Impact Of Faculty Development Programs On Medical Teachers Education Essay

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Tejinder Singh, Department of Pediatrics, Christian Medical College, Ludhiana. Willem De Grave, Department of Educational Development, Maastricht University, The Netherlands (Co-Supervisor). Cees Van der Vlueten, Department of Educational Development, Maastricht University, The Netherlands (Supervisor)

Faculty development, staff development or professional development is an important pre-requisite for academic growth and vitality. Faculty development (FD) has been defined as the broad range of activities that institutions use to renew or assist the faculties in their varied roles (Centra, 1978). It can include initiatives aimed at improving the effectiveness of the faculties in teaching, research or administration (Sheets & Schwenk, 1990). FD also aims at improving practices and ability at managing change (Bligh, 2005) by enhancing individual as well as organizational capabilities. Most of the FD programs target the instructional abilities as instruction is the central and most visible of all teaching activities. However, a number of programs have targeted other areas as well, including research, writing skills, administration etc. (Burdick, Morahan, & Norcini, 2007).

Training is a relatively costly intervention. It involves not only the direct training costs but also indirect costs related to travel, absence from place of work and replacement of the person being sent for training. It is but natural that any organization investing in training including FD will like to seek evidence for effectiveness or outcomes of such an intervention. Providing evidence of effectiveness of these programs has been a major challenge (Burchell, Dyson, & Rees, 2002). Guskey (Guskey, 2002) rightly points out that it is difficult to prove the outcomes of FD programs but we can surely collect evidence to suggest that these programs produce certain outcomes.

Measuring the effects of FD has been considered as a priority area for research (Dalen, 2008). We need to look at the changes that FD programmes induce in teachers in addition to the data so often collected as a proof of outcome. Self-renewal of faculty has to do more with change in thought process rather than simple acquisition of new skills. Isolated attention to behaviors is unlikely to produce the desired change. A better strategy seems to be target changes in behaviors as well as beliefs and norms. (Argyris & Schon, 1996). Anecdotes and testimonials, although considered subjective and poor data sources, can provide good personalized evidence that most people believe. (Guskey, 2002).

Most evaluations of FD programs are limited to immediate vicinity of the program and rely on quantitative measures. These include participant satisfaction, short term gain in knowledge, application of the newly acquired skills and effects on the student learning and/or the organization. The long term studies of the impact have been sparse. Even where reported, such effects include objective markers of application like presentations, publications, promotions and leadership positions (Morzinski & Simpson, 2003; Marks, 1999; Steinert, Nasmith, McLeod, & Conochie, 2003). However, these narrowly defined quantitative program outcomes may miss the detection of deeper and more sustained changes in participants' personal and professional growth. (Knight, Carrese, & Wright, 2007b)

The BEME review of research on FD (Steinert et al., 2006) reported that 74% of the published studies assessed the reactions of the participants. These reactions were assessed using Likert type scales and generally rated participant satisfaction from poor to excellent. Change in attitudes was also measured using pre- and post designs. A few studies also reported change in knowledge, while some others focused on changes in teaching behavior. However, insight into some of the key issues such as the factors which motivated the participants to come for the programme, how their thought process changed and what it inspired has not been adequately captured. There has been little or no examination of how individual trainers have acquired or applied the skills and no clear theoretical framework exists to describe how medical teachers develop (MacDougal & Drummand, 2005). The BEME review (Steinert et al., 2006) specifically noted the paucity of studies which focused on the process orientation and those which used qualitative methodologies to find the impact of various interventions. These methodologies will also help us to capture the complexities of what happens during and after FD interventions. Most of the FD programs aim to bring change in educational practice. The change can be directed towards the individual teachers or towards the educational organization. The interventions for both differ as do outcomes of each (Donnelly, 2008). Given the complicated nature of change, the impact of FD programs is difficult to be captured in narrowly defined quantitative studies. (Knight, Carrese, & Wright, 2007a)

Many of the FD programs are still of a generic nature, aimed at promoting the latest policies amongst teaching communities. Authentic development should recognize genuine needs of teachers as thoughtful adult learners (Schwarz, 2010). Using teacher narratives has been considered as one of the ways to build on the narratives of experience and design programs accordingly. It can serve both as an impetus for research and a method of enquiry. In another study (Shehu, 2009), participants felt that professional development programs are often generic and fail to mesh up with the subtleties and nuances of teaching and learning a particular subject. They also felt the needs for deconstruction of such programs to establish connections with teachers' livid experiences in actual settings. Such insights are difficult to come by in a typical quantitative evaluation.

The change in thought process of the teachers following participation in a FD program is generally assessed using self-reports and this seems to be a weakness of the entire approach. Self-reports are generally considered inconsistent and unreliable measures of program outcomes. However, studies have shown (D'Eon, Sadownik, Harrison, & Nation, 2008) that self-reports can provide fairly reliable and consistent measure of outcomes. It is possible to improve reliability of such reports by aggregating the individual responses. By combining the reports from a number of respondents, unreliability is ironed out (D'Eon & Eva, 2009). Averaging across numerous self-assessments helps us to dilute the error to the point of being able to determine the effectiveness of the intervention. Further, as the scores changed over pre and post intervention assessments, they provided validity evidence for self-assessments ( D'Eon, Sadownik, Harrison, & Nation, 2008). Other authors (Burchell, Dyson, & Rees, 2002) have also accepted the utility of self-reports as being important vehicles for evaluating the impact of FD programs. It has been argued that self-reports form the basis on which unique individual patterns of learning and development can be identified. Teachers' explanation of the ways in which this relates to changing class room practices indicates that learning has been internalized and embedded in practice. This also suggests having a flexible approach in interpreting the relationship between professional development and its impact. The authors suggest that "the ability to articulate the interplay between the tangible outcomes and the more affective, motivational and value based dimensions that suggest to us a more secure shift in professional development".

