Empowering junior faculty: Penn State's faculty development and mentoring program.

Empowerment of faculty is essential for academic success. The Junior Faculty Development Program (JFDP), sponsored by the Office of Professional Development of the Penn State College of Medicine, was established in 2003 with the goal of promoting the development and advancement of junior faculty so they can achieve success in their academic careers. The program consists of two components: a curriculum in research, education, clinical practice, and career development, and an individual project completed under the guidance of a senior faculty mentor. The curriculum provides faculty with knowledge, skills, and resources. Mentoring provides relationships and support. Together, these elements combine to empower junior faculty to better manage their careers.The effectiveness of the program has been demonstrated by several measures: participants evaluated the program highly, demonstrated increases in their perceptions of their own abilities, and completed tasks important to the advancement of their careers. Participants stated they were better prepared to advance their academic careers and that the individual projects would contribute to their career advancement.On the basis of this experience, the authors suggest that faculty development programs should empower faculty so that they can more effectively chart a successful career in academic medicine. This report describes an empowerment model, and the design, implementation, and evaluation of the Junior Faculty Development Program in 2003-04 and 2004-05. The authors offer this program as a model for the benefit of other institutions and for one of their most valuable assets: junior faculty.     

Informal mentoring between faculty and medical students.

Mentoring skills are valuable assets for academic medicine faculty, who help shape the professionalism of the next generation of physicians. Mentors are role models who also act as guides for students' personal and professional development over time. Mentors can be instrumental in conveying explicit academic knowledge required to master curriculum content. Importantly, they can enhance implicit knowledge about the "hidden curriculum" of professionalism, ethics, values and the art of medicine not learned from texts. In many cases, mentors also provide emotional support and encouragement. The relationship benefits mentors as well, through greater productivity, career satisfaction, and personal gratification. Maximizing the satisfaction and productivity of such relationships entails self-awareness, focus, mutual respect, and explicit communication about the relationship. In this article, the authors describe the development of optimal mentoring relationships, emphasizing the importance of experience and flexibility in working with beginning to advanced students of different learning styles, genders, and races. Concrete advice for mentor "do's and don'ts"is offered, with case examples illustrating key concepts.     

Introduction to the medical professions through an innovative medical student-run pipeline program

Underrepresented minorities (URMs) make up a disproportionately small percentage of medical school applicants, matriculants, and physicians relative to the general US population. Preprofessional pipeline programs may help introduce URMs to careers in the medical field. MiniMeds was developed as a paracurricular enrichment program that targeted URM students. The curriculum was designed and administered by medical students, and 2 trials of this program were conducted. Data were collected pre and post program through a survey that assessed knowledge of medical concepts and knowledge of and interest in careers in medicine. Attendance at program sessions correlated with baseline knowledge about medical professions. Knowledge about medical concepts increased significantly from baseline to follow-up for boys, a group significantly represented by URMs in our cohort. Median scores for knowledge of medical careers increased significantly from baseline to followup for URMs as well as for boys and girls. Preprofessional pipeline programs such as MiniMeds are able to engage and develop medical knowledge in URM students at a critical developmental age. Further evaluation and implementation of programs that incorporate medical students to actively develop and lead pipeline programs are warranted.     

Using an outcomes-logic-model approach to evaluate a faculty development program for medical educators.

PURPOSE: This study used an outcomes-logic-model approach to examine the impact of participating in a nontraditional professional development program. Building and using a logic model provides a structure for the program to examine the degree that the desired learner outcomes, the program delivery methods, and the measurement approaches are aligned. METHOD: Structured telephone interviews were conducted in 2001 with 16 Harvard Medical School (HMS) participants in the Harvard Macy Program for Physician Educators (HM-PE): five who completed the program in 1998, five in 1999, and six in 2000. Interviews were also conducted with four Faculty Scholars, alumni of the HM-PE program who taught in subsequent programs. In 2004, online questionnaires were sent to the 16 participants and four Faculty Scholars. Immediate outcomes, such as greater use of active learning principles, and intermediate outcomes, such as commitment to medical education, were examined. RESULTS: Of those interviewed in 2001, 80% responded to the 2004 online questionnaire. Thirteen of 16 (81%) HMS respondents reported increased knowledge about and confidence using learner-center teaching methods; 10 of 16 (63%) said they gave fewer lectures and added alternative educational methods. Thirteen of 16 (81%) reported a stronger commitment to the field of medical education: almost one third felt the HM-PE program was a turning point in their careers. CONCLUSIONS: The outcomes logic model provided data to judge how well the program mission and plan were implemented, and whether outcomes had been attained.     

