Abstract
ABSTRACT
Instructors in the health professions today must acquire knowledge and competencies that go beyond disciplinary expertise. It is now generally accepted that educational training as a teacher is essential to a faculty member's effectiveness as an educator. The educational challenges across the health professions share many similarities. In this article, we draw on the medical education literature and focus on faculty development designed to enhance teaching effectiveness. We first address commonly included faculty development topics, including instructional improvement, organizational development, the development of professional academic skills, and the teaching of specific content areas. We then review a variety of educational approaches and formats that are described in the literature. Included in this discussion are commonly used workshops, seminars, short courses, and fellowships, as well as longitudinal programs, peer coaching, mentorship, self-directed learning, and computer-aided instruction. We also briefly explore learning at work and in communities of practice, and we discuss several frequently encountered challenges in designing and implementing faculty development activities, including motivating colleagues and assessing program effectiveness. We conclude the discussion by presenting a set of guidelines for the design of effective faculty development programs.
Preparing to teach in the health professions today requires the acquisition of knowledge and competencies that go beyond disciplinary expertise. Whereas it was once assumed that expertise in one's field was sufficient to prepare for teaching, it is now generally accepted that educational training as a teacher is essential. For faculty members to be effective as educators, beyond their disciplinary expertise, direct enhancement of educational skills is indispensable. Faculty development activities, which have been designed to address this need and improve teacher effectiveness, have been offered in many of the health professions. However, despite increasing attention to the need for faculty development in veterinary education, a search of the literature found few reports of such initiatives in this field.
The goal of this article is to draw upon the medical education literature and focus on faculty development designed to improve teaching effectiveness. To achieve this objective, we will discuss common practices (including key content areas and common educational formats), frequently encountered challenges, and principles for designing effective programs.
For the purposes of this discussion, we will consider faculty development (or staff development, as it is often called) to include that broad range of activities that institutions use to renew or assist faculty in their roles.1 Faculty development is a planned program, or set of programs, designed to prepare institutions and faculty members for their various roles,2 with the goal of improving individual instructors’ knowledge and skills in the areas of teaching, research, and administration.3 In many ways, faculty development programs aim to help faculty members acquire the skills relevant to their institutional and faculty positions and to sustain their vitality, both now and in the future.4
For some years, it has been recognized that comprehensive faculty development programs cannot focus solely on individual improvement; they must also address the increasingly complex institutions in which teaching and learning occur.5 To elaborate, at the individual level, faculty development should address attitudes and beliefs; provide knowledge about approaches to teaching and learning based on current understanding of these practices; and promote the development of skills in teaching, curriculum design, and assessment of learners while providing opportunities for reflection. At the organizational level, faculty development should focus more on the systems that influence faculty members in their teaching roles. Some broad aims include the need to support teachers in ongoing learning and development; empower teachers and reward excellence in teaching and learning; create opportunities for faculty to learn together, in both intra-professional and inter-professional groups; and address contextual issues that influence the effectiveness of teaching and learning.
Important changes are occurring in education for the health professions, and these changes influence faculty development. Perhaps the most fundamental changes are the shift toward learner-centered education and a better appreciation of the adult learner. Learner-centered education places the student at the center of the education process; it focuses on the teacher as a facilitator of students’ learning, shifting away from total reliance on the teacher as a transmitter of knowledge. An example of this is seen in a statement from the Royal Veterinary College's LIVE! Centre for Excellence in Lifelong and Independent Veterinary Education,6 which describes a focus on successful completion by all students of the important switch from pedagogical to andragogical learning that is a feature of effective tertiary education.7 The second change, perhaps earlier in its development, is toward the introduction of inter-professional learning into professional education to prepare learners for the future workplace and practice. These changes will clearly influence the development and focus of faculty development programs, as well as the skills that veterinary teachers will require.
Most faculty development programs have been designed to improve teaching by enhancing individual instructors’ skills in the following areas: clinical teaching, small group facilitation, lecturing, feedback and evaluation, and teaching in community or ambulatory settings. Less attention has been paid to the personal and professional development of teachers, educational leadership, or organizational development and change.4 Faculty development programs designed to enhance the teaching of specific content areas (e.g., inter-professional practice; communication skills; evidence-based practice) have also been less frequently reported.
