MUMEENA Faculty Development

1. MUMEENAFaculty Development Richard Fuller, Anne Marie Reid Leeds Institute of Medical Education School of Medicine, University of Leeds, UK

2. Welcome to the Working Group! Outcomes for today…. Defining what & who are ‘Professional’ teachers Agreeing models of Faculty Development Designing a Teacher Training Centre Developing local faculty development – and content

3. Activities ‘Mini Lectures’ (memory stick provided) Group Discussion Small group work and exercises to design the TTC and staff development activities

4. Needs Analysis 1(TSU and TMSU) Critical that successful faculty development is contextual: Institutional & Curriculum Readiness Evidence of faculty development Levers for change & Potential Barriers Key needs Important considerations (infrastructure, training, healthcare, regulation etc)

5. For example, we are aware from TMSU/TSU needs analysis that Continuing Professional Development programmes are at an early stage – but there is legislation for licenses for practice This provides opportunities to improve CPD and accreditation by linkage with evidence for a license to practice

6. Needs Analysis 2TMSU Evidence of positive change: Previous EU review of TMSU Improving the programme - Moving clinical practice earlier into the curriculum Curriculum Committee Great introduction of modern methods of assessment (e.g. OSCE) Needs? Cultural change to accommodate new ways of working Introducing successful quality assurance Curriculum integration (e.g. CBCR) Faculty development (e.g. build on success with OSCE) Research skills (and training for staff in teaching this)

7. Needs Analysis 3TSU Some good progress already! Successful self review using WFME standards Quality Assurance committee Strategic planning to help curriculum and staff (e.g. reduction in disciplines in year 1) Great approaches to integration (e.g. integrated science modules in year 2 and 3) Needs? Develop existing culture of change and improvement Use WFME standards again to build confidence in QA Scope for deeper curriculum integration Successful faculty development with limited resources Research skills (and training for staff in teaching this)

8. Professionalisation of Teaching and Teachers Myths and Legends…..

9. Content Myths of medical teaching Measuring excellence in teaching

10. Myth 1 Effective teaching is not important and medical students succeed despite of medical school attendance

11. So……. Does the quality of teaching actually influence student performance?

12. Excellence in clinical teaching & student exam performance

13. Griffith et al 2000 Concluded that there is an association between better clinical teaching with better student examination performance

14. Conclusion 1 Good teaching is important in producing competent doctors

15. Myth 2 Self directed learning is the ideal learning method for students

16. What about the ‘Adult Learner’? Described by Malcolm Knowles in 1973 Andragogy – the art and science of adult education In brief….. Adult learners are more motivated by internal forces than external forces Hence self directed learning is a natural state for adult learners

17. However….. Self directed learning requires the identification of areas of weakness which need to be addressed Self assessment is therefore a vital component

18. Andragogy and Medical Education? But: Studies of (medical) students have shown weaknesses at self assessment (Gordon 1991) Teaching self assessment has limited success (Gordon 1992) People gravitate to those areas they like and are good at (Sibley et al 1982) – and this is no different for adults…. The psychological motivation for medical students learning is dependent on many and varied factors (Misch 2002)

19. Conclusion 2 We shouldn’t depend on self-directed learning We still need good teachers

20. Myth 3 Good teachers are born not made

21. One of the most important lessons I learnt about teaching came before I was in medicine or had ever taught. While studying ballet, I saw that even the most talented dancer at the New York City Ballet had to work hard to succeed. Talent along was not enough. Great teachers know this.

22. On expertise…….. No such thing as innate talent Expertise comes from deliberate practise 10,000 hours or 10 years The key to success is continued challenge

23. Conclusion 3 Teaching is like any other skill You become an expert by hard work and deliberate practise

24. Myth 4 Teaching is (just) the transmission of facts

25. Facts “Now what I want is facts. Teach these boys and girls nothing but facts. Facts alone are wanted in life. Plant nothing else, and root out everything else. You can only form the minds of reasoning animals upon facts: nothing else will ever be of service to them.” Thomas Gradgrind in Charles Dickens’s Hard Times

26. Information doubling times

27. We are drowning in information and starving for knowledge Rutherford Roger

28. Conclusion 4 Modern teachers need to help learners create their own knowledge from the ever expanding mass of information

29. How do we measure excellence? Excellence in Teaching = Technical competence x approach to teaching x personal development

30. Technical competence (TC) TC = I(eq) + R(eq) + F(eq) + A(eq) + C(eq) + L(eq) I information giver R Role model F Facilitator A Assessor C Curriculum planner L Learning resource developer e extent q quality

31. Approach to teaching (AtT) AtT = S x E x D x T S = Scientific principles of education E = Ethics and attitude D = Decision making (BEME) T = Team worker

