DESIGNING FACULTY DEVELOPMENT PROGRAMS FOR PROFESSIONALISM Yvonne Steinert PhD McGill University How...

DESIGNING FACULTY DESIGNING FACULTY DEVELOPMENT PROGRAMS DEVELOPMENT PROGRAMS

FOR PROFESSIONALISMFOR PROFESSIONALISMYvonne Steinert PhDYvonne Steinert PhD

McGill UniversityMcGill University

How to reference this document: Steinert Y., Faculty Development for Professionalism. CanMEDS Train-the-Trainer Program on Professionalism. 2009.

OBJECTIVESOBJECTIVES

By the end of this session, participants will be able to:

• Describe principles and strategies for designing a faculty development initiative for teaching and evaluating professionalism

• Discuss the challenges inherent in developing a faculty development program for teaching and evaluating professionalism

• Design a faculty development initiative pertinent to their own setting.

•

SESSION OUTLINESESSION OUTLINE

• Why FACDEV?

• Common Challenges

• FACDEV for Professionalism - A Case Study

• Guidelines for Designing FACDEV Programs & Activities

• Designing a Faculty Development Initiative– Targeting Teachers’ Needs– Targeting the Organizational Culture

FACULTY DEVELOPMENTFACULTY DEVELOPMENT

That broad range of activities institutions use to renew or assist faculty in their multiple roles.

-Centra, 1978

FACULTY DEVELOPMENTFACULTY DEVELOPMENT

•... A planned program to prepare institutions and faculty members for their academic roles - including teaching, research, administration, writing - and career development.

-Bland et al, 1990

•... The goal of faculty development is to teach faculty members the skills relevant to their institutional setting and faculty position and to sustain their vitality, both now and in the future.

-Whitcomb, 2003

FACDEV (CONT’D)FACDEV (CONT’D)

At the individual level, FACDEV should:• Address attitudes and beliefs • Transmit knowledge • Develop skills

At the organizational level, FACDEV should: • Define a shared vision • Create new opportunities • Address systems issues

-Wilkerson & Irby, 1998

• Are you involved in the design and/or delivery of faculty development activities to enhance the teaching and/or evaluation of professionalism?

• Do you and/or your colleagues focus on individual or organizational change?

• What faculty development strategies do you and/or your colleagues use?

FOR DISCUSSION...FOR DISCUSSION...

WHY FACDEV - IWHY FACDEV - I

• Teachers must possess and demonstrate professionalism – and they must be able to teach it!

• Teachers believe that they are “professional” – and that teaching professionalism is intuitive

• Professionalism must be taught and evaluated

• Professionalism must be valued by the organization/culture

WHY FACDEV - IIWHY FACDEV - II

• Role modeling is no longer as effective as it once was – and yet it is key...

• Teaching professionalism is not an “add on”

• Teaching must be integrated into the clinical setting

FACDEV CHALLENGESFACDEV CHALLENGES

.Individual Level

Program Level

Systems Level

AT AN INDIVIDUAL LEVEL …AT AN INDIVIDUAL LEVEL …

We must:

• Build motivation for learning

• Overcome resistance

• Make the implicit explicit

http://upload.wikimedia.org/wikipedia/commons/7/7e/Balance_scale.jpg

AT A PROGRAMMATIC LEVEL …AT A PROGRAMMATIC LEVEL …

We must:

• Develop programs that focus on content and teaching methods

• Use appropriate FACDEV formats and methods

• Focus on teaching and evaluating professionalism

• Make learning relevant and fun

COMMON FACDEV FORMATSCOMMON FACDEV FORMATS

• Faculty retreats and/or “think tanks”

• Workshops and/or seminars

• Short courses

• One-on-one consultations

• Role modeling and/or coaching

• Self-directed initiatives

• Integrated, longitudinal programs

• Fellowships or sabbaticals

COMMON WORKSHOP COMMON WORKSHOP METHODSMETHODS

• Interactive lectures• Small group discussions• Case presentations• Role plays or simulations• Films or videotape reviews• Experiential learning• Role modeling or demonstrations• Directed readings and/or independent learning

