Improving the teaching skills of residents as tutors/facilitators and addressing the shortage of faculty facilitators for PBL modules

Background  

Residents play an important role in teaching of medical undergraduate students. Despite their importance in teaching undergraduates they are not involved in any formal training in teaching and leadership skills. We aimed to compare the teaching skills of residents with faculty in facilitating small group Problem Based Learning (PBL) sessions.     

Health maintenance organizations and medical education: breaking the barriers

Academic medical centers (AMCs) are under pressure to increase ambulatory medical education, but their capacity for such teaching is limited. Health maintenance organizations (HMOs) are a large and growing institutional setting that could participate in clinical education. Until now, relatively few HMOs and AMCs have reached agreements about teaching, because traditional suspicions have blocked collaboration. Responding to a case prepared as the basis of discussion, about 450 academics and HMO medical directors explored the barriers to and incentives for cooperation between AMCs and HMOs in clinical education. The two groups identified different issues as barriers to collaboration, leaving considerable room to negotiate agreements. AMCs, especially, need to be prepared to offer meaningful academic and financial inducements to attract HMOs to participate in teaching.     

Scholarly productivity of geriatrics senior faculty members and faculty trainees compared with that of other health professions educators.

To compare the scholarly productivity levels of senior geriatrics educators and faculty trainees, and to compare their productivity with those of other faculty groups, the authors analyzed questionnaires completed in 1988 by 97 senior staff members of geriatrics education centers nationwide and in 1985-1989 by 91 faculty enrollees in the year-long professional development program of the Texas Consortium of Geriatric Education Centers. The chief difference between the two groups was that more senior educators (75%) than enrollees (40%) had published in the three years previous to completing the questionnaire. The authors conclude that the productivity levels of the two groups compare favorably with previously reported productivity levels of health sciences faculties in general.     

Attitudes of part-time community internal medicine faculty about their teaching.

The authors sent a six-item questionnaire regarding attitudes about teaching to 130 part-time community internal medicine faculty at the University of Illinois College of Medicine at Rockford in August 1991; of the 90 (69%) who responded, 53 were salaried and 37 nonsalaried. Substantial numbers of the salaried faculty responded (1) that teaching is important for their career development (25, 48%), compared with nine (22%) of the nonsalaried faculty, and (2) that they expected to increase their commitments to the medical school (50, 75%), compared with 24 (65%) of the nonsalaried faculty. Of all the faculty, fewer than the authors expected--22 (24%)--felt that their teaching interfered with their clinical practices. As expected, most (76, 84%) responded that salary was necessary. The authors suggest that their results may be helpful to other medical schools, because with the setting of medical education changing from the hospital to the community, the importance of part-time faculty is increasing.     

Characteristics of medical school faculty members serving on institutional review boards: results of a national survey.

PURPOSE: To understand the characteristics of medical school faculty members who serve on institutional review boards (IRBs) in U.S. academic health centers. METHOD: Between October 2001 and March 2002, a questionnaire was mailed to a stratified random sample of 4,694 faculty members in 121 four-year medical schools in the United States (excluding Puerto Rico). The sample was drawn from the Association of American Medical College's faculty roster database for 1999. The primary independent variable was service on an IRB. Data were analyzed using standard statistical procedures. RESULTS: A total of 2,989 faculty members responded (66.5%). Eleven percent of respondents reported they had served on an IRB in the three years before the study. Of these, 73% were male, 81% were white (non-Hispanic). Virtually all faculty IRB members (94%) conducted some research in the three years before the study, and, among these, 71% reported conducting clinical research, and 47% served as industrial consultants to industry. Underrepresented minority faculty members were 3.2 times more likely than white faculty members to serve on the IRB. Clinical researchers were 1.64 times more likely to be on an IRB than were faculty members who conducted nonclinical research. No significant difference was found in the average number of articles published in the three years before the study comparing IRB faculty to non-IRB faculty. CONCLUSIONS: The faculty members who serve on IRBs tend to have research experience and knowledge that may be used to inform their IRB-related activities. However, the fact that almost half of all faculty IRB members serve as consultants to industry raises potential conflicts of interest.     

Criteria of the "educators' pyramid" fulfilled by medical school faculty promoted on a teaching pathway.

