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 Academic Year Day 2011 Faculty of Health Sciences, Stellenbosch University Centre for Health Sciences Education Parallel Session 17 August 2011 Academic Year Day 2011 Faculty of Health Sciences, Stellenbosch University Centre for Health Sciences Education Parallel Session 17 August 2011 Dr F Cilliers & Ms N Herman - Center for Teaching and Learning Dr K von Pressentin - Langeberg Sub-district Dr F Coetzee - Malmesbury Hospital

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 Hammoud et al., 2004; Spickard & Corbett, 1996; Wamsley et al., 2004; Wipf et al., 1999; Roop & Pangaro, 2001; Stern, Williams, et al Longer term: Ensuring appropriate preparation of next generation of leaders

3

4

Roles of the African Family Physician Mash (2008) SA Fam Pract 50(3):

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? 6

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 7

Respondent profile 8

Kirkpatrick's four levels Used in Analysis of Interviews to Assess Module’s Influence 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, 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

Results Evidence of - change in behaviour - perceived benefits Factors underlying these changes 10

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 … 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.” “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.” 11 “Ek het vir die eerste keer ʼn konsep geleer dat ‘to teach people doesn’t mean they are learning’. Om net te praat, jy verloor baie gou die ‘audience’. So, ek probeer dat die gehoor deelneem aan die gesprekke, ek probeer verskillende opinies kry op ʼn vraag terwyl ons praat.” “Ek help mense spesifiek met die liggaamstaal van ʼn praatjie, alles van die praatjie, want mense, dokters ken nie van voor mense praat nie, want dis nie deel van ons werk gewoonlik nie.” “Dit het my maar net bewus gemaak dat omdat, as ek nou ʼn huisarts is, daar van my verwag gaan word om ander mense te leer. Ek het dit nooit so gesien nie.”

Factors underlying these changes 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.” 12 Role of context “Hulle kan waarskynlik die geleentheid gaan soek. Wel, ek het, maar ek dink party dokters is baie oorwerk in daai opsig. Maar miskien as hulle spesialisposte kry dan kan jy tyd hê om dit te maak, want daar is altyd mense wat opleiding soek.”

Discussion Succeeded in achieving aim and outcomes of module Influenced 3 of FP roles: Most exciting - changed attitude and practice towards teaching and learning 13

14 Attributes of a competent 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): Passion Employ basic pedagogic principles Identify learners’ needs Be a reflective and mindful teacher Demonstrate effective lecturing and facilitating small group learning Goal: Effective Learning

Dr Klaus von Pressentin COMMENTS OR QUESTIONS? 15 Thank you!