AT A SYSTEMS LEVELAT A SYSTEMS LEVEL

We must:

• Promote “buy in”

• Address the organizational climate and culture

• Identify opportunities for teaching and learning

• Determine the need for specialty-specific training

• Train the trainers - and facilitate dissemination

FACDEV FOR FACDEV FOR PROFESSIONALISMPROFESSIONALISM

A Case Study:

• The FACDEV Process

• Key FACDEV Content

• Key Methods & Materials

• Lessons Learned

THE FACDEV PROCESSTHE FACDEV PROCESS

“Think tank” onteaching

professionalism

Invitational FDworkshop on teaching

professionalism

Faculty-wide FDworkshop on teaching

professionalism

Think tank onevaluating

professionalism

Invitational workshopon evaluating

professionalism

FACDEV PROCESS - IFACDEV PROCESS - I

Consensus & buy-inof department heads and

leaders; translation of content into terms that can be taught.

Think tank on teaching

professionalism

Consensus on importance;buy-in of leaders;

discussion of how to get faculty “buy-in”.

Goals Activity Outcomes

Invitational FD workshop on teaching

professionalism

Faculty wide FD workshop on teaching

professionalism

FACDEV PROCESS - IIFACDEV PROCESS - II


professionalism


professionalism


professionalism

Trial of ‘translated content’ in FD workshop;

buy-in of larger group.


Consensus & buy-in; development of a planfor full FD program &

recommendations to the Faculty; training of group leaders for FD program.

FACDEV PROCESS - IIIFACDEV PROCESS - III


professionalism


professionalism


professionalism

Improve teaching of professionalism; buy-in

of whole faculty.

Buy-in at faculty level; spin-offs: departmental

workshops & grand rounds;more content experts;

curriculum change.


FACDEV PROCESS - IVFACDEV PROCESS - IV

“Think tank” on evaluating

professionalism

Invitational workshop on evaluating

professionalism

Define educators’ needs forevaluating professionalism;identify current evaluation

strategies, develop anapproach to evaluating

professionalism.

Identification of educators’ needs for evaluating

professionalism & current evaluation strategies;Development of an

approach to evaluatingprofessionalism; planninga workshop on Evaluation.


FACDEV PROCESS - VFACDEV PROCESS - V

Think tank on evaluating

professionalism

Invitational workshop on evaluating

professionalism

To develop methods for evaluating professionalism;

to draw on educational measurement expertise &

expertise outside medicine.

Development of tools for evaluating professionalism –

the “what & how” of assessment; identification of

a pool of behaviors that describe core attributes;

recommendations to the Faculty.


LESSONS LEARNED - ILESSONS LEARNED - I

• FACDEV takes time

• This is a process

• We need a “common language”

• We need “buy in”

• We need “champions”

• FACDEV is more than a workshop...

KEY CONTENT FOR FACDEVKEY CONTENT FOR FACDEV

• The core content of professionalism

• Teaching methods – and the “matching” of teaching methods to objectives

• Evaluation strategies – and the “matching” of strategies to knowledge & behaviours

• Overcoming common problems & challenges•

METHODS & METHODS & MATERIALSMATERIALS

Methods:

• Interactive plenary presentations

• Small group discussions & exercises

Materials:

• Core definitions

• Case vignettes

• Organizing frameworks for learning

• Action plans

CORE DEFINITIONSCORE DEFINITIONS

• Altruism: the unselfish regard for, or devotion to, the welfare of others; placing the needs of the patient before one’s self-interest.

• Self-regulation: the privilege of setting and maintaining standards; being accountable for one's actions and conduct in medical practices, for the conduct of one’s colleagues, and the profession.