Although instructional effectiveness at the individual level is critically important, individual teacher's effectiveness is clearly affected by the larger system or culture of the organization. Fostering the development of individuals who will provide leadership in education programs, act as educational mentors, and design and deliver innovative educational programs is critical for sustaining the organization's educational work. Cusimano and David8 note a need for more health care professionals trained in methods of educating others so that medical education will continue to be responsive to driving forces of change. This insight applies to veterinary education as well.9
Teaching is at heart a scholarly activity. Increasingly, faculty members in the health professions are choosing education as their focus for inquiry, and faculty development plays an important role in creating an educational climate that encourages and rewards educational scholarship, leadership, innovation, and excellence. Several authors have suggested that changes in organizational systems and leadership strategies may be needed to promote more productive educational environments.2, 10 Clearly, we need to link individual and organizational needs,11 and we should pair organizational development with individual skill development.12 Faculty development can also contribute to organizational development by helping to define criteria for assessing and rewarding teaching excellence.
Teaching and educational work form an integral part of the faculty member's academic role and are influenced by each individual's professional academic skills. These skills include an understanding of the underlying values, norms, and expectations of academia; knowing how to manage a productive career; and establishing a network of experienced and knowledgeable professional colleagues.2, 5, 13 Orientation programs for junior faculty may include an introduction to these skills; however, this exposure is more frequently delegated to the individual's department, and the information is often conveyed haphazardly and inconsistently. Faculty development programs designed to meet this objective would be timely. Examples of topics to be addressed include how to achieve academic promotion and how to identify and work with a mentor.2, 14
In some settings, faculty development is viewed as a component of continuing professional development (CPD). Whereas continuing medical education (CME) has traditionally focused on specific content areas and the upgrading of clinical skills,15 health professionals also need to improve their ability to teach important content areas, including professionalism, communication skills, and evidence-based medicine. These new areas are emerging across the continuum and will affect teachers and learners at all levels.
For example, Cruess and Cruess16 have highlighted the need to teach professionalism at all levels of medical education in response to changing societal expectations. Communication skills may also not be receiving the attention they deserve. In veterinary medicine, literature specifically addressing communication skills teaching has lagged behind the development of such literature in human medicine; however, the need for these skills is recognized in standards and policy statements (e.g., Professional Competencies of Canadian Veterinarianss: A Basis for Curriculum Development17) and, more recently, has been the focus of two international conferences on communication in veterinary medicine,18 with key features presented in a series of 16 articles just published in the Journal of Veterinary Medical Education.19
Information technology is transforming many aspects of our personal and professional lives20 and is another area in which faculty skills need to be upgraded. Younger learners and recent graduates are increasingly computer literate, necessitating faculty training in this area to fill the gap for those whose professional training took place before the information age. Crandall and colleagues21 have outlined a series of skills that might be included in such faculty development initiatives: accessing and managing the relevant literature; planning and delivering lesson plans and presentations; using computers for research and writing; and integrating computers into practice. Although many individuals acquire these skills on their own initiative, and diverse providers offer computer courses, the organizational culture also influences the degree to which instructional technology is adopted and used.9 Faculty development initiatives should target those areas that enhance teaching and learning and that are not taught elsewhere (e.g., using computers for feedback and practice; conducting online discussions and quizzes). Helping students and residents learn how to incorporate computers into their practice and research endeavors will also become a priority for faculty development. Two groups of articles addressing the use of information technology in veterinary education have recently been published in the Journal of Veterinary Medical Education,22 emphasizing the breadth of information-technology approaches in veterinary education.
Faculty development most commonly includes workshops and seminars, short courses, and fellowships.23 Workshops are one of the most popular formats because of their inherent flexibility and promotion of active learning. Faculty members also value a variety of teaching methods within this format, including interactive lectures, small-group discussions and exercises, role-playing and simulations, and experiential learning.24, 25 However, given the changing needs and priorities of health professional schools and instructors, as well as emerging understandings about effective teaching and learning, we should consider alternative formats for faculty development that include integrated longitudinal programs, decentralized activities (activities outside of the institution), peer coaching, mentoring, self-directed learning, and computer-aided instruction.26 Instructors and supervisors have different learning styles and, like students, benefit from a variety of ways in which to meet their needs. It is also important to remember that any format (e.g., a workshop) is not inherently effective; many formats can be used effectively, and they should be selected based on the values and goals of the institution. Some examples of alternative formats are described below.
