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, Stellenbosch U Dr F Cilliers & Ms N Herman Center for Teaching & Learning, Stellenbosch U Dr K von Pressentin Family Physician, Langeberg Sub-district Dr F Coetzee Family Physician, Malmesbury Hospital SOUTH AFRICA AMEE Conference August 2011 Vienna, Austria AMEE Conference August 2011 Vienna, Austria

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

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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

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 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.” “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.”

Factors underlying these changes 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 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

Prof Marietjie de Villiers 15 Thank you Baie dankie Enkosi kakhulu