• Responsibility to Society: the obligation to use one's expertise for, and to be accountable to, society for those actions, both personal and of the profession, which relate to the public good.

VIGNETTES FOR DISCUSSIONVIGNETTES FOR DISCUSSION

CASE # 1 - A senior resident asks a medical student to put in an arterial line. The student has never seen or performed this procedure before. The resident explains the technique, and then tells the student to proceed.

CASE # 2 - A long-time patient of yours requests a note from you documenting a non-existent illness in order to recover cancellation penalties from the airlines on a nonrefundable ticket.

CASE # 3 - An anesthesiologist smells alcohol on the breath of the operating surgeon and believes he is inebriated during a late evening emergency operation.

ORGANIZING FRAMEWORKS – IORGANIZING FRAMEWORKS – I

Attributes of the Healer and Professional

EDUCATIONAL METHODOLOGIES

Interactive Lectures

Small Group Discussions

Case Discussions /

Vignettes

Experiential Learning

Role Modelling/

Demonstrations

Role Plays/ Simulations

Films/Videotape Reviews

Narratives / Portfolios

Directed Reading /

Independent Learning

Altruism

Autonomy

Caring and Compassion

Commitment

Competence

Confidentiality

Insight

Integrity and Honesty

Morality and Ethical Conduct

Trustworthiness

Openness

Presence and Accompany

Respect for the Healing Function

Respect for Patient Dignity and Autonomy

Responsibility to the Profession

Responsibility to Society

Self-Regulation

Teamwork

ORGANIZING FRAMEWORKS - IIORGANIZING FRAMEWORKS - II

ATTRIBUTE: ALTRUISM

WHO SHOULD EVALUATE?

WHEN SHOULD WE EVALUATE?

Desirable Behaviors Undesirable Behaviors

ATTRIBUTE: SELF-REGULATION

Desirable Behaviors Undesirable Behaviors

ORGANIZING FRAMEWORKS - IIIORGANIZING FRAMEWORKS - III

METHODS OF EVALUATION

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Attribute: Altruism

Attribute: Self-Regulation

Please rate the methods according to the following scale: 1 = the most desirable method; 2 = the next best method; 3 = a potentially acceptable method. Adapted from Toolbox of Assessment Methods© Accreditation Council for Graduate Medical Education (ACGME) and American Board of Medical Specialists (ABMS). Version 1.1

COMPLETING AN ACTION COMPLETING AN ACTION PLANPLAN

ACTION PLAN

Name:

University and Department:

E-Mail Address:

Proposed Activity(ies): 1. 2. 3.

Proposed Content: 1. 2. 3.

Potential Barriers to Implementation:

Potential Solution:

Other Comments:

LESSONS LEARNED - IILESSONS LEARNED - II

The value of:

• Defining core content

• Providing conceptual frameworks

• Enabling experiential learning

• Promoting application to own settings•

•

PARTICIPANT FEEDBACKPARTICIPANT FEEDBACK

This workshop:

• Provided me with a framework for further development.

• Made me look at professionalism and my role as a teacher in a more conscious, informed way.

• Will help re-value the profession…

LESSONS LEARNED - IIILESSONS LEARNED - III

The value of:

• Promoting “buy in”

• Emphasizing the “teaching” of the competency

• Training leaders and co-leaders

• Incorporating follow-up activities/tasks

I learned that:

• Professionalism can - and should be - defined and taught explicitly, not just implicitly.

• We must address this issue first with colleagues. We must increase our own awareness before teaching it to residents and students.