Continuous quality improvement and community-based faculty development through an innovative site visit program at one institution.

This article describes and evaluates a unique site-visit process for community-based teaching sites. A continuous quality-improvement program was developed by the undergraduate program in the Department of Family and Community Medicine at the University of Toronto Faculty of Medicine to facilitate and document both self- and peer-assessment. A pilot program was launched in 2000, and, after some adjustments based on initial feedback, the program in its current form was implemented in 2002. This program provides individualized support mechanisms to address the faculty development needs and infrastructure requirements of community-based, mostly volunteer, teachers. It also trains participating reviewers to provide individualized faculty development at the point of teaching. During their training, reviewers receive a toolkit consisting of suggestions for initial contact with teachers, guidelines for peer assessments, previously completed previsit teacher surveys, reviewer checklists, postvisit feedback forms, sample thank-you letters, and a faculty development reference resource list. A two-year evaluation of the program demonstrated that faculty and reviewer participants perceived it to be comprehensive, consistent, informative, and an acceptable method of reviewing existing and prospective community-based teaching sites. This program should be transferable to other institutions that engage in community-based teaching.     

Evaluating knowledge retention of third-year medical students taught with an innovative pharmacology program.

PURPOSE: To explore the degree of retention of pharmacologic knowledge of third-year medical students taught in a new pharmacology teaching program. METHOD: In 1997, the authors administered a retention test consisting of 100 multiple-choice questions, each with only one correct answer, to 457 third-year medical students at the National University of Mexico. Students were not told in advance about this diagnostic evaluation, which was given eight months after they completed the second-year pharmacology course. As a comparison, the authors also analyzed the results obtained by the same students in the three partial examinations taken during the second-year pharmacology course. The Kolmogorov-Smirnov procedure and Wilcoxon and chi-square tests were used to analyze data. RESULTS: The distribution of scores obtained in the partial exams well approximated a symmetrical bell-shaped curve, and the mean score was 59.9%. In contrast, in the retention test the distribution was negatively skewed, the mean score (69.8%) was significantly higher (p <.001), and the curve was clearly displaced to the right of that corresponding to the partial exams. The percentage of students obtaining at least a passing score (60%) was considerably higher for the retention test (82.5 versus 51.9). CONCLUSION: These findings, indicating that medical students taught in a new pharmacology program developed adequate basic pharmacologic knowledge, should encourage other medical schools to formally evaluate their teaching programs and continue efforts to improve pharmacologic education of medical students.     

The Junior Faculty Laboratory: an innovative model of peer mentoring

Mentoring in academic medicine has been shown to contribute to the success of junior faculty, resulting in increased productivity, career satisfaction, and opportunities for networking. Although traditional dyadic mentoring, involving one senior faculty member and one junior protégé, is the dominant model for mentoring in the academic environment, there is increasing recognition that the sharing of knowledge, skills, and experiences among peers may also contribute to the career development of junior faculty. The authors describe the structure, activities, and outcomes of the Junior Faculty Laboratory (JFL), a self-organized, flexible, and dynamic peer-mentoring model within the Duke University Center for the Study of Aging and Human Development. As an innovative mentoring model, JFL is entirely peer driven, and its activities are determined by the real-time needs of members. In contrast to some other peer-mentoring models, JFL lacks senior faculty input or a structured curriculum, members are multidisciplinary, meeting times are project driven rather than preset, and participation in collaborative projects is optional based on the interests and needs of group members. Additionally, JFL was not formed as a substitute for, but as a complement to, the dyadic mentoring relationships enjoyed by its members. The model, now in its fifth year, has demonstrated success and sustainability. The authors present the JFL as an innovative, mentoring model that can be reproduced by other junior faculty seeking to foster collegial relationships with peers while simultaneously enhancing their career development.     

