Effect of teaching context and tutor workshop on tutorial skills

Predictive power of training design on employee performance: an empirical approach in Pakistan's health sector

Purpose

The purpose of this study is to ascertain the role of training design on employee performance in the health sector of Pakistan.

Design/methodology/approach

This cross-sectional study applies random sampling to select respondents among Pakistan's trained health nurses. The study uses a survey questionnaire as a primary tool to collect the data. The 306 completed questionnaires form the study sample, with their data analyzed to find the results.

Findings

Structural equation modeling shows the positive and significant roles of training content and learning style on employee performance. In contrast, the study finds the role of the trainer on nurses' employee performance in Pakistan to be insignificant.

Practical implications

This research generally makes a valuable contribution to the training literature, particularly in Pakistan. Employers need to provide more training programs to reduce the cost of recruiting and training new staff members. Furthermore, the study recommends the provision of feedback to employees after training so they become aware of areas where they can improve their performance. This study's findings warrant consideration in the current training and development environment, and by policymakers and health sector planners of the Pakistani government.

Originality/value

This research study will help researchers to fill the gap in the international investigation by testing the training design and performance factors.

Sustained effects of faculty leadership development modules for clinical instructors of core competences education in Taiwan: a four-year explanatory case study

BACKGROUND

The Accreditation Council for Graduate Medical Education (ACGME) core competencies (CC) in general medicine-based primary care are essential for junior medical trainees. In this country, a regular faculty development (FD) program aimed at training faculty in instructing (teaching and assessing) these CC had operated. However, leadership was not emphasized. In a new intervention module, the roles and associated responsibilities of clinical instructors to conduct, design, and lead CC-based education were emphasis.

AIMS

This follow-up explanatory case study compares the effectiveness of intervention module with that of the previous regular module.

METHODS

The regular group (n = 28) comprised clinical instructors who participated in the FD module during the 2013-2014 year while the intervention group (n = 28) was composed of 2015-2016 participants. Prior to the formal (hands-on) training, participants in the intervention group were asked to study the online materials of the regular module. These participants then received a 30-h hands-on training in conducting, designing, and leading skills. Finally, they prepared a 10-h reflective end-of-module presentation of their real-world practices.

RESULTS

Following the training, a higher degree improvement in participants self-reported familiarity with CC education, self-confidence in their ability to deliver CC education and sustained involve CC education were noted among the intervention FD group, compared with the regular FD group. In the intervention group, senior academicians (associate and full professor) are more substantially involved in designing and leading CC-based courses than junior academicians (lecturers and assistant professors). Among non-teaching award winners of in the intervention FD group, the follow-up degree of sustained involvement in delivering, designing and leading CC-based courses was significantly higher than that of the regular group.

CONCLUSIONS

Our study demonstrated that leadership training in the intervention FD modules substantially motivated clinical instructors to become leaders in CC education.

Refinement of a training concept for tutors in problem-based learning

The use of problem-based learning (PBL) in the Charité Berlin Human Medicine model curriculum requires the annual training of 80 to 100 new PBL tutors using PBL tutor training (PTT). Therefore, the following three measures were taken: The existing traditional PTT (Trad-PTT) was further developed into an interactive PTT (Inter-PTT), which is using more interactive teaching tools. Both PTT concepts ran for 12 months, respectively. The review of the Inter-PTT was significantly better, as the PBL tutors understood their tasks within the PBL process better and felt more motivated. A follow-up survey after the initial experience with PBL confirmed almost all the positive aspects of the Inter-PTT. In addition, the Inter-PTT was also offered to non-clinicians and other scientific staff to make the training interdisciplinary. PTT made it possible to communicate beyond specialist boundaries; however, the interdisciplinary idea was no longer detectable in the follow-up survey. In order to increase the number of available PBL tutors, a self-commitment was introduced for the departments. This increased the number of "involuntary" participants for PTT, but reduced the amount of necessary training courses. The fulfilment of self-commitment succeeded in almost all departments. A PTT tailored to the needs of the tutors is a basic prerequisite in order to excite teachers about PBL and to familiarise them with their role as learning facilitators. The increase of interactive teaching forms led to a joint interdisciplinary learning process within PTT. The excellent review of Inter-PTT makes it a solid basis for further training concepts.

