|ORIGINAL ARTICLE ON MEDICAL EDUCATION
|Year : 2021 | Volume
| Issue : 2 | Page : 125-133
Factors influencing the success of faculty development programme: Our experience and future recommendations
Madhubari Vathulya1, Shalinee Rao2, Rajesh Kathrotia3, Manisha Naithani4, Manisha Bisht3, Saurabh Varshney5, Gita Negi6, Latika Mohan3, Pratima Gupta7, Ravi Kant8
1 Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Professor of Department of Pathology, Head of Advanced Center of Continuous Professional Development, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
3 Department of Physiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
4 Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
5 Department of Otorhinolaryngology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
6 Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
7 Department of Microbiology, AIIMS, Rishikesh, Uttarakhand, India
8 Director, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
|Date of Submission||10-Mar-2021|
|Date of Decision||11-Aug-2021|
|Date of Acceptance||11-Aug-2021|
|Date of Web Publication||30-Aug-2021|
Dr. Shalinee Rao
Professor, Department of Pathology, Head of Department of Advanced Center of Continuous Professional Development, AIIMS Rishikesh, Uttarakhand
Source of Support: None, Conflict of Interest: None
Background: The success of any training program is influenced by factors such as the course facilitator, learner and learning environment. Faculty Development Programs are conducted in institutes from time to time to train the trainer. Aims: The article aims to evaluate two Faculty Development Programs conducted at a tertiary care institute and address the concerns and suggestions as educationists. Subjects and Methods: Data generated from the 4-day workshop on Faculty Development Course conducted in two subsequent programmes in the year 2019 were reviewed. The performance of participants was analyzed based on their performance in pre-test and post-test administered through a set of pre-validated questionnaires. Participant feedback as well as their response to facilitatory and hindering factors was evaluated. Results: A total of 57 participants attended the workshop (cumulative both FDP). Pre-test post-test scores were 7.55 ± 2.2 and 12.5 ± 1.87, and improvement in knowledge was statistically significant with P < 0.0001. Overall, FDP was rated very good to good by 97% of the participants. Interactive sessions, group activity and discussions facilitated learning, while prolonged and hurried up sessions as well as non-availability of prior reading material were major hindrances. Conclusion: A low baseline knowledge of participants emphasizes the need for an early introduction to FDP with interactive sessions, good time management and a non-threatening environment to maintain the interest of learner and facilitates learning. The article in addition also discusses about the inadequacies and lacunae of the existing programme.
Keywords: Concerns, factors, Faculty Development Programme, inadequacies, lacunae
|How to cite this article:|
Vathulya M, Rao S, Kathrotia R, Naithani M, Bisht M, Varshney S, Negi G, Mohan L, Gupta P, Kant R. Factors influencing the success of faculty development programme: Our experience and future recommendations. J Med Evid 2021;2:125-33
|How to cite this URL:|
Vathulya M, Rao S, Kathrotia R, Naithani M, Bisht M, Varshney S, Negi G, Mohan L, Gupta P, Kant R. Factors influencing the success of faculty development programme: Our experience and future recommendations. J Med Evid [serial online] 2021 [cited 2021 Sep 25];2:125-33. Available from: http://www.journaljme.org/text.asp?2021/2/2/125/324959
| Introduction|| |
Faculty Development Programme (FDP) plays a significant role in imparting skills of a teacher as well as bringing a positive behavioural change for the sustenance of academic vitality.
The strengths of a good FDP rest on several factors such as the right strength of participants, motivated resource faculty/participants and activity-based learning. This training programme mainly focuses on sharing concepts of educational objectives, familiarising with a plethora of teaching–learning media and methods available, as well as active teaching–learning experience, ideal evaluation tools, group dynamics and microteaching. It is presumed that, with the experience gained during this course, the trainee will be able to deliver as a medical teacher more effectively and decipher specific educational problems in their local setting. At the same time, the programme strives to inspire them to develop a positive attitude and contribute towards Medical Educational Unit in their institute, the building block for education. These programmes are particularly helpful in medical and nursing Colleges to train their teaching faculty for successively running their undergraduate and postgraduate courses.
