Kelley M. Skeff

Stanford University, Palo Alto, California, United States

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Publications (48)223.73 Total impact

  • Kelley M Skeff ·

    Gastroenterology 12/2014; 147(6):1208-11. DOI:10.1053/j.gastro.2014.10.022 · 16.72 Impact Factor
  • Kelley M Skeff ·

    Journal of General Internal Medicine 08/2013; 29(1). DOI:10.1007/s11606-013-2573-3 · 3.42 Impact Factor
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    ABSTRACT: Objective: To understand how teaching behaviors contribute to simulation-based learning, we used a 7-category educational framework to assess the teaching behaviors used in basic skills training. Methods: Twenty-four first-year cardiothoracic surgery residents and 20 faculty participated in the Boot Camp vessel anastomosis sessions. A portable chest model with synthetic graft and target vessels and a tissue-based porcine model simulated coronary artery anastomosis. After each 2-hour session on days 1 and 2, residents assessed teaching behaviors of faculty using a 20-item questionnaire based on the 5-point Likert scale. After session on day 1, faculty completed a self-assessment questionnaire. At 3 months, faculty completed self-assessment questionnaires regarding teaching behaviors in simulation and clinical settings. Each questionnaire item represents 1 or more teaching categories: "learning climate," "control of session," "communication of goals," "promoting understanding and retention," "evaluation," "feedback," and "self-directed learning." Results: Generally, resident ratings indicated that faculty showed positive teaching behaviors. Faculty self-assessment ratings were all lower (P < .025) than those assigned to them by the residents except for 1 component representative of "feedback," which approached significance (P = .04); 2 items, representative of "promoting understanding and retention" and "evaluation", had mean scores of less than 3. At 3 months, compared with self-assessment at Boot Camp, faculty ratings suggested improved teaching behaviors in their simulation settings in the following: "learning climate," "control of session," "communication of goals," "promoting understanding and retention," and "evaluation." The simulation environment was perceived as more positive for technical skills training in certain aspects compared with clinical setting: instructor reviewed function and operation of equipment with learner before session (representative of "promoting understanding and retention") and instructor allowed the learner ample time to practice (representative of "control of session" and "promoting understanding and retention") (P < .025). Conclusions: Simulation-based skills training is perceived by residents to be associated with positive teaching behaviors. Faculty self-ratings indicate that they do not always use many of these teaching behaviors and that their performance can be improved. The simulation setting may provide greater opportunity for positive teaching behaviors compared with the clinical environment.
    The Journal of thoracic and cardiovascular surgery 10/2012; 145(1). DOI:10.1016/j.jtcvs.2012.07.111 · 4.17 Impact Factor
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    J Johansson · K M Skeff · G.A. Stratos ·
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    ABSTRACT: The Stanford Faculty Development Center at Stanford University has developed a teaching improvement course for medical teachers that has been widely disseminated using a train-the-trainer model. This study was designed to investigate the relative impact of role playing as an instructional technique within that course for facilitating change in teaching behaviours. From January 2009 to April 2010, six faculty development courses were delivered at Uppsala University Hospital to 48 physicians from different departments. The standard course presentation includes a range of instructional methods including short lectures, small group discussion, review of video re-enactments, role-play exercises and personal goal setting. For this study, participants were randomised to participate in (1) a 'standard' course with role play or (2) an 'alternative' course with no role play. The effects of the course on teaching performance were assessed with retrospective pre- and post-course self-ratings of 29 specific teaching behaviours. Self-assessment ratings indicated significantly greater positive changes in teaching behaviour among faculty who attended the standard course (with role play) as compared to those in the alternative course (p = 0.015). This study validates the commonly held view that role play is a useful instructional method for improving teaching.
    Medical Teacher 02/2012; 34(2):e123-8. DOI:10.3109/0142159X.2012.644832 · 1.68 Impact Factor
