Faculty development for educational leadership and scholarship.

The Medical Education Scholars Program (MESP) at the University of Michigan Medical School is designed to develop leaders in medical education. The program's goals are to enable faculty to provide curriculum direction, improved teaching, educational research, and development, and institutional leadership at all levels of medical education. This one-year program uses a variety of educational methods and provides a broad curriculum in educational theory, assessment and evaluation, research design and methods, teaching-skills development, and educational leadership. Faculty are admitted on a competitive basis and one half-day per week of release time is funded as part of the program. Salient outcomes of the program (promotions, educational research and development, curriculum leadership, and educational scholarship) were measured in a pre- and post-program design in which each scholar acted as his or her own control. There were major increases in promotions and educational awards, new educational responsibilities, and new educational programs. A particularly important outcome was the emergence of educational scholarship in the professional portfolios of the program scholars in the form of peer-reviewed presentations and publications and educational grant funding. A cost-outcome analysis indicates that these multi-year outcomes were obtained from a one-time investment of approximately $21,000 per graduating scholar. This evaluation indicates that intensive faculty development programs can have measurable impacts on the careers of the participants and the institutional environment.     

Promoting academic excellence through leadership development at the University of Washington: the Teaching Scholars Program.

The University of Washington Teaching Scholars Program (TSP) was established in 1995 to prepare faculty for local and national leadership and promote academic excellence by fostering a community of educational leaders to innovate, enliven, and enrich the environment for teaching and learning at the University of Washington (UW). Faculty in the Department of Medical Education and Biomedical Informatics designed and continue to implement the program. Qualified individuals from the UW Health Sciences Professional Schools and foreign scholars who are studying at the UW are eligible to apply for acceptance into the program. To date, 109 faculty and fellows have participated in the program, the majority of whom have been physicians. The program is committed to interprofessional education and seeks to diversify its participants. The curriculum is developed collaboratively with each cohort and comprises topics central to medical education and an emergent set of topics related to the specific interests and teaching responsibilities of the participating scholars. Core sessions cover the history of health professions education, learning theories, educational research methods, assessment, curriculum development, instructional methods, professionalism, and leadership. To graduate, scholars must complete a scholarly project in curriculum development, faculty development, or educational research; demonstrate progress towards construction of a teaching portfolio; and participate regularly and actively in program sessions. The TSP has developed and nurtured an active cadre of supportive colleagues who are transforming educational practice, elevating the status of teaching, and increasing the recognition of teachers. Graduates fill key teaching and leadership positions at the UW and in national and international professional organizations.     

Making it work: the evolution of a medical educational fellowship program.

Longitudinal programs to enhance the educational skills of medical school faculty are present in many medical schools and academic health centers. Multiinstitutional programs are less common. Three health professions schools, Baylor College of Medicine, The University of Texas Medical School at Houston, and The University of Texas Dental Branch have jointly sponsored the Educational Scholars Fellowship Program (ESFP) since 2003. The evolution of this program, from one that addressed the faculty educator development needs of one medical school in the mid-1990s to a more flexible model that includes faculty and fellows from three institutions, reflects the changing needs of faculty as well as those of other health professions schools. The ESFP's strengths lie in the effective use of resources across three schools; the opportunity for an interinstitutional and interdisciplinary collaborative network; the flexibility of the curriculum offerings; and the positive impact on fellows' knowledge, skills and leadership in medical and dental education. The evolution of this program represents a cost-effective and educationally sound response to the changing needs of faculty educators.     

From novice to informed educator: the teaching scholars program for educators in the health sciences.

