Teaching, Scholarship & Production: Expectations for Contemporary
Clinical Faculty
Bill Hendricson
Assistant Dean, Education & Faculty Development
UTHSCSA Dental School
Associate Editor, Journal of Dental Education
Academy for Academic Leadership
Clinical ScholarModel
Research
Teaching
Service
Hypothesis:
Dental Schools Desire Clinical Faculty Who Are Fully Engaged With the School
Goal:
Share a Vision of “Scope of
Practice” for Clinical Faculty
Service
We’re Talking about Faculty Who Teach in Labs and Clinics
2500 hrs X 56 schools =
140,000 hrs
Influence on Productionand Clinic Revenue ??
Questions for you to ponder:
Will more frequent use of “teaching best practices” influence students’ speed & patient completion?
What effect will movement to a “clinical scholar” model for faculty have on students’ functioning in the clinic / $$ productivity?
Can clinical faculty function in a more “academic” role within the standard clinical education model of dental school?
Agenda • Academic roles for clinical faculty in dental
schools – historical trends• What makes clinical faculty “happy &
satisfied”?• Clinical scholar model / examples• Scholarship opportunities • Service opportunities • Teaching roles
You ponder “implications”
Competencies for Dental School Faculty
• Clinical Teacher • Clinical Scholar • Research-Intensive Scholar
Hand JS. Identification of competencies for effective dental faculty. J Dent Educ 2006; 70(9):937-47.
ClinicScholar
Clinic Teach
ResearchIntensive
Clinical Teacher• Teaching students in laboratories & clinics
is primary focus.
• Limited classroom teaching.
• May participate in research as a clinician.
• May publish, but not a major expectation.
• Low service expectations.
Clinical Scholar• Expected to participate in teaching, research &
service. “triple threat” faculty • Expected to serve as course director & teach in
the classroom, lab & clinic.• Expected to participate on committees.• Expected to publish in peer-reviewed journals • Not expected to secure NIH-level funding. • Should have capacity to secure seed money
funding for pilot projects from foundations.
Research-Intensive Scholar• Expected to teach with emphasis on graduate
students. • Expected to develop a research “niche” & secure
NIH-level grant funding. • Expected to publish research in highly ranked
journals. • Expected to recruit other researchers & mentor
them.
ClinicalScholar
Clinical Teacher
ResearchIntensive
1945 - 1985
1985 - 2008
2010 - 2030
Fully Engaged Faculty
Historical Trends
Issues: Clinical Teacher• Perception of “isolation” from school
activities & events; i.e., out of the loop
• Disconnect from classroom instruction
• Tensions between clinical scholar faculty & clinical teacher; perceived hierarchy
• Core school functions not being performed often or well – educational planning
• High turn-over at some schools
Haden. Quality of Dental School Faculty Work Life. J Dent Educ. May, 2008
ResearchScholarshi
p
TeachingMentoring
Service For School
2010 - 2030
Clinical Scholar Model
Return to Academic
“Triple Threat” ??
Clinical Faculty More “Fully Engaged” in
School Affairs
What are clinical faculty perceptions of
academic work-life?
The good, the bad & the ugly
Report of 2007 Dental School Faculty
Work Environment Questionnaire
Haden, JDE. May 2008
• Fully engaged faculty are most satisfied with academic career & report best “balance”
• Roger, Wehmeyer, Milliner. Reflections on academic careers by
current dental school faculty. J Dent Educ. 2008; 72 (5)
• Haden. Quality of dental faculty work life. J Dent Educ. 2008; 72 (5).
