The Role of Faculty Development in a College of Medicine’s Promotion and Tenure Process*Mark H. Gelula, Ph.D., Richard P. Foley, Ph.D. Department of Medical Education (M/C 591)University of Illinois at Chicago College of Medicine
This paper describes the history and genesis of an institutionalized approach to faculty development at the University of Illinois at Chicago College of Medicine (UICCOM). Additionally the paper provides data about participant progression in the promotion and tenure (P&T) process, describes the program structure, examines the evolution of the program and review participant evaluations. The program, Scholars for Teaching Excellence (STE), is a direct result of an initiative from the Dean of UICCOM who underscored the importance of quality teaching and emphasized it in the College’s promotion and tenure P & T process. The STE program is institutionalized because it is integrally linked to the promotion and tenure process and because it is an on-going, non-episodic activity which encompasses all departments and reaches the College's junior teaching faculty. Institutionalization of faculty development is unusual in medical education. A thirty-year history of faculty development in medical education reflects episodic programming which sporadically seeks to meet the needs of faculty typically through workshops and brief courses about topics of momentary interest. These efforts generally are without institutional support. This pattern has remained static, essentially today the same as three decades ago.1,2.3 Background Promotion and tenure processes commonly examine faculty progress as summative events. Materials describing the candidate’s achievements in publications, grants, and standing in the national and international academic community have been central to a successful review. For research faculty, these guidelines have been more or less appropriate and certainly historically consistent.4 For clinical faculty in a college of medicine, these same guidelines are no longer appropriate given their focus on clinical activities and teaching versus attention to research and publication As academic faculty, clinicians are expected to maintain the same high national and international profiles as their research colleagues. In addition, they must teach and perform clinical work. This clearly seems unfair. Other avenues, such as teaching, should be considered that allow clinicians a path to promotion. Recognizing the inherent problem of this practice, in 1996 UICCOM established a process which supports clinical teachers’ teaching activities as a basis for tenure and promotion. The new system has been heralded as a process which seeks to advance the role of teaching as central to the College of Medicine. It offers a venue by which all faculty may define their teaching strengths and identify their deficiencies. Essential to the process is a set of guidelines and procedures for documenting teaching, "Evaluating Teaching in the College of Medicine: A Handbook." which was disseminated to each department and faculty member eligible for tenure or promotion. All junior faculty who were likely to be interested in this option were recipients. Providing procedures, schedules, and evaluation forms to document teaching involvement and effectiveness, the handbook’s materials are the foundation of a faculty member’s teaching portfolio.5 To supplement the materials, the Dean requested that a faculty development program be established to specifically support the improvement of teaching. His intention was that the program help all junior faculty who sought tenure. It became the primary author’s role to develop and implement this program. Prior to the implementation of the Scholars for Teaching Excellence program, Foley completed a survey of all faculty in the College of Medicine regarding their needs and interests with respect to a variety of topics on instruction and curriculum. The survey was structured to mirror a previous needs assessment conducted at UIC twenty years before in order to determine the extent to which faculty had changed their views about faculty development.6 Both instruments asked faculty to rate their interests in participating in workshops or short programs given a list of instructional topics. Content included areas such as lecturing skills, leading small groups, supervision and feedback, and writing multiple choice questions. The instrument also solicited favored formats for faculty development, including, for example, an option for departmentally focused programming. Few differences were seen in the results between the two survey periods. In each survey the majority of respondents indicated preference for single session formats of two-to-three hours duration, and minimal departmental interest was expressed despite the fact that departmental faculty development was taking place. Knowing the shortcomings of episodic workshops, it was clear that another way to interest and involve faculty was necessary. An institutional perspective was envisioned which led to the following tenets: 1) junior faculty would be trained to be expert teachers; 2) the program would support professional and faculty development, 3) each participant would develop a professional teaching portfolio, 4) the participant group would be interdisciplinary, meet at regular intervals for a specific duration, cover an explicit curriculum, and foster a network of faculty teaching scholars; 5) these scholars would ultimately support other faculty development efforts and could serve as consultants to their own departments, mentor other junior faculty, and ultimately serve as STE instructors as the program grew. It was conceived that an individual would remain in the program as long as they were interested, regardless