A review of literature documents a good number of published literature on FDP., However, there has been limited literature focussing on challenges, obstacles and lacunae that may influence the success of program/learners satisfaction. Such an educational programme has to be evaluated from time to time to study its effectiveness. However, it is equally important to study the hits and misses for strengthening the programme. This will be a step towards the identification of hindering/limiting factors and take necessary action to overcome shortcomings.
The present study was done to evaluate the basic course on FDP in Medical educational technologies based on the performance of participants in pre-test and post-test and to identify unachieved objectives of the course that requires further attention. In addition, we aimed to recognise hindering factors/obstacles, misconception, weakness as well as inadequacies and subsequently propose possible solutions to ensure satisfactory learning experience by participants.
| Subjects and Methods|| |
Data generated from the four-day workshop on FDP/Course conducted in two subsequent programmes in the year 2019 were reviewed.
This course had been conducted with objectives that at the end of the course the participants shall be able to:
- Demonstrate the application of principles of educational science in undergraduates training
- Recognise small group dynamics/active learning practices and its utility in learning
- Acquire effective teaching skills through the micro-teaching technique
- Practice ethical principles as a teacher
- Explore, identify and resolve a specific educational problem in a local setting
- Develop a positive attitude towards educational science to effectively contribute to the establishment/strengthening of the Medical Education Unit/Cell in his/her institution.
Modules covered during this FDP course were interspersed with interactive sessions to reinforce the knowledge and skill acquired and at the same time perform formative assessment, simultaneously assessing the progress of participants during the training programme [Table 1], [Table 2], [Table 3], [Table 4]. Teaching–learning media adopted for delivery of resource material comprised a document camera, PowerPoint, White Board, Smart Board, Flip Charts, Flash cards, role play and video clippings.
|Table 1: Structure of modules in faculty development programs and feedback of participants for various sessions of day 1 (values in percentage)|
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|Table 2: Structure of modules in faculty development programs and feedback of participants for various sessions of day 2 (values in percentage)|
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|Table 3: Structure of modules in faculty development programs and feedback of participants for various sessions of day 3 (values in percentage)|
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|Table 4: Structure of modules in faculty development programs and feedback of participants for various sessions of day 4 (values in percentage)|
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The quantitative data obtained from the pre- and post-tests scores were entered on an excel sheet and analysed. Feedback obtained from the participant at the end of the course on each module delivered through this course [sessions in [Table 1], [Table 2], [Table 3]-, [Table 4]] was evaluated on a 3-Point Likert scale. Few of the feedback questions were open ended, for which participants gave a descriptive response. Open-ended questions were analysed using the identification of common themes in their response which was then quantified. Data on participant performance were further studied to identify post-test questions which were incorrectly answered. Data were then subjected to statistical analysis to evaluate the significance of the results obtained.
| Results|| |
A total of 57 participants attended the workshop (cumulative both FDP). These participants completed their undergraduate and postgraduate degrees from different parts of India and were first time attending FDP. All of them were already working as faculty/instructors with post-residency experience ranging from 3 to 14 years.
The pre-test score was 7.55 ± 2.2 which increased significantly during post-test to 12.5 ± 1.87 (P < 0.0001) as shown by the Boxplot [Figure 1], and improvement in knowledge was statistically significant. On assessing the improvement in post-test item wise, it was found that responses for all the questions showed a significant improvement in post-test except question no 1, 12 and 15 which showed no significant improvement [Figure 2]. Question no 5, 8, 9, and 10 regarding teaching methods and skills and question 14 assessing item analysis showed major improvement in knowledge [Figure 2]. The overall rating of the programme was very good to good by the majority of participants (97%) [Figure 3].
|Figure 1: Boxplot comparing of pre-test and post-test scores (*P < 0.0001)|
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|Figure 2: Improvement in post-test scores (%) compared to pre-test scores (*P < 0.05)|
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On a 3-point Likert scale, feedback on various aspects of the programme was analysed and the mean value was found to be 2.85 ± 0.02 (range from 2.82 to 2.88) for successfully completing course objectives. The mean value was 2.55 ± 0.14 (range from 2.38 to 2.85) for the scope of active participation during sessions. Participants' feedback on the application of learnt material in their academic and work environment showed a mean score of 2.35 ± 0.05 (range from 2.31 to 2.39). The mean value of overall satisfaction on the entire programme was 2.78 ± 0.4 on a 3-point Likert scale [Table 1], [Table 2], [Table 3], [Table 4].