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    ABSTRACT: Most medical faculty receive little or no training about how to be effective teachers, even when they assume major educational leadership roles. To identify the competencies required of an effective teacher in medical education, the authors developed a comprehensive conceptual model. After conducting a literature search, the authors met at a two-day conference (2006) with 16 medical and nonmedical educators from 10 different U.S. and Canadian organizations and developed an initial draft of the "Teaching as a Competency" conceptual model. Conference participants used the physician competencies (from the Accreditation Council for Graduate Medical Education [ACGME]) and the roles (from the Royal College's Canadian Medical Education Directives for Specialists [CanMEDS]) to define critical skills for medical educators. The authors then refined this initial framework through national/regional conference presentations (2007, 2008), an additional literature review, and expert input. Four core values grounded this framework: learner engagement, learner-centeredness, adaptability, and self-reflection. The authors identified six core competencies, based on the ACGME competencies framework: medical (or content) knowledge; learner- centeredness; interpersonal and communication skills; professionalism and role modeling; practice-based reflection; and systems-based practice. They also included four specialized competencies for educators with additional programmatic roles: program design/implementation, evaluation/scholarship, leadership, and mentorship. The authors then cross-referenced the competencies with educator roles, drawing from CanMEDS, to recognize role-specific skills. The authors have explored their framework's strengths, limitations, and applications, which include targeted faculty development, evaluation, and resource allocation. The Teaching as a Competency framework promotes a culture of effective teaching and learning.
    Academic medicine: journal of the Association of American Medical Colleges 08/2011; 86(10):1211-20. DOI:10.1097/ACM.0b013e31822c5b9a · 2.93 Impact Factor
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    ABSTRACT: Medical school faculty members are charged with the critical responsibility of preparing the future physician and medical scientist workforce. Recent reports suggest that medical school curricula have not kept pace with societal needs and that medical schools are graduating students who lack the knowledge and skills needed to practice effectively in the 21st century. The majority of faculty members want to be effective teachers and graduate well-prepared medical students, but multiple and complex factors-curricular, cultural, environmental, and financial-impede their efforts. Curricular impediments to effective teaching include unclear definitions of and disagreement on learning needs, misunderstood or unstated goals and objectives, and curriculum sequencing challenges. Student and faculty attitudes, too few faculty development opportunities, and the lack of an award system for teaching all are major culture-based barriers. Environmental barriers, such as time limitations, the setting, and the physical space in which medical education takes place, and financial barriers, such as limited education budgets, also pose serious challenges to even the most committed teachers. This article delineates the barriers to effective teaching as noted in the literature and recommends action items, some of which are incremental whereas others represent major change. Physicians-in-training, medical faculty, and society are depending on medical education leaders to address these barriers to effect the changes needed to enhance teaching and learning.
    Academic medicine: journal of the Association of American Medical Colleges 02/2011; 86(4):453-9. DOI:10.1097/ACM.0b013e31820defbe · 2.93 Impact Factor
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    J Johansson · K Skeff · G Stratos ·
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    ABSTRACT: The Stanford Faculty Development Center (SFDC) at Stanford University developed a teaching improvement course for medical teachers that has been widely disseminated using a train-the-trainer model. We were curious to see if cultural factors might influence the applicability and impact of the course when delivered to non-American participants by a facilitator from that culture. A Swedish anaesthesiologist at Uppsala University Hospital, Sweden, was trained in October 2004 at Stanford University. From January 2005 to March 2007 he delivered five faculty development seminar series at Uppsala University Hospital to 40 physicians from different departments. Participants rated the usefulness of the seminar series and retrospective pre- and post-seminar ratings were used to assess effects on participants' teaching skills and behaviours. Participants rated the seminars as highly useful (M = 4.8, SD = 0.4). Participants' ratings of their teaching ability indicated significant increases across a variety of clinical and non-clinical teaching settings (p < 0.001), and positive changes in teaching behaviours were found for all seven educational categories assessed (p < 0.001). This faculty development model is highly transportable to medical teachers in Sweden, and capable of producing positive results, consistent with those found in the United States.
