Faculty development for problem-based learning

Implementation of Problem-Based Learning in Undergraduate Medical Education in Ethiopia: An Exploratory Qualitative Study

Background

The poor quality of health professional education in Ethiopia, which was rooted in a traditional curriculum, has posed significant challenges for graduates in effectively addressing real-life health problems. In response, there has been curricular reform by adopting problem-based learning across Ethiopian medical schools. Given the dearth of literature on the topic and the significance of context in the effective implementation of problem-based learning, it is imperative to provide local institutional evidence to pinpoint critical intervention areas and support the effective implementation of problem-based learning.

Methods

A qualitative design based on in-depth, individual, semi-structured interviews was used to explore medical educators, program coordinators, and educational leader's experiences and perspectives on the problem-based learning implementation in health sciences education. A total of 24 participants recruited from five undergraduate health science programs participated in the study. All sessions were audio recorded and transcribed verbatim. Results were analyzed following a qualitative thematic analysis method.

Results

Analysis of the transcripts revealed three main themes, along with their corresponding subthemes. Within the first main theme, participants discussed the importance of integrating Problem-Based Learning into undergraduate medical programs and the educational benefits it brings to medical education. The second main theme explored issues related to challenges in implementing problem-based learning which include inadequate staff training, deficiencies in curricular design and governance, constraints in educational resources, and a lack of preparedness in the educational environment. The third theme deals with the strategic recommendations to address the challenges that contributed to the poor implementation of problem-based learning in undergraduate medical schools.

Conclusion

Our study has addressed several issues related to the implementation of Problem-Based Learning in Ethiopian Health Sciences Colleges. The study's findings have the potential to provide educational stakeholders and policymakers with essential information to strategize successful problem-based learning implementation in undergraduate medical schools.

Effectiveness of tutor shadowing on faculty development in problem-based learning

BACKGROUND

To enhance tutors' teaching skills, tutor shadowing for novice tutors of problem-based learning (PBL) in addition to conventional faculty development (FD) was applied. This study aimed to develop a tutoring-skill scale (TS-scale) and evaluate the effect of shadowing on PBL tutors.

METHODS

This study employed a before-and-after study design with three phases. In phase 1, a TS-scale was elaborated. A validity examination was performed in phase 2. Phase 3 was a study of the effectiveness using a TS-scale survey of novice PBL tutors before and after the FD course. The FD course for novice PBL tutors included an FD workshop and PBL shadowing activities.

RESULTS

A TS-scale with a 32-item questionnaire of self-rated confidence for PBL tutors was identified in phase 1. In phase 2, 7 experienced specialists in medical education were invited to evaluate the content validity of the scale. The item content validity index (I-CVI) ranged from 0.86 to 1, and the scale-CVI (S-CVI) was 0.95. A total of 85 novice PBL tutors completed the TS-scale before the FD course, yielding a Cronbach's alpha of 0.98. An exploratory factor analysis with varimax rotation was performed. The twenty-four items with significant loadings greater than 0.5 were incorporated into a new TS-scale and were grouped into three factors: student contact, medical expertise, and teaching expertise. In phase 3, 76 novice PBL tutors completed the 24-item TS-scale before (pretest) and after (posttest) the FD course. Their self-rated confidence improved significantly across the three factors after the FD course. The pretest and posttest scores did not differ according to the tutors' gender, the grades they taught, or their specialty background.

CONCLUSIONS

Novice PBL tutors benefit from FD that incorporates tutor shadowing in the 3 key domains of tutoring competencies. The TS-scale developed in this study can be applied in future research on FD design.

Development of a questionnaire to measure teachers' student-centred perspectives based on the Onion Model

BACKGROUND

Teachers with a teacher-centred perspective have difficulties applying student-centred approaches in Problem Based Learning (PBL) because they are inclined to show teacher-centred behaviours. The six aspects explained in Korthagen's Onion Model (environment, behaviour, competencies, beliefs, identity, and mission) are assumed to contribute to teachers' perspectives, showing that both the environment and personal characteristics influence behaviours. For teachers to function properly in PBL, those six aspects should reflect a student-centred perspective. Previous instruments to measure teaching perspectives focused on only a few of these relevant aspects. Therefore, we developed the Student-Centred Perspective of Teachers (SCPT) questionnaire with subscales for each aspect in the Onion Model. This study aimed to provide evidence for its internal and external validity.

METHODS

The SCPT was distributed in a survey to 795 teachers from 20 medical schools. For the internal validation, Confirmatory Factor Analysis was performed to analyse theoretical fit model validation, convergent validation, and discriminant validation. For the external validation, teachers' perspective scores were compared among three groups of amount of PBL training using Analysis of Variance (ANOVA) and post-hoc Least Significant Difference (LSD) tests. The p-value for all tests was set at .05.

RESULTS

A total of 543 out of 795 teachers (68.3%) participated. Confirmatory Factor Analysis showed the evidence of the SCPT's internal validation with acceptable fit for the six subscales measured by 19 items and the following Composite Reliability scores: environment (.72), behaviour (.74), competencies (.63), beliefs (.55), identity (.76), and mission (.60). All items' factors loadings reached a good standard (.5 or greater). Only the environment subscale had the Average Variance Extracted (AVE) score higher than .5 and the Maximum Shared Variance score lower than the AVE score. ANOVA and Post-hoc LSD tests showed that teachers who participated in more PBL training showed significantly higher student-centred perspectives, providing evidence for external validity.

