Lynn McNicoll, MD and Renee Shield, PhD Alpert Medical School, Brown University ENHANCING TEACHING SKILLS OF GERIATRICS FACULTY BACKGROUND The need to care for an aging population is rapidly expanding There are not enough healthcare professionals trained in gerontology or geriatrics to care for an aging population Geriatrics should ideally incorporate the training of other healthcare providers in geriatric principles and management Few geriatric/gerontology programs emphasize developing master teachers in geriatrics BACKGROUND Successful faculty development programs require a significant time commitment by Geriatric Education Clinicians (GEC) Most universities have faculty development programs that are minimally utilized by clinical faculty As part of the Reynolds grant, the Alpert Medical School Division of Geriatrics worked collaboratively with the Brown Sheridan Center for Teaching and Learning SHERIDAN CENTER FOR TEACHING AND LEARNING Harriet W. Sheridan Center for Teaching and Learning honors Brown University's long-standing commitment to teaching The Center recognizes the diversity of learning styles and encourages reflective, independent, lifelong learning Through its programs, services and publications, the Sheridan Center explores a variety of pedagogical approaches and offers support to all members of Brown's teaching community PURPOSE In collaboration with the Sheridan Center, the Division of Geriatrics developed a faculty development program that provides ongoing training, reflection, and opportunity for improvement and is specific to geriatric educator clinicians (GEC). AIMS 1. 2. The aims of this workshop are: to describe a structured faculty development program for GEC that accommodated the unique needs of geriatrics faculty teaching various learners in unique settings To identify benefits of the program by: 1. Analyzing the aggregated feedback from GEC participants regarding the program to determine benefits of the program 2. Analyzing the Individual Teaching Consultation (ITC) reports for unifying themes for faculty development 3. Quantifying the scholarly activity among GEC participants and the impact of the Sheridan program. METHODS Year 1 Sheridan Teaching Certification Level 1 Years 2 and 3 New members – Sheridan Teaching Certification Level 1 Sheridan Teaching Certification Level 4 Monthly Workshops Self directed learning SHERIDAN CERTIFICATION LEVEL 1 Seminars 1. Developing a reflective teaching practice 2. Defining your goals and objectives 3. Teaching to different learning styles 4. Grading and Evaluation 5. Teaching as persuasive communication Examples: Syllabus development Goal development Effective communication Gauging the learner’s feedback and assessment SHERIDAN CERTIFICATION LEVEL 1 Workshops Followed 1-2 weeks after each seminar Facilitators- Geriatrician or Sheridan Center faculty Assignments: e.g. a. Questions assigned following the seminars b. Syllabus development SHERIDAN CERTIFICATION LEVEL 1 Microteaching Session • • • 15-minute presentations to the whole group, with immediate feedback from the group on content, style, presentation Encouraged participants to critically appraise colleagues for improvement Topics were medical or non-medical e.g., Hobbies “I appreciated the feedback. And in addition, it gave me a chance to provide feedback in a constructive manner to my peers in a nonthreatening manner.” SHERIDAN CERTIFICATION LEVEL 1 Individual Teaching Consultation (ITC) • • • Two Sheridan Center faculty educators attend a 1 hour lecture given by participant and videotape session Faculty review videotape and provide a written final report Participants and faculty meet to review consultation results and discuss improvement strategies. “Immensely helpful! … It was very useful to have expert educators analyze my teaching style, mannerisms, objectives, and evaluate to help enhance my teaching.” YEARS 2&3 – NEW MEMBERS 2 junior faculty and 3 senior fellows participated in level 1 certification in subsequent years They participated in GEC monthly workshops They participated in writing the paper but did not submit data YEARS 2&3 – MONTHLY WORKSHOPS Self-directed but collaborative learning Individual and group annual goals developed collaboratively Curriculum development seminars Faculty development seminars Writing workshops by professional writers and consultants Invited presentations e.g., IT powerpoint, wiki, social media Support group for geriatric clinician educators Peer mentoring YEARS 2&3 Projects that benefitted from the workshop Reynolds projects Anatomy cadaver treasure hunt Mandatory internal medicine block rotation Mandatory family medicine rotation at affiliated hospital Geriatric medicine fellowship program Nursing education programs YEARS 2&3 Sheridan Teaching Certification Level 4 Enhanced training on critique and observation Participants become teaching consultants for geriatric peers and other faculty Learning how to give constructive feedback teamed up with an expert teacher DATA COLLECTION 1. 