of tenure status. This scheme required significant college-wide support. Supporting the idea, the Senior Associate Dean for Medical Education introduced the STE program’s concept to each Department Head and Section Chief by letter. Meetings were held with the majority of the heads of clinical departments to introduce the program, describe the syllabus and obtain the names of junior faculty who were likely to be interested. Regretfully, no meetings with basic science heads materialized. Through this strategy, an initial group of 27 persons was recruited. Now in its third year, STE counts more than fifty junior faculty participants and program alumni, for whom the appeal has been teaching versus clinical or bench research. Participants and alumni represent eleven specialties and approximately 30% of the tenure track junior clinical faculty. This continued level of participation is a mark of the program’s success as are data on the following topic. Participant Progress in the P&T Process Several STE participants and program alumni are actively in pursuit of tenure having passed their midway probationary review. One has received tenure using an extended teaching and educational research portfolio to support her application, another has recently submitted final P&T papers and a teaching portfolio, and a third, midway in her six year P&T process, was complemented by her Department Head for the organization and completeness of her portfolio. The Head later recommended this person as a model and resource for others in the department. Three STE alums – two from the same department ¾ have been given new leadership positions, one as an assistant dean for the UIC College of Medicine preclinical curriculum, one as a residency director, and the third as a student clerkship director. One very active alumnus has just been selected as one of two Fellows in the college's Faculty Development Fellowship program. Ten others are actively completing the required portfolio materials as part of their efforts to remain on the tenure track. It would be very simple to create a curriculum and then teach it through a combination of small group work, lecture, and readings. Moreover, we could have used the standard faculty development practice of utilizing videotape review with follow-up discussion. Instead a comprehensive process has been designed which uses both these methods and more.
Every element of the program is based on reflective theory.8 At least four program elements encourage reflective thinking:
Program Evaluation Participants identified the following priorities for their development as they became more sophisticated about teaching and learning issues: 1) improvement of clinical teaching, 2) increased skill and comfort with lecturing skills, and 3) improved facilitator and small group instructional practice skills. Reflection on these needs led to a reconceptualization of STE’s goals which are to assist faculty to: a) strengthen clinical teaching and lecture skills, b) develop sound curriculum and evaluation strategies, c) explore research opportunities available through teaching, d) create a network of faculty teaching scholars who support each other and effectively serve as consultants to their own departments, and e) establish high quality professional teaching portfolios to serve as a foundation for each faculty participant’s promotion and tenure package. Participant expectations have matured to the point where suggestions for in-depth review of certain topics, requests for readings, and discussion of experiences in their own clinical teaching settings are now presumed. Participants appear to have learned how to discuss teaching issues openly and reflect on them privately. Just as reflection supports individualized learning, collaborative learning is the foundation of group learning. A variety of small group teaching methods which support collaboration are used. Because this is instruction-on-instruction, the rationale for why specific instructional methods are used is consistently examined, as is an exploration of how these and other teaching strategies could be employed in the participants' clinical teaching settings. Over time, the group has become more sophisticated and responsive to individual members and to group needs, even as new members join and complete the program. Not surprisingly, the instructor’s teaching has become more dynamic, creative and attentive to participant’s wishes. For example, in one case, a participant, his peers and the instructor united to explore a teaching problem. The analysis ultimately mimicked the standard manner in which patient problems are diagnosed (i.e., history, data, hypothesis generation, and potential treatment and management plans). For the instructor, that particular session led to greater awareness of the appropriateness for spontaneous teaching and the creative use of analogy for teaching instructional processes. It also reinforced his commitment to collaborative learning and other social learning models of education and how they can be applied to adult education and clinical teaching. This example typifies the variety and flexibility of content and teaching which has evolved since the teacher-centered focus of earlier STE sessions and exemplifies a method for motivating exceptional adult learners.9 Much of the STE program consists of activities outside of group meetings. Consultation has included: 1) observation of small group teaching, lectures and clinical teaching, 2) assistance with the preparation of small group sessions, 3) assistance in the planning of a new curriculum, 4) discussions regarding the meaning of course or program evaluation data, 5) work with a participant as she organized and ran faculty development sessions for her department, and 6) review