Longitudinal programs represent one approach to creating effective educational programs. A variety of faculty development methods are used within a longitudinal program, in which faculty commit 10–20% of their time over one or two years in an attempt to increase their skills in particular faculty roles. The Teaching Scholars Program at McGill University27 is one example of such a program. Integrated longitudinal programs offer the advantage of allowing instructors and faculty members to continue to practice and teach and to apply what they have learned while improving their educational knowledge and skills. These programs also allow for the nurturing and development of educational leadership and for scholarly as well as teaching improvement.
In peer coaching, teachers help each other to reflect on and improve their teaching. Such collaboration among teachers has not always been part of the culture of universities, where teaching has often been regarded as the instructor's private responsibility. However, this method of faculty development has been described extensively in the educational literature and, more recently, in the health sciences.28, 29 Reflecting on teaching, with the aid of peers, is congruent with the collaborative values and skills that we wish to encourage among our learners. Generally, such coaching involves agreement by the teacher and peer upon specific goals, focused observation of teaching by a peer, and the provision of feedback, analysis, and support.29 Peer coaching has particular appeal because it occurs in the participant's practice setting, enables individualized learning, and fosters collaboration. It also offers the opportunity to receive feedback and discuss teaching challenges, and it is usually perceived as non-threatening, as the focus is on improvement rather than on evaluation. It also acts as a means to cross-disciplinary and professional boundaries and allows for health care professionals to learn about one another as they teach together.
Mentoring is a long-standing tradition that has been used to promote the development of faculty in higher education and in academic medical faculties. A variety of mentoring programs have been described, including a collaborative peer group30 as well as the more traditional senior–junior faculty member relationship.31 However, it appears that mentorship programs are presently an underutilized approach for faculty development that could be offered in a more formal and systematic fashion. Effective mentorship programs depend on the formation of successful partnerships between mentor and protégé, as well as an institutional climate that supports such relationships.13, 32
Daloz33 has described a mentorship model that balances three key elements: support, challenge, and vision of the individual's future career. When these elements are considered in the light of teaching development, they involve helping individuals to validate and develop the attitudes and beliefs they hold about teaching; to assess and pursue their professional development needs; and to reflect and build on their experience and expertise.
The fact that self-directed learning initiatives are infrequently described in the faculty development literature may reflect the prevailing emphasis on instructor-driven staff development, aimed at preparing teachers for specific institutional needs. Other areas of professional education (e.g., continuing professional development) include self-directed learning as a major developmental approach.26 Self-directed learning is clearly a means to acquire skills that are essential to effective teaching and learning, as well as to ongoing development as a teacher. Self-directed learning relies heavily on the faculty member's ability to reflect, both in action and on action,34 and to identify personal areas of needed growth. Further, self-directed activities may assist faculty in pursuing their individual and personal goals in teaching. Faculty development programs can contribute to self-directed learning by encouraging teachers to determine their own needs (through self-reflection, student evaluation, and peer feedback) and by helping them to design their own development activities.24
As faculty embark on self-directed learning activities, new approaches may be required of faculty and staff developers. Faculty may require support in identifying their learning needs and in locating the resources, both formal and informal, that can be helpful to meet their goals. In some cases, faculty developers may be involved in “brokering” for faculty to connect them directly to relevant resources.26
Decreasing time for professional development, the explosion of technology to create interactive instructional programs, and the desire to improve access for faculty makes the use of computer-based learning opportunities an important area to explore. Web-based learning can allow for individual programs targeted to specific needs and can promote the sharing of resources. Such activities may “stand-alone” or may complement other activities.