The overall rating of the FDP Programme was concluded as very good to good by 97% of participants [Figure 3]. Practicing ethics: Teachers' responsibility and art of giving feedback and dealing students with problems were rated the best sessions with good applicability in their profession ahead. Although few participants had difficulty in understanding Specific Learning Objective (SLO), they were benefited from the session on matching assessment to objectives and learning outcomes with choosing the appropriate assessment tool (activity-based learning session).
There were various facilitating and hindering factors that were identified by participants [Table 5]. Interactive learning (32.89%), group activity or discussions (29.61%), role-playing or demonstration (15.13%), a friendly environment, good presentation and resource faculty were mentioned as facilitating factors for learning during the course [Table 5]. Nearly 60.78% of participants opined that hindering factors were none during the training. Lengthy or exhaustive sessions have been stated by 24.18% of participants as a hindrance in the learning process [Table 5]. Few of the participants expressed other factors such as poor audio quality at times, no availability of prior reading material, time constraint or fast sessions as other hindering factors. A few of the constructive suggestions posed by the participants were effective time management, relate the programme to current logistics in implementation and phasic introduction of the course to the learning group.
|Table 5: Factors facilitating and hindering learning in programme (n=57)|
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| Discussion|| |
Teaching is an art and a profession requiring mastery over a set of essential skills of a teacher. It is not just a mechanical delivery of content and precise assessment skills. Hence, teachers should not be mere tools to deliver content and assess skills but also be equipped with various essential skills to achieve an effective learning. Unlike other sectors of education, medical colleges do not require formal structured full-time training and certification on Bachelor of Education/Master of Education before their recruitment as a teacher. In medical undergraduate training, there exists a Pedagogy approach, therefore, a pertinent question that can be raised is, are we ignoring such indispensable focussed training approach for potential medical teachers?
Although during residency, postgraduates are involved in teaching activities in clinics, practical and tutorials, this minimal exposure to teaching–learning activities may not be enough to understand all the nuances of the educational system and process. Senior Residency Programme after postgraduation may also not be enough to acquire all the essential requirements of a medical teacher. Teaching practices immediately after residency programme is either based on their experience during residency or by following the footsteps of their senior as role model. To bridge this gap, basic FDP on Medical Educational Technologies is a training course made mandatory for all faculty of Medical Colleges in India by Medical Council of India (Renamed as National Medical Commission) which is facilitated through nodal centres. The objectives of FDP are to train faculty members on the educational process and basic attributes of a teacher to deliver effectively as an educationist. Improvement in knowledge and skill assist the faculty to function better as a medical teacher.
There is literature on evidence regarding the effectiveness of FDP but lacks studies focussing on its limitations, hurdles and lacunae. Critical analysis of FDP to identify obstacles, challenges and gaps would be a significant step to look for possible solutions and improve its overall efficiency. Analysis of pre-test assessment in our study revealed that the participants attending the workshop had very less knowledge about effective teaching methods such as interactive teaching. They also lacked insight about assessment tools including those that can assess the application, affective domain, psychomotor domain and item analysis for MCQ assessment. Bahar-Ozvaris et al. also found improvement in knowledge in a similar study as documented in literature.
It is a matter of concern that baseline knowledge of participants was low and yet they were already functioning as a teacher. This emphasizes the need for introducing such programmes right from the residency period so that they are better equipped as teachers when they actually take up this role. Therefore, an ideal solution to this would be training them before they take up professional duties as a faculty, lecturer or tutor. Since, it is difficult to unlearn what is already ingrained and re-learn. To overcome these lacunae, it is best that a policy is created by authorised educational bodies regarding the right time to undergo a basic FDP Course. Bin Abdulrahman et al. in their published work documented that it is the fresh or junior faculty as well as senior faculty who should be trained in FDP. In a study by Abid et al., results showed that participants of FDP strongly recommended this as a mandatory course for the newly recruited faculty in medical schools.,,,,,,,,,,,,, We further propose that it would be best that an individual completes this basic training immediately after completing their residency programme in various training centres already available. To nurture the right culture, the concepts created at the beginning of a career should be correct as it builds a strong foundation over which one evolves in the right direction.
