The Family Medicine Curriculum Resource Project: implications for faculty development

Faculty development implications related to implementing the Family Medicine Curriculum Resource (FMCR) Project provide an opportunity to look at the recommendations of the Society of Teachers of Family Medicine's federally funded Faculty Futures Initiative (FFI) and the recent Future of Family Medicine (FFM) project. Implications for faculty development include the importance of the clerkship setting, originally defined in 1991, with new features added in today's practice environment as outlined by the FFM and the changing assumptions in approaching faculty development. Previously, faculty development focused on teaching learners to master current knowledge. Now, faculty must teach learners how to master new competencies throughout their lives; learners need to learn how they and others learn now. Teaching must focus on how to learn in the future as well as what to learn for the present. Competence ("what individuals know or are able to do in terms of knowledge, skills, and attitudes") has become the focus of curriculum development efforts over the last few years and most appropriately serves as the focus of curriculum development in the FMCR Project. Implications for developing teachers and preceptors focus on the skills and circumstances required to teach and evaluate all types (cognitive, metacognitive, and affective) of competence. In the new culture, novel teaching methods will serve as the focus of faculty development in teaching and of educational ("best practices") research.     

Nurses' perceptions of temporary nursing service agencies

Temporary staffing agencies have indeed carved out a role for themselves, and our free enterprise system lends itself to the perpetuation of the entrepreneurial spirit in all: nurses, agencies, and hospitals alike. It is wiser to learn to work with current structure realizing that supply and demand plays an important role in the survival and success of agencies. Although there are problems associated with temporary nursing staffing, they are surmountable. Orientation programs, performance monitoring, ensuring accountability of both nurse and agency are but a few that can enhance utilization and quality of service.     

Research faculty development: an historical perspective and ideas for a successful future

What does it take to be successful as a tenure-track research faculty member in a School of Medicine? What are the elements necessary to run a successful laboratory? How does one find the resources and help to know what is important for promotion and tenure? Most training in graduate school or in clinical fellowships does not answer these questions. Too often, new junior tenure-track research faculty members are left to learn from the “school of hard knocks” and essentially are reinventing the wheel, which is a huge waste of time. This article describes the history of research faculty, what makes them successful, and offers suggestions on how we can help them reach their greatest potential.     

Awareness of the National Standards for Culturally and Linguistically Appropriate Services at an academic health center

The study's objectives were to (a) determine the level of familiarity of faculty and students at an academic health center with the National Standards for Culturally and Linguistically Appropriate Services (CLAS), (b) identify faculty's and students' interest and preferred method of learning Medical Spanish, and (c) determine their aptitude for working with medical interpreters. A survey was developed, piloted, and sent via e-mail to all faculty members (n = 1,025) and students (n = 1,956) currently affiliated with or enrolled at the Medical College of Georgia. Reminder e-mails were sent after 2 weeks, and responses were accepted for 1 month. The total response rate for faculty members was 29% (300/1,025), and that for students was 44% (871/1,956). Nearly 22% of the responding faculty and 23% of the responding students reported that they were less than familiar with the National Standards for CLAS. Both faculty (46%) and students (70%) were willing to spend time learning Medical Spanish. Web-based instruction was the preferred educational delivery mode for those who completed the survey; however, 18% of faculty and 5% of students strongly disagreed with this point. When questioned about how often interpreters services are used, the rates for faculty and students ranged from 34% to 39%. These results suggest that a void exists in understanding the National Standards for CLAS and that there are varying levels of willingness to learn medical Spanish.     

Models of faculty development for problem-based learning

Learning an innovative teaching method such as a problem-based learning is difficult for most faculty members because the method is based upon assumptions about learning that are often at variance with their beliefs. Faculty development can challenge assumptions about learning, provide experience with a new technique, and offer specific pedagogical skills that are needed to succeed as a tutor. A comprehensive approach to faculty development, derived from the literature in higher education, would include: instructional development, professional development, leadership development, and organizational development. Research on faculty development indicates positive results of such efforts. Faculty members who choose to learn about problem-based learning appear to progress through predictable stages of development that include: understanding and valuing the rationale for problem-based learning, acquiring general and content-specific tutor knowledge and skills, developing advanced skills in problem-based learning, and developing leadership and scholarship skills. Each of these steps, plus organizational vitality, are described along with recommendations for implementing such programs. Finally, five models of faculty development derived from medical schools with problem-based learning curricula are examined.     

