Embedding faculty development in teaching hospitals: moving beyond the status quo.
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ABSTRACT: The Objective Structured Teaching Encounter (OSTE) has been proposed as a means of promoting and assessing the teaching skills of medical faculty. To describe the uses of the OSTE and the evidence supporting its effectiveness. MEDLINE (January 1966 through February 2010) was searched for English-language studies detailing the use of an OSTE for any educational purpose. Reference lists from relevant review articles and identified studies were also searched. Of the 354 papers initially identified, 22 were included in the review. The OSTE has been used to assess and improve teaching performance and to assess the impact of other means of faculty development. Although qualitative results have been generally positive, there is little quantitative data to support using the OSTE as a means of improving teaching performance. There is moderate evidence suggesting the OSTE is a reliable and valid means of assessing teaching, although few ratings instruments have been adequately studied. The OSTE is a promising innovation with potential application to assessing and promoting the teaching skills of medical faculty. Further study is required to determine the most effective OSTE design.Medical Teacher 01/2011; 33(11):893-903. · 1.82 Impact Factor
Article: LETTER TO THE EDITOR
- Journal of General Internal Medicine 10/2004; 19(9):989; author reply 989. · 3.28 Impact Factor
Blackwell Publishing, Ltd.
Embedding Faculty Development in Teaching Hospitals
Moving Beyond the Status Quo
In this issue of the
Clark et al. present valuable data on the spread of faculty
development (FD) programs in U.S. teaching hospitals.
Their findings indicate moderate diffusion, with 39% of
hospitals having “ongoing” programs. The results also show
significant institutional barriers to FD. Current FD efforts
can be largely attributed to the internal motivation and
dedication of faculty to the FD mission. However admirable,
individual motivation will not be sufficient in the current
academic environment to spur greater efforts to improve
For FD on teaching to become integral
to departments of medicine, we must both increase aware-
ness of the potential for FD to benefit faculty and their
institutions, and establish a research agenda to guide FD
policy and practice.
Teaching improvement appears inconsistently valued
by schools and departments. From interviews with the
facilitators we have trained at the Stanford Faculty
Development Center, we know that the participants and
content of FD activities can remain under-recognized, if
not invisible, to key administrators. It is incumbent upon
faculty developers to more effectively publicize their
programs’ potential benefits and outcomes.
From an historical point of view, the time may be right
for institutions to implement FD on teaching—gaining
benefits directly relevant to their patient care and research
missions. With national attention focused on physician
professionalism, patient safety, and even new approaches
to training medical scientists, the success of prior medical
education methods must be brought into question.
need for more effective teaching is clear. In our own
experience, we have seen FD participants show greater
commitment to specific areas of clinical care (e.g., geriatrics
and palliative care), stronger dedication to institutional
improvement, and increased involvement in scholarly
activities (e.g., research, publication, and self-directed
learning). We also have seen FD participants acquire more
positive attitudes toward their role as clinician-educators.
Further demonstration of such benefits in today’s climate
can lead to increased recognition of the utility of FD, and
thereby, greater institutional support.
This survey also provides a stimulus for continued
research on faculty development. A broad-based FD research
agenda for contemporary academic medicine is needed
to understand the effects of context, process, topics, and
types of participating faculty on FD outcomes. New research
Journal of General Internal Medicine
is needed because the current depth and rate of institu-
tional change may yield results that differ from prior
RESEARCH ON CONTEXT
What difference does the presence of offices of medical
education or “faculty development directors” or a “critical
mass” of previously trained faculty make to continued
implementation of faculty development at institutions?
How do hospital re-organizations affect support for FD?
Who sets the vision for FD at an institution? Does the
inclusion of methods targeting institutional change help
participants overcome institutional barriers?
RESEARCH ON PROCESS
What are the effects of differences in training method,
extent of training, and type of facilitators on the acquisition
of knowledge or skills critical to teaching? Although it
might seem ideal for faculty to be involved in long-term,
comprehensive FD, the potential for increased attend-
ance associated with briefer courses may ultimately make
them more effective for institutions as a whole.
Can we develop new methods of delivery to expand on
those in common use? Can regional and national training
extend the reach of faculty development to greater numbers
of teachers? What is the effectiveness of various diffusion
models (e.g., opinion leader, change agent, train-the-trainer,
and champion models) in addition to those factors examined
in this survey. What types of longitudinal (or booster)
training are useful for individual teachers as they evolve
in their careers? Can computer-based technologies make
FD accessible to populations of teachers who find it difficult
to attend more traditional methods?
RESEARCH ON TOPICS
As medicine changes, faculty are responsible for teach-
ing new skills and knowledge to medical trainees, such as
the new goals for trainees by the Accreditation Council
on Graduate Medical Education
learning and system-based care. These goals provide the
stimulus for new programs in faculty development. For
example, the Stanford Faculty Development Center has
recently developed a program in “Contemporary Practice”
to help faculty teach trainees to take a more active role in
Volume 19, March 2004
the success and improvement of their medical care system.
Further research to identify topics most relevant to faculty
and institutional needs can guide the allocation of FD
RESEARCH ON FD PARTICIPANTS
As shown in the article by Clark et al., participation
in FD varies across faculty with different backgrounds
(generalists vs subspecialists) and those teaching in differ-
ent settings (e.g., university vs community). Learning how
FD programs can assist a greater variety of faculty will
extend the impact of FD. Generalist faculty have benefited
from the grants on faculty development in primary care.
Yet, subspecialist teachers also face serious educational
challenges and could use assistance. Additional com-
parison groups might include junior vs senior faculty and
basic science vs clinical faculty. Needs assessment across
faculty groups can guide the development of more effective
The paper by Clark et al. shows us that, although
not optimal, FD on teaching skills has a presence in
departments of medicine nationally. The results highlight
opportunities for further program development and
research to ensure that faculty development becomes
integral to the culture of medical education.—
Merlynn R. Bergen, PhD
, Stanford University School of Medicine, Stanford,
Kelley M. Skeff,
1. Clark JM, Houston TK, Kolodner K, Branch WT, Levine RB, Kern
DE. Teaching the teachers: national survey of faculty development
in departments of medicine of U.S. teaching hospitals. J Gen Intern
2. Mangan KS. Physician, teach thyself. Chron High Educ. 50 (14): A18.
3. Cohen JJ. Our Compact with Tomorrow’s Doctors. Acad Med. 2002;
4. The Academic Medical Center Working Group of the Institute for
Healthcare Improvement. The Imperative for Quality. A Call for
Action to Medical Schools and Teaching Hospitals. Acad Med.
5. Sung NS, Gordon JI, Rose GD, et al. Science education. Educating
future scientists. Science. 2003;301(5639):1485.
6. Accreditation Council for Graduate Medical Education Web Site. Avail-
able at: http://www.acgme.org/DutyHours/dutyHoursCommonPR.pdf.
Accessed December 26, 2003.