UNIVERSITY OF PUERTO RICO
School of Medicine
San Juan, Puerto Rico
Team Contact/Coordinator: Anibal Marin, M.D.
E-mail: a_marin@rcmaca.upr.clu.edu
Phone: 787/758-7825
Fax: 787/751-9648
Faculty Development Needs to Address at the Models That Work Conference
We would like to establish a faculty development program to prepare multi-skilled primary care faculty.
Preliminary Needs Assessment Plan
Our medical school has recently embarked on a revision of its curriculum. This revision has entailed significant changes in the way the curriculum was traditionally taught. Its main focus is on the student (student centered approach) and teaching in an integrated fashion. As of August, 1998, we have reduced the conference time by 50%, increased the active learning activities (case-based discussions, problem based learning, small group discussions, etc.) And have allocated 25% of the curriculum time to student self learning. These changes, thus far, have been welcomed by the students who are content with the close interaction with faculty members and appreciative of the reduced time spent on long lectures in a cold, passive learning environment of an amphitheater.
The above changes, however, have brought chaos to the faculty, particularly our senior faculty, who are accustomed to giving traditional lectures with minimal active interaction with students. The junior faculty, although enthusiastic with the changes, also feel uneasy in participating in active learning activities for which they have not received any official training and lack experience. They are also concerned in being facilitators or providing leadership in case discussions on topics which are not within their area of expertise.
Other important issues which are of concern to our faculty are:
1. Determining what content material should be given in lecture format, active learning activity or assigned as independent self-learning to the student.
2. How to integrate multiple disciplines in a coherent teaching process.
3. How to write exam questions which assess knowledge comprehension and not mere recall.
4. Ensure that topics such as ethics, prevention, environmental and occupational medicine, and nutrition, which influence all disciplines, are genuinely covered in the curriculum.
5. Accept the challenge to conduct active learning activities with a large class of students (115-120) when physical facilities for small group discussions are limited and faculty resources are scarce due to their demand for clinical productivity and resident supervision.
Upon reviewing the above concerns, one might concur that what is perhaps needed is an increased in the budget of the medical school in order to recruit and hire additional faculty staff. Although this might be an apparent solution for some of the problems, it does not address the real issue which is that while medical teachers are experts in their fields, most have not had an adequate training in ways of teaching effectively, particularly in an integrated curricular environment. We strongly believe that Faculty must be taught how to teach effectively.
Thoughts on Faculty Development Program
Clinical faculty have always been utilized in the teaching of third and fourth year medical students during their clinical rotations in ambulatory and hospital settings. Occasionally they have also been used to provide clinical correlations for first and second year students during their basic sciences years. However, with the advent of the new integrated curriculum and its emphasis on generalism, these clinicians are being asked to collaborate more closely with their colleagues of the basic sciences in the design of cased-based curricula, PBL and as facilitators for small group discussions. This is particularly true for the primary care physicians - family medicine, general internal medicine, and general pediatrics. They are being sought after for their general expertise on what is important rom a clinical perspective to teach to medical students and their broad knowledge and skills in patient care. They are considered to be multi skilled because they can effectively interact in a wide variety of teaching situations. For the most part they possess those "people skills" which facilitate student/patient - teacher/doctor communication and have already learned their own integrated curriculum throughout their years of clinical practice. What they lack is formal training in educational methodology.
We are proposing to establish a faculty development program which addresses our need to prepare a cadre of multi skilled faculty from the primary care specialties who would become the primary mediators of the integrated curriculum. That is, they would assist their colleagues in the design and implementation of the curriculum and act as facilitators in the various active learning modalities required by the new curriculum.
Some of the areas in which most of our primary care faculty lack formal training are: preparation and use of standardized patients and OSCE'S, computer assisted instruction, concept mapping, case writing, writing USLE type questions, mentoring, group dynamics, and others.
We have initially identified three members of our junior faculty from the primary care specialities, one from each discipline, and two community preceptors who have expressed interest in participating in the program. We are also proposing the creation of an "academic fellowship" for chief residents in these disciplines, in order to start an early recruitment and enable them to acquire effective teaching skills during their residency years.
Should our institution be accepted as a pilot site, we are confident that with your expertise and experience with models which have been successful, we can achieve the development of our program. To quote Victor Hugo..."no army can withstand the idea whose time has come."