Teaching economics in the graduate health administration curriculum: a mini-case simulation approach

Training in the discipline of economics has long been recognized as an important component of the curriculum in graduate health administration (GHA) education. Yet economics is a subject that is often considered hard to teach and difficult for students to learn. What is missing is a body of literature that identifies methods that are most appropriate for teaching economics to graduate students aspiring to be health care managers. Moreover, given the keen interest in developing competency-based curricula today, what is also needed is empirical evidence, which systematically links the key skills, knowledge, and abilities economics courses try to develop with the teaching approaches best suited to do so. This paper helps fill this gap in the literature by describing and evaluating the author's "Top of the News" (TOTN) mini-case simulation series piloted in her Health Care Economics course in the Master of Health Administration (MHA) curriculum at Saint Louis University during the spring semester of 2002. This approach combines elements of the case study and simulation methods used by others, but adds several innovations. Although the TOTN method was designed specifically for a course in health care economics, it is one that can be readily adapted for courses across the GHA curriculum. The article concludes that although the TOTN exercises proved to be fairly successful, GHA faculty and practitioners concerned about preparing today's students to meet tomorrow's health care leadership challenges need to not only identify effective teaching methods, but also have a lot more to discover about the learning styles of the students they teach.     

A five-step "microskills" model of clinical teaching.

Teaching family practice residents in a clinical setting is a complex and challenging endeavor, especially for community family physicians teaching part-time and junior faculty members beginning their academic careers. We present a five-step model of clinical teaching that utilizes simple, discrete teaching behaviors or "microskills." The five microskills that make up the model are (1) get a commitment, (2) probe for supporting evidence, (3) teach general rules, (4) reinforce what was done right, and (5) correct mistakes. The microskills are easy to learn and can be readily used as a framework for most clinical teaching encounters. The model has been well received by both community family physicians interested in teaching and newer residency faculty members.     

Breast self-examination and mammography among university staff and faculty

Women faculty and staff (N = 201) answered a series of questions about breast self-examination (BSE) and mammography. Although all subjects indicated familiarity with BSE, and two-thirds of them knew it should be practiced monthly, only 31% actually did so. Women who learned BSE from physicians or other health professionals reported more frequent BSE than those who learned from other sources. About one-third of respondents indicated that they would like to learn more about BSE; women health professionals were the most preferred learning source. Respondents indicated that they fail to do BSE because they do not remember to do it and reported that reminders would increase their likelihood of compliance. Of subjects age 40 and older, about four-fifths had had a mammogram. Those who had not had one reported that the cost of mammography was a significant barrier for them. These results are discussed and recommendations for practice and for future research are made.     

Simulation center uses real-world training

--Students, hospital staff, and faculty all participate in training sessions. --Facility provides ability to train and learn without harm to patients. --Scenarios can be created with specific learning in mind.     

Breast Self-Examination and Mammography Among University Staff and Faculty

Women faculty and staff (N = 201) answered a series of questions about breast self-examination (BSE) and mammography. Although all subjects indicated familiarity with BSE, and two-thirds of them knew it should be practiced monthly, only 31% actually did so. Women who learned BSE from physicians or other health professionals reported more frequent BSE than those who learned from other sources. About one-third of respondents indicated that they would like to learn more about BSE; women health professionals were the most preferred learning source. Respondents indicated that they fail to do BSE because they do not remember to do it and reported that reminders would increase their likelihood of compliance. Of subjects age 40 and older, about four-fifths had had a mammogram. Those who had not had one reported that the cost of mammography was a significant barrier for them. These results are discussed and recommendations for practice and for future research are made.     

“望闻问切”与内部审计

中医的望闻问切辨证论治理论与审计理论有相通之处,如何将此理论应用于内部审计工作,可借鉴之处很多。     

The development of medical teachers: an enquiry into the learning histories of 10 experienced medical teachers

AIM: The aim of the study was to explore the different ways in which doctors have learned to teach and train. INTRODUCTION: There is no coherent theory of medical teacher development. Doctors are experts in what they teach; most have had little or no training in how they teach. Research has mostly concentrated on the acquisition and improvement of pedagogical skills by attendance at formal, generally short courses. These may have limited impact. METHODS: We carried out semistructured interviews with 10 experienced medical teachers. A review of the literature had suggested areas to explore. Interviews were transcribed and coded and thematic analysis and grounded theory used as the framework for qualitative analysis. RESULTS: Four areas were identified as important in teacher development: acquisition of educational knowledge and skills; modelling and practice of teaching skills; encouragement and motivation of teachers, and constraints on teaching and learning. DISCUSSION: The results suggest a model for teacher development that begins with doctors as learners, learning to learn and watching teachers teach. They then start to teach, acquiring and practising skills, and subsequently move on to reflect on their teaching. They can be encouraged to teach but may also be prevented from teaching. CONCLUSIONS: This inductive study proposes a model for medical teacher development that attempts to explain how doctors learn to teach and train. More research is needed to clarify the findings. There are implications for faculty development.     