    Medical Teacher 08/2009; 31(8):e377-82. DOI:10.1080/01421590802638055 · 1.68 Impact Factor
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    ABSTRACT: Faculty and academic institutions face significant challenges in delivering effective ambulatory-care teaching to house staff and medical students. The effects of a faculty-development program on individual ambulatory-care faculty's knowledge, skills, and attitudes; and on participants' recommendations for improving the ambulatory-care environment were examined. The faculty development program trained faculty in either clinical teaching (CT), medical decision making (MDM), or preventive medicine (PM). Ten facilitators implemented a faculty-development program for 64 ambulatory-care faculty. On a 5-point scale (1 = definitely not, 5 = definitely yes), participants rated the usefulness of the seminars as 4.8 or greater. For the CT seminars, statistically significant pre- to post-intervention improvements were found for all seven categories of teaching skills covered (p< 0.001). For the MDM seminars, the participants' content knowledge increased from a pretest mean of 49% correct to a posttest mean of 70% correct (p = 0.01). Participants formulated 45 recommendations for improving the ambulatory-care setting; approximately one-half of these recommendations had been implemented by the institutions 6 months after completion of the program. Faculty-development programs improve the skills of individual faculty and may provide a method for generating recommendations to improve ambulatory-care education and patient care at the institutional level.
    Medical Teacher 07/2009; 19(4):285-292. DOI:10.3109/01421599709034206 · 1.68 Impact Factor
  • Kelley M. Skeff · Georgette A. Stratos · Jane F. S. Mount ·
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    ABSTRACT: This article focuses on the evolution of faculty development in medicine. Of note, improving teaching in medical education is not a new concept. At a minimum, it was seriously discussed by pioneers like George Miller and Steve Abrahamson as early as the 1950s [Simpson & Bland (2002). Stephen Abrahamson, PhD, ScD, educationist: A stranger in a kind of paradise. Advances in Health Science Education Theory Practice, 7, 223–234]. By 2005, significant numbers of medical school faculty have participated in teaching improvement methods [Clark et al. (2004). Teaching the teachers: National survey of faculty development in departments of medicine of US teaching hospitals. Journal General Internal Medicine, 19, 205–14]. Yet, views of the importance and value of faculty development have evolved slowly. Fortunately, we are now in a more receptive era for program developers to assist faculty in their difficult roles.
    Teaching and Teacher Education 04/2007; 23(3):280-285. DOI:10.1016/j.tate.2006.12.019 · 1.32 Impact Factor
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    Kelley M Skeff ·
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    ABSTRACT: The process of teaching is ubiquitous in medicine, both in the practice of medicine and the promotion of medical science. Yet, until the last 50 years, the process of medical teaching had been neglected. To improve this process, the research group at the Stanford Faculty Development Center for Medical Teachers developed an educational framework to assist teachers to analyze and improve the teaching process. Utilizing empirical data drawn from videotapes of actual clinical teaching and educational literature, we developed a seven-category systematic scheme for the analysis of medical teaching, identifying key areas and behaviors that could enable teachers to enhance their effectiveness. The organizational system of this scheme is similar to that used in natural sciences, such as genetics. Whereas geneticists originally identified chromosomes and ultimately individual and related genes, this classification system identifies major categories and specific teaching behaviors that can enhance teaching effectiveness. Over the past two decades, this organizational framework has provided the basis for a variety of faculty development programs for improving teaching effectiveness. Results of those programs have revealed several positive findings, including the usefulness of the methods for a wide variety of medical teachers in a variety of settings. This research indicates that the development of a framework for analysis has been, as in the natural sciences, an important way to improve the science of the art of teaching.
    Transactions of the American Clinical and Climatological Association 02/2007; 118:123-32.
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    Georgette A Stratos · Merlynn R Bergen · Kelley M Skeff ·

