1. Building and Developing Our Team
LuAnn Wilkerson, Ed.D.
David Geffen School of Medicine at UCLA

2. Objectives
Consider the role that faculty development plays in revitalizing an organization
Identify the components of a comprehensive faculty development program and examples of “best practices” for each component
Opportunities for networking
Programs to meet a diversity of needs
Institutional environment that values teaching

3. Loss of Faculty Vitality
Ludmerer, Bland
Changes in academic medicine are threatening the environment for learning
Individual faculty are under increased time pressures
Increasing clinical productivity demands
Loss of time for academic collaboration
Academic Health Centers are focused on survival
Increasing emphasis on the business of medicine
Deterioration in the work environment
Increasing regulation
Lack of a vision by institutional leadership that encompasses education

4. Faculty Development is a Tool for Renewal
Commonwealth Fund Task Force of AHCs, 2002
IOM, Health Professions Education, 2003
Blue Ridge Academic Health Group, 2003
AAMC Institute for Improving Med Education, 2004

5. Envisioning the Future of Academic Health Centers
Commonwealth Fund Task Force on AHCs, 2003
Invest in training faculty as educators
Develop systems of performance measurement that promote continuous improvement in education

6. Reforming Medical Education: Urgent Priority for AHCs
Blue Ridge Academic Health Group, 2003
Make education an explicit, manifest priority
Devote more and better resources to teaching the clinical transaction
Develop a budget for education
Develop a core of faculty with education expertise

7. Educating Doctors to Provide High Quality Medical Care
AAMC Institute for Improving Medical Education, 2004
Develop and support a cadre of teaching faculty
Require participation in orientation programs on curricular goals & competencies
Ensure that all students are exposed to the outstanding clinical faculty

8. What is faculty development?
Programs, leaders, and resources to:
Assist individual faculty in acquiring the knowledge, skills and values needed to succeed in their academic roles
Create a productive institutional environment for learning in which teaching is visible, valued and rewarded

9. Designing a Comprehensive Faculty Development Program
Networks and teams to support teachers
Faculty development programs targeted to identified teaching needs
An organizational climate that values excellence in education

10. Networks and Teams that Support Teachers
- Faculty continue to report a lack of opportunity to learn how to teach.
- They feel unsupported in their work as teachers.
+ Satisfied faculty report having a network of productive colleagues who share a common vision

11. Examples of Networks and Teams to Support Teachers
A Learning Community for excellent teachers
Common goal is to foster a culture of learning.
The work of all members is valued.
Discussion is the medium for formulating a shared understanding.
Offices of educational development and evaluation
Clerkship site director teams

12. An Academy of Medical Educators University of California, San Francisco
Creates a network of excellent teachers using a peer-reviewed process
Encourages interdisciplinary collaboration
Provides small grants for innovation
Sponsors an annual education day to display best work
Facilitates mentoring of new teachers

13. UCLA Center for Educational Development & Support
Provides professional consultation to faculty members
Faculty development
Curriculum development
Course and faculty evaluation
Instructional design and technology
Interdisciplinary course support
Conducts educational research in partnership with faculty

14. Collaborative Clerkship Team
Meet regularly
Develop and refine objectives
Share teaching ideas and materials
Design and review assessment tools
Review performance results

15. A Range of Programs Targeted to Needs
Organizational leaders committed to education
Educational scholars
Educational leaders &
innovators
Effective teachers
New teachers & residents
Wilkerson & Irby, Acad Med, 1998

16. What do we know about improving teaching skills?
Multifaceted programs of hours over 2+ days
Resources targeted to identified needs
Individual consultation and feedback
Reminder systems
Wilkerson & Irby, Acad Med, 1998.

17. Needs of New Faculty as Teachers
Understand the educational goals of the school
Know values, norms, and expectations for teaching
Identify opportunities to teach
Develop basic teaching skills
Understand the promotion process
Connect with senior mentors for teaching and scholarship

18. Mentoring for New Faculty Mayo Medical School
Assignment of an experienced faculty member to a new faculty
An individualized plan to optimize academic success
Regular review

19. Needs of Effective Clinician Educators
Teach during patient care
Outpatient clinics
Hospital wards
Facilitate case-based discussions
Give effective presentations
Evaluate learning and give feedback
Use information technology to support teaching and patient care

20. Outpatient Teaching Workshops
4 evening CME workshops with dinner
Topics:
Creating Shared Expectations
The One-Minute Preceptor
Arrows in the Quiver: Strategies for Teaching with Patients
Evaluation and Feedback

21. Educational Topics in Departmental Conferences
In grand rounds
Highlight work of departmental educators
Invite national figures in education
In resident conferences
In faculty meetings
Through awards for resident and student education