Evaluation of an early medical school selection program for underrepresented minority students.

PURPOSE: To evaluate the academic performance in the first two years of medical school of underrepresented minority students (URMS) who participated in an early identification and admission program. METHOD: The study involved 39 early-selection URM students who entered one medical school from 1992 through 1999. Successful completion of the first two years of medical school and passing the United States Medical Licensure Examination (USMLE) Step 1 were correlated with Scholastic Aptitude Test I (SAT I) scores and Medical College Admission Test (MCAT) scores. The students were required to maintain an overall grade-point average of at least 3.0 on a 4.0 scale to remain in the program. RESULTS: Students who had combined scores of at least 900 on the SAT I and total scores of at least 18 on the three multiple-choice sections of the MCAT had more success completing the first two years of medical school and passed USMLE Step 1 with greater frequency than did those students who scored at lower levels on these tests. CONCLUSION: An early-selection program for URM students can identify early in their academic careers students who can complete the first two years of medical school and pass the USMLE Step 1.     

Enhancing exposure to genetics and genomics through an innovative medical school curriculum

PurposePhysicians entering medical practice in the 21st century will require more than a basic understanding of human genetics because of rapid progress in the field of genetics and genomics. The current undergraduate medical curriculum at most institutions is not adequate to prepare medical students for these challenges. Enhancing exposure to genetics throughout the medical school curriculum should help prepare the next generation of physicians to use genetic and genomic information for optimal patient care.MethodsWe have introduced a Genetics Track Curriculum to the undergraduate medical curriculum at Baylor College of Medicine.ResultsThis track runs in parallel to the existing 4-year curriculum and includes didactic sessions, small group discussions, longitudinal clinical experiences, clinical and laboratory rotations, community outreach, and scholarly projects related to genetics. It also provides the students a means to network and discuss topics and career paths in medical genetics.ConclusionWe have developed a novel curriculum that enhances genomic education for medical students with the ultimate goal of enabling our graduates to deliver more effective and personalized medical care. We believe that the Genetics Track Curriculum at Baylor College of Medicine can serve as a prototype for other medical schools across the country and abroad.Genet Med 2012:14(1):163–167.     

Aging of medical school faculty and the end of mandatory retirement.

In anticipation of the end of mandatory retirement for tenured professors in 1994 (mandatory retirement ended for other academics in 1986), the author analyzed the demographics of medical school faculty, using 25 years of data taken in mid-1989 from the Faculty Roster of the Association of American Medical Colleges. The annual growth rate of the number of full-time faculty dropped from well over 10% before 1972 to about 1.5% after 1982, while the mean age of the faculty increased from under 42 years to over 45 in 1988. Retirement patterns changed little after the minimum mandatory retirement age was raised in 1982 from 65 to 70 (for tenured professors). Only about 2.5% of all faculty separations in 1984-1987 occurred at or after age 70, and only 5.5% did even in the tenure tracks of the 20 largest private medical schools. Since such a small proportion of openings is created each year by mandatory retirement, uncapping will have little effect on the age or turnover of medical faculty.     

Attitudes of medical school faculty toward gifts from the pharmaceutical industry.

The American Medical Association (AMA) has recently published guidelines for the receipt of gifts from industry representatives. To examine faculty members' attitudes toward that AMA policy as it pertains to gifts from the pharmaceutical industry, the authors surveyed the faculty of the University of Kentucky College of Medicine in 1991. Of 462 faculty members, 248 (54%) completed the questionnaires. The faculty generally agreed with the AMA guidelines. A majority of the faculty believed that personal relationships had the potential to influence prescribing patterns but that gifts, in general, did not greatly influence prescribing behaviors. Compared with the 169 M.D. faculty, the 69 Ph.D. faculty significantly favored more restrictive policies (p less than .001). The authors discuss both the ethical considerations and the utility of guidelines for physician-industry interactions.     

