ENHANCING TEACHING SKILLS OF GERIATRICS FACULTY

Lynn McNicoll, MD and Renee Shield, PhD Alpert Medical School, Brown University

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, life-long 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 The aims of this workshop are: 1. to describe a structured faculty development program

for GEC that accommodated the unique needs of geriatrics faculty teaching various learners in unique settings

2. 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 non-threatening 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. Evaluations of Certification Level 1 - Year 1 members only

2. Aggregated results of ITC reports – Year 1 members only

3. Evaluations of GEC faculty development program - Years 2 and 3

4. 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 and Confidence

“I have never felt confident nor ‘good’ at teaching, 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 Session Comments

“I appreciated the feedback. It gave me a chance to provide feedback in a constructive manner to my peers in a non-threatening manner.”

ITC Comments

“Immensely helpful… to have expert educators analyze my teaching style, mannerisms, and objectives,”“Observing myself on video was extremely insightful for my non-verbal communication.”

RESULTS – COMMON THEMES IN ITCLogistics and Handouts

Punctuality is appreciatedDistribute handouts at the beginning and not during the talk (too distracting)Use laser pointers judiciouslyAvoid acronymsStand if possible and make sure to have eye contact with all learnersUse movement to retain audience attention, move closer to audience who ask questions.

Voice Appropriate volume and pace for learnersAvoid reading directly from notesAvoid ‘Ums’ and ‘Uhs’Modify tone or emphasis when mentioning important points.

RESULTS – COMMON THEMES IN ITCAddressing the Needs of Different Learners

Use tangible examples and pictures or tables or graphs for visual learnersUse personal examples to make the topic real for learnersNotice if learners are not as engaged and try to change tactics in real timeleave enough time for response (5 seconds), acknowledge response

Introduction Provide audience with a planUse humor, a hook, or a clinical case to engage the learnerAsk audience to introduce themselves or assess their current level of knowledge.

RESULTS – COMMON THEMES IN ITCContent Use contextual examples – helps make

complicated theoretical concepts more concreteAlign objectives, outline and sections of the talkHave concluding or summarizing slides after each major section.

Conclusion Ending with a question is a nice summative mechanismAllow time for questions at the end and make self available afterwards for learners who are uncomfortable sharing with the groupAsk learners if content is appropriate for all learners especially if learners have different levels of training.

RESULTS – SCHOLARLY ACTIVITY

  NHlectu

re

Division of Ger

lectures

Local Presentatio

ns

Invited

Presentatio

ns

Poster or

Paper Abstra

ct

Journal

article or

book chapt

er

National

Comm Membership

Total % increa

se from baseli

ne

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

  NHlectu

re

Division of Ger

lectures

Local Presentatio

ns

Invited

Presentations

Poster or

Paper Abstra

ct

Journal article

or book

chapter

National

Comm Membership

Total

% increa

se from baseli

neNP (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