The Teaching Scholars Program for Educators in the Health Sciences at McGill University, in Montreal, Quebec, was designed to promote the professional development of health science educators by increasing their expertise in developing and implementing educational programs and taking on leadership roles in education. This program, which was initiated in 1997 and is tailored to the individual needs of the participants, consists of participation in: two university courses; a monthly seminar; a research study or an educational project, consisting of curriculum design and evaluation; and faculty-wide faculty development activities. As of 2006, 34 scholars have completed this program. Outcome data indicate that the majority of teaching scholars have taken on new roles and responsibilities in medical education; maintained the changes implemented in their teaching practices; continued to participate in faculty development activities; and presented their work at educational meetings. A number of scholars have also applied successfully for educationally related grants and have published their educational projects. Five of the scholars have pursued advanced studies. This program, which aims to move beyond the improvement of teaching skills by providing a foundation for educational leadership and scholarship, resembles many others in its emphasis on independent study, peer support, and the maintenance of ongoing responsibilities. It is innovative in that scholars participate in university courses and are encouraged to attend an "outside" conference or course. The overall benefits of this program, as noted by the scholars, include increased knowledge and skills, introduction to a "community of practice," and new career paths and opportunities.     

Developing educational leaders: the teaching scholars program at the University of California, San Francisco, School of Medicine.

A Teaching Scholars Program (TSP) was established in 1998 in the University of California, San Francisco (UCSF), School of Medicine with the mission of building knowledgeable and skilled educational leaders, teachers, and scholars. Conducted through the Office of Medical Education (OME), the TSP is a 10-month program that accepts 12 scholars per year. Financial support for the program, including salary support for co-directors and staff, is provided by the OME. Scholars' departments are required to provide release time for one afternoon per week for 10 months. The TSP provides participants with an intensive weekly seminar series, collaborative learning experiences, mentored projects, and a network of educational colleagues. The weekly seminars use an interactive format to address topics within seven targeted areas: (1) learning theory; (2) teaching methods; (3) curriculum development/evaluation; (4) assessment of learning; (5) leadership and organizational change; (6) career development; and (7) educational research. Since its inception, 76 scholars have graduated from or are currently enrolled in the TSP. The majority are clinicians at assistant professor rank, although four basic scientists, two medical students, and three OME staff members have also participated in the program. The TSP is highly valued by participants, and preliminary evaluation data suggest that the program has resulted in an increase in educational research, scholarly activities, and the number of skilled and knowledgeable faculty with major leadership roles in medical education at UCSF. Challenges facing the TSP include scholar release time, mentoring time, and follow-up contact to encourage TSP graduates' postgraduation productivity, continuing educational development, and support.     

Promoting research in medical education at the University of California, San Francisco, School of Medicine.

Over the past seven years, educational innovations and scholarship have flourished at the University of California, San Francisco, (UCSF) School of Medicine. Prior to 1998, there was no infrastructure to support educational research and yet a few faculty members published in medical education journals and were active in national professional associations. With the initiation of curriculum reform in 1998, a great deal of excitement about education was generated and innovative new educational programs were envisioned. These changes became opportunities for educational scholarship. With the development of an Office of Medical Education in 1997 and the Haile T. Debas Academy of Medical Educators in 2001, the infrastructure was in place to expand educational research and the scholarship of teaching. The components of this support include educational leadership, faculty development, the Teaching Scholars Program, the Office of Educational Research and Development, the Academy, a Fellowship in Medical Education Research, collaborative research, and extramural grants. As a result of these investments, the number of UCSF faculty members who are involved in educational research has increased significantly. There has been a four-fold increase in peer-reviewed articles published in medical education journals and a greater increase in the publication of educational abstracts, editorials, chapters, and books, plus presentations at U.S. professional association meetings. In this article, the authors describe the changes that have occurred at UCSF to achieve these results.     

Medical education research at the University of Washington School of Medicine: lessons from the past and potential for the future.

Faculty in the Department of Medical Education and Biomedical Informatics at the University of Washington School of Medicine received over $1.2 million in direct grant and contract support in 2003. In this case study, the authors provide some of the history and background of the evolution of the department's structure and its role in providing leadership in medical education research at the university, as well as regionally, nationally, and internationally. The authors offer their observations and reflections on what has helped and hindered the department's success, and end with some predictions on medical education research in the future. The University of Washington's five-state regional WWAMI educational program, establishing a single medical school for the states of Washington, Wyoming, Alaska, Montana, and Idaho, has been an important environmental influence on the direction of the department's educational and research activities. External support has helped the department to create the Northwest Consortium for Clinical Performance Assessment, the Center for Medical Education Research, the Teaching Scholars Program, and a Biomedical and Health Informatics graduate and fellowship training program, as well as a number of international programs.     