2. 3. 4. Evaluations of Certification Level 1 - Year 1 members only Aggregated results of ITC reports – Year 1 members only Evaluations of GEC faculty development program - Years 2 and 3 Aggregated scholarly activities – Year 1 members only 1. Comparing baseline 2006-7 academic year to the following 3 years RESULTS 8/9 completed Certification level 1 (last participant completed it in year 2) Overall, program improved Reflective teaching ability Lecturing skills Self-confidence RESULTS - GEC COMMENTS REGARDING SHERIDAN PROGRAM Reflective Teaching “…makes you a better communicator and generates interest [and enthusiasm] in students o learn and become competent in a topic.” Lecturing Skills “Before, I would place all my efforts on the content of a lecture, my agenda, and my delivery. Once over, I would feel relieved. Now, I take the time to reflect and challenge myself to assess the needs of the learners and evaluate whether I reached my teaching objectives.” Self-Assessment “I have never felt confident nor ‘good’ at teaching, and Confidence always thinking that I did not have the ‘stage presence’ to be effective. SC has given me the plan to know how to prepare both content and my mental being to become confident – now I just need to do it – and do it!” RESULTS - GEC COMMENTS REGARDING SHERIDAN PROGRAM Microteaching “I appreciated the feedback. It gave me Session a chance to provide feedback in a Comments constructive manner to my peers in a non-threatening manner.” ITC “Immensely helpful… to have expert Comments educators analyze my teaching style, mannerisms, and objectives,” “Observing myself on video was extremely insightful for my non-verbal communication.” RESULTS – COMMON THEMES IN ITC Logistics and Handouts Punctuality is appreciated Distribute handouts at the beginning and not during the talk (too distracting) Use laser pointers judiciously Avoid acronyms Stand if possible and make sure to have eye contact with all learners Use movement to retain audience attention, move closer to audience who ask questions. Voice Appropriate volume and pace for learners Avoid reading directly from notes Avoid ‘Ums’ and ‘Uhs’ Modify tone or emphasis when mentioning important points. RESULTS – COMMON THEMES IN ITC Addressing the Use tangible examples and pictures or tables Needs of Different or graphs for visual learners Learners Use personal examples to make the topic real for learners Notice if learners are not as engaged and try to change tactics in real time leave enough time for response (5 seconds), acknowledge response Introduction Provide audience with a plan Use humor, a hook, or a clinical case to engage the learner Ask audience to introduce themselves or assess their current level of knowledge. RESULTS – COMMON THEMES IN ITC Content Use contextual examples – helps make complicated theoretical concepts more concrete Align objectives, outline and sections of the talk Have concluding or summarizing slides after each major section. Conclusion Ending with a question is a nice summative mechanism Allow time for questions at the end and make self available afterwards for learners who are uncomfortable sharing with the group Ask learners if content is appropriate for all learners especially if learners have different levels of training. RESULTS – SCHOLARLY ACTIVITY NH Division lecture of Ger lectures Local Present ations Invited Poster Journal National Present or Paper article or Comm ations Abstract book Member chapter ship Total % increase from baseline MD (n=3) Baseline 2006-7 5 7 5 2 3 8 0 30 Year 1 2007-8 6 10 7 0 3 18 2 46 53 Year 2 2008-9 6 10 13 6 5 15 5 60 100 Year 3 2009-10 8 9 12 9 13 25 5 81 170 RESULTS – SCHOLARLY ACTIVITY NH Division lecture of Ger lectures Local Invited Poster Journal National Total % Present Presen or Paper article or Comm increase ations tations Abstract book Members from chapter hip baseline NP (n=5) Baseline 2006-7 0 12 3 3 6 1 0 25 Year 1 2007-8 13 15 6 3 2 2 0 41 64 Year 2 2008-9 15 14 7 2 3 3 0 44 76 Year 3 2009-10 8 24 20 4 1 3 0 60 140 CONCLUSIONS Clinical faculty are expected to be expert clinicians as well as master educators GEC lack resources, dedicated time, and have revenue expectations which limit their ability to become master educators External faculty development programs are highly valued but difficult for GEC to attend CONCLUSIONS Systematic review of faculty development programs showed the following as key features of a successful program Experiential learning activities Timely and constructive feedback Collaborative relationships with colleagues Strategies based on proven educational principles Using a variety of educational methods to meet the learning styles of different learners CONCLUSIONS We believe our program met all these criteria Also interdisciplinary composition of the group was very beneficial Increase in scholarly activity is remarkable (170% and 140% increase from baseline) for physicians and nurse practitioners respectively Greatly increased odds of promotion