32. Personal Development (P) P keeps up to date shares expertise with others assesses their own competence

33. Summary Better teaching = better chances of student performance Good teachers are more successful than self directed learning Good teachers are the product of technical expertise, deliberate practice and sustained effort Their excellence is a product of competence, approach and professional development

34. Exercise Develop criteria for a professional teacher in your own institution Use student, peer and institutional view points

35. Feedback……

36. Coffee and comfort break

37. Designing Faculty Development programmes

38. Summary from Anne Marie’s talk: Good teaching is important in producing competent doctors To achieve expertise, we need hard work and deliberate practice Modern teachers need to help learners in age of information explosion Teaching excellence is more than technical competence – it demands personal development. Professionalising Faculty

39. Planning Travelling Arriving Reflecting The journey ahead…..

40. Key stages Planning Travelling Arriving Reflecting Activity Key elements/context Using organisational theory & creating change Modelling the programme & measuring success Designing a successful programme

41. Planning your programme:What are the key elements?

42. Planning your programme – key elements

43. Key elements – Institution Institutional support – commitment to professionalising and developing teachers & teaching pan-institution(s) Curriculum Faculty development must be in context, and follow curriculum in ‘real time’ Faculty development must mirror the relationship between programme and activity of teachers (one of the problems with PBL) Understand local delivery Dornan. Med Educ. 2005;39 Lieff. . Academic Medicine. 2009;84(1)

44. Cost Of delivering a faculty development programme Of faculty attending & participating Of not using resources wisely (some excellent programmes in low income countries)

45. Key elements – Institution 2 Ethos & culture (& why do those most in need fail to attend?) Valuing activity Making opportunities for career development & improvement Professional recognition (especially where health and university are separate) and acceptance of culture Reward (financial, professional) Steinert. Med Educ. 2009;43

46. Faculty – who are they? Junior or senior? Clinical or non-clinical? Undergraduate or postgraduate? Bedside/opportunistic teaching vs. greater levels of involvement? Scholars, researchers, educators?

47. Faculty – what do they do? Traditional ‘view’ Teaching skills Assessor training Supervision & Feedback Alternative view? self awareness & peer coaching Using Theory and practice Technology enhancement Curriculum change, research skills Pololi. Med Educ. 2005;39

48. Faculty - environment Critical to planning successful CPD Are faculty central or distributed (geographically)? Online / bitesize (opportunistic faculty development for opportunistic teachers?) Satellite – central agreement, local delivery Centralised activity

49. Linking curriculum and faculty development – how have others done it? Bowe. Med Educ. 2003;37 Loeser. Academic Medicine.2007;82(4) Using organisational change to manage curriculum development Creating urgency Guiding coalition Vision & Strategy Communicate Short Term wins Consolidate & anchor within the institution

50. Using organisational change to manage Faculty development Identifying conflict between curriculum & commitment Coalition – transforming into action Dealing with fears and concerns Pilot projects and monitoring Evaluation

51. Ripple Model – rural medical school More distributed faculty Use organisational change to improve what people do Extend and share this Watch the ripple effect through faculty Saw positive changes in institutional identity Suchman. J Gen Intern Med. 2004;19

52. Fish hook Centralised faculty change Key factors all common in organisational change methodology Range of impacts Scholarly growth More network ties Increasing status and credibility by peers Baker. Med Educ . 2010;44

53. Arrival (and Exercise) Modelling your solution must be contextual Literature (and experience!) suggest that an iterative, evolutionary pattern of change more successful Subject your faculty programme to a needs analysis Peers (faculty) Curriculum Institution(s) Choose a model of faculty development that will best meet your curriculum, faculty and students

54. Feedback

55. Feedback

56. Lunch Break!

57. Faculty Development UnitsDesign and infrastructure

58. Building your TTC Revisit your model Evolutionary, Revolutionary or new? Vital to base your project plan around the chosen model, context and needs

59. Resources Staff Leadership & Management Project planning Measuring outputs (later in this session) Building Blocks

60. Technology Tempting to rely on latest IT Critically question how IT adds value (no different from learning) Concentrate efforts on support for distance learning, or reusable objects (e.g. for examiner training) Requirements

61. Physical Space What is the minimum space requirement? Is it available now? Permanent usage as FDU or shared? Location & Access? Economic support? Requirements

62. Cross linkage with the staff development group What resources already exist locally? What resources are adaptable from elsewhere (caution: language and cultural translation)? What resources do you need to develop – and in what order? Aim for content that maps onto project aims – and sees repeated use by Faculty Requirements – Content & Resource

63. Who can attend? Who must attend? Who needs to attend? ‘Ensuring those most in need most likely to attend’ Publicity Inducements – rewards and success stories more effective than compulsion Qualifications? Staff

64. Academic leadership Use organisational theory models to guide strategic development Coalition, vision, short term ‘wins’ etc Imperative that this interlinks with curriculum committee and programme Administration and management of FDU Organisation/Coordination Publicity Measurement Leadership & Management

