Teaching, Scholarship


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Teaching, Scholarship

  1. 1. Teaching, Scholarship & Production: Expectations for Contemporary Clinical Faculty Bill Hendricson Assistant Dean, Education & Faculty Development UTHSCSA Dental School Associate Editor, Journal of Dental Education Academy for Academic Leadership Hypothesis: Dental Schools Desire Clinical Faculty Who Are Fully Engaged With the School Goal: Share a Vision of “Scope of Practice” for Clinical Faculty Service Clinical Scholar Model Research Teaching Service
  2. 2. We’re Talking about Faculty Who Teach in Labs and Clinics 2500 hrs X 56 schools = 140,000 hrs
  3. 3. Influence on Production and Clinic Revenue ?? <ul><li>Questions for you to ponder: </li></ul><ul><li>Will more frequent use of “teaching best practices” influence students’ speed & patient completion? </li></ul><ul><li>What effect will movement to a “clinical scholar” </li></ul><ul><li>model for faculty have on students’ functioning in </li></ul><ul><li>the clinic / $$ productivity? </li></ul><ul><li>Can clinical faculty function in a more “academic” </li></ul><ul><li>role within the standard clinical education model </li></ul><ul><li>of dental school? </li></ul>?
  4. 4. Agenda <ul><li>Academic roles for clinical faculty in dental schools – historical trends </li></ul><ul><li>What makes clinical faculty “happy & satisfied”? </li></ul><ul><li>Clinical scholar model / examples </li></ul><ul><li>Scholarship opportunities </li></ul><ul><li>Service opportunities </li></ul><ul><li>Teaching roles </li></ul>You ponder “implications”
  5. 5. Competencies for Dental School Faculty <ul><li>Clinical Teacher </li></ul><ul><li>Clinical Scholar </li></ul><ul><li>Research-Intensive Scholar </li></ul>Hand JS. Identification of competencies for effective dental faculty. J Dent Educ 2006; 70(9):937-47. Clinic Scholar Clinic Teach ResearchIntensive
  6. 6. Clinical Teacher <ul><li>Teaching students in laboratories & clinics is primary focus. </li></ul><ul><li>Limited classroom teaching. </li></ul><ul><li>May participate in research as a clinician. </li></ul><ul><li>May publish, but not a major expectation. </li></ul><ul><li>Low service expectations. </li></ul>
  7. 7. Clinical Scholar <ul><li>Expected to participate in teaching, research & service. “triple threat” faculty </li></ul><ul><li>Expected to serve as course director & teach in the classroom, lab & clinic. </li></ul><ul><li>Expected to participate on committees. </li></ul><ul><li>Expected to publish in peer-reviewed journals </li></ul><ul><li>Not expected to secure NIH-level funding. </li></ul><ul><li>Should have capacity to secure seed money funding for pilot projects from foundations. </li></ul>
  8. 8. Research-Intensive Scholar <ul><li>Expected to teach with emphasis on graduate students. </li></ul><ul><li>Expected to develop a research “niche” & secure NIH-level grant funding. </li></ul><ul><li>Expected to publish research in highly ranked journals. </li></ul><ul><li>Expected to recruit other researchers & mentor them. </li></ul>
  9. 9. 1945 - 1985 1985 - 2008 2010 - 2030 Fully Engaged Faculty Historical Trends Clinical Scholar Clinical Teacher Research Intensive
  10. 10. Issues: Clinical Teacher <ul><li>Perception of “isolation” from school activities & events; i.e., out of the loop </li></ul><ul><li>Disconnect from classroom instruction </li></ul><ul><li>Tensions between clinical scholar faculty & clinical teacher; perceived hierarchy </li></ul><ul><li>Core school functions not being performed often or well – educational planning </li></ul><ul><li>High turn-over at some schools </li></ul>Haden. Quality of Dental School Faculty Work Life. J Dent Educ . May, 2008
  11. 11. 2010 - 2030 Clinical Scholar Model Return to Academic “Triple Threat” ?? Clinical Faculty More “Fully Engaged” in School Affairs Research Scholarship Teaching Mentoring Service For School