While Web-based learning is closely tied to self-directed learning initiatives, not all educational resources for independent learning are computer-based, and not all computer-based resources are used primarily for self-directed learning. Web-based learning for community preceptors has been described in the faculty development literature.35 Based on these experiences, online resources and learning programs can be considered a supplement to site-specific and centralized faculty development programs. They can also be used as part of a “staged approach” later in the development of teachers and faculty members. The literature reports the use of Web-based discussion groups for learners at all levels. This use is certainly possible for faculty development purposes and can include both in-house and distant sites, allowing faculty members in distant locations to benefit from working with their teaching colleagues.36
Faculty development activities have traditionally been conducted away from the faculty member's direct workplace, requiring faculty members to take their “lessons learned” back to the workplace. This approach remains important; however, more is being understood about the impossibility of separating work and learning and about the learning that occurs in the context of work.37
Related to “learning at work” is the concept of situated learning and communities of practice. By working together and participating in a larger community, faculty can build new knowledge and understanding and develop approaches to problems faced in teaching and learning.38 Communities of practice can work at two levels. First, there is the everyday workplace, where faculty conduct their clinical research and teaching activities and interact with colleagues and students. Faculty can be supported to see these experiences as learning experiences and can be encouraged to reflect with colleagues and students on the learning that has occurred. Second, at the level of staff development, faculty can become involved in new communities of practice whose focus is more on teaching. Together, they can exchange and build new understandings of teaching and learning.
Faculty development programs cannot be designed or delivered in isolation. Other factors can act as both enablers and barriers to successful programs. These include institutional support, organizational goals and priorities, resources for program planning, and individual needs and expectations. Common challenges faced by faculty developers include defining goals and priorities; balancing individual and organizational needs; motivating faculty to participate in staff development initiatives; obtaining institutional support and “buy-in”; promoting a “culture change” that reflects renewed interest in teaching and learning; and overcoming limited human and financial resources.39 Two of the most common challenges will be described here.
Motivation deserves particular consideration. Teachers as learners are unique in several ways. Their vast experience has given them more life experience and more deeply learned behaviors that have served them well, and change may be seen as a greater threat. Also, time for learning is not routinely allocated or valued, challenging even the most highly motivated teachers. Faculty development programs must be cognizant of these challenges and consider their effect. A variety of factors affects participation, including whether teaching improvement is viewed as important, whether the institution is perceived as supportive, and whether instructors are aware of the availability and potential value of such activities.
As faculty developers, we can work within our institutions to promote the development of a culture that encourages professional development. At the program level, a variety of activities that are relevant and of good educational quality, tailored to meet individual and organizational needs, will be important. We must also build a network of interested individuals, encourage and assist faculty in identifying their own needs, encourage the dissemination of information, use student feedback to illustrate needs, recognize participation in faculty development, and, if possible, provide flexible programming and “release time.” Linking development activities with ongoing programs (e.g., hospital rounds; CME events) also connects instructors with the everyday work of clinical teaching.
Work in other fields can help us as well. Learning new teaching behaviors involves change, and changing behavior is not straightforward. Moreover, once change has been made, it needs to be maintained.40 For faculty developers, this means that learners, and potential learners, may be at various stages in their readiness to change. Some of our activities may need to be developed with the goal of increasing awareness; others may need to address more specifically the changes to be made, or work to sustain them. In health professional education, curricula that have incorporated problem-based learning are a good example of these different stages of change. While some instructors may see no need to incorporate more active, learner-centered methods of teaching and learning, others may wish to make changes, recognizing that they will need help to acquire the necessary skills. Perhaps the most important challenge for faculty development is that of supporting faculty members to sustain the changes they have made. Follow-up sessions or refresher courses, together with appropriate systems changes, may help teachers to avoid slipping back into earlier, more comfortable ways of teaching.
Other factors are also pertinent to motivating faculty to engage in faculty development. As developers, we need to ensure that the learning is perceived as relevant to the work setting, to the problems teachers face, and to the profession. Learning is most engaging when learners are actively involved. Learning methods should therefore be interactive, participatory, and experientially based, using the participants’ previous learning and experience as a starting point. All stakeholders should be represented in the planning and organization of activities. A positive learning environment (communicating respect and understanding of similarities and differences) and a sense of institutional support are additional enhancers and reinforcers of learning. Lastly, faculty members are motivated to attend activities whose effectiveness has been demonstrated.