65. Achievable timeline!! Resourcing Collaboration Quality Assurance Aim for measurable goals along the way to help publicize success (including to the student body) Project planning

66. Identify the key ‘building blocks’ within your curriculum and medical school using the checklist crib Spend time designing your model of the TTC and how it will work Suggest a timeline Small group Exercise

67. Faculty Development Training teachers

68. To identify who are the teachers To consider current roles and responsibilities of staff To identify Faculty Development needs To plan Faculty Development programme Aims

69. Academic staff Research staff Clinical staff Students- peer teaching Patients? Others? Who are the teachers

70. Is there currently a good balance of academic, clinical, support staff or should this change? How are staff recruited for teaching? How are staff development needs identified? How are staff equipped for teaching? What opportunities exist for professional development? Current training programme

71. Do staff have a teaching workload which is balanced with other activities such as clinical practice/research? Is there a process for monitoring workload? Is there a process for identifying development needs? Is there Institutional support for ongoing staff development? Roles and responsibilities of staff

72. Summary from earlier slides…. Better teaching = better chances of student performance Good teachers are more successful than self directed learning Good teachers are the product of technical expertise, deliberate practice and sustained effort Their excellence is a product of competence, approach and professional development

73. Can teaching occur without learning? Can learning occur without teaching? Which should be the priority? Learning and Teaching

74. Subjects are best understood when they are taught in the context in which they will be needed i.e. When the theory is applied to practice Current learning theory shows that as we are naturally sociable, learning occurs most effectively when students are given the opportunity to learn actively alongside others Learning theory

75. Students should be actively involved in learning Opportunities for peer support and group-work -helps students to develop better understanding Student-centred teaching allows students to learn at their own pace Frequent checks on learning & feedback improve students’ performance Implications?

76. Less emphasis on teacher as ‘expert’ Less emphasis on teaching, more emphasis on creating opportunities for learning Teacher as facilitator- encouraging students to learn together with guidance Encourage ‘active’ learners Emphasis on feedback - supports further learning Role of teacher?

77. More engaged students having more fun Students more responsibility for own learning Teachers spend time on designing more creative ways for learning and less on routine lecturing More effective learning More independent students - more active in learning in clinical years Better doctors – able to identify own learning needs – maintain high standards of patient care Advantages?

78. How do you match the content to the learning outcomes? What teaching methods do you currently use? Could you make these more ‘learner ’centred’? What other teaching methods would you like to use? Designing Learning & Teaching

79. Understanding how students learn Designing and planning teaching sessions How to make lectures more interactive How to involve students fully in seminars Designing tutorial and small group sessions Learning & Teaching workshops – possible themes

80. Understanding student-centred learning through enquiry-based learning methods Teaching clinical skills effectively Using technology in supporting teaching How to design good assessment methods Workshop themes continued

81. Any questions?

82. Identify which of these workshops would be of value (and why)? What else would be helpful How would you design and build content? How would you (and others) be able to apply the lessons from the workshops in your teaching activity? What are the priorities? Suggest a timeline for introducing workshops. Small group Exercise

83. Feedback and Summary

84. Faculty Development :Putting it all together…..in Leeds

85. Reflection – Measuring Success What to evaluate Activity Numbers attending Perceptions of quality Impact Faculty – future activities, progress, engagement Curriculum – impact on teaching & assessment (e.g. OSCE) Institution – research outputs, identity.. Output - Professionalised students (Papadakis) Cole. Academic Medicine. 2004;79(5)

86. How to evaluate Predicated on ‘what’ you are evaluating – but must be systematic Simple, individual level quantitative data Short wins, Evidence of success More complex, longitudinal programme activity evaluation (e.g. CIPP) Context – setting, and environment Input – resource (financial, supporters, stakeholders) Process – descriptive Product – impact (including post organisational change)

87. Putting it all together Useful resources: BEME guide (2006) AMEE guide (2008) Helpful focus on implementation and evaluation Steinert. BEME guide 2006 McClean .AMEE guide 2008

88. Small group activity Work in your groups (e.g. 3a and 3b) to complete the reporting grids You will have some more time tomorrow to build on these – looking at quality and change This will help you present your plan to the wider group on Wednesday afternoon

89. Complete each project activity (marked with a MUMEENA reference) against these questions What did you do in the workshop? Who was involved Summarise what was achieved What do you need to do next? When does this need to be done by (some actions will be ‘immediate’ and some ‘later’) Day 2 – Reporting Grid 1

90. We want you to use the material you worked on together in reporting grid 1 Think about the messages from the quality presentation this morning: Reflect on your outcomes – how would you measure quality/quality assure outcomes? What is the impact of change – on roles and responsibilities Where are you on the PDSA cycle (you can record this as P, D, S or A with an explanation) Day 3 Reporting Grid 2