  12. 12. <ul><li>What are clinical faculty perceptions of </li></ul><ul><li>academic work-life? </li></ul><ul><li>The good, the bad & the ugly </li></ul>Report of 2007 Dental School Faculty Work Environment Questionnaire Haden, JDE. May 2008
  13. 13. <ul><li>Fully engaged faculty are most satisfied with academic career & report best “balance ” </li></ul><ul><li>Roger, Wehmeyer, Milliner. Reflections on academic careers by current dental school faculty. J Dent Educ . 2008; 72 (5) </li></ul><ul><li>Haden. Quality of dental faculty work life. J Dent Educ . 2008; 72 (5). </li></ul>Clinical Scholar Scope of Practice: T eaching R esearch S ervice R T S
  14. 14. Gen X Faculty Expectations <ul><ul><li>Trower CA. (CCI) Making academic dentistry more attractive to new teacher – </li></ul></ul><ul><ul><li>scholars. Journal of Dental Education. May 2007; pgs 601- 605 </li></ul></ul>Academic Decision-Making Teaching Research Curriculum Planning Component Narrow within discipline Resistance Trans-disciplinary Collaboration Experimentation Centered around disciplines Centered around problems / needs Opaqueness “ Head-scratchers” Transparent Vagueness Ad - hoc Openness Systematic What They Find in Academia What X’ers Expect & Value
  15. 15. What makes clinical faculty “happy & satisfied”? <ul><li>Variety of work assignments </li></ul><ul><ul><li>Teaching in different settings & levels </li></ul></ul><ul><ul><li>School service: contribute to planning </li></ul></ul><ul><ul><li>Scholarship: disseminate educational methods </li></ul></ul><ul><li>Opportunity to be a “player” in school </li></ul><ul><li>Learn new skills / roles </li></ul><ul><li>Create new programs </li></ul><ul><li>Interaction with students </li></ul>“ The best thing about my job is that I can move from project to project, and task to task and never have time to get bored. No day is ever identical to another which keeps me charged up and learning new things.” Haden. Quality of dental faculty work life. J Dent Educ . 2008; 72 (5).
  16. 16. Clinical Scholar Model Opportunities Fully Engaged Faculty Research Scholarship T S
  17. 17. Quality of Teacher & Student Interactions Factors Teachers Can Control Teaching Strategies in Classroom & Clinic Design of Curriculum Evaluation Methods Student Variables Learning Style & Self - Concept Difficult Behavior Students’ Expectations & Preferences Research Opportunity
  18. 18. What is ER? <ul><li>It’s not Thursday 9 pm “Must See TV” </li></ul>
  19. 19. What is Educational Research (ER)? <ul><li>Exploration of factors, conditions, techniques and interferences that influence the outcomes of teaching and learning processes, </li></ul><ul><li>including personal traits and habits of teachers, students and the overall environment of the school and it’s community. </li></ul><ul><li>John Dewey </li></ul><ul><li>Human Nature & Conduct (1927) </li></ul>
  20. 20. Dewey & Eisenhower Beginning of Educational Research
  21. 21. Types of ER <ul><li>Prediction studies: admissions, GPA, boards </li></ul><ul><li>Influences on student achievement (emotional intelligence, personality factors, academic variables) </li></ul><ul><li>Students’ perceptions of education & issues </li></ul><ul><li>Traits of teachers, students & school environment </li></ul><ul><li>Students’ study habits & learning styles </li></ul><ul><li>What is appropriate curriculum content? </li></ul><ul><li>Organizational development / change strategies </li></ul><ul><li>Proof of concept studies - assessment </li></ul><ul><li>Proof of concept studies - teaching methodology </li></ul><ul><li>Hot issues / best practices – Critical Thinking </li></ul>
  22. 22. Examples: ER Papers in JDE <ul><li>Evaluation of Clinical Mock Boards & Their Influence on Qualifying Exam Success. J Dent Educ. 2002 </li></ul><ul><li>What is the Impact of Case-based Seminars on Student Self-Assessment of Orthodontic Skills? </li></ul><ul><li>J Dent Educ 1994; 58 </li></ul><ul><li>What is the Agreement Between Clinicians & A Computer-Based Decision Support System for Planning Dental Treatment? J Dent Educ. 2002; 66 </li></ul>