The post-test analysis showed that the programme was successful in imparting knowledge regarding the various teaching and assessment tools. However, they still lacked clarity on the use of tools such as OSCE/OSPE in testing the various domains as reflected by their wrong choice of options in the post-test involving these topics by the majority of the candidates in spite of it being covered during the sessions. The majority of the candidates had not understood that the assessment should be linked to learning objectives and learning domains. Although they found the session on the last day quite useful, in which they linked the SLO with learning outcomes for assessment and proposed appropriate evaluation tool as reflected in their feedback. These findings re-emphasise the fact that a single training session may not be enough and re-training be encouraged on specific modules. Medical education in institutes should focus on having regular training on specific modules as short focussed training for reinforcement.
Active learning is encouraged due to the fact that learner learns better through participation. Sessions on active learning were delivered through those specific methods itself for better understanding. However, some of the participants could not grasp the 'Think Pair Share method for active learning'. Abid et al. used experiential learning during FDP similar to ours. Bransford et al. documented active learning teaching strategies can be learnt by participants independently.
Variable experiences of participants and low scores in assessment may also be influenced by several other factors such as diversity of participants, delivery of method and environment, background, level of understanding and learner pace of grasping. In their feedback, participants clearly mentioned that their learning was satisfactory. Faciliatory factors include a non-threatening and congenial atmosphere created by resource faculty. A reason for them missing out on some points could be because of hurried sessions due to a lack of time in this exhaustive 4-day FDP workshop, as mentioned by participants. A good team effort, good preparation, time management and the art of sticking to time on any discussion generated would be a good way of ensuring no session is ignored or hurried up.
There was not much improvement in scores about clinical vignette and OSCE; however, the pre-test scores itself were high for these topics suggesting participants were aware of it. This could be due to the fact that this institute promote objective assessment and focussed training has been given for making clinical vignettes and OSCE in the past. Most of the participants failed to answer in pre-test and post-test questions on syllabus indicating a lack of clarity for this topic by them. Curriculum and syllabus were briefly conveyed but not covered exhaustively during our FDP.
The highlight of the FDP programme was the new sessions which were included – teaching psychomotor skill, ethics as a teacher, SLO linking to learning outcome, choosing an appropriate assessment tool. The art of giving feedback and dealing students with problems. These topics were scored as excellent by participants with exceptional good feedback.
There is not much-published literature on the impact and evaluation of FDP and this may be due to ever-evolving nature of FDP influenced by reforms/innovations. Another reason sighted is the multistep process required to be followed considering all complexities and the final impact on faculty development. There are various models that can be applied to evaluate the teaching modules, and one such is Kirkpatrick's model which can evaluate the effectiveness of the developed module. Kirkpatrick Model encompasses four levels of evaluation to include Reaction (Level 1), Learning (Level 2), Behaviour (Level 3) and Results (Level 4). Point to be noted is that at every level Kirkpatrick Model provides a more explicit measure of efficacy/value/usefulness of the training programmes. Our Basic FDP course module as evaluated by the Kirkpatrick model for Level 1 (Reaction) showed an overall positive reaction by participants for the sessions taken reflected by the mean value of overall satisfaction on the entire programme as 2.78 ± 0.4 on a 3-point Likert scale. As for the next Level 2 (Learning), improvement in knowledge of participants was found to be statistically significant with P < 0.0001 reflects that the overall objective of course was met. The usefulness of FDP has been well documented in the literature and has been reiterated by Bilal et al. through a meta-analysis on the impact of FDP with a mean effect size of 0.73 revealing a significant improvement in participants knowledge and professional competence with P < 0.05 on using the random-effects model and forest plot.
For exploring evaluation at Level 3 (behaviour), ideally one needs to assess it a few months after the training because that gives the opportunity to the trainee to apply their learnt material. Wadhwa et al. assessed the effectiveness of FDP based on the change in participants' behaviour, a year later through semi-structured interviews of participants and found satisfactory results. Evaluation of Level 4 (results) is a tedious prolonged and expensive process. However, it is considered to be the primary goal of the programme, and it is this level that determines the overall success of the programme based on expenditure for resources used and work efficiency of individuals who have undergone training through that course. To assess Level 4 for our training, one needs to follow-up on the trainee and their students' performance in examination as well as their rank in exit exams for selection in the postgraduate examination and beyond as well as evaluate long term feedback from their peers and students.