of papers planned for publication and review of posters prior to display at a scientific conference. From personal feedback we can infer that this consultation has benefited participants well beyond the gains they felt were made during group sessions. Formative evaluation has led to the suggestion that the two are actually complementary. Participant Evaluation Participants have been requested to provide formal responses to brief questionnaires at three intervals over the past three years. In the first, respondents were asked about the program, giving concrete examples of their experiences and what they had learned, noting the relationship of their comments to their teaching effectiveness and their personal needs. Participants were also asked to suggest ways in which the program should be modified. While a few suggested greater program structure, most praised the openness of the sessions and their highly interactive nature. Also convincing, were the suggestions that the collaborative group structure compelled participants to find strengths for themselves from others’ teaching presentations, grow from the interdisciplinary nature of the group, and following discussions, explore alternative teaching methods. "The participants have been an excellent resource for ideas," noted an emergency medicine physician who reflects what has come to be a critically approved strength of the program over its three year history. Like her, most now believe that the mix of discipline specific perspectives, the variety of group exercises used to facilitate discussion, and the ensuing discussions led them to think about their personal approaches to teaching. Responses to the second evaluation survey were different. When asked what changes they had made in their teaching as a result of the STE program, respondents provided examples of courses developed, new approaches taken to teaching, and other specific experiences. A few participants offered illustrative examples which included: 1) more hands on teaching for students (with patients); 2) use of more open-ended questions; 3) increased use of questions during lecture to promote involvement; 4) using more small group sessions with differing formats; 5) working with others to develop and implement teaching sessions; 6) changes in how individuals taught their residents to teach; 7) improved documentation of teaching efforts and evaluations for their P&T portfolios; 8) improved feedback methods to residents and to students, and; 9) greater awareness of the importance of "wait-time" in questioning. The time to wait ("wait-time") for an answer to a question, rather than "jumping in" to answer for a slowly responding student is an acquired skill, often difficult to learn, among inexperienced teachers. Through the group sharing process, participants have confirmed that some of their experiences, while often difficult and frightening, are not unusual among neophyte teachers, and that the presence of a teaching model in the instructor has been highly beneficial. The third evaluation revealed considerable breadth about participants thinking. Equally varied were their attempts at change. Reflective learning and making the "reflective turn"10 are central conceptual organizing elements for the program. Thinking about and testing new teaching methods, inside and outside of STE program sessions, fosters growth by each individual member. This deliberate risk-taking by Fellows has also led to STE’s enhancement and is the basis upon which the standardized medical student program element was introduced. Eventually we will need to determine additional outcomes: to what extent are participants influencing their peers, and in what ways? Is there additional evidence of increased effectiveness and creative teaching? In what more rigorous ways can we assess teaching productivity? What long-term effects does the STE program have on efforts of teaching and curricular reform in the College? Conclusion The qualitative data described here are completely formative. They have been used to support the contention that the program has changed and has been accepted as a force for personal and professional improvement by STE’s participants. These data also demonstrate that institutionalization of the program has begun. Behavioral changes are being evidenced, more and more faculty are hearing about the program, there are new participants, some have reached stages where promotion and tenure is a likely event, participants are achieving important educational leadership roles, and lastly, many participants are themselves disseminating teaching information to others. Ongoing evaluation will continue to examine personal perceptions. Additionally, as the program matures and more participants move toward tenure, it is anticipated that the documentation of teaching materials should provide quantitative information to illustrate how participants spend their educational time, how they are reviewed by their department heads and senior faculty, and the extent to which outside evaluators perceive the strengths of their teaching portfolios. In conclusion, the program described here has demonstrated that it can make a difference in the way teaching improvement occurs in a college of medicine. It has distinguished itself as different from other faculty development programs and can be replicated in the following ways:
These five findings may be seen as an integrated model which serves a keystone to the STE program’s success. References
Reference: Gelula MH, Foley RP. The role of faculty development in a college of medicine’s promotion and tenure process. Med Educ Online [serial online] 1999;4,3. Available from URL http://www.Med-Ed-Online.org Correspondence should be addressed to: Mark H. Gelula, Ph.D Phone: 312 - 996 - 2696 |