There have been some reports of impact of FD programs using qualitative approach and have reported some interesting and useful findings. A study to find out long term impact of FD programs using qualitative approach found that the program affected the participants' professional as well as personal life (Knight, Carrese, & Wright, 2007a). Based on the open ended responses provided by the respondents, researchers identified four major domains viz. intrapersonal development (changes in self and approaches to self-management), interpersonal development (interaction with others), development as a teacher (teaching ability) and career development (professional growth and career opportunities).

Donnelly (2008) explored the self-perception of change in teaching practices following a FD program. All the respondents indicated that their teaching practices had changed. The most significant changes included reflection on current teaching, use of new teaching strategies, an increase in confidence about teaching and a more student centered approach to teaching. Teachers reported (Swan & Swain, 2010) a change in practice from transmission and constructivist to connectionist orientation. This orientation is important to help teachers to develop a connection between their prior knowledge and the new concepts being taught.

Another major area of impact of FD programs has been their ability to improve the self-perceptions of the participants regarding their teaching skills. Rowe (Rowe & Skyes, 1989 ) demonstrated strong positive effects on professional self-perceptions. Energy, enthusiasm and satisfaction with teaching showed a significant improvement. Belief in own efficacy as teacher or self-efficacy beliefs (SEB) is another area which has been investigated as a possible outcome of FD programs. Improvements in SEB are considered important because higher SEB have been shown to be associated with student achievement (Ashton & Webb, 1986) and motivation (Midgley, Feldlaufer, & Eccles, 1989). Setting better goals and planning (Allinder, 1994), accepting students less critically (Guskey, 1988; Ashton & Webb, 1986) and greater enthusiasm for teaching (Guskey, 1984; Martin, McCaughtry, Hodges-Kulinna, & Cothran, 2008) have also been reported to be affected by these beliefs.

Other research has also indicated that FD programs lead to a change in the way of professional thinking and acting. Participants also seem to believe that the changes are attributable to participation in the program. (Flecknoe, 2002). They also believed that certain changes visible in their departmental colleagues could also be attributed to the process of diffusion by observing changed behavior of the participant.

Participation in FD programs allowed teachers to feel confident about changing curriculum delivery (Grieve & McGinley, 2010). They felt an enhancement in their status within the institution and a diffusion of effect to even those who had not participated. Participants reported more involvement in school activities, reflecting a practical leadership style, which was flexible, situational and distributive.

Most of the studies reviewed above have been conducted on elementary of K 12 school teachers, where formal education in teaching methods is the norm. There is a paucity of studies involving medical teachers. It is important to explore this area because participation in FD programs is voluntary, a lot of skills teaching is involved and the participants of such programs deal with adult learners rather than with school children. The present study is designed to explore the impact of FD programs on medical teachers using qualitative methodology.

Context:

A number of programs for FD are of a longitudinal nature and aim at changing the thought process of the participants and enhanced peer support through a community of practice in addition to imparting specific knowledge and skills.

FAIMER Regional Institute Fellowship (FRIF) is being offered to faculty in South Asia since 2005 through 3 regional institutes. The fellowship is a 2years longitudinal program with 2 onsite sessions of 1 week each at the beginning and after 1 year. The first onsite session equips the participants with knowledge about educational methods, assessment, change management, conflict management and educational networking. In addition, participants work on refining the curriculum innovation project submitted as part of the application process and in the context of that proposal learn about program evaluation. Intersession period is devoted to intensive listserv based discussions on various topics selected by the participants through a multi-voting process. At the end of one year, they return to present the outcome of their project as well as learn about advanced educational methods, writing for publication, educational scholarship and strategies to sustain change. Another year is spent in listserv discussions as described (Anshu, Bansal, Mennin, Burdick, & Singh, 2008). Throughout the program, emphasis is on experiential learning and a deliberate effort is made to create educational networks and develop mentoring relationships between new and returning fellows. A total of 56 Fellowships are offered every year through the regional institutes. A total of ….. teachers have successfully completed the Fellowship program.

Methodology

E mail invitations will be mailed to all the Fellows who have completed the Fellowship program. Purpose of the study will be explained to them and a survey tool will be mailed to those who indicate their willingness to participate. The covering mail will inform them that participation is optional and completing and sending the survey will be taken as consent to participate. Those completing the survey will be given a complimentary copy of the 3rd edition of the book Principles of Medical Education by Tejinder Singh, Piyush Gupta and Daljit Singh.

The survey will collect basic demographic information and information about teaching activities. The respondents will be asked to rate 2 statements (effect of the program on their professional and personal life) on a 4 point scale (0= none; 1= a little; 2= moderate; 3= a lot). They will also be asked to respond to the open ended questions using as much description as possible. In addition, they will also be asked to provide specific examples and instances to support their statements.

The responses will be analyzed using grounded theory approach to evaluate the impact of participation in a longitudinal FD program using qualitative methodology.

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