UNIVERSITY OF HAWAII
John A. Burns School of Medicine
Honolulu, Hawaii
Team Contact/Coordinator: Gordon Greene, Ph.D.
E-mail: greeneg@jabsom.biomed.hawaii.edu
Phone: 808/956-9984
Fax: 808/956-4461
Faculty Development Needs to Address at the Models That Work Conference
We need assistance in developing the faculty development framework for coordinating and integrating all elements of our methods of training faculty to become excellent tutors in our Problem-Based Learning curriculum.
Preliminary Needs Assessment Plan
For the past 10 years, the John A. Burns School of Medicine has trained its first and second year students with an extensive problem-based learning (PBL) curriculum. The foundation of their training during these years is their small-group tutorial during which they encounter roughly 80 carefully designed healthcare problems organized into five units. This training is supplemented by focused lectures as well as clinical skills training and experiences in community medicine bu t the PBL tutorial is the clear centerpiece of training.
As one would expect, from the beginning there have been programs to train faculty members to serve as PBL tutors. Now, however, given the evolution of our PBL teaching methods and changing circumstances within our school over the last several years, we have a need to redesign the ways in which we develop faculty members as tutors. We are beginning to address these issues, both through informal discussion with many of those engaged in our PBL curriculum. Our interest in this HRSA conference and program stems from our recognition that we need to have a well-designed faculty development program that is effective and well integrated into the overall management of our curriculum.
Below are listed several of the issues we face and some ways in which we will be addressing them:
1) Over the last three years, the school has gone through a significant reduction in state-supported positions for teaching and there has been corresponding reduction in the number of faculty available to serv as PBL tutors. Whereas we previously had the luxury of exposing many faculty to PBL methods and then filling the pool of tutors primarily with those who found this method both easy and intuitive, we now have a greater need to actually develop tutors who may not initially find PBL tutoring to be easy and intuitive. We need to methodically teach and practice those skills that make a good tutor.
Plan: We have proposed (and are having reviewed) a set of ten seminars on topics in PBL tutoring. Each one would be offered as a 1-3 hour workshop at least once year. These seminars reflect our goal of becoming much more explicit in identifying and teaching skills that will optimize the PBL methods we use.
2) If we are going to make a greater emphasis on the development of tutoring skills, we need a greater emphasis on formative tutor evaluation as well. We currently have students evaluate their tutors but, by policy, that feedback can only go to the tutor and to his/her course director. This makes it difficult to have an accurate overall perspective on the strengths and weaknesses of the tutors. It also makes it difficult to provide specific help in skill development to tutor in a timely fashion.
Plan: There is an ongoing discussion with department and unit chairs regarding the methods and policy issues involved in evaluating tutors. It is clear that we need a system that goes beyond student evaluation of faculty but how to do that fairly and efficiently is unclear.
3) Adoption of the PBL curriculum has placed central governance of medical education in the hands of an interdisciplinary MD Program Committee. While course content and assignment of teaching are no longer the responsibility of department chairs, issues of recruitment of new faculty, development of faculty, tenure and promotion and post-tenure review are largely determined by department chairs. Given this we find that department chairs who are often not trained as PBL tutors are responsible for evaluating faculty member's tutoring skills. A number of chairs have asked that we develop a summative evaluation system for faculty to be used school-wide in issues of promotion, tenure and faculty development.
Plan: We are discussing a plan whereby a group of "master tutors" are designated. This group becomes the faculty for our faculty development program and serve as resources for faculty seeking help. They also will be given the responsibility of evaluating tutors periodically and providing summative and formative feedback to the proper department chairs.
4) As our PBl curriculum has matured, we have begun to acknowledge that the PBL that occurs in the firs 15 weeks of medical is different than the PBL that occurs at the end of the first year and is different from the PBL that occurs at the end of the second year. Given this, the chairs of the different units of PBL instruction are asking for more specific training and preparation of their tutors.
Plan: As an example, next month we will begin using a new model of tutor training. Instead of training a large number of potential tutors in the generic skills of PBL tutoring, we will be training four faculty specifically to tutor in Unit 5, a group of cases used over twelve weeks at the end of the second year when students themselves are already well-versed in PBL methods.
5) We have begun sharing our expertise in the development and use of PBL curricula with faculty from other medical schools and we would like to expand our capability to do this, both through introductory workshops as well as long-term consulting relationships such as one we have with Sung Kyun Kwan University in Korea. There certainly is overlap in the types of activities we do for our faculty and for outside faculty but we would like to better align our objectives in these areas so that we can justify this use of limited resources.
6) Currently, there are few extrinsic rewards for tutoring effectively; tenure and promotion within this university are still based largely on publication records and our school does not have a specific track for medical education teaching that is recognized. In addition, those faculty who have redirected their academic efforts to medical education teaching do not know how to develop teaching portfolios. We know that such expertise exists nationally and we would like to find assistance in developing a specific medical education/teaching promotion track for our faculty.