R
T
S
Clinical Scholar
Scope of Practice: TeachingResearch Service
Gen X Faculty ExpectationsComponent What X’ers
Expect & ValueWhat They Find in
Academia
Curriculum Planning
Openness
Systematic
Vagueness
Ad - hoc
Research Centered around problems / needs
Centered around disciplines
Teaching Trans-disciplinary
Collaboration
Experimentation
Narrow within discipline
Resistance
Academic Decision-Making
Transparent Opaqueness
“Head-scratchers”
Trower CA. (CCI) Making academic dentistry more attractive to new teacher – scholars. Journal of Dental Education. May 2007; pgs 601- 605
What makes clinical faculty “happy & satisfied”?
• Variety of work assignments– Teaching in different settings & levels
– School service: contribute to planning– Scholarship: disseminate educational methods
• Opportunity to be a “player” in school
• Learn new skills / roles
• Create new programs
• Interaction with students
“The best thing about my job is that I can move from project to project, and task to task and never have time to get
bored. No day is ever identical to another which keeps me charged up and learning new things.”
Haden. Quality of dental faculty work life. J Dent Educ. 2008; 72 (5).
ResearchScholarshi
p
T
S
Clinical Scholar Model
Opportunities
Fully Engaged Faculty
Quality of Teacher &
Student Interactions
Factors Teachers Can Control
Teaching Strategies in Classroom & Clinic
Design of Curriculum
Evaluation Methods
Student Variables
Learning Style & Self - Concept
Difficult Behavior
Students’ Expectations& Preferences
Research
Opportunity
What is ER?
• It’s not Thursday 9 pm “Must See TV”
What is Educational Research (ER)?• Exploration of factors, conditions, techniques
and interferences that influence the outcomes of teaching and learning processes,
• including personal traits and habits of teachers, students and the overall environment of the school and it’s community.
John Dewey
Human Nature & Conduct (1927)
Dewey & Eisenhower
Beginning of Educational Research
Types of ERPrediction studies: admissions, GPA, boards Influences on student achievement (emotional
intelligence, personality factors, academic variables)Students’ perceptions of education & issuesTraits of teachers, students & school environment Students’ study habits & learning stylesWhat is appropriate curriculum content?Organizational development / change strategies Proof of concept studies - assessmentProof of concept studies - teaching methodologyHot issues / best practices – Critical Thinking
Examples: ER Papers in JDE
• Evaluation of Clinical Mock Boards & Their Influence on Qualifying Exam Success. J Dent Educ. 2002
• What is the Impact of Case-based Seminars on Student Self-Assessment of Orthodontic Skills?
J Dent Educ 1994; 58• What is the Agreement Between Clinicians & A
Computer-Based Decision Support System for Planning Dental Treatment? J Dent Educ. 2002; 66
2008 ADEA Competencies for the New General DentistADEA Council of Sections Task Force on Competencies & Foundation Knowledge
Major Change in Emphasis: Critical Thinking
How do you assess your students’ capacity to:
Recognize, analyze & describe problems
Gather & assess relevant information, weigh it against existing knowledge, to better understand the problem
Interpret information & arrive at well-reasoned conclusions
Explain rationales for decisions & answer questions
Communicate effectively with others while exploring problems
What if a CODA site visit team asked these questions at the next review?
Tremendous Research Opportunities
How do dental students develop critical thinking?
Novice Expert
♦
@
♦
@
Vertical – compartmentalized Horizontal – networked
Data Knowledge
Hendricson, ADEA CCI. Educational Strategies Associated with Development of Critical Thinking and Self-Directed Learning. J Dent Educ. 2006; 70(9): 925-936.
Assessment of Critical Thinking Capacity
• Fresno Test• Health Science Reasoning Test
(HSRT)• California Critical Thinking
Disposition Inventory
It All Starts With Questions
• It's easy to find answers. The hard part is finding good questions.
Thomas Edison
• It’s far better to get an approximate answer to the right question than an exact answer to the wrong question.
John Tukey
A Quick Trip Through Research Questions
Hot Research Questions in the 13th Century
• How many angels can dance on the point of a fine needle without jostling each other?
• Can angels pass from one place to another without going through the middle? Can angels move from point A to point C without passing point B?