A teaching scholars program to develop leaders in medical education.

The authors describe a year-long faculty development initiative to develop leaders in medical education. The Teaching Scholars Program for Educators in the Health Sciences at McGill University enables faculty to improve their educational knowledge and skills while maintaining their clinical, teaching, and research responsibilities. The program, tailored to the participant's individual needs, consists of five main components: two university courses; independent study; participation in faculty-wide faculty development workshops and medical education rounds; a monthly seminar; and attendance at a national or international conference or course. Since its inception in 1997, 22 faculty members have completed the program; four are currently participating in it. This report discusses the experience of 15 scholars who completed the program by September 2000. Evaluations indicate that the scholars achieved most of their stated objectives. The university courses provided a foundation in educational principles and methodology; independent study allowed them to work on educational projects relevant to their disciplines; and the monthly seminars, faculty development workshops, and outside courses offered opportunities for skill acquisition and reflection. Participants also appreciated the opportunity to meet others interested in medical education and to become aware of available educational resources. A year after completing the program, many had joined new educational committees, taken on new leadership roles in medical education, and developed new courses for students and residents. Some of their projects had been presented at national meetings and were being prepared for publication. Two scholars had pursued further study at a master's level. Despite the ongoing challenge of protecting time for educational pursuits, this program has been beneficial in helping to develop educational leaders in the Faculty of Medicine.     

Increasing the pool of educational leaders for UCLA.

The dual goals of the faculty Fellowship in Medical Education (MEF) program at the David Geffen School of Medicine at UCLA, established in 1992, are to prepare excellent teachers to serve as clerkship chairs, course chairs, or residency program directors while strengthening their dossiers for promotion based on a scholarly approach to curriculum development, implementation, and evaluation. Fellows are nominated from their departments and must demonstrate a strong interest in assuming educational leadership in their respective specialties. A total of eight fellows are accommodated each year based on interviews with the MEF faculty. The two-year program consists of two seminars and two projects focused on four objectives: to critique teaching and testing practices in medical education in light of current theories of learning; to develop and implement curricula that reflect these theories; to improve personal teaching skills through reflection and feedback; and to design and conduct an educational research or program evaluation study. An analysis of the curricula vitae of faculty members who have completed the fellowship suggest that this program continues to provide educational leaders for the school as originally intended. Of the 71 medical school faculty members who completed the MEF between 1993 and 2004 and have remained at the university, 43 (61%) have assumed new leadership roles in medical education. The evaluation data strongly suggest that the MEF has had a major role since its inception in creating a pool of faculty members with the confidence to manage the tasks of educational planning and implementation.     

Increasing departmental and college-wide faculty development opportunities through a teaching scholars program.

The University of Iowa Teaching Scholars Program was initiated in 1999 at the University of Iowa Carver College of Medicine (CCOM) with the overall goal of promoting leadership in faculty development related to teaching skills. Specific goals of this program are (1) to promote the development of a cadre of faculty members who have the skills to implement faculty development within their departments and the CCOM; (2) to increase departmental involvement in faculty development efforts; (3) to increase resources available for dissemination of college-wide faculty development efforts; and (4) to acknowledge the extra effort faculty put into developing their skills and knowledge in medical education and in providing continuing education to their faculty colleagues. All clinical and basic science departments in the CCOM are given the opportunity to have a faculty member participate in the program. Unlike other programs reported in the literature, competitive decisions for program participation are made at the departmental level. The three-year program combines monthly meetings and other activities to train faculty to provide faculty development in teaching skills. Each scholar develops and implements a project to address departmental faculty development needs as well as needs of other departments in the CCOM. To date (2006), 50 faculty members from 19 different departments have participated in the program with an average of 12 scholars per class. The program has resulted in a substantial increase in departmental and college-wide faculty development programming and has had a positive impact on individual scholars' teaching skills and leadership roles.     

The UCSF Academy of Medical Educators.

