe KD (2003). Faculty Development for Educational Leadership and ScholarshipAcademic Medicine;78: 137-141.
- Mennin SP, Kaufman A (1989). The change process and medical education. Medical Teacher; 11 (1):9-16.
- Skeff KM, Stratos GA, Mygdal WK, DeWitt TG et al (1997b). Clinical teaching improvement: past and future for faculty development. Family Medicine;29:252-257.