A study done by Abid et al. and Bahar-Ozvaris et al. showed similar results as ours on overall satisfaction on delivery and teaching–learning media quite useful and relevant to in reference to content and objectives.,, The feedback analysis revealed that a majority of participants were confident in transferring this learning to their academic and work environment. The main point of contention here is how to ensure the same. One way to achieve this would be by taking regular feedback from the students. Even the performance of students indirectly conveys the effectiveness and impact of the programme.
As expected in Andragogy or adult learning, the majority of the candidates felt that active discussion, role-playing, hands-on training, interactive learning all facilitated their learning and those fully embracing them were the best sessions delivered by resource faculty. The programme helps us to realise that the enthusiasm and energy of the teacher are a key ingredient to a successful learning process. Such facilitatory factors should be identified as they are the real strengths that should be utilised for the success of the teaching programme. There were few obstacles as identified by the participants such as longer sessions being too exhaustive and restricting time for other sessions. It highlights the importance of time management and time delegation (ensuring adequate time for key and unfamiliar topics) for a successful teaching programme. One of the barriers expressed by participants in a similar study done by Wadhwa et al. was also related to the time factor. A time gap is necessary in between the sessions to allow for a healthy discussion and recall of what has been learnt previously. In fact, these programmes can also be taken in phases to prevent overburdening of the participants with too many facts. It can also be understood by this evaluation that these programmes need to be repeated more frequently to reinforce the key objectives and find their long-term effect.
It is essential to introspect on weakness identified so that it is not repeated in the future. In our analysis, several points have come forward which need attention. These include:
- The participants may be from culturally diverse group and from different parts of country and also differ in years of experience. They may have been subjected to different teaching and assessment methods during residency days/in their early professional career of academic grooming
- These adults have an opinion, they come with a set of beliefs, teaching style and ethics
- Learning pace and understanding of an individual differs. It is essential to try and balance the pace to cater to all
- Active learning gives a win-win situation and acceptable to learners
- Long sessions should be discouraged as the learner loses attention and the purpose is defeated. They can be split into two sessions if necessary
- A non-threatening environment eases the situation for both the facilitator and learner
- The discussion should also focus on the elimination of misconceptions of participants which should be resolved during the course
- Topics such as the systemic approach and SLO should be reinforced by hands-on activity. These topics are convoluted and need more insight. Hands-on provides a better learning opportunity
- Always convey to the learner objectives of the course in the introductory session and communicate that only basic concepts are being dealt with and more focussed training on each topic should be attended by them in the future as online or in-person training programmes as per their convenience for a stronger foundation
- Schedule regular separate workshops/or training on each topic and encourage faculty to join it
- The availability of pre-course material may be helpful. To generate interest, the participant can be given to work on some tasks and discuss it during training
- Introducing the basics through formal training in medical education, early in the career for medical teachers can be more fruitful. Participants should be encouraged to attend FDP, preferably during their senior residency or assistant professorship. This way, the difficulty of unlearning the wrong and re-learning the right can be circumvented since, it is easier to manage change than handle inertia.
Shortage of teachers in India has influenced quality of medical education., At present, a prominent gap seen is the ability to create and develop an educational leadership asset. An option is to have an extended course for medical teachers through distance learning for a wider participation and focus on educational leadership and pedagogy. A recent interesting direction in FDP as documented by Burgess et al. is to shift towards long-term programmes as a longitudinal event to foster innovation and excellence in teaching for early career teachers.
Feedback sought one time immediately after the completion of the workshop is insufficient. The resource faculty should aim to get feedback from the candidates after regular intervals to understand the drawbacks while incorporating these tools in their teaching and assessment methods. By this way, the practicality of such programmes can also be tested in the long run and pave way for amendments.
| Conclusion|| |
The effectiveness of the basic FDP rests on a well-structured programme with delivery through interactive sessions. Ensuring good time management and non-threatening environment maintains the interest of learners and ease to learn. Exposure to FDP early in career would be an appropriate stepping stone in medical education and avoids unlearning and relearning. A single training workshop may be inadequate in enabling teachers with required knowledge and skills and therefore, re-training should be scheduled for a better outcome.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]