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      Faculty development program evaluation: a need to embrace complexity

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          Abstract

          Faculty development is essential for renewing and assisting faculty to maintain teaching effectiveness and adapt to innovations in Health Professions educational institutions. The evaluation of faculty development programs appears to be a significant step in maintaining its relevance and efficiency. Yet, little has been published on the specific case of faculty development program evaluation in spite of the availability of general program evaluation models. These models do not measure or capture the information educators want to know about outcomes and impacts of faculty development. We posit that two reasons account for this. The first is the evolving nature of faculty development programs as they adapt to current reforms and innovations. The second involves the limitations imposed by program evaluation models that fail to take into account the multiple and unpredictable outcomes and impacts of faculty development. It is generally accepted that the outcomes and impacts are situated at various levels, ranging from the individual to the institutional and cultural levels. This calls for evaluation models that better capture the complexity of the impacts of faculty development, in particular the reciprocal relationships between program components and outcomes. We suggest conceptual avenues, based on Structuration Theory, that could lead to identifying the multilevel impacts of faculty development.

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          Reframing medical education to support professional identity formation.

          Teaching medical professionalism is a fundamental component of medical education. The objective is to ensure that students understand the nature of professionalism and its obligations and internalize the value system of the medical profession. The recent emergence of interest in the medical literature on professional identity formation gives reason to reexamine this objective. The unstated aim of teaching professionalism has been to ensure the development of practitioners who possess a professional identity. The teaching of medical professionalism therefore represents a means to an end.The principles of identity formation that have been articulated in educational psychology and other fields have recently been used to examine the process through which physicians acquire their professional identities. Socialization-with its complex networks of social interaction, role models and mentors, experiential learning, and explicit and tacit knowledge acquisition-influences each learner, causing them to gradually "think, act, and feel like a physician."The authors propose that a principal goal of medical education be the development of a professional identity and that educational strategies be developed to support this new objective. The explicit teaching of professionalism and emphasis on professional behaviors will remain important. However, expanding knowledge of identity formation in medicine and of socialization in the medical environment should lend greater logic and clarity to the educational activities devoted to ensuring that the medical practitioners of the future will possess and demonstrate the qualities of the "good physician."
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            Competency is not enough: integrating identity formation into the medical education discourse.

            Despite the widespread implementation of competency-based medical education, there are growing concerns that generally focus on the translation of physician roles into "measurable competencies." By breaking medical training into small, discrete, measurable tasks, it is argued, the medical education community may have emphasized too heavily questions of assessment, thereby missing the underlying meaning and interconnectedness of how physician roles shape future physicians. To address these concerns, the authors argue that an expanded approach be taken that includes a focus on professional identity development. The authors provide a conceptual analysis of the issues and language related to a broader focus on understanding the relationship between the development of competency and the formation of identities during medical training. Including identity alongside competency allows a reframing of approaches to medical education away from an exclusive focus on "doing the work of a physician" toward a broader focus that also includes "being a physician." The authors consider the salient literature on identity that can inform this expanded perspective about medical education and training.
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              AMEE Guide no. 34: Teaching in the clinical environment.

              Teaching in the clinical environment is a demanding, complex and often frustrating task, a task many clinicians assume without adequate preparation or orientation. Twelve roles have previously been described for medical teachers, grouped into six major tasks: (1) the information provider; (2) the role model; (3) the facilitator; (4) the assessor; (5) the curriculum and course planner; and (6) the resource material creator (Harden & Crosby 2000). It is clear that many of these roles require a teacher to be more than a medical expert. In a pure educational setting, teachers may have limited roles, but the clinical teacher often plays many roles simultaneously, switching from one role to another during the same encounter. The large majority of clinical teachers around the world have received rigorous training in medical knowledge and skills but little to none in teaching. As physicians become ever busier in their own clinical practice, being effective teachers becomes more challenging in the context of expanding clinical responsibilities and shrinking time for teaching (Prideaux et al. 2000). Clinicians on the frontline are often unaware of educational mandates from licensing and accreditation bodies as well as medical schools and postgraduate training programmes and this has major implications for staff training. Institutions need to provide necessary orientation and training for their clinical teachers. This Guide looks at the many challenges for teachers in the clinical environment, application of relevant educational theories to the clinical context and practical teaching tips for clinical teachers. This guide will concentrate on the hospital setting as teaching within the community is the subject of another AMEE guide.
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                Author and article information

                Journal
                Adv Med Educ Pract
                Adv Med Educ Pract
                AMEP
                amep
                Advances in Medical Education and Practice
                Dove
                1179-7258
                16 April 2019
                2019
                : 10
                : 191-199
                Affiliations
                [1 ]Centre for Pedagogy Applied to the Health Sciences, Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal , Montréal, QC H3C 3J7, Canada
                [2 ]Unité des Internistes Généralistes et Pédiatres (UIGP), Unité de développement et de recherche en éducation médicale (UDREM), Faculty of medicine, University of Geneva, Centre Médical Universitaire , Genève 4 1211, Switzerland
                Author notes
                Correspondence: Nicolas FernandezCentre for Pedagogy Applied to the Health Sciences, Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal , C.P. 6128 Succ. Centre-ville, Montréal, QCH3C 3J7, CanadaTel +1 514 343 6111, ext. 0788Email Nicolas.fernandez@ 123456umontreal.ca
                Article
                188164
                10.2147/AMEP.S188164
                6497855
                31114419
                e567dc3b-5d2b-4cae-b470-b3deced2072a
                © 2019 Fernandez and Audétat.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 20 September 2018
                : 22 January 2019
                Page count
                Figures: 1, References: 81, Pages: 9
                Categories
                Perspectives

                structuration theory,complexity theory,identity development,organizational norms,interpersonal relationships,program assessment

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