• Is there excrement in paradise? • Why are angels more logical in thought when it is
warm & sunny versus when it is cold & wet?
Royal. St Thomas Aquinas: The Person and his Work. 1996.
W – H – I –F QuestionsWhat Would Happen If?
Hendricson. It All Starts with Questions JDE, Sept, 2004
What would happen to student attrition if we [ fill in the blank ]?
What would happen to board scores if we [ fill in the blank ] ? Why do students have difficulty learning [ fill in the blank ] ?
What would happen to clinic performance if we [ fill in the blank ] ?
Based on the literature, what are best practices for [ blank ] ?
What are barriers to implementing [ fill in the blank ] ?
What would happen if we stopped [ blank ] & started [ blank ] ?
ER Question Generator
WHIFs from My CareerWhat would happen if we…
• Provided feedback to faculty on their lecture skills? Hendricson, Hawkins, Hudepohl, Littlefield. Effects of Providing Feedback to Lecturers via Videotape Recordings &
Observer Critiques. Am J of Pharm Educ. 1983.
• Changed eval forms to focus on 4 global skills versus 13 component tasks?
del Rio, Dale, Hendricson: A Method for Training Endodontic Evaluators. JDE. 1983.
• Compared clinical errors among students who learned endodontics by 4 methods?
Hendricson, Sandoval, Dale: A Comparison of 4 Instructional Methods for Reviewing Clinical Endodontics. JDE. 1987.
Compared dental students’ performance on “work alone” competency exams and daily grades.
Berrong, Dale, Hendricson, JDE 1983.
Write A WHIF for a Potential Educational Research Project at
Your School
• What Would Happen If we …. ????
Case 1Fully Engaged Faculty
4 Years at Dental School
Dr. Tom TransitionReturning Boomer
Fully Engaged Clinical Faculty
Teaching Course Director Fr
Lab instructor Soph
Clinic: 5 sessions Jrs
2 Electives Srs
2 teacher training programs
Course Drs Group
Class Advisor
Research One ER study each yr
ER study group
2 ER pubs; 4 abstracts
3 invited presentations
Clinician on grant
Student research mentor
Piloting new method
Service Clinical niche – “the expert” at school
Chair – Curr Comm
Strat Plan Comm
Mentor for new faculty
One new project each year
in each area:
TeachingResearchService
R
T
Service For School
Clinical Scholar Model
Opportunities for Service in Curriculum
Fully Engaged Faculty
Persistently Advocated Reforms in Dental Education
Kassebaum, Hendricson, Hayden, Taft. J Dent Educ. Sept 2004; 68(9): 914 – 931
Eliminate “smokestack” (silo)approach to curriculum
Dental Students Spend More Time in Lecture than Clinic
0%
10%
20%
30%
40%
50%
60%
Lecture Lab Clinic
Dental
Medical
Nursing
Alternative Teaching / Learning
Are We Getting it Right?Avoiding False Positives & False
Negatives When Evaluating Students’ Performance in Labs and Clinics
Dental Education Has Not Adopted New
Assessment Methods Used In Other H
PE
Albino, Young, Hendricson. D
ecember 2008; J Dent Educ.
What we evaluate, we do it the right way.. But I’m not sure we’re right in what we choose to evaluate.
ADEA CCI Competency Assessment Survey, 2008
Focus of Assessment in Dental Education?
Curriculum Revision MethodsStrategy Characteristics
Mount Olympus This is what we’re going to do!
Sneak Attack “Oh, by the way, we now have a new clinical ...”