The POD: a new model for mentoring underrepresented minority faculty.

Mentoring, long recognized as a catalyst for successful careers, is particularly important to the career development of underrepresented minority (URM) faculty. In academic medicine, mentor-protégé relationships are seriously threatened by increased clinical, research, and administrative demands and an emphasis on scholarship over citizenship. New mentoring models are needed, and they should be adaptable to a medical school's unique structure and mission. The Peer-Onsite-Distance (POD) model, developed in 2002 by the authors and introduced at the College of Medicine at the University of Arkansas for Medical Sciences, is a targeted, multilevel mentoring prototype that is built on a solid research foundation and tailored to the unique needs of URM medical school faculty. The mentee's individual needs for guidance related to career goals, resources, and the content and interaction skills that are known to be critical to successful academic careers are targeted for development. The multilevel approach provides a unique network of peer and faculty mentors who provide site-specific career guidance. Also in the network are leaders in their fields who can provide access to accurate information, cautions, predictions, and announcements of future resources or potential restrictions in academic medicine. Mentor commitments are clearly defined and time contributions are maximized. The POD model aims to promote retention and advance the careers of URM faculty by wrapping them in a protective cushion of interpersonal and intrapersonal support. The flexibility of the design allows for adaptation to any institution's unique structure and mission.     

Training program at medical school of Chieti, Italy

We describe the changes in medical training program offered at the G. D'Annunzio University Medical School in Chieti-Pescara, Italy, which took place over the last decade. The new curriculum differs from the previous one in several important aspects, including limited number of students admitted to school depending on the estimated needs for physicians, obligatory class attendance, student attendance in preclinical laboratories, formative credits as a measure of student activity, and elective subjects. Furthermore, all medical graduates are allowed to take the State exam to obtain the licence to practice, which was not the case previously. As a result of these major changes, a higher number of students graduates in due time. The changes made in the medical education curriculum in Italy have enabled Italian medical graduates to work in European Community Hospitals, because their medical degree is recognized in other EU countries. The main motif that drives the Medical School in Chieti-Pescara is the achievement of high quality in medical education and biomedical research by creating as strong a relationship between education and research as possible.     

Modelling the end of mandatory retirement for U.S. medical school faculty.

The author used data taken in mid-1989 from the Faculty Roster of the Association of American Medical Colleges to calculate the age distributions of U.S. medical school faculty active at any time from 1978 to 1988 and their age-specific probabilities of separating from their academic positions (e.g., to take another position, to enter the private sector, or to retire). A simple Markov model was constructed to predict the future faculty age distributions, isolating the factors of growth rate, separation probability, and potential delays in retirement. Age projections proved most sensitive to assumptions about future growth rate, less sensitive to the choice of separation probabilities within the range of those observed in the previous decade, and least sensitive to modelled delays in retirement of as much as five years for half the retiring faculty. The same pattern of sensitivity was true of projected turnover. The conclusion is that the end of mandatory retirement alone will have a negligible effect on medical faculty demographics.     

An online discussion for medical faculty: an experiment that failed.