• We need to give professionalism the attention that it deserves…

FEEDBACK (CONT’D)FEEDBACK (CONT’D)

GENERAL GUIDELINESGENERAL GUIDELINES

• Understand the institutional/organizational culture

• Determine appropriate goals and priorities

• Conduct needs assessments to ensure relevant programming

• Target diverse stakeholders

• Develop different programs to accommodate diverse needs

• Incorporate principles of adult learning and instructional design

•

INSTRUCTIONAL DESIGNINSTRUCTIONAL DESIGN

Evaluation Content

Teaching Methods and Aids

Goals and Objectives

TopicTarget Audience

Participant Needs

GENERAL GUIDELINES – IIGENERAL GUIDELINES – II

• Offer a diversity of educational methods – in a variety of settings

• When possible, incorporate activities into ongoing programs

• Promote “buy in” and market effectively• Incorporate relevant theoretical frameworks

• Overcome common challenges

• Remain relevant and practical

• Evaluate – and demonstrate – effectiveness

COMMON CHALLENGESCOMMON CHALLENGES• Defining goals and priorities

• Balancing individual and organizational needs

• Motivating faculty

• Working within limited resources

• Choosing appropriate methods and formats

• Remaining relevant and practical

• Obtaining institutional support

• Evaluating effectiveness

CONCEPTUAL FRAMEWORKSCONCEPTUAL FRAMEWORKS

• Situated Learning (Brown, 1998)

• Principles of Adult Learning (Knowles, 1985)

• Leading Change (Kotter, 1990)

KOTTER’S FRAMEWORK - IKOTTER’S FRAMEWORK - I

• Establish a sense of urgency– Sources of complacency must be minimized in order for

change to occur.• Form a guiding coalition

– A powerful team is required to implement and sustain the process.

• Create a vision– Vision clarifies the direction of the change and helps to both

motivate and align key players.• Communicate the vision

– Those involved in the change must have a common understanding of its goals and direction.

KOTTER’S FRAMEWORK - IIKOTTER’S FRAMEWORK - II

• Empower others to act on the vision– Change requires the efforts of many

• Generate short-term wins – Short-term wins help to fine-tune the vision, reinforce efforts

taken, and build momentum.• Consolidate gains and produce more change

– It is essential to consolidate gains and sometimes produce “more change” as resistance to change can undermine early success.

• Anchor new approaches in the culture– New approaches must be institutionalized in the culture to

assure transformation.

SMALL GROUP WORKSMALL GROUP WORK

• Designing a FACDEV program

– Targeting Teachers’ Needs

– Targeting the Organizational Culture

• Overcoming Common Challenges

DESIGNING A FACDEV DESIGNING A FACDEV PROGRAM - IPROGRAM - I

Who is your AUDIENCE?What are your GOALS & OBJECTIVES for this FACDEV activity/program?

What are their NEEDS?

What KEY CONTENT do you wish to transmit?What FACDEV FORMAT & METHODS will you use?

What FACDEV CHALLENGES do you foresee?How will you overcome these CHALLENGES?

What RESOURCES (e.g. speakers; materials) will you need?

How will you ensure FOLLOW-UP?

ADDITIONAL NOTES RE: IMPLEMENTATION

DESIGNING A FACDEV PROGRAM DESIGNING A FACDEV PROGRAM - II- II

1

Establish a Sense of Urgency

2

Form a Guiding Coalition

3

Create a Vision

4

Communicate the Vision

5

Empower Others to Act on the Vision

6

Generate Short-Term Wins

7

Consolidate Gains and Produce More Change

8Anchor the Change in the Culture

CONCLUDING THOUGHTS - ICONCLUDING THOUGHTS - I

• Define core concepts

• Provide conceptual frameworks

• Enable experiential learning

• Promote application to own setting

• Start with a focus on teaching

• Coordinate with other FACDEV initiatives

• Remember that role modeling is one of the key methods for teaching & learning...

•

CONCLUDING THOUGHTS - IICONCLUDING THOUGHTS - II

• Consider models of change...

• Work on the informal and hidden curricula

• Acquire necessary resources

• Bring about change at the systems level...

“The greatest difficulty in life is to make knowledge effective, to convert it into practical wisdom.”

-Sir William Osler

“It goes without saying that no man can teach successfully

who is not at the same time a student.”

- Sir William Osler

THANK YOU!THANK YOU!

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