  23. 23. Patient Care Critical Thinking Practice Management Health Promotion Professionalism Communication Oral Healthcare Professional* 2008 ADEA Competencies for the New General Dentist ADEA Council of Sections Task Force on Competencies & Foundation Knowledge
  24. 24. Patient Care Major Change in Emphasis: Critical Thinking Critical Thinking Professionalism Communication Oral Healthcare Professional Promotion Health Management Practice Critical Thinking
  25. 25. Critical Thinking How do you assess your students’ capacity to: Recognize, analyze & describe problems Gather & assess relevant information, weigh it against existing knowledge, to better understand the problem Interpret information & arrive at well-reasoned conclusions Explain rationales for decisions & answer questions Communicate effectively with others while exploring problems What if a CODA site visit team asked these questions at the next review? Tremendous Research Opportunities
  26. 26. How do dental students develop critical thinking? <ul><li>Novice Expert </li></ul>  ♦            @    ♦           @   Vertical – compartmentalized Horizontal – networked Data Knowledge Hendricson, ADEA CCI. Educational Strategies Associated with Development of Critical Thinking and Self-Directed Learning. J Dent Educ. 2006; 70(9): 925-936.
  27. 27. Assessment of Critical Thinking Capacity <ul><li>Fresno Test </li></ul><ul><li>Health Science Reasoning Test (HSRT) </li></ul><ul><li>California Critical Thinking Disposition Inventory </li></ul>
  28. 28. It All Starts With Questions
  29. 29. <ul><li>It's easy to find answers. The hard part is finding good questions. </li></ul><ul><ul><ul><ul><ul><li>Thomas Edison </li></ul></ul></ul></ul></ul><ul><li>It’s far better to get an approximate answer to the right question than an exact answer to the wrong question. </li></ul><ul><li>John Tukey </li></ul>
  30. 30. A Quick Trip Through Research Questions
  31. 31. Hot Research Questions in the 13 th Century <ul><li>How many angels can dance on the point of a fine needle without jostling each other? </li></ul><ul><li>Can angels pass from one place to another without going through the middle? Can angels move from point A to point C without passing point B? </li></ul><ul><li>Is there excrement in paradise? </li></ul><ul><li>Why are angels more logical in thought when it is warm & sunny versus when it is cold & wet? </li></ul><ul><li>Royal. St Thomas Aquinas: The Person and his Work . 1996. </li></ul>
  32. 32. W – H – I –F Questions W hat W ould H appen If ? Hendricson. It All Starts with Questions JDE , Sept, 2004
  33. 33. W hat w ould h appen to student attrition if we [ fill in the blank ]? W hat w ould h appen to board scores if we [ fill in the blank ] ? Why do students have difficulty learning [ fill in the blank ] ? What would happen to clinic performance if we [ fill in the blank ] ? Based on the literature, what are best practices for [ blank ] ? What are barriers to implementing [ fill in the blank ] ? W hat w ould h appen if we stopped [ blank ] & started [ blank ] ? ER Question Generator
  34. 34. WHIFs from My Career <ul><li>What would happen if we… </li></ul><ul><li>Provided feedback to faculty on their lecture skills? </li></ul><ul><li>Hendricson, Hawkins, Hudepohl, Littlefield. Effects of </li></ul><ul><li>Providing Feedback to Lecturers via Videotape Recordings & Observer Critiques. Am J of Pharm Educ. 1983. </li></ul><ul><li>Changed eval forms to focus on 4 global skills versus 13 component tasks? </li></ul><ul><li>del Rio, Dale, Hendricson: A Method for Training Endodontic Evaluators. JDE. 1983. </li></ul><ul><li>Compared clinical errors among students who learned endodontics by 4 methods? </li></ul><ul><li>Hendricson, Sandoval, Dale: A Comparison of 4 Instructional Methods for Reviewing Clinical Endodontics. JDE. 1987. </li></ul>Compared dental students’ performance on “work alone” competency exams and daily grades. Berrong, Dale, Hendricson, JDE 1983.