PURPOSE: To compare the results of academic promotion to associate professor and professor via the teaching pathway at the Wake Forest University School of Medicine (WFUSM) with the criteria of the "educators' pyramid" of Sachdeva et al. METHOD: Data on all candidates promoted to associate professor and professor in the academic years 1995-2000 at WFUSM were collected from candidates' portfolios and compared with the criteria for educator (level three) and master educator (level four) from a modified version of the educators' pyramid. RESULTS: Of 186 faculty promoted, 38 were on the teaching pathway. Everyone promoted on the pathway fulfilled all teacher and master teacher criteria. All educator criteria were found among the associate professors, and all but one of the master educator criteria were found among professors. More than 75% of associate professors demonstrated "sustained participation in significant amounts of effective teaching in more than one modality" and "service as a medical student clerkship, course, or residency director." Less than 30% demonstrated "service as assistant dean of education or student affairs" or "service as the chair of departmental education committees." Most associate professors had not regularly participated in national education meetings. For professors, more than 50% demonstrated "achievement of leadership positions in national organizations, committees, and medical school education"; "recognition as a national leader in specialty education"; and "mentorship of other faculty members locally and nationally." Less than 30% demonstrated "pursuit of further training in education through workshops, faculty development programs, or educational fellowship programs" or "development and implementation of nationally-recognized (in education) innovative curricula or teaching programs." No one promoted to professor on the teaching pathway had made what was considered to be a landmark contribution to educational research and development. CONCLUSION: The findings suggest that the educators' pyramid is generalizable to medical faculty being promoted on a teaching pathway at WFUSM. Documentation of achievement in teaching criteria is essential and faculty should be encouraged to maintain records of accomplishment before becoming candidates for promotion.     

关于青年教员提高药理学教学效果的探讨

本文从药理学教学角度出发,树立"以学员为根本"的理念,通过授课前准备、授课过程以及授课后分析,探讨青年教员如何提高教学效果。     

Overcoming barriers to teaching the behavioral and social sciences to medical students.

Most U.S. medical schools offer courses in the behavioral and social sciences (BSS), but their implementation is frequently impeded by problems. First, medical students often fail to perceive the relevance of the BSS for clinical practice. Second, the BSS are vaguely defined and the multiplicity of the topics that they include creates confusion about teaching priorities. Third, there is a lack of qualified teachers, because physicians may have received little or no instruction in the BSS, while behavioral and social scientists lack experience in clinical medicine. The authors propose an approach that may be useful in overcoming these problems and in shaping a BSS curriculum according to the institutional values of various medical schools. This approach originates from insights gathered during their attempts to teach various BSS topics at four Israeli medical schools. They suggest that medical faculties (1) adopt an integrative approach to learning the biomedical, behavioral, and social sciences using Engel's "biopsychosocial model" as a link between the BSS and clinical practice, (2) define a hierarchy of learning objectives and assign the highest priority to acquisition of clinically relevant skills, and (3) develop clinical role models through teacher training programs. This approach emphasizes the clinical relevance of the BSS, defines learning priorities, and promotes cooperation between clinical faculty and behavioral scientists.     

A model for faculty practice teaching clinics developed at the Oregon Health Sciences University.

In 1988 the Oregon Health Sciences University established its first faculty practice teaching clinic wherein physicians in training were incorporated into a faculty private practice clinic; this pilot project proved very successful and has been subsequently adopted as the model for essentially all outpatient clinics (both medical and surgery) in the university system. The model encourages efficiency, overhead control, and appropriate staffing; it also compensates faculty members for their additional time spent teaching. The authors conclude this model may help other academic training centers adapt to the changing demands of medical education.     

Recognizing the value of community involvement by AHC faculty: a case study.

Physicians seek connections to their communities. Some health care and academic leaders believe that facilitating the creation of more such community connections is one way to reverse the trend of waning social and political legitimacy for the U.S. medical profession. For academic health centers (AHCs), such connections can maintain local and state support crucial to their long-term success. Multiple barriers exist to such involvement, especially for physicians in AHCs, where work done beyond direct patient care, administration, and research rarely contributes to the tenure and promotion process. The authors present a case study to show how one department in an AHC, beginning in the late 1990s, has been overcoming these barriers to incorporate the scholarship of community engagement into its mission and structure. The case study incorporates theoretical underpinnings to crystallize the following lessons that the department has learned so far: (1) If academic departments wish community service to be a central part of their mission, they need ways to institutionalize community engagement within organizational structures. (2) Community engagement can be scholarly. (3) If faculty members are to be recognized for their service activities, measures are necessary to determine what constitutes "excellence" and "scholarship" in community service. (4) Scholarship of community engagement goes beyond performing service activities in the community.