OBJECTIVE: Although online discussion groups are being used with increasing frequency in undergraduate and postgraduate education, their usefulness in faculty development has not been explored. The goal of this innovation was to offer an online discussion group following a faculty development workshop in order to reinforce workshop concepts and to allow participants to seek advice related to specific teaching and learning problems. We also wanted to assess the benefits of this educational tool. DESCRIPTION: We originally wanted to implement an online discussion group following a one-day workshop "The "Problem" Resident: Whose Problem Is It?" However, once this proposal was presented to our academic administrators, they asked us not to implement the discussion group because of concerns related to confidentiality and due process. They were worried that an online discussion might replace the faculty's evaluation and promotion guidelines, that teachers might no longer go to the "right" person to discuss a problem, and that we would give teachers a false sense of security. To respect these concerns, we changed the discussion topic and decided to implement an online discussion following a workshop "Promoting Interaction in Small-group Teaching." We chose this venue because it was less "emotionally charged" and because online discussions are seen as a potential adjunct to small-group teaching. We introduced the idea of a facilitated WebCT group discussion at the end of the workshop, and gave faculty members clear instructions on how to access the discussion group. Most of the workshop participants liked the idea of a follow-up to the workshop, but they preferred an e-mail listserv. We therefore decided to offer the WebCT discussion group to half of the participants, and an e-mail listserv to the others. To initiate the discussion, we posted several issues for both groups, and we awaited the participants' responses. To our surprise, only two individuals (8%) responded on the e-mail listserv, after several attempts to stimulate discussion. DISCUSSION: In looking back at our "medical experiment" we were disappointed that our efforts to facilitate an online discussion following a faculty development workshop were not successful. However, based on personal reflections and conversations with a number of the workshop participants, we feel that some important lessons were learned. Time and competing demands clearly pose a major barrier. In addition, the "perceived need" of the initiative is critical. Our faculty members did not see the need for discussing interactive small-group teaching techniques online. Faculty members' comfort with technology must also be considered. Many of our teachers were not familiar with the potential uses of online learning. Moving faculty development beyond workshops also remains a challenge. With these lessons in mind, we plan to initiate another online discussion with faculty members, based on a need that they have defined around a topic that they have identified as critical to their own development as faculty members. We continue to believe that follow-up activities are essential in faculty development and that we need to further assess the potential value of this educational method.     

The present and future of appointment, tenure, and compensation policies for medical school clinical faculty.

The authors present data and information about appointment, tenure, and compensation policies to describe how medical schools are redefining the terms under which they relate to their full-time clinical faculties. First, the authors note the increasing differentiation of clinical faculty members into two groups, researchers and clinicians. The present-day competitive realities of both research and clinical enterprises have prompted this change and the principles of mission-based management are reinforcing it. Second, they document the long-term tendency of schools to appoint new clinical faculty members to contract-term (as opposed to tenure) appointments, as special non-tenure-eligible tracks for clinically oriented faculty proliferate. Third, they report on the policies of schools to limit the financial guarantees provided to clinical faculty members who are awarded tenure. For schools that have yet to address this issue, they discuss the various employment and pay arrangements that inform or confuse the question. Fourth, they describe historic problems with clinical faculty compensation arrangements and illustrate, with examples from ten schools, the characteristics of recently implemented performance- and risk-based compensation plans. While these trends in institutional policies and practices may initially concern faculty advocate groups, the authors argue that they may serve the long-term interests of those groups. The terms of relationships between medical schools and their clinical faculties are tied closely to the specifics of organizational structure, which are currently undergoing review and change. The challenge all schools face is to define these terms in ways that allow them to continue to attract high-quality clinical faculty while avoiding an insupportable financial liability.     

Development and implementation of an innovative ward-based program to help medical students acquire end-of-life care experience.

The authors developed and implemented a new ward-based end-of-life care experience for third-year medical students at Yale University School of Medicine, which began on a pilot basis in 2005. The primary objectives of the program, which still continues, are to improve students' comfort and skills in communicating with and assessing patients facing the end of life and to reflect on their experiences. Students interview a hospitalized patient, family, and caregivers; assess specified end-of-life domains and management plans; reflect on the experience; and then prepare a report for presentation at a case conference facilitated by dedicated multidisciplinary faculty. Many students interview patients while rotating on psychiatry consults, and the case conference occurs during the psychiatry clerkship. A total of 45 students in the pilot year (2005), 76 students in the following year, and 48 thus far in the current year have completed the program. An assessment of the personal impact of the exercise on the students who completed the program in 2005 and 2006 revealed six themes, including students' recognition of the complexity of patients' reactions to dying, students' appreciation of the value of the clinicians' presence, and students' personal reflections. This experience suggests that a hands-on end-of-life exercise is feasible and will be well received in the acute inpatient setting. Key features for success include separate, dedicated faculty for the case conference (which is integrated into a single clerkship), emphasis on student self-reflection, and a requirement that the written component become part of the student's portfolio.