The Academy of Medical Educators at the University of California, San Francisco (UCSF), was established in 2000 to (1) foster excellence in teaching, (2) support teachers of medicine, and (3) promote curricular innovation. A membership organization, it recognizes five categories of educational activity: direct teaching, curriculum development and assessment of learner performance, advising and mentoring, educational administration and leadership, and educational research. Excellent medical student teaching and outstanding accomplishment in one or more areas of educational activity qualify a teacher for membership. Candidates prepare a portfolio that is reviewed internally and by national experts in medical education. Currently 37 faculty members, 3% of the entire school of medicine faculty, belong to the academy. The academy's innovations funding program disburses one-year grants to support curricular development and comparisons of pedagogical approaches; through this mechanism, the academy has funded 20 projects at a total cost of $442,300. Three fourths of expended funds support faculty release time. Faculty development efforts include promotion of the use of an educator's portfolio and the establishment of a mentoring program for junior faculty members built around observation of teaching. The Academy of Medical Educators vigorously supports expanded scholarship in education; the academy-sponsored Education Day is an opportunity for educators to present their work locally. Recipients of innovations-funding program grants are expected to present their work in an appropriate national forum and are assisted in doing this through quarterly scholarship clinics. The Academy of Medical Educators has been well received at UCSF and is enhancing the status of medical education and teachers.     

Development of a teaching program in clinical medical ethics at the University of Chicago

The University of Chicago Pritzker School of Medicine has developed and evaluated an extensive teaching program in clinical ethics coordinated primarily through the Center for Clinical Medical Ethics. The program provides medical students with a foundation in medical ethics during the four years of medical school and augments the clinical ethics knowledge and teaching skills of the housestaff and clinical faculty at the University of Chicago. Together, medical student teaching and clinical faculty development have made clinical ethics an integral part of medical education at the University of Chicago. Through these efforts, the teaching program aims to incorporate clinical ethics considerations into medical decisions and in this way contribute to improving patient care. (A detailed overview of all clinical ethics instruction at the school is provided.)     

Evaluation of a faculty development program in managing care.

PURPOSE. To evaluate a faculty development program that teaches quality improvement and cost-effectiveness. METHOD. From October 2000 to February 2001, a two-part faculty development program was offered to 39 physicians from 19 U.S. medical schools supported by grants from the Partnerships for Quality Education (PQE) and Undergraduate Medical Education in the 21st Century (UME-21). Special features of the program included partnerships between academic and community physicians from each school, development of an educational innovation of interest to the participants, concurrent development of teaching skills and new medical knowledge, learning leadership skills (e.g., how to train colleagues to teach), and practice periods. The program focused on quality improvement and cost-effectiveness, but included other "managing care" topics. Prior to and after the course, participants assessed their knowledge of and competence to teach these topics, as well as other managing care topics. They also assessed their competence as medical educators and leaders. After the course, they indicated their progress in implementing their proposed educational innovations. RESULTS. Thirty-two of the 39 physicians completed evaluations both before and after the program. Self-assessed knowledge and competence to teach quality improvement and cost-effectiveness were significantly higher at the end of the course, as were all self-assessed teaching and leadership skills. The largest change scores occurred in assessments of competency to teach the new topics and to teach in new ways. Participants who implemented their innovations rated their competencies to teach quality improvement and cost-effectiveness higher than did non-implementers. CONCLUSION. Opportunities for faculty to learn how to teach a topic of stated importance to them, to practice what they have learned, and to work collaboratively with partners improved teaching skills.     

Effects of expert and non-expert facilitators on the small-group process and on student performance.

At the University of Michigan Medical School in 1990, the authors investigated the effects of faculty facilitators' levels of content expertise on the educational process and learning outcomes of small-group teaching sessions. The study was conducted in a microbiology course for second-year students in which four small-group sessions were used to replace 38 hours of lecture and laboratory time. The interactions between 11 expert and ten non-expert faculty facilitators and 156 students were observed and coded. The students' levels of knowledge and satisfaction were measured. The results indicate that, although significant differences in faculty-student interactions were not observed, the students in the 11 groups led by the content experts had higher levels of satisfaction and higher examination scores.     

Enhancing clinical skills education: University of Virginia School of Medicine's Clerkship Clinical Skills Workshop Program.