    Journal of General Internal Medicine 04/2004; 19(3):286-7. · 3.45 Impact Factor
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    Georgette A. Stratos · Merlynn R. Bergen · Kelley M. Skeff ·

    Journal of General Internal Medicine 03/2004; 19(3):286 - 287. DOI:10.1111/j.1525-1497.2004.40101.x · 3.42 Impact Factor
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    ABSTRACT: Background Clinicians need self-directed learning skills to maintain competency. The objective of this study was to develop and implement a curriculum to teach physicians self-directed learning skills during inpatient ward rotations. Methods Residents and attendings from an internal medicine residency were assigned to intervention or control groups; intervention physicians completed self-directed learning curricular exercises. Results Among the 43 intervention physicians, 21 (49%) completed pre- and post-curriculum tests; and 10 (23%) completed the one-year test. Immediately after exposure to the curriculum, the proportion of physicians defining short- and long-term learning goals increased [short-term: 1/21 (5%) to 11/21 (52%), p = 0.001; long-term: 2/21 (10%) to 15/21 (71%), p = 0.001]. There were no significant changes post-curriculum in the quantity or quality of clinical question asking. The physicians' mean self-efficacy (on a 100-point scale) improved for their abilities to develop a plan to keep up with the medical literature (59 vs. 72, p = 0.04). The effects of the curriculum on self-reported learning behaviors was maintained from the immediate post-curriculum test to the one-year post curriculum test: [short-term learning goals: 1/21 (5%) pre-, 11/21 (52%) immediately post-, and 5/10 (50%) one-year after the curriculum (p = 0.0075 for the pre- vs one-year comparison); long-term learning goals: 2/21 (10%) pre-, 15/21 (71%) immediately post-, and 7/10 (70%) one-year (p = 0.0013 for the pre- vs one-year comparison). At one-year, half of the participants reported changed learning behaviors. Conclusions A four-week curriculum may improve self-directed learning skills.
    BMC Medical Education 10/2003; 3(1). DOI:10.1186/1472-6920-3-7 · 1.22 Impact Factor
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    ABSTRACT: To study how clinical preceptors select patients for medical student teaching in ambulatory care and to explore key factors they consider in the selection process. Qualitative analysis of transcribed interviews. Harvard Medical School, Boston, Mass. Nineteen physicians (14 general internists and 5 general pediatricians) who serve as clinical preceptors. Responses to in-depth open-ended interview regarding selection of patients for participation in medical student teaching. Preceptors consider the competing needs of the patient, the student, and the practice the most important factors in selecting patients for medical student teaching. Three dominant themes emerged: time and efficiency, educational value, and the influence of teaching on the doctor-patient relationship. These physicians consciously attempt to select patients whose participation in medical student teaching maximizes the efficiency of the clinical practice and optimizes the students' educational experiences, while minimizing any potential for harming the relationship between preceptor and patient. These findings may help validate the frustration preceptors frequently feel in their efforts to teach in the outpatient setting. Becoming more cognizant of the competing interests-the needs of the patient, the student, and the practice-may help physicians to select patients to enhance the educational experience without compromising efficiency or the doctor-patient relationship. For educators, this study suggests an opportunity for faculty development programs to assist the clinical preceptor both in selecting patients for medical student teaching and in finding ways to maximize the efficiency and educational quality of the outpatient teaching environment.
    Journal of General Internal Medicine 10/2003; 18(9):730-5. DOI:10.1046/j.1525-1497.2003.20838.x · 3.45 Impact Factor
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    Journal of General Internal Medicine 01/2003; 12(s2):56 - 63. · 3.42 Impact Factor
  • D K Litzelman · G R Westmoreland · K M Skeff · GA Stratos ·