Self-Observation and Peer Feedback as a Faculty Development Approach for Problem-Based Learning Tutors: A Program Evaluation

PROBLEM

Good teaching requires spontaneous, immediate, and appropriate action in response to various situations. It is even more crucial in problem-based learning (PBL) tutorials, as the tutors, while directing students toward the identification and attainment of learning objectives, must stimulate them to contribute to the process and provide them with constructive feedback. PBL tutors in medicine lack opportunities to receive feedback from their peers on their teaching strategies. Moreover, as tutorials provide little or no time to stop and think, more could be learned by reflecting on the experience than from the experience itself. We designed and evaluated a faculty development approach to developing PBL tutors that combined self-reflection and peer feedback processes, both powerful techniques for improving performance in education.

INTERVENTION

We developed an observation instrument for PBL facilitation to be used both by tutors to self-observe and reflect on own teaching strategies and by peers to observe and provide feedback to tutors. Twenty PBL sessions were video-recorded. Tutors completed the instrument immediately after their PBL session and again while watching their video-recorded session (self-observation). A group of three observers completed the instrument while watching each recorded session and provided feedback to each tutor (peer observation and feedback). We investigated tutors' perceptions of the feasibility and acceptability of the approach and gathered data on its effectiveness in enhancing tutors' facilitation skills.

CONTEXT

The preclinical medical curriculum at the University of Geneva is essentially taught by PBL. A new program of faculty development based on self-observation and peer feedback was offered to voluntary tutors and evaluated.

OUTCOME

Our results suggest that self-observation and peer feedback, supported by an instrument, can be effective in enhancing tutors' facilitation skills. Reflection on self-observation raised teachers' awareness of the effectiveness of the strategies they used to foster student learning. This motivated a need to change their teaching practice. However, for the changes to become operative, peer feedback was required, providing the cues and strategies needed to improve the facilitation skills.

LESSONS LEARNED

Peer coaching was considered feasible and useful to improve tutors' facilitation skills. Evaluating the program made it possible to assess tutors' needs and the reasons underlying their difficulties, and this in turn provided the basis for advanced workshops. Nonetheless, aspects related to logistics and the time constraints of such an individualized approach, as well as the cultural appropriation of peer coaching, might be obstacles that need to be addressed.

Exploring trainers’ engaging instructional practices: a collective case study

Purpose

– This study aims to explore the phenomenon of training engagement from the trainers’ perspective. Specifically, two questions guided this inquiry. First, how do trainers define engagement in the training context? and What strategies do trainers use to engage trainees?

Design/methodology/approach

– The collective case study approach was adopted for this qualitative study. Seven cases were selected for in-depth analyses. Data were collected through individual, face-to-face interviews and analyzed using the constant comparative analysis method.

Findings

– Major findings suggest that engaging training practices take various forms. They include being trainee-centered, maximizing learning through entertaining and interesting instruction, accommodating different learning styles, eliciting trainee participation by creating an encouraging learning environment and connecting with trainees by building rapport early in a training session.

Research limitations/implications

– The small sample limits the generalizability of the findings. However, this study expands training literature by focusing on an under-explored research area, the role of engaging trainees in maximizing learning outcomes.

Practical implications

– For trainers, this study offered some specific strategies they can use to engage learners in the training context to achieve desired learning outcomes. In addition, the seven cases selected for this study may be used as a benchmark against which both experienced and novice trainers compared their own practices.

Originality/value

– This is one of very few qualitative studies with a focus on emotional aspects involved in training. The rich data from this study shed light on areas for future improvement, particularly regarding how to effectively engage trainees to maximize learning outcomes.

Success of a Faculty Development Program for Teachers at the Mayo Clinic

BACKGROUND

There has been limited research on the improvement of underperforming clinical teachers.

