Faculty Development Faculty Development for Ambulatory Care Educationfor Ambulatory Care Education

LuAnn Wilkerson, Ed.D.

UCLA

What is faculty development?What is faculty development?

Assists faculty in acquiring the knowledge, skills and values needed to succeed in their academic roles– as educators– as scholars– as members of the academy

Strengthens organizations so they can fulfill their educational mission

The DilemmasThe Dilemmas Physicians skilled in ambulatory care but

inexperienced as teachers Physicians skilled in inpatient teaching but

inexperienced as ambulatory teachers Increasing productivity demands. Residents unskilled as teachers Office staff unclear about expectations for

teaching

Does your school use community Does your school use community preceptors? N=100preceptors? N=100 Fields et al, Acad. Med.,1998Fields et al, Acad. Med.,1998

96 schools use community preceptors

73 used them in each year of the curriculum

10 -27 hours a week 12-18 weeks a year Most frequently from

primary care Multiplicity of sites

ObjectivesObjectives

Consider the possible goals of faculty development and effective strategies

Discuss predominant models of ambulatory faculty development

Explore possible models for the future

Possible Goals of Instructional Possible Goals of Instructional DevelopmentDevelopment

Motivate and Stimulate New IdeasChange Beliefs and BehaviorsPromote Educational ScholarshipChange Curriculum and Organizations

Types of Faculty DevelopmentTypes of Faculty Development

Professional Development Instructional Development

– Improving teaching skills– Connecting teaching and learning

Leadership Development Organizational Development

Teaching Improvement -- 1950’sTeaching Improvement -- 1950’s

Teaching can be improved by increasing content knowledge and expertise.

Teaching Improvement -- 1960’sTeaching Improvement -- 1960’s

Teaching can be improved by providing feedback from student evaluations.

Teaching Improvement -- 1970’sTeaching Improvement -- 1970’s

Teaching can be improved by coupling teaching evaluations with consultation.

Teaching Improvement -- 1980’sTeaching Improvement -- 1980’s

Teaching can be improved by helping teachers connect knowledge, beliefs, and

reasoning with teaching acts.

Teaching Improvement -- 1990’sTeaching Improvement -- 1990’s

Teaching can be improved by– using reflective practices– in collaboration with colleagues– with institutional support for education

The Proposed SolutionThe Proposed Solution

More faculty development!

GIMGEL

FFI

Models that Work

PEP

What Works?What Works?

Workshops that are longer, involve more than one intervention, and are followed up with practice and feedback.

Feedback on teaching coupled with expert consultation

Current Models of Ambulatory Current Models of Ambulatory Faculty DevelopmentFaculty Development

Round Them Up Train the Trainers Disseminate Tips Catch Them Unaware Stimulate Self-Improvement Incentivize Participation

Round Them UpRound Them Up

Goals:– Motivate and stimulate

new ideas

– Change beliefs and behaviors

Formats:– Interactive workshops

– Multiple modalities Examples:Arrows in the QuiverOne Minute PreceptorPrimary Care Futures

Train the TrainersTrain the Trainers

Goals:– Change curriculum &

organizations

– Promote scholarship

Formats:– “sabbaticals”

– degrees or fellowships

– Observed practicumExamples:Stanford ProgramUSC MastersMSU Fellowship

Disseminate TipsDisseminate Tips

Goals:– Stimulate new ideas

Formats:– WWW

– Videotape

– Handbooks, newsletters

Contracts

Examples:EPIC at UNCPEP from STFM

Catch Them UnawareCatch Them Unaware

Goal:– Motivate and stimulate

new ideas

Formats:– Presentations at

regularly scheduled meetings

– CME activitiesExamples:

Using Grand Round at UTMBCommunity teams at UCLA

Stimulate Self-ImprovementStimulate Self-Improvement

Goals:– Change beliefs and

behaviors

Formats:– Student ratings linked to

norms, guidelines

– Site visits

– Self-assessment

Examples: Peer coaching at Case Reflective practice at MCOW

Incentivize ParticipationIncentivize Participation Goals:

– Motivate and stimulate new ideas

– Change attitudes and behaviors

– Change curriculum and organizations

Formats:– Faculty appointments– Financial support– Computer assistance

Examples: Value added students Connectivity

Academic EducatorsAcademic Educators

• Educational leaders

•Skilled teachers

•Skilled teachers with PCK

• Educational scholars

•Organizational leaders committed to education

ConclusionConclusion

Faculty development is a key to academic vitality, organizational learning and change

Strategies should be matched to desired outcomes.

Evidence suggests some strategies may be more powerful in changing teaching behaviors than others.

ReferencesReferences

Anderson WA, et al. Faculty development for ambulatory care education. Acad Med.1997;72:1072-5.

Anderson WA, et al. Outcomes of Three Part-time Faculty Development Fellowship Programs. Fam Med. 1997;29:204-8.

Bland, et al. Faculty Development Special Issue. J. Fam. Med. 29(4):230-293, 1997.

DeWitt TG, Goldberg RL, Roberts K. Developing community faculty: principles, practice, and evaluation. AJDC. 1993;147:49-53.

ReferencesReferences Dodson MC. Motivation and reward factors that

affect private physician involvement in an obstetrics and gynecology clerkship. Ob Gyn,1998;92:628-33.

Fields SA, et al. The use and compensation of community preceptors. Acad Med. 1998;73:95-7.

Flynn SP, Bedinghaus J., Snyder, Hekelman F. Peer coaching in clincal teaching. Fam Med. 1994;26:569-70.

Hitchcock MA, Stritter FT, Bland CJ. Faculty development in the health professions. Med Teach. 1993;14:295-309.

ReferencesReferences Krippendorf MD, Simpson DE, Schiedermayer D.

Promoting reflective teaching with PDAs. Acad Med. 1999;74:577.

Irby DM. Faculty Development and Academic Vitality. Academic Medicine. 68:760-763, 1993.

Lesky LG, Wilkerson L. Using ‘standardized students’ to teach a learner-centered approach to ambulatory precepting. Acad Med. 1994;69:955-7.

Quirk ME, et al. Evaluation of Primary Care Futures. Acad Med. 1998;73:705-7.

ReferencesReferences Rediske V, Simpson DE. Web-based instruction to

enhance the clinical teaching of community preceptors. Acad Med. 1999;74;577-8.

Reid A, Stritter FT, Ardt JE. Assessment of faculty development program outcomes. Fam Med. 1997;29:242-247.

Skeff KM, et al. The Stanford Faculty Development Program. Teach Learn Med. 1992;4:180-7.

Szauter K, Boisaubin E, Levetown M. Teaching professionalism in medical grand rounds. Acad Med. 1999;74:581-2.

ReferencesReferences

Tresoilini CP, Loonsk J. The Expert Preceptor Interactive Curriculum (EPIC). IME, 1998.

Wilkerson L, Irby DM. Strategies for Effective Change in Teaching Practices: A Comprehensive Approach to Faculty Development. Acad Med. 73:387-396, 1998.

Wilkerson L, Sarkin R. Arrows in the quiver: evaluation of a workshop on ambulatory teaching. Acad Med. 1998;73:67-9.

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