Faculty development initiatives are widely described in the literature; however, research demonstrating the effectiveness of faculty development activities is still needed.3, 4 Relatively few programs have conducted comprehensive evaluations to ascertain their effect on faculty members or on learners. Of the studies that have been conducted in this area, most have relied on the assessment of participant satisfaction; some have assessed the impact on learning, in terms of attitudes, knowledge, and skills (or performance), and a few have examined the long-term impact of these interventions. In addition, most studies have measured outcomes using self-report rather than objective measures or observations of change. More specifically, methods to evaluate staff development programs have included end-of-session evaluations, follow-up survey questionnaires, pre- and post-assessments of cognitive or attitudinal change, direct observations of teaching behavior, student evaluations, and faculty self-ratings of post-training performance. Common problems include a lack of control or comparison groups and small sample sizes. Notwithstanding these challenges, some high-quality studies have provided evidence about the effectiveness of specific activities.25
For example, the literature suggests that participants rate faculty development activities highly, that they perceive the experience to be useful, and that they often recommend participation to their colleagues.41 Other studies have demonstrated an impact on instructors’ knowledge, skills, and attitudes, and some have noted effects on student perceptions of teaching effectiveness. Additional benefits have included increased personal interest and enthusiasm, improved self-confidence, a greater sense of belonging to a community, and educational leadership and innovation.27
A challenge for faculty developers is to conduct more rigorous evaluations of diverse initiatives from the outset, to consider a variety of models of program evaluation, to make use of both qualitative and quantitative research methods, and to seek as many perspectives as feasible. We should also be mindful of the importance of participant satisfaction. Although researchers often question the value of this data source, regarding it as merely an indicator of “happiness,” participant satisfaction remains important if faculty members are to be motivated to learn and to recommend staff development initiatives to their colleagues. Well-designed participant-satisfaction instruments yield valuable feedback to program planners regarding the effectiveness of teaching and learning strategies and the perceived relevance of the content.
The literature reveals that the initiative and responsibility for developing programs may rest with different people in different institutions, depending upon individuals and on institutional structures and cultures. The following guidelines are intended to help individuals or groups design and deliver effective staff development programs. A fuller discussion of these guidelines is found in Steinert;39 however, we will briefly highlight them here.
Faculty development programs occur within specific institutional or organizational contexts. It is imperative to understand the institutional culture and to be responsive to its needs. Ideally, faculty developers should capitalize on the organization's strengths and work with the leadership to ensure success. Sometimes the context can be used to promote or enhance staff development efforts, as in times of educational or curricular reform.42 Underlying this understanding is knowledge of institutional support and available resources. Clearly, staff development cannot occur in a vacuum. In light of the need to enhance inter-professional understanding and practice, such programs will likely benefit from inter-professional participation from faculty across the health sciences. Not only would the wealth of inter-professional expertise and perspectives be shared, the institution's resources would be wisely used. To date, the literature reports few such programs (although both authors have such programs at their schools); sharing these experiences, and the evaluation of their effectiveness, will be very important in informing future development.
Effective faculty development programs are guided by clear goals and priorities. Goals and objectives must be carefully determined, as they will influence the target audience, choice of program, content, and methodology of the faculty development activities. In addition to establishing program goals, it is important to consider what values and principles will form the foundation of the program and guide its development. Clarifying these values is very important, as, explicitly or implicitly, they have a large impact on the design of the program.
Faculty development programs should be based on the needs of the individual as well as those of the institution. Student needs, patient needs, and societal needs may also help to direct relevant activities. Some needs may be ongoing, such as the need to maintain current knowledge; others may be emerging and not yet obvious to the faculty member. Assessing needs is necessary to refine goals, determine content, identify preferred learning formats, and assure relevance. It also can promote early “buy-in” and interest. Common methods include written questionnaires or surveys; interviews or focus groups with key informants (e.g., participants, students, educational leaders); observations of instructors “in action”; literature reviews; and environmental scans of available programs and resources. Clearly, an individual teacher's perceived needs may differ from those expressed by his or her students or peers. Using as many sources of information as possible helps to build an accurate picture of needs. Needs assessments can also help to further translate goals into objectives that will serve as the basis for program planning and evaluation of outcomes.