22. Needs of Educational Leaders & Innovators
Understand how people learn
Identify and respond to learning problems
Analyze innovations in medical education
Plan a curriculum
Set learning objectives
Select appropriate teaching methods
Evaluate learning
Manage the curricular change process

23. APGO / Solvay Scholars Format: 8-day course over 3 sessions
Purpose: develop faculty leaders for ob/gyn education
Topics:
Teaching Skills
Program administration
Educational research

24. Needs of Clinician Educator Researchers
Review the educational literature
Design educational research and evaluation studies
Collect and analyze data
Write and present results
Develop professional networks in education

25. Fellowship in Evaluation Medical College of Wisconsin
Format: One-year, part time
Purpose:
Build a network of colleagues
Develop skills in educational research and writing
Participate in “works in progress” seminars
Participants: 6-8 faculty a year
Outcomes: publications and presentations on medical education

26. An institutional environment in which teaching is valued
Frequent communication and group cohesiveness
Adequate and fair salary structure
Credit for inquiry, innovation, & scholarship in teaching
Quality improvement system
Individual empowerment
Open to learning and change
Bland et al, Acad Med, 2002

27. Is Education a Valued Contribution?
Beasley & Wright, JAMA, 1997.
Ranking: 1 = most important

28. Two Strategies for Increasing the Value of Education
Making education required and visible.
Educator’s Portfolio
Working to revise the promotion system
Creating new tracks or revising criteria

29. Making Education Visible: The Portfolio
A portfolio is a systematic collection of information documenting expertise in an area, usually incorporating multiple sources of information collected over time to demonstrate excellence

30. Educational Portfolios
Simpson, Hafler, Brown, & Wilkerson, Acad Med,2004.
64% of medical schools have a portfolio with at least 3 of the following:
Teaching
Advising
Curriculum development
Educational administration
Honors/Awards
Teaching evaluation: student, resident, peer
Evidence of dissemination of innovations
Personal statement, e.g., philosophy, goals, etc.
Assessment of learning outcomes

31. UCLA Dossier
Personal statement intended to make a case for one’s accomplishments: why, what, impact, quality.
Teaching Record, i.e., term, enrollment, role
Other Teaching Activities, i.e., grand rounds
Mentorship and Advising
Honors and Special Recognition
Professional Activities, i.e., societies, invited talks
Summarized student/resident evaluations
Peer evaluations
Bibliography

32. Working to Revise the Promotion System
Creation of Clinical series
Redefinition of scholarship
Requirement for peer review of teaching
Systematic collection of teaching evaluations with comparative reports

33. Clinical Tracks
Jones & Gold, Acad Med, 1998
91 (73%) of medical schools have 1 or more clinical tracks
Teaching
Clinical service
64 require scholarship defined broadly

34. Clinical Series University of California
Howell & Bertakis, Acad Med, 2004.
Clinical X: A series for clinical educators and investigators added in early 1980’s
Broadly defined scholarship
Classroom and clinical teaching
Academic Senate membership
7-year limit
Salaried Clinical: a series for clinical service and teaching added in the early 1990’s
No research/creative requirement
Clinical teaching
No 7-year limit

35. Scholarship in Education
Integration
Discovery
Application
Teaching
Boyer, Scholarship Reconsidered, 1990

36. Scholarship of Discovery
What is yet to be found?
research in clinical teaching
educational outcome studies
Morrison EH et al. Reliability and validity of an Objective Structured Teaching Exam for Generalist Resident Teachers. Acad Med, 77:S29-32

37. Scholarship of Integration
What do these various findings mean when taken together?
textbooks
review articles
CME review courses

38. Scholarship of Application
How can knowledge be applied to solve consequential problems?
Shrank, Reed & Jernstedt, Fostering Professionalism in Medical Education: A Call for Improved Assessment and Meaningful Incentives. JGIM, 2004.

39. Scholarship of Teaching
How can knowledge be transformed for the learners?
New courses and rotations
Cases for problem-based learning
On-line learning modules

40. Other Ideas for Clinical Tracks
Levinson & Rubenstein, Acad Med, 2000
Eliminate national reputation requirement
Establish & support Clinical Education Researchers
Beasley & Wright, JGIM, 2003
Increase protected time for creative work
Increase senior mentorship for teaching & research
“take charge of their own promotion”
Beckman et al, JGIM, 2004
Improve measures of clinical teaching

41. Designing a Comprehensive Faculty Development Program
Create networks and teams to support teachers
Provide faculty development resources targeted to identified teaching needs
Develop an organizational climate that values excellence in education