The Art of Medicine through the Humanities: an overview of a one-month humanities elective for fourth year students

BACKGROUND: The purpose of incorporating humanities teaching into medical education is to encourage students to develop into more sensitive and caring doctors who communicate well with their patients and colleagues. CONTENT: A unique 4th year student elective at the Medical College of Wisconsin incorporates reflective and writing activities. Small group sessions are facilitated by faculty with specific interest and expertise in the humanities. EVALUATION: Students keep a journal in which they record their reflections on personal issues, career planning and reactions to classroom discussions. Each student writes a poem and an essay or short story. The course is well received and oversubscribed. CONCLUSIONS: Students increase their understanding of the humanities through readings, small group discussions, journal keeping and formal writing. By incorporating humanism into their professional lives, medical students can learn to care for their patients in a more humane and thoughtful manner.     

Faculty development: if you build it,they will come

Medical Education 2010: 44 : 900–907 Objectives The goals of this study were three‐fold: to explore the reasons why some clinical teachers regularly attend centralised faculty development activities; to compare their responses with those of colleagues who do not attend, and to learn how we can make faculty development programmes more pertinent to teachers’ needs. Methods In 2008–2009, we conducted focus groups with 23 clinical teachers who had participated in faculty development activities on a regular basis in order to ascertain their perceptions of faculty development, reasons for participation, and perceived barriers against involvement. Thematic analysis and research team consensus guided the data interpretation. Results Reasons for regular participation included the perceptions that: faculty development enables personal and professional growth; learning and self‐improvement are valued; workshop topics are viewed as relevant to teachers’ needs; the opportunity to network with colleagues is appreciated, and initial positive experiences promote ongoing involvement. Barriers against participation mirrored those cited by non‐attendees in an earlier study (e.g. volume of work, lack of time, logistical factors), but did not prevent participation. Suggestions for increasing participation included introducing a ‘buddy system’ for junior faculty members, an orientation workshop for new staff, and increased role‐modelling and mentorship. Conclusions The conceptualisation of faculty development as a means to achieve specific objectives and the desire for relevant programming that addresses current needs (i.e., expectancies), together with an appreciation of learning, self‐improvement and networking with colleagues (i.e., values), were highlighted as reasons for participation by regular attendees. Medical educators should consider these ‘lessons learned’ in the design and delivery of faculty development offerings. They should also continue to explore the notion of faculty development as a social practice and the application of motivational theories that include expectancy–value constructs to personal and professional development.     

Predictors of job satisfaction among academic faculty members: do instructional and clinical staff differ?

Medical Education 2010: 44> : 985–995 Objectives This study aimed to identify and compare predictors of job satisfaction between instructional and clinical faculty members. Methods A 61‐item faculty job satisfaction survey was distributed to 1898 academic faculty members at the University of Michigan Medical School. The anonymous survey was web‐based. Questions covered topics on departmental organisation, research, clinical and teaching support, compensation, mentorship, and promotion. Levels of satisfaction were contrasted between faculty members on the two tracks, and predictors of job satisfaction were identified using linear regression models. Results Response rates for the instructional and clinical faculty groups were 43.1% and 46.7%, respectively. Clinical faculty members reported being less satisfied with how they were mentored and fewer reported understanding the process for promotion. There was no significant difference in overall job satisfaction between the two faculty groups. Surprisingly, clinical faculty members with mentors were significantly less satisfied with how they were mentored and with career advancement, and were significantly less likely to choose an academic career if they had to do it all over again compared with instructional faculty mentees. Additionally, senior‐level clinical faculty members were significantly less satisfied with their opportunities to mentor junior faculty members compared with senior‐level instructional faculty staff. Significant predictors of job satisfaction for both groups included areas of autonomy, meeting career expectations, work–life balance, and departmental leadership. In the clinical track only, compensation and career advancement variables also emerged as significant predictors of overall job satisfaction. Conclusions Greater emphasis must be placed on faculty members’ well‐being at both the institutional level and the level of departmental leadership. Efforts to enhance job satisfaction and improve retention are more likely to succeed if they are directed by locally designed assessments involving department chairs and are specifically aimed at fostering more effective mentoring relationships and increasing the opportunities available for career advancement activities such as research work. Our findings show that these strategies can have significant impacts on job satisfaction and the retention of clinical track faculty members.     