In 1993, the University of Virginia School of Medicine began a clinical skills workshop program in an effort to improve the preparation of all clerkship students to participate in clinical care. This program involved the teaching of selected basic clinical skills by interested faculty to small groups of third-year medical students. Over the past 14 years, the number of workshops has increased from 11 to 31, and they now involve clerkship faculty from family medicine, internal medicine, and pediatrics. Workshops include a variety of common skills from the communication, physical examination, and clinical test and procedure domains such as pediatric phone triage, shoulder examination, ECG interpretation, and suturing. Workshop sessions allow students to practice skills on each other, with standardized patients, or with models, with the goal of improving competence and confidence in the performance of basic clinical skills. Students receive direct feedback from faculty on their skill performance. The style and content of these workshops are guided by an explicit set of educational criteria.A formal evaluation process ensures that faculty receive regular feedback from student evaluation comments so that adherence to workshop criteria is continuously reinforced. Student evaluations confirm that these workshops meet their skill-learning needs. Preliminary outcome measures suggest that workshop teaching can be linked to student assessment data and may improve students' skill performance. This program represents a work-in-progress toward the goal of providing a more comprehensive and developmental clinical skills curriculum in the school of medicine.     

Promoting fundamental clinical skills: a competency-based college approach at the University of Washington.

The focus on fundamental clinical skills in undergraduate medical education has declined over the last several decades. Dramatic growth in the number of faculty involved in teaching and increasing clinical and research commitments have contributed to depersonalization and declining individual attention to students. In contrast to the close teaching and mentoring relationship between faculty and students 50 years ago, today's medical students may interact with hundreds of faculty members without the benefit of a focused program of teaching and evaluating clinical skills to form the core of their four-year curriculum. Bedside teaching has also declined, which may negatively affect clinical skills development. In response to these and other concerns, the University of Washington School of Medicine has created an integrated developmental curriculum that emphasizes bedside teaching and role modeling, focuses on enhancing fundamental clinical skills and professionalism, and implements these goals via a new administrative structure, the College system, which consists of a core of clinical teachers who spend substantial time teaching and mentoring medical students. Each medical student is assigned a faculty mentor within a College for the duration of his or her medical school career. Mentors continuously teach and reflect with students on clinical skills development and professionalism and, during the second year, work intensively with them at the bedside. They also provide an ongoing personal faculty contact. Competency domains and benchmarks define skill areas in which deepening, progressive attention is focused throughout medical school. This educational model places primary focus on the student.     

A multidisciplinary program to improve the teaching skills of incoming housestaff

Residents at the School of Medicine and Biomedical Sciences at the State University of New York at Buffalo (SUNY at Buffalo) expressed an interest in receiving instruction in teaching skills. In 1988, under sponsorship of the Graduate Medical-Dental Education Consortium, faculty and residents implemented an orientation program for 110 incoming housestaff. Residents received instruction in large-group teaching skills, bedside teaching, small-group discussion, and student evaluation. The program was rated positively by the residents, 5% of whom became instructors in the orientation program for the following year. Because of the program's structure, both faculty and housestaff receiving training in teaching skills, which may lead to an overall improvement in the teaching of SUNY at Buffalo's medical students.     

MEDPREP--30 years of making a difference.

The Medical/Dental Education Preparatory Program (MEDPREP) of Southern Illinois University School of Medicine has served over 1000 educationally or economically disadvantaged students since its inception in 1972. Seventy-eight percent of the former students (95% of the current students) are members of AAMC-defined underrepresented minority groups (URMs). Over the course of its 30-year history, 68% of the students have been accepted to professional schools, with 92% being accepted to medical schools and attending 90 different medical schools in the country. Of those accepted to professional schools, 87% have graduated or are expected to graduate. MEDPREP has had this impact on the profession by staying true to its original mission, assisting minority students and other students with disadvantaged backgrounds to prepare for admission and success in medical school. MEDPREP is an environment of high expectations, teamwork, personal growth, and opportunities to achieve goals. Students are served by an advisor who helps structure an individualized curriculum designed to develop a knowledge base and learning and reasoning skills. The success of the program is due to the school's commitment and support, the faculty who serve the students, and the sacrifice and hard work of the MEDPREP students.