    Academic Medicine 11/1999; 74(10 Suppl):S25-7. DOI:10.1097/00001888-199910000-00030 · 2.93 Impact Factor
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    ABSTRACT: Community-based clinical teachers provide an important cadre of faculty for medical education. This study was designed to examine the feasibility and value of an American College of Physicians-sponsored regional teaching improvement program for community-based teachers. We conducted five regional (Connecticut, New Hampshire/Vermont, New York, Ohio, and Virginia) 1- to 2-day teaching-improvement workshops for 282 faculty (49% community based, 51% university based). The workshops were conducted by regional facilitators trained by the Stanford Faculty Development Program using large group and small group instructional methods to teach participants a framework for analyzing teaching, to increase their repertoire of teaching behaviors, to define personal teaching goals, and to identify the educational needs of their teaching site. Participants used Likert ratings [1 (low) to 5 (high) scale] to assess workshop quality, facilitator effectiveness, and rewards for and barriers to teaching in their clinics. Using retrospective pre- and postintervention ratings, participants also assessed workshop impacts on teacher knowledge, attitudes, and skills. Finally, participants completed open-ended questions to identify recommended changes to improve their clinic as an educational site for students and residents. At all sites, participants evaluated the program as highly useful (4.6 +/- 0.6, mean +/- SD). Participants' ratings indicated that the program had a positive effect on their knowledge of teaching principles (4.0 +/- 0.9), an increase in their teaching ability (P <0.001), and an increase in their sense of integration with their affiliated institution (P <0.001). Regional training of university and community faculty can be an effective way of promoting the improvement of teaching and the collaboration between community-based teachers and academic centers. National physician organizations and regionally based facilitators can provide important resources for the delivery of such training.
    The American Journal of Medicine 01/1999; 106(1):76-80. DOI:10.1016/S0002-9343(98)00360-X · 5.00 Impact Factor
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    Diane L. Elliot · Kelley M. Skeff · Georgette A. Stratos ·
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    ABSTRACT: Background: Among nonmedical educators, longitudinal faculty development programs most effectively increase teachers' abilities. Despite most medical settings providing little reinforcement for newinstructional skills, teaching improvement programs infrequently have explicit ongoing activities. We carried out a longitudinal program for medical educators designed to reinforce and firmly establish new teaching skills. Description: We conducted a longitudinal(18 months of biweekly 1-hr meetings) faculty development program. Its activities followed an initial structured seminar series, and the ongoing meetings involved reviewing video tapes of participants' teaching, enacting and debriefing role-plays, and a modified Balint group for medical educators. Evaluation: We assessed the program's process and outcomes using attendance, self-reported teaching behaviors, perceived program usefulness, educational administrative responsibilities, and qualitative analysis of audiotapes and session notes. Conclusions: Participants maintained high attendanceduring18months of meetings. Ratings of usefulness were high, comparable to other faculty development activities with established utility, and qualitative data support unique benefits of the ongoing meetings. The longitudinal component built on the initial seminar series; it seemed to enhance collegial support, to allow observation of instructional outcomes to reinforce newinstructional skills, and to foster greater involvement in the institution's teaching activities. Teaching improvement programs for physician educators have taken several forms, from workshops and expert consultations to month-long minisabbaticals. However, most are single or sequenced interventions, without an explicit long-term component. We present the structure of an 18-month program for clinician teachers and report observations supporting the program's utility. We hope that this descriptive study promotes greater attention to and subsequent prospective research of longitudinal faculty development.
    Teaching and Learning in Medicine 01/1999; 11(1-1):52-57. DOI:10.1207/S15328015TLM1101_12 · 0.66 Impact Factor
  • Kelley M. Skeff · Sunita Mutha ·

    New England Journal of Medicine 01/1999; 339(27):2015-7. DOI:10.1056/NEJM199812313392710 · 55.87 Impact Factor
  • K M Skeff · GA Stratos · M R Bergen · D P Regula ·
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    ABSTRACT: Relatively little research has focused on faculty development methods that assist basic science teachers to improve their instructional skills. This study was designed to assess the effectiveness for basic science faculty of a faculty development seminar series that had been previously shown useful for clinical teachers. The Stanford Faculty Development Program's seminars on clinical teaching were adapted for basic science instruction. Eight pathology faculty participated in a series of nine small-group seminars designed to provide teachers with knowledge of a framework for analyzing teaching and identifying areas for improvement, and skill-based training in specific teaching behaviors. Each seminar included (1) brief lectures, (2) review of videotaped reenactments of teaching interactions, (3) role-play exercises with videotape review, and (4) formulation of personal and departmental teaching goals. Program evaluation included multiple measures: participant self-assessment, student ratings of the participants, and blinded ratings of pre- and post-seminar videotapes of participants' classroom teaching. All measures indicated a positive effect of the intervention. Faculty development programs have significant potential to enhance basic science instructors' teaching effectiveness.
    Academic Medicine 07/1998; 73(6):701-4. DOI:10.1097/00001888-199806000-00018 · 2.93 Impact Factor

Publication Stats

1k Citations
223.73 Total Impact Points


  • 1986-2014
    • Stanford University
      • • Department of Medicine
      • • Department of Management Science and Engineering
      Palo Alto, California, United States
  • 1988-2004
    • Stanford Medicine
      • Department of Medicine
      Stanford, California, United States
  • 2003
    • Harvard Medical School
      • Department of Population Medicine
      Boston, Massachusetts, United States
  • 1999
    • Indiana University-Purdue University Indianapolis
      • Department of Medicine
      Indianapolis, Indiana, United States