Atilla the Hun Mandated across-the-board cuts
Fire-fighting Temporary “pothole-filling”
Department review “Fox guarding the chicken coop”
Interdis peer review Plastic surgery (nip & tuck)
CQI Model Parallels scientific decision - making process
Abrahamson. Diseases of the Curriculum J Med Educ 1978
Continuous Program MonitoringSystematic Process
CAAMP 2008
Curriculum Quality
Case 2Fully Engaged Faculty
4 Years at Dental School
Dr. Ima New30-Something Clinician
Fully Engaged Clinical Faculty
Teaching Lecture Course Fr
Course Dir Soph
Support Lab Soph
Clinic Faculty Jrs
Teaching Methods
Course - HSC
National Teaching
Course
Research 2 studies – motor skill
6 abstracts
3 invited presentations
Institutional grant
Co-I foundation grant
Team for NIH grant
Service IPE Curriculum TF
Med-Dent HomelessEvening Clinic
Alternate Track Comm
Student org advisor
ADEA CCI
WFA at HSC
Goals:
Predoc Educ Director for Department
Clinical Education Director for Dental
School
R
Teaching
S
Clinical Scholar Role
Fully Engaged Faculty
Faculty Perception of Role in Clinic
Checker
Cover
Coach
Clinician / Fireman
Irby. Acad Med. 1995
Linn. Rev Educ Research. 1991
Glance and Grade
Research on Clinical Teaching• Chambers. Association among factors thought to be
important by instructors in dental education and perceived effectiveness of these instructors by students. Eur J Dental Education. 2004;8:147-51.
• Manogue. Clinical assessment of dental students: values and practices of teachers in restorative dentistry. Med Educ. 2001;35:364-70
• McGrath. Development and Evaluation of a Questionnaire to Evaluate Clinical Dental Teachers. Br Dent J. 2005;198:45-8.
• Victoroff. Students’ perceptions of effective learning experiences in dental school: A qualitative study using a critical incident technique. J Dent Educ 2006; 70:124-132.
• Henzi. North American dental students’ perspectives about their clinical education. J Dent Educ 2006; 70: 361-377.
• Schonwetter. Students’ perceptions of effective classroom & clinical teaching in dental & dental hygiene education. J Dent Educ. 2006; 70: 624-635
7 Microskills of Clinical Teaching• Set expectations, assess learner’s level & needs• Coach students through patient care
– Guide assessment & planning with questions & pearls – Provide tips during patient care– Debrief: what went right & wrong? how to handle next time?
• Ask questions to stimulate thinking • Give constructive “how to improve” feedback• Explain “why, how, where, when” (prescriptions) • Provide personal support & encouragement• Model professional behavior & valuesNeher. Microskills Model of Clinical Teaching. J Am Board Fam Pract. 1993; 6: 86-87 Irby. Teaching & learning in ambulatory care: thematic review of literature. Acad Med.
1995; 70(10): 898-931
Exemplary Clinical Faculty Use a Bookends Teaching
Orient students before patient encounter• Ask “assessment & planning” questions - What do you plan to do & why? - How & why did you rule-out alternatives?• Priming & anticipatory guidance questions
Debrief students after patient encounter• Ask reflection & self-assessment questions
- What is the most important thing you learned today?- What could we do differently next time?- Review specific trouble spots
Irby. Teaching in Ambulatory Care Setting: Thematic Review of Literature. Acad Med.
Chambers. Association Among Factors Thought Important by Instructors & Perceived Effectiveness
of These Instructors by Students. Eur J Dent Educ. 2004:8:147-51.
Exemplary Clinical Scholars
“Check” is just one part of
overall mentoring process
See themselves as students’ professional
mentor
• “A poor surgeon hurts 1 person at a time.”
• “A poor teacher hurts 130."
Dr. Ernest Boyer– Former President , Carnegie Foundation– United States Commissioner of Education
Renewed Sense that Quality Teaching is Really Important
Influence of enhanced focus on coaching versus checking on clinical operations?
ResearchScholarshi
p
TeachingMentoring
Service For School
Clinical Scholar Model
Goal:
Future “Scope of Practice” for Clinical Faculty
Effect on Clinic Production: Operations
OrganizationsIncome
Thank You!
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