Abstract
CONTEXT: Faculty development has received considerable investment of resources from medical institutions, though the impact of these efforts has been infrequently studied.
OBJECTIVE: To measure the impact of the Stanford Faculty Development Program in Clinical Teaching on ambulatory teaching behavior.
DESIGN: Pre-post.
SETTING AND PARTICIPANTS: Eight internal medicine faculty participating in local faculty development.
INTERVENTION: Participants received 7 2-hour sessions of faculty development. Each session included didactic, role-play, and videotaped performance evaluation.
MAIN OUTCOME MEASURE: Before and after the intervention, faculty were video-taped during a case presentation from a standardized learner, who had been trained to portray 3 levels of learners: a third-year medical student, an intern, and a senior medical resident. Teacher and learner utterances (i.e. phrases) were blindly and randomly coded, using the Teacher Learner Interaction Analysis System, into categories that capture both the nature and intent of the utterances. We measured change in teaching behavior as detected through analysis of the coded utterances.
RESULTS: Among the 48 videotaped encounters, there were a total of 7,119 utterances, with 3,203 (45%) by the teacher. Examining only the teacher, the total number of questions asked declined (714 vs 426, P=.02) with an increase in the proportion of higher-level, analytic questions (44% vs 55%, P<.0001). The quality of feedback also improved, with less “minimal” feedback (87% vs 76%, P<.0005) and more specific feedback (13% vs 22%) provided.
CONCLUSIONS: Teaching behaviors improved after participation in this faculty development program, specifically in the quality of questions asked and feedback provided.
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References
Bowen J, Alguire P, Tran L, et al. Meeting the challenges of teaching in ambulatory settings: a national, collaborative approach for internal medicine. Am J Med. 1999;107:193–7.
Crist T, Clayton C. Generalist faculty teaching in community-based settings: an interim report on the General Internal Medicine Faculty Development Project. Am J Med. 2001;111:588–92.
Anderson W, Carline J, Ambrozy D, Irby D. Faculty development for ambulatory care education. Acad Med. 1997;72:1072–5.
Clark J, Houston T, Kolodner K, Branch W, Levin R, Kern D. Teaching the teachers: national survey of faculty development in departments of medicine of U.S. teaching hospitals. J Gen Intern Med. 2004;19:205–14.
Dennick R. Long-term retention of teaching skills after attending the Teaching Improvement Project: a longitudinal, self-evaluation study. Med Teach. 2003;25:314–8.
Nasmith L, Steinert Y. The evaluation of a workshop to promote interactive lecturing. Teach Learn Med. 2001;13:43–8.
Furney S, Orsini A, Orsetti K, Stern D, Gruppen L, Irby D. Teaching the one-minute preceptor: a randomized controlled trial. J Gen Intern Med. 2001;16:620–4.
Hewson M, Copeland H, Fishleder A. What’s the use of faculty development? Program evaluation using retrospective self-assessments and independent performance ratings. Teach Learn Med. 2001;13:153–60.
Cole K, Baker L, Kolodner K, Williamson P, Wright S, Kern D. Faculty development in teaching skills: an intensive longitudinal model. Acad Med. 2004;79:469–80.
Skeff K, Stratos G, Bergen M, Sampson K, Deutsch S. Regional teaching improvement programs for community-based teachers. Am J Med. 1999;106:76–80.
Rost K, Gordon G. The teacher simulation exercise: changes in physician teaching emphasis and stategy. The SGIM task force on the medical interview. J Gen Intern Med. 1989;4:121–6.
Skeff K, Stratos G, Campbell M, Cooke M, Jones H. Evaluation of the seminar method to improve clinical teaching. J Gen Intern Med. 1986;1:315–22.
Douglas K, Hosokawa M, Lawler F. A Practical Guide to Clinical Teaching in Medicine. New York: Springer Publishing Company; 1988.
Westberg J, Jason H. Collaborative Clinical Education: The Foundation of Effective Health Care. New York: Springer Publishing Company; 1993.
Lawrence R. The goals for medical education in the ambulatory setting. J Gen Intern Med. 1988;3:S16-S25.
Halperin A, Kaufman A. Ambulatory medical education: a reconsideration of sites and teachers. J Gen Intern Med. 1990;5:S35-S44.
Hewson M. Clinical teaching in the ambulatory setting. J Gen Intern Med. 1992;7:76–82.
Jackson J, O’Malley P, Salerno S, Kroenke K. The teacher and learner interactive assessment system (TeLIAS): a new tool to assess teaching behaviors in the ambulatory setting. Teach Learn Med. 2002;14:249–56.
Lesky L, Wilkerson L. Using “standardized students” to teach a learner-centered approach to ambulatory precepting. Acad Med. 1994;69:955–7.
Gelula M, Yodkowsky R. Microteaching and standardized students support faculty development for clinical teaching. Acad Med. 2002;77:941.
Salerno S, O’Malley P, Pangaro L, Wheeler G, Moores L, Jackson J. Faculty development seminars based on the One-Minute Preceptor improve feedback in the ambulatory setting. J Gen Intern Med. 2002;17:779–87.
Marvel K. Improving teaching skills using the parallel process model. Fam Med. 1991;23:279–84.
Salerno S, Jackson J, O’Malley Interactive faculty development seminars improve the quality of written feedback in ambulatory teaching. J Gen Intern Med. 2003;18:831–4.
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The authors have no conflict of interest to declare for this work. This work was presented at the plenary session of the annual Society of General Internal Medicine Meeting, May 2004, Chicago, IL
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
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Berbano, E.P., Browning, R., Pangaro, L. et al. The impact of the stanford faculty development program on ambulatory teaching behavior. J GEN INTERN MED 21, 430–434 (2006). https://doi.org/10.1111/j.1525-1497.2006.00422.x
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DOI: https://doi.org/10.1111/j.1525-1497.2006.00422.x