OBJECTIVE

To determine whether a faculty development program could improve the evaluations of clinical teachers in an internal medicine residency program.

METHODS

A total of 123 teachers completed faculty development at the Mayo Clinic from 2009 to 2012. The faculty enhancement and education development program (FEED) consists of 6 interactive, small group, 2-hour sessions taught by experienced Mayo Clinic faculty over 1 year. These sessions address the following competencies: asking questions, diagnosing learners, giving feedback, using teaching frameworks, recognizing learning styles, and providing clinical supervision. Resident-of-faculty Mayo teaching effectiveness (MTE) scores have previously demonstrated content, internal structure, and criterion validity. Teachers were grouped into the top 80% or the bottom 20%, according to baseline MTE scores. Mixed linear models were used to compare these groups regarding changes in MTE scores after completion of FEED. Results were adjusted for teacher age, sex, medical specialty, academic rank, and teaching awards.

RESULTS

For all participants combined, the adjusted MTE scores (mean; standard error) improved from baseline (3.80; 0.04) to completion of FEED (3.93; 0.04; P < .001). However, the bottom 20% had a significantly greater improvement in scores than the top 80% (score-change difference  =  0.166, P < .001).

CONCLUSIONS

We describe a low-intensity faculty development intervention that benefited all clinical teachers, but was particularly effective for underperforming teachers in internal medicine. The approach may be suitable for adoption or adaptation in other graduate medical education programs.

Evaluation of the peer teaching program at the University Children´s Hospital Essen - a single center experience

Since 1986 medical students at the University Children's Hospital Essen are trained as peers in a two week intensive course in order to teach basic paediatric examination techniques to younger students. Student peers are employed by the University for one year. Emphasis of the peer teaching program is laid on the mediation of affective and sensomotorical skills e.g. get into contact with parents and children, as well as manual paediatric examination techniques. The aim of this study is to analyse whether student peers are able to impart specific paediatric examination skills as good as an experienced senior paediatric lecturer. 123 students were randomly assigned to a group with either a senior lecturer or a student peer teacher. Following one-hour teaching-sessions in small groups students had to demonstrate the learned skills in a 10 minute modified OSCE. In comparison to a control group consisting of 23 students who never examined a child before, both groups achieved a significantly better result. Medical students taught by student peers almost reached the same examination result as the group taught by paediatric teachers (21,7±4,1 vs. 22,6±3,6 of 36 points, p=0,203). Especially the part of the OSCE where exclusively practical skills where examined revealed no difference between the two groups (7,44±2,15 vs. 7,97±1,87 of a maximum of 16 points, p=0,154). The majority of students (77%) evaluated peer teaching as stimulating and helpful. The results of this quantitative teaching study reveal that peer teaching of selected skills can be a useful addition to classical paediatric teaching classes.

Development and implementation of a technical and didactical training program for student tutors in the dissection course

BACKGROUND

student tutors have a long tradition in gross anatomy instruction. However, the full potential of the tutors is generally not tapped, since little attention is paid to their technical and didactical training. The aim of this paper is to report a systematic approach to the development, didactic reasoning and implementation of a curriculum for training student tutors in gross anatomy.

METHODS

the training program was developed using the six-step approach of Kern's curriculum development model. For needs assessment, the literature research was amended by a survey among the 1st and 2nd year students of the dissection course (n=167) and two independent 90 min focus group interviews with the tutors who supervised these students (n=15). Protocols were transcribed and analyzed by margin coding. The training curriculum was setup on the basis of these data.

RESULTS

corresponding to the literature, the students want student tutors with good teaching competence as well as adequate content knowledge and technical competence. Supporting that, the tutors request a training program enhancing their didactic skills as well as their knowledge of content and working using relevant methods. Thus, a combined didactic and professional training program has been developed. Six professional and 11 didactic learning objectives were defined. A 3 weeks training curriculum was implemented, using microteaching and group exercises for didactics and active dissection for technical training. Both parts were interlocked on a contextual and practical level.

