Janet Riddle, MD
In 2015, Janet Riddle, MD, and her colleagues published an article1 outlining 12 key themes for delineating how fellowship programs in medical education should be developed (See “12 Tips for Developing Successful Fellowship Programs for Medical Educators,” below.)
The ASCO Post talked with Dr. Riddle, Director of Faculty Development in the Department of Medical Education at the University of Illinois College of Medicine at Chicago, about what constitutes successful faculty development in oncology, how medical institutions can develop a faculty program in oncology, and how to evaluate an effective faculty development program.
Keys to Success
What is involved in developing a successful faculty development program in oncology?
There are varied definitions of what faculty development is or ought to be. For example, in 1997, Kelley M. Skeff, MD, PhD, and colleagues published a paper defining faculty development as the “personal and professional development” of faculty members dedicated to meeting the “goals, vision, and mission of the institution” regarding its “social and moral responsibility to the communities it serves.”2
But the current definition that best explains what I do in faculty development is the one developed by Yvonne Steinert, PhD [Professor in the Department of Medicine at McGill University]: “[Faculty development involves] all activities health professionals pursue to improve their knowledge, skills, and behaviors as teachers and educators, leaders and managers, and researchers and scholars in both individual and group settings.” The work I do with faculty members separate from graduate courses focuses on those areas of knowledge and skills for teachers and educators.
A faculty development program that is focused solely on a grand rounds on how to give feedback is not one I would consider productive. You have to find ways of allowing faculty development participants to gain new knowledge and skills and practice that new knowledge and those skills, which can be done in a number of different ways. Workshops are a very common format for faculty development and could include how to supervise medical students in the outpatient setting, how to give effective feedback, how to complete end-of-rotation evaluation forms, or how to remediate learners.
When designing a faculty development program you have to consider what level of time and commitment people are willing to make, so I always start by asking, “What are the intended outcomes of the faculty development program?” Once that is determined, I ask, “What aspect of oncology care do I want participants to do better, and what skills or core competencies do I want them to display as a result of the work I do with them?” Then I think about what resources I might use to facilitate learning, such as video recordings, simulated patients, or mannequins, to recreate a clinical environment.
The key work I’m doing is to try to help faculty develop awareness of themselves as teachers and educators and then increase their capacity to be more learner-centered and to allow their learners to engage in more active rather than passive learning.
Active vs Passive Learning
Please describe the difference between active and passive learning.
The images that come to mind when I think about passive learning settings are lecture halls and classrooms, where the teacher is doing all the talking and the students are listening, although I acknowledge that any learning involves some mental or cognitive activity, so even in those settings learning isn’t completely passive.
Many of us as faculty are also learners, and we recognize that there is some value in hearing information, but most of the time we incorporate that information into what we already know and what we already do, and that’s what I describe as active learning.
When we ask our learners to synthesize clinical information, create a differential diagnosis or treatment plan, or evaluate evidence in support of a diagnostic or therapeutic plan, those are all higher-order cognitive activities that require ever more activity on the part of the learner.
Qualifications and Goals
What qualifications do faculty need to be effective in preparing fellows in patient care?
There are several purposes to consider in faculty development. One is to prepare learners for work in an academic setting. I imagine that many clinical oncologists are asked to supervise fellows and residents. Some important questions to ask include: Where do those clinical oncologists work? What is their prior experience with supervising trainees? What is the desired level of performance the oncologist wants the learner to attain?
In academic university and academic hospital settings, we generally have a shared mental model of what it means to supervise trainees, and it includes having the trainees, residents, and fellows do the initial assessment of the patient and propose a management plan they present to the patient and the supervisor.
In my institution, the learners present a patient to me, and we discuss the patient and the management plan. I then cosign notes and orders based on what I’ve observed.
In community practice settings, the learner is an addition to the workflow the supervising physician is accustomed to. There needs to be a plan for developing the skills the learner must have that includes more than just watching the supervising physician.
What are the factors used to evaluate an effective faculty development program?
Typically, I evaluate the extent to which the intended outcomes of the program were achieved. For example, in a workshop on giving effective feedback, I would ask participants about their level of comfort and confidence in giving formative feedback to trainees and to reflect on what was easy or difficult in giving feedback.
In the university or academic medical setting, program directors need to adhere to the accreditation standards of the Accreditation Council for Graduate Medical Education (ACGME), which has very specific standards related to direct and indirect supervision of trainees. These standards influence the outcomes that need to be achieved in a faculty development program, focusing on effective clinical supervision and teaching. In community practice settings, trainees are exposed to a spectrum of patient types that aren’t seen in academic- or university-based practices. So, we also want community oncologists to be good exemplars of the real-world practice of medicine.
The planning of medical education fellowship programs does not just involve knowing the intended outcomes and what resources are available, but also understanding the faculty and the nature of the teaching practice for those individuals and where the opportunities are for them to learn and grow. In faculty development, there has to be active engagement by the faculty members. ■
Disclosure: Dr. Riddle reported no potential conflicts of interest.
1. Dewey CH, Turner TL, Perkowski L, et al: Twelve tips for developing, implementing, and sustaining medical education fellowship programs: Building on new trends and solid foundations. Med Teach 38:141-149, 2015.
12 Tips for Developing Successful Fellowship Programs for Medical Educators
Adapted from Dewey CH, et al.1