Exploring the influence of a module in teaching and learning on family physician trainees Prof M de Villiers & Ms M van Heusden - Faculty of Health Sciences Dr F Cilliers & Ms N Herman - Center of Teaching and Learning Dr K von Pressentin - Robertson Hospital Dr F Coetzee - Malmesbury Hospital 4th Annual SAAHE Conference 30 June – 2 July 2011 Potchefstroom

Background Postgraduate studies in medical specialties prepares students (registrars) for: o Advanced clinical practice in specialty o Leadership roles o Advancing the discipline though teaching and research

Why equip medical registrars as teachers? Twofold motivation Immediate: Most registrars help educate & train medical students o typically not prepared for this role o quality of clinical teaching affects: - student perceptions - student performance Longer term: Ensuring appropriate preparation of next generation of leaders Hammoud et al., 2004; Spickard & Corbett, 1996; Wamsley et al., 2004; Wipf et al., 1999; Roop & Pangaro, 2001; Stern, Williams, et al. 2000

Role of African family physician Mash (2008) SA Fam Pract 50(3):58-59

Research question What influence, if any, does a module on teaching and learning have on family medicine registrars? Objectives: How do registrars’  perceptions of their role as specialists change?  attitudes towards teaching change?  confidence with and participation in teaching activities change?

Method  Phase 1: Qualitative design  13 graduates, Western Cape  In-depth interviews, recorded and transcribed  Thematic analysis  Ethics approval N10/07/238  FIRLT funding  Phase 2: interviews with current students  Phase 3: questionnaire for students taught by registrars

Participant profile

Kirkpatrick's four levels  Level 1 - Learner's/participant’s reactions  Level 2a - Modification of attitudes & perceptions  Level 2b - Acquisition of knowledge & skills  Level 3 - Change in behaviour  Level 4a - Change in organisational practice  Level 4b - Benefits to patients/clients/students Adapted by Barr et al: Barr H, Freeth D, Hammick M, Koppel I, Reeves S. Evaluations of interprofessional education: a United Kingdom review of health and social care. London: CAIPE/BERA, 2000.

Results Evidence of - change in behaviour - perceived benefits Factors underlying these changes

Results L4: Practice change & benefitsL3: Behaviour change L2a: Modification of attitudesL2b: Knowledge & skills acquisition “The way the module said plan your work and think about how you are going to address the learning needs of your audience or how would you evaluate that this was a successful talk or presentation, in that sense definitely. It put everything into a structured way and made it easier to handle a teaching task.” “Previously I used to think of teaching more as a duty. Like the students would stand there. Whereas once I started involving them more in the patient or giving them a bit more things to think about, I could see how much they were taking in and the level of interest increase.” “I learnt for the first time the concept that ‘to teach people doesn’t mean they are learning’. You loose your audience by speaking yourself all the time. So now I try to get the audience to participate, and to obtain different opinions on a question.” “It made me aware that because I am now a family physician, I am expected to teach other people. I never saw it like that.” “I specifically help people with the body language of a talk, everything about the talk, because people, doctors do not know about talking in front of people, as it is not usually part of our work.” “The teaching and learning module helps me make it more interesting for the staff to learn about something, rather than me just telling them what to do. It’s more that they discover for themselves what the possibilities are for treatment for their patients.

Role of context  “They can probably go and look for the opportunity. That is what I did but I think some doctors are too overworked. But perhaps when they get specialist (family physician) posts then they will make time, as there are always people looking for training.” Personal factors  “I am naturally a shy person who would prefer not to speak in front of a crowd. I gained quite a bit of confidence in doing that, in doing the PowerPoint and in actually presenting it.”

Discussion Succeeded in achieving aim and outcomes of module Overwhelming positive feedback Influenced 3 of FP roles – care provider, supervisor, capacity builder Students embraced concepts, reported changed behaviour Most exciting - changed attitude and practice towards teaching and learning

Attributes of competent teacher Demonstrate passion as a teacher Acknowledge goal of effective teaching as effective learning Employ basic pedagogic principles Demonstrate skills for effective lecturing and facilitating small group learning Identify learners’ needs Be a reflective and mindful teacher Hatem CJ, Searle NS, Gunderman R, Krane NK, Perkowski L, Schitze GE, Steinert Y. The educational attributes of effective medical educators. Academic Medicine2011;86(4):

Dankie Thank you Enkosi kakhulu Prof Marietjie de Villiers