CONCLUSION

our focus group analyses revealed that a specific training program for student tutors in the dissection course is necessary. We describe a feasible task-oriented training curriculum combining didactic and professional objectives.

When a problem-based learning tutor decides to intervene

PURPOSE

To appropriately contribute to group discussion, tutors should be experts in their field and possess facilitative skills. However, knowing when to interject is always a difficult question. This study investigated the specific scenarios or cues during group tutorial sessions that prompted or motivated tutors to interject and participate in the group discussion.

METHOD

From 2005 through 2008, the authors, using the interpersonal process recall method, videotaped 40 tutorial discussions led by eight experienced tutors from the departments of medicine, nursing, and clinical psychology. The tutors were later shown the tapes and asked to explore their intentions and analyze the contexts for the 636 episodes in which they had intervened in the discussions.

RESULTS

Qualitative analyses revealed three themes for the tutors' interventions: (1) Tutorial group process included 10 categories related to discussion sequence, students' roles, and group dynamics, (2) quality of discussion included nine categories related to clarity and accuracy of the information brought forward by the students, and relevance and critical appraisal of the information in relation to the major objectives, and (3) quality and quantity of the materials discussed included eight categories related to amount, datedness, accuracy, representativeness, and source (whether primary or secondary).

CONCLUSIONS

These findings provide valuable insights into the contextual situations that lead problem-based learning tutors to intervene and provide material to build a framework for training new tutors.

Consultants in Scotland: survey of educational qualifications, experience and needs of Scottish consultants

AIMS

To survey Scotland's NHS consultants regarding their teaching roles; educational qualifications/training; attitudes to educational qualifications; perceptions of health boards' attitudes to educational activities; usefulness of various educational courses and preferred delivery methods.

METHODS

Postal questionnaire (n=3615).

RESULTS

Sixty two percent response rate (n=2246). 98% had one or more roles in education/training. 54% spent more time in educational roles than job-plan allocations. 6% had educational qualifications. 30% rated educational qualifications valuable to their educational role; 21% to their career. 48% had not attended any educational training. 19% of respondents rated their health board as supportive of their educational activities. Respondents rated dealing with underperforming students (74%), dealing with challenging behaviour (63%), appraising students (63%), trainee assessment (61%) and feedback (58%) as the most useful topics.

CONCLUSIONS

Scottish consultant involvement in educational activities is virtually universal but consultants perceive they need more time than allocated in job plans. Most consultants had no teaching qualifications. Nearly half had no formal training for educational activities. Educational qualifications were valued by a minority regarding both career development and educational activities. Increased access to staff development for teaching is required as NHS sources are not meeting the need for teacher training of consultant staff.

Tutor training, evaluation criteria and teaching environment influence students' ratings of tutor feedback in problem-based learning

AIM

In a problem-based learning (PBL) curriculum, tutor's feedback skills are important. However, evaluation studies often show that students rate many tutors as ineffective in providing feedback. We explored whether this is related: (a) to tutors' skills, and hence a teaching intervention might improve their performance; (b) to the formulation of the evaluation item, hence a more specific wording might help students better recognize a feedback when received; (c) to PBL teaching environment, and hence the tutors' teaching unit might influence students' ratings.

METHODS

Students rated 126 tutors of 13 one-month teaching units over three consecutive years on their ability of providing feedback. We assessed how (a) a teaching intervention given between years 1 and 2, (b) a rewording of the evaluation item which took place in year 3, and (c) the tutors' teaching unit, influenced students' ratings.

RESULTS

The ratings of tutors considered as effective by students at year 1 improved after the teaching intervention, while those of unsatisfactory tutors did not progress. However the ratings of the latter increased after reformulation of the evaluation item. This increase varied across teaching units.

DISCUSSION

Students' ratings of tutors' ability to give feedback seem to vary in function of the tutors' training, of the formulation of the evaluation item, and of the tutors' teaching environment. These variables should be considered for setting up effective strategies in faculty development.