  35. 35. Write A WHIF for a Potential Educational Research Project at Your School <ul><li>W hat W ould H appen If we …. ???? </li></ul>
  36. 36. Case 1 Fully Engaged Faculty 4 Years at Dental School Dr. Tom Transition Returning Boomer
  37. 37. Fully Engaged Clinical Faculty One new project each year in each area: Teaching Research Service Strat Plan Comm Mentor for new faculty Clinical niche – “the expert” at school Chair – Curr Comm Service Clinician on grant Student research mentor Piloting new method One ER study each yr ER study group 2 ER pubs; 4 abstracts 3 invited presentations Research 2 teacher training programs Course Drs Group Class Advisor Course Director Fr Lab instructor Soph Clinic: 5 sessions Jrs 2 Electives Srs Teaching
  38. 38. Clinical Scholar Model Opportunities for Service in Curriculum Fully Engaged Faculty R T Service For School
  39. 39. Persistently Advocated Reforms in Dental Education Kassebaum, Hendricson, Hayden, Taft. J Dent Educ. Sept 2004; 68(9): 914 – 931
  40. 40. <ul><li>Eliminate “smokestack” (silo) </li></ul><ul><li>approach to curriculum </li></ul>
  41. 41. Dental Students Spend More Time in Lecture than Clinic
  42. 42. Alternative Teaching / Learning
  43. 43. Are We Getting it Right? <ul><li>Avoiding False Positives & False Negatives When Evaluating Students’ Performance in Labs and Clinics </li></ul>Dental Education Has Not Adopted New Assessment Methods Used In Other HPE Albino, Young, Hendricson. December 2008; J Dent Educ. What we evaluate, we do it the right way.. But I’m not sure we’re right in what we choose to evaluate. ADEA CCI Competency Assessment Survey, 2008
  44. 44. Focus of Assessment in Dental Education?
  45. 45. Curriculum Revision Methods Abrahamson. Diseases of the Curriculum J Med Educ 1978 Strategy Characteristics Mount Olympus This is what we’re going to do! Sneak Attack “ Oh, by the way, we now have a new clinical ...” Atilla the Hun Mandated across-the-board cuts Fire-fighting Temporary “pothole-filling” Department review “ Fox guarding the chicken coop” Interdis peer review Plastic surgery (nip & tuck) CQI Model Parallels scientific decision - making process
  46. 46. Continuous Program Monitoring Systematic Process CAAMP 2008 Curriculum Quality
  47. 47. Case 2 Fully Engaged Faculty 4 Years at Dental School Dr. Ima New 30-Something Clinician
  48. 48. Fully Engaged Clinical Faculty Goals: Predoc Educ Director for Department Clinical Education Director for Dental School Student org advisor ADEA CCI WFA at HSC IPE Curriculum TF Med-Dent Homeless Evening Clinic Alternate Track Comm Service Institutional grant Co-I foundation grant Team for NIH grant 2 studies – motor skill 6 abstracts 3 invited presentations Research Teaching Methods Course - HSC National Teaching Course Lecture Course Fr Course Dir Soph Support Lab Soph Clinic Faculty Jrs Teaching
  49. 49. Clinical Scholar Role Fully Engaged Faculty R Teaching S
  50. 50. Faculty Perception of Role in Clinic Checker Cover Coach Clinician / Fireman Irby. Acad Med. 1995 Linn. Rev Educ Research. 1991 Glance and Grade
