Preparing healthcare professionals for teaching is regarded as essential to enhancing
teaching effectiveness. Although many reports describe various faculty development
interventions, there is a paucity of research demonstrating their effectiveness.
To synthesize the existing evidence that addresses the question: "What are the effects
of faculty development interventions on the knowledge, attitudes and skills of teachers
in medical education, and on the institutions in which they work?"
The search, covering the period 1980-2002, included three databases (Medline, ERIC
and EMBASE) and used the keywords: staff development; in-service training; medical
faculty; faculty training/development; continuing medical education. Manual searches
were also conducted. Articles with a focus on faculty development to improve teaching
effectiveness, targeting basic and clinical scientists, were reviewed. All study designs
that included outcome data beyond participant satisfaction were accepted. From an
initial 2777 abstracts, 53 papers met the review criteria. Data were extracted by
six coders, using the standardized BEME coding sheet, adapted for our use. Two reviewers
coded each study and coding differences were resolved through discussion. Data were
synthesized using Kirkpatrick's four levels of educational outcomes. Findings were
grouped by type of intervention and described according to levels of outcome. In addition,
8 high-quality studies were analysed in a 'focused picture'.
The majority of the interventions targeted practicing clinicians. All of the reports
focused on teaching improvement and the interventions included workshops, seminar
series, short courses, longitudinal programs and 'other interventions'. The study
designs included 6 randomized controlled trials and 47 quasi-experimental studies,
of which 31 used a pre-test-post-test design.
Despite methodological limitations, the faculty development literature tends to support
the following outcomes: Overall satisfaction with faculty development programs was
high. Participants consistently found programs acceptable, useful and relevant to
their objectives. Participants reported positive changes in attitudes toward faculty
development and teaching. Participants reported increased knowledge of educational
principles and gains in teaching skills. Where formal tests of knowledge were used,
significant gains were shown. Changes in teaching behavior were consistently reported
by participants and were also detected by students. Changes in organizational practice
and student learning were not frequently investigated. However, reported changes included
greater educational involvement and establishment of collegiate networks. Key features
of effective faculty development contributing to effectiveness included the use of
experiential learning, provision of feedback, effective peer and colleague relationships,
well-designed interventions following principles of teaching and learning, and the
use of a diversity of educational methods within single interventions. Methodological
issues: More rigorous designs and a greater use of qualitative and mixed methods are
needed to capture the complexity of the interventions. Newer methods of performance-based
assessment, utilizing diverse data sources, should be explored, and reliable and valid
outcome measures should be developed. The maintenance of change over time should also
be considered, as should process-oriented studies comparing different faculty development
strategies.
Faculty development activities appear highly valued by participants, who also report
changes in learning and behavior. Notwithstanding the methodological limitations in
the literature, certain program characteristics appear to be consistently associated
with effectiveness. Further research to explore these associations and document outcomes,
at the individual and organizational level, is required.