Various educational formats have been described above. Programs are required that can accommodate diverse goals and objectives, various content areas, and the needs of both the individual and the organization. For example, if the goal is to help your colleagues improve their lecturing skills, a half-day workshop might be the program of choice. On the other hand, if the need is to improve aspects of clinical teaching, a series of interactive sessions may be effective, whereby participants can practice and receive feedback on the skills as they are learning them. Program content is dynamic and, along with teaching and learning methods, must evolve over time.
Understanding learning is a key aspect of planning faculty development activities. Further, it is important to make explicit our beliefs about learning and teaching, as they heavily influence how we design and implement faculty development activities. Learning theories have not played a large role in faculty development in veterinary education.43
Many programs incorporate principles of adult learning to guide their development. Key principles of adult learning (e.g., Knowles;44 Merriam and Caffarela;45 Kaufman, Mann, and Jennett46) include the following:
Adults are independent learners.
Adults come to learning situations with a variety of motivations and specific expectations about particular learning goals and teaching methods.
Adults demonstrate a variety of learning styles.
Adult learning often involves “relearning” as well as new learning.
Adult learning often involves changing attitudes as well as skills.
Most adults prefer learning that is relevant to the problems of their everyday lives.
Incentives for adult learning usually come from within the individual; however, external incentives also play a role.
Feedback is usually more important than tests and evaluations to promote improvement and achievement of goals.
Incorporating these principles into the design of a staff development program can enhance receptivity, relevance, and engagement.39 Principles of instructional design should also be followed. For example, it is important to develop clear learning goals and objectives, identify key content areas, design appropriate teaching and learning strategies, and create appropriate methods of evaluation—of both the learners and the curriculum. It is equally important to plan programs that are congruent with current understandings of learning and to use teaching and learning strategies that reflect best practices. However, although theory should inform practice, practice can also inform design and theory, as the work of staff development is to facilitate teachers’ ability to address the real situations and problems that they face.
Faculty development programs should try to offer a variety of educational methods that promote experiential learning, reflection, feedback, and immediacy of application. Activities to assist faculty in transferring new skills back to their work are also important. Common learning methods include interactive lectures, case presentations, small-group exercises and discussions, role-playing and simulations, videotape reviews, and live demonstrations. Practice with feedback is also key, as is the opportunity to reflect on personal values and attitudes. Computer-aided instruction, debates and reaction panels, journal clubs, and self-directed readings are additional methods to consider. Whatever the teaching and learning method, the needs and learning preferences of the participants should be respected, and the method should match the objective.
The decision to participate in a faculty development program or activity is not as simple as it might at first appear. Therefore, for faculty developers, overcoming resistance and marketing programs effectively are important. The value of targeted mailings, professionally designed brochures, and “branding” to promote interest has been reported elsewhere.39 Continuing-education credits as well as free and flexible programming can also help to facilitate motivation and attendance. “Buy-in” involves agreement on importance, widespread support, and dedication of time and resources at both individual and systems levels, and it must be considered in all programming initiatives.
Evaluating faculty development is more than an academic exercise. Findings from the BEME systematic review25 can be used to inform the design, delivery, and marketing of programs in this area. As we stated earlier, staff development must strive to promote education as a scholarly activity; faculty development must model this approach.
In preparing to evaluate a staff development program or activity, there are several considerations, including the goal of the evaluation; available data sources (e.g., participants, peers, students or residents); common methods of evaluation (e.g., questionnaires, focus groups, objective tests, observations); and resources to support assessment (e.g., institutional support, research grants). Moreover, as evaluation is an integral part of program planning, it should be planned at the beginning of any program.
Academic vitality depends on faculty members’ interest, expertise, and evolution. Faculty development has a critical role to play in promoting academic excellence, educational innovation, and professional growth of the individual and the institution. Indeed, to meet the challenges of educating professionals for the complex and demanding practice that our graduates will enter, new approaches to faculty development and institutional support for instructors are essential. As we design and develop faculty development programs, we should strive for relevant activities and varied learning opportunities that will support faculty members in their diverse educational roles, promoting their continued professional growth and satisfaction as well as their effectiveness in preparing the next generations of professionals.
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