  51. 51. Research on Clinical Teaching <ul><li>Chambers . Association among factors thought to be important by instructors in dental education and perceived effectiveness of these instructors by students. Eur J Dental Education . 2004;8:147-51. </li></ul><ul><li>Manogue. Clinical assessment of dental students: values and practices of teachers in restorative dentistry. Med Educ . 2001;35:364-70 </li></ul><ul><li>McGrath. Development and Evaluation of a Questionnaire to Evaluate Clinical Dental Teachers. Br Dent J. 2005;198:45-8. </li></ul><ul><li>Victoroff . Students’ perceptions of effective learning experiences in dental school: A qualitative study using a critical incident technique. J Dent Educ 2006 ; 70:124-132. </li></ul><ul><li>Henzi. North American dental students’ perspectives about their clinical education. J Dent Educ 2006; 70: 361-377. </li></ul><ul><li>Schonwetter. Students’ perceptions of effective classroom & clinical teaching in dental & dental hygiene education. J Dent Educ . 2006; 70: 624-635 </li></ul>
  52. 52. 7 Microskills of Clinical Teaching <ul><li>Set expectations, assess learner’s level & needs </li></ul><ul><li>Coach students through patient care </li></ul><ul><ul><li>Guide assessment & planning with questions & pearls </li></ul></ul><ul><ul><li>Provide tips during patient care </li></ul></ul><ul><ul><li>Debrief: what went right & wrong? how to handle next time? </li></ul></ul><ul><li>Ask questions to stimulate thinking </li></ul><ul><li>Give constructive “how to improve” feedback </li></ul><ul><li>Explain “why, how, where, when” (prescriptions) </li></ul><ul><li>Provide personal support & encouragement </li></ul><ul><li>Model professional behavior & values </li></ul><ul><li>Neher. Microskills Model of Clinical Teaching. J Am Board Fam Pract. 1993; 6: 86-87 </li></ul><ul><li>Irby. Teaching & learning in ambulatory care: thematic review of literature. Acad Med. 1995; 70(10): 898-931 </li></ul>
  53. 53. Exemplary Clinical Faculty Use a Bookends Teaching <ul><li>Orient students before patient encounter </li></ul><ul><li>Ask “assessment & planning” questions </li></ul><ul><li>- What do you plan to do & why? </li></ul><ul><li>- How & why did you rule-out alternatives? </li></ul><ul><li>Priming & anticipatory guidance questions </li></ul><ul><li>Debrief students after patient encounter </li></ul><ul><li>Ask reflection & self-assessment questions </li></ul><ul><ul><ul><li>- What is the most important thing you learned today? </li></ul></ul></ul><ul><ul><ul><li>- What could we do differently next time? </li></ul></ul></ul><ul><ul><ul><li>- Review specific trouble spots </li></ul></ul></ul>Irby. Teaching in Ambulatory Care Setting: Thematic Review of Literature. Acad Med. Chambers. Association Among Factors Thought Important by Instructors & Perceived Effectiveness of These Instructors by Students. Eur J Dent Educ. 2004:8:147-51 .
  54. 54. Exemplary Clinical Scholars <ul><li>“ Check” is just one part of </li></ul><ul><li>overall mentoring process </li></ul>See themselves as students’ professional mentor
  55. 55. <ul><li>“ A poor surgeon hurts 1 person at a time.” </li></ul><ul><li>“ A poor teacher hurts 130.&quot; </li></ul><ul><li>Dr. Ernest Boyer </li></ul><ul><ul><li>Former President , Carnegie Foundation </li></ul></ul><ul><ul><li>United States Commissioner of Education </li></ul></ul>Renewed Sense that Quality Teaching is Really Important Influence of enhanced focus on coaching versus checking on clinical operations?
  56. 56. Clinical Scholar Model Goal: Future “Scope of Practice” for Clinical Faculty Effect on Clinic Production: Operations Organizations Income Research Scholarship Teaching Mentoring Service For School
  57. 57. Thank You!