Faculty Development (Education)

1. Faculty Development (Education) June 3, 2010 George Trachte

2. Agenda • Review of principles agreed upon at past meetings • Examples of teaching philosophies • Alan Johns • Trachte • Proposed Guidelines for Course Directors

3. Consensus from previous meetings • Real commitment is to improving our teaching and students’ preparation • Include formative assessment in courses (quizzes) • Reinforce learning with the use of cases • Review “Board” questions to provide one assessment of relevance of material • Develop teaching philosophies incorporating some of the information from the teaching/learning philosophy info • A key idea is to focus material including numerous examples and a problem-solving emphasis

4. Teaching Philosophy of Alan Johns • My major goal of teaching is to guide medical students toward their ultimate goal, becoming an excellent physician, hopefully in primary care. To define my teaching philosophy, I have used the “Apprenticeship Perspective” as described by Pratt, et. al, in the Journal of Continuing Education in the Health Professions, Volume 21, pp. 70-81, 2001. Key beliefs of this perspective as stated in the article include:

5. Teaching Philosophy (Johns) • Learning is a process of enculturation into a community of work. • Knowledge is constructed while interacting and participating in the work. • Knowledge is best learned in the contexts in which it is to be used. • The product of learning is of two kinds: competence or skilled performance and identity in relation to a profession.

6. Teaching Philosophy (Johns) • Assessment should be done in a holistic manner that best supports the learning objectives of the lesson or course I am teaching. I will use three types of assessment. Multiple choice exam formats will be used but only with appropriate clinical stems. The second method of assessment is observing students demonstrate skills that match our teaching objectives. This observation could take place in the form of OSCE’s, simulations, or actual patient care. The third method is a short response form of exam that would help assess clinical reasoning skills. Responses would be a paragraph in length.

7. Teaching Philosophy (Johns) • Teaching in the apprenticeship model incorporates the concepts of androgogy - adult education. These concepts are based on seven principles developed by Malcolm Knowles. Three that are relevant for my teaching are: • Establish an effective learning climate, where learners feel safe and comfortable expressing themselves. • Teach with a clinical context using relevant tasks, problems and assignments. • Encourage learners to identify resources and devise strategies for using resources.

8. Teaching Philosophy (Johns) • Because I teach students in all four years of school, my methods of teaching will vary. Lectures in years one and two will be related to a case, usually an actual patient of mine. By using this approach, the didactic presentation will hopefully be more relevant to the students. Lectures will be interspersed with questions and discussion. The Turning Point audience response software can also augment active learning in lectures. Development of clinical reasoning skills is best performed on an individual and group basis. Unknown cases will be given to students starting in the first year and continued throughout their four years. Cases in the first two years will be presented in a simulated manner, either by e-learning or simulations. Most of the cases in years three and four are actual patients seen in their clinical rotations. The cases will hopefully be at an appropriate complexity level for their stage of education. By using these approaches, I hope to take passive learners and turn them into lifelong reflective practicing physicians.

9. Teaching Philosophy (Trachte) • My teaching philosophy involves respect for students and teaching colleagues. Part of my respect for students involves a belief that they should be challenged in a manner that benefits them and develops their ability to think critically. • The first step in teaching involves creating objectives/outcomes for the class. In general the objective of my teaching is to provide students with enough essential information to allow them to apply the information in unfamiliar situations. In other words, the teaching should result in the ability to problem solve.

10. Teaching Philosophy (Trachte) • The second step is identification of the essential/important material to deliver. I accomplish this task by consulting reviews on the topic and by consulting national websites identifying essential information. This process typically involves accessing “Treatment Guidelines from the Medical Letter” or a similar publication for a Pharmacology lecture followed by consultation of the “Knowledge Objectives for Pharmacology” on the ASPET website. • The third step requires assimilation of the material in a logical sequence. This process typically is intuitive, simply arranging the material in an understandable hierarchy/sequence. Modifications are needed as directed by student feedback if aspects of the presentation are deemed “out of sequence”.

11. Teaching Philosophy (Trachte) • The fourth step involves engaging students with questions necessitating the utilization of the information to solve a problem or answer a question. I particularly appreciate the use of personal response systems (clickers) to provide anonymous feedback regarding comprehension of a specific concept. A pharmacological example involves injection of an unknown drug to produce an effect and use of specific receptor antagonists to decipher the identity of the unknown agent. This system requires synthesis of information, analysis, application and basically tests and develops problem-solving skills. • The fifth step utilizes a summary to reiterate key concepts and essential details to ensure that students leave the classroom with the key information from the presentation.

12. Teaching Philosophy (Trachte) • The sixth step is to address any questions students have regarding the material. Enlighten when possible and admit ignorance when the correct answer is not known. It is easy to e-mail the answer afterward if some point needs clarification or additional information is sought. • The last step is evaluation. This is assessed by the personal response system in the short term, test questions requiring problem-solving skills designed to test major concepts in the intermediate term and performance on National Board of Medical Examiners step 1 examination in the long term. In pharmacology, this process typically centers on the concept of receptor specificity. The number of reasoning steps required to answer the question determines the degree of difficulty of questions. Obscurity of information is not used to assess competence.

13. Proposed Guidelines for Course Directors • These were obtained from Creighton Medical School

14. Proposed Guidelines for Course Directors • Course Planning • Review & revise course goals & competencies annually • Assemble needed expertise to deliver curriculum • Develop course teaching and learning methods • Develop student evaluation plan including: • Appropriate combination of written, practical and performance measures • Grading scheme consistent with practices in other courses • Prepare a course Schedule

15. Proposed Guidelines for Course Directors • Course Implementation • Monitor & insure faculty adherence to the course schedule • Coordinate small group sessions • Ensure faculty attendance • Ensure uniform coverage of curricular material among groups • Ensure that grade differences among groups and among group members are not arbitrary

16. Proposed Guidelines for Course Directors • Course Implementation • Attend instructional sessions as appropriate • Examinations: • Compile and review examination questions from participating faculty • Prior to an examination conduct a review of test items and materials with course faculty to address mistakes and duplications and to ensure appropriate coverage of course objectives • After examination, review the examination to test reliability, validity and fairness • Work with office of medical education to maintain a test item bank

17. Guidelines for Course Directors • Course Assessment • Use student input, personal observation, peer evaluation and other sources to evaluate the performance of individual faculty members • Review strengths and weaknesses of the course annually with participating faculty • Prepare an annual report addressing the status of the course

18. Questions or Comments?

19. Summary • Major point is to improve our preparation of students to practice medicine • We might all benefit from the perspectives of other teachers regarding how to teach (teaching philosophies) • Developing guidelines for course directors should provide useful expectations for course directors • Should be beneficial to students • Should result in improved courses/examinations etc