Faculty development: a ‘Field of Dreams’?

Objectives  Participants in faculty development workshops often comment that 'those who need faculty development the most attend the least'. The goals of this study were to explore the reasons why some clinical teachers do not participate in centralised faculty development activities and to learn how we can make faculty development programmes more relevant to teachers' needs.
Methods  In 2006, we conducted focus groups with 16 clinical teachers, who had not participated in faculty development activities, to ascertain their perceptions of faculty development, reasons for non-participation and perceived barriers to involvement. Content analysis and team consensus guided the data interpretation.
Results  Focus group participants were aware of faculty development offerings and valued the goals of these activities. Important reasons for non-participation emerged: clinical reality, which included volume of work and lack of (protected) time; logistical issues, such as timing and the central location of organised activities; a perceived lack of financial reward and recognition for teaching, and a perceived lack of direction from, and connection to, the university.
Conclusions  Clinical reality and logistical issues appeared to be greater deterrents to participation than faculty development goals, content or strategies. Moreover, when asked to discuss faculty development, teachers referred to their development as faculty members in the broadest sense, which included personal and career development. They also expressed the desire for clear guidance from the university, financial rewards and recognition for teaching, and a sense of 'belonging'. Faculty development programmes should try to address these organisational issues as well as teachers' personal and professional needs.     

Using Flashcards to Support Your Learning

The idea that if you listen to a lecture and make notes you will, by some mysterious process, have learnt all that the lecturer has covered, is a myth. Unfortunately, the lecture is just the start. The best way to learn is by doing. This can be achieved by completing set practical tasks by reading and creating your own notes, listening again to parts or the whole of a lecture via a screencast or using diagrams and illustrations that you annotate. Similarly creating your own learning materials can be useful as actually putting questions and answers together helps you to learn.

One of the many ways to support your learning, especially in difficult topics like anatomy and physiology, learning about bones, medical terminology or indeed any subject where there are a lot of new words and terms to learn, is making use of an old technique brought up to date with new technologies called “flashcards”.     

The use of a developmental continuum in early childhood clinical experiences: building preservice teachers’ knowledge of cognitive development

The quality of early caregiving and educational environments has a significant effect on children’s later cognitive outcomes. Early childhood teachers are an important determining factor in the quality of these environments and therefore they need appropriate professional preparation. The purpose of this study was to describe the ways in which early childhood preservice teachers learn about children’s cognitive development and developmentally appropriate pedagogical practices at three select universities. Participants included preservice teachers and faculty members. The researcher collected and analysed data from interviews, documents, and surveys. Participants from this study proposed preservice teachers gained knowledge about children’s cognitive development as well as learned how to use this knowledge in their pedagogical practices by participating in clinical experiences that targeted a developmental continuum approach.     

Using flashcards to support your learning

The idea that if you listen to a lecture and make notes you will, by some mysterious process, have learnt all that the lecturer has covered, is a myth. Unfortunately, the lecture is just the start. The best way to learn is by doing. This can be achieved by completing set practical tasks by reading and creating your own notes, listening again to parts or the whole of a lecture via a screencast or using diagrams and illustrations that you annotate. Similarly creating your own learning materials can be useful as actually putting questions and answers together helps you to learn. One of the many ways to support your learning, especially in difficult topics like anatomy and physiology, learning about bones, medical terminology or indeed any subject where there are a lot of new words and terms to learn, is making use of an old technique brought up to date with new technologies called "flashcards".     

Effects of Problem-Based Learning Curricula on Faculty Learning: New Lenses, New Questions

Literature on the impact of problem-based learning (PBL) in medical education has short-changed important questions about the effect of PBL curricula on faculty learning and on faculty knowledge of their subject matter. This paper opens up new questions about the impact of PBL in medical colleges and other health sciences by focusing attention on its effects on faculty learning, on collegial networks in medical colleges, and, consequently, on other scholarly work by faculty. A brief review of research on the effects of PBL on faculty and faculty development is followed by a synthesis of relevant research findings from research on teaching and faculty learning in other disciplines. A new conceptual framework, drawn from the educational paradigms, methods and empirical findings from those other areas of higher education research and research on secondary school teaching, is applied to designing, examining, and evaluating problem-based learning. Viewing faculty as learners prompts a new research agenda including questions such as: What do faculty members learn by participating in integrative, interdisciplinary problem-based learning courses? How? How is that learning related to or integrated with other aspects of their scholarly work?