CONCLUSION

The SCPT is a reliable and valid instrument to measure teaching perspectives. Identifying aspects that do not represent the adoption of a student-centred perspective may provide valuable input for faculty development in the context of PBL.

Contextual attributes to promote positive social interdependence in problem-based learning: a focus group study

BACKGROUND

Problem-based learning (PBL) is classified as a collaborative learning approach, wherein students learn while contributing meaning to experiences and interactions with others. An important theoretical fundament of PBL is social interdependence theory (SIT) because positive social interdependence within a group has been found to be key to better learning performance and future attitudes towards team practice. However, most previous studies in health professions education focused on cognitive outcomes, and few studies have focused on collaborative behaviors in PBL groups. The lack of this empirical insight makes implementation of PBL difficult, especially in contexts where there is limited experience with collaborative learning. Therefore, the aim of this study was to elucidate what promotes or hinders positive social interdependence and how the attributes work during PBL.

METHODS

We conducted four focus groups among clinical year medical students (n = 26) who participated in PBL tutorials in the formal curriculum. We asked semi-structured questions that corresponded with the overall concept of SIT. We analyzed the transcript using constructivist grounded theory and developed a model to explain contextual attributes that promote or hinder positive social interdependence in PBL.

RESULTS

Two contextual attributes of "academic inquisition" and "desire for efficiency" affect social interdependence among a student group in PBL. Academic inquisition is students' desire to engage in their academic learning, and desire for efficiency is students' attitude toward learning as an imposed duty and desire to complete it as quickly as possible. These attributes are initially mutually conflicting and constructing social interdependence through multiple steps including inquisition from a case, seeking efficient work, sharing interest in problem solving, expecting mutual contributions, and complementing learning objectives.

CONCLUSION

These findings will contribute to understanding collaborative learning environments in PBL and may help explain contexts where PBL is less successful. The model can also be used as a tool to support innovation of PBL as collaborative learning.

The Clumsy Horse: A Professional Development Tool for Facilitators of Self-Directed, Case-Based Learning

INTRODUCTION

With the constant evolution of science and advancing technology, future physicians must learn to navigate an ever-changing health care environment by continuous learning throughout their professional careers. Lifelong, self-directed learning is a critical component of medical education to ensure future physicians are adept at identifying knowledge gaps and seeking, analyzing, and communicating new information. To train faculty who teach case-based, self-directed learning, we designed the Clumsy Horse Case.

METHODS

The Clumsy Horse Case was created as part of a faculty development program for facilitators of a new case-based, self-directed curriculum known as Patient-Centered Education (PaCE) Cases. An unfamiliar veterinary medicine case was designed to level the playing field for faculty from different specialty areas in order to provide an authentic self-directed learning experience. To determine effectiveness, faculty participants completed a standardized eight-question evaluation survey after the Clumsy Horse Case session, and facilitators received student feedback at the end of each semester via a standard faculty evaluation form.

RESULTS

Student ratings indicated that faculty were adequately prepared to be effective facilitators. The Clumsy Horse Case was an integral part of facilitator preparation and provided an engaging learning experience for over 60 faculty. Survey ratings and comments from faculty participants indicated a high level of engagement and satisfaction with the learning experience.

DISCUSSION

The Clumsy Horse Case is generalizable for developing faculty in any curriculum with a case-based, self-directed learning component. It can be modified to fit any school's curriculum and integrated into a professional development program.

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.

Informal teacher communities enhancing the professional development of medical teachers: a qualitative study

BACKGROUND

Informal peer learning is a particularly powerful form of learning for medical teachers, although it does not always occur automatically in the departments of medical schools. In this article, the authors explore the role of teacher communities in enhancing informal peer learning among undergraduate medical teachers. Teacher communities are groups of teachers who voluntarily gather on a regular basis to develop and share knowledge. Outside of medical education, these informal teacher communities have proved to be an effective means of enhancing peer learning of academic teachers. The processes underlying this outcome are, however, not known. This study therefore aims to explore the processes that make informal teacher communities effective in supporting peer learning of teachers.

METHODS

A qualitative study was performed at a Dutch medical school, where a student-centred undergraduate curriculum had recently been introduced. As part of this curriculum, tutors are segregated into separate specialty areas and thus have only limited opportunities for informal learning with other tutors. The authors followed two informal teacher communities aimed at supporting these tutors. They observed the interactions within the teacher communities and held semi-structured interviews with ten of the participants. The observation notes and interview data were analysed using thematic analysis.

RESULTS

The informal teacher communities allowed the tutors to engage in a dialogue with colleagues and share questions, solutions, and interpretations. The teacher communities also provided opportunities to explicate tacit expertise, which helped the tutors to develop an idea of their role and form a frame of reference for their own experiences. Furthermore, the communities enhanced the tutors' sense of belonging. The tutors felt more secure in their role and they felt valued by the organisation due to the teacher communities.

CONCLUSIONS

This study shows that informal teacher communities not only support the professional development of tutors, but also validate and strengthen their identity as teachers. They seem to provide a dialogical space where informal intercollegiate learning is stimulated, stories are shared, tacit knowledge is made explicit, concerns are shared, and teacher identity is nurtured.

Nursing students' experiences with facilitator in problem-based learning class

PURPOSE

Problem-based learning (PBL) is now extensively utilized within contemporary nursing education. This study was done to explore the nursing students' experiences with facilitators in PBL classes as they transitioned from the first package to the fourth package during the entire sophomore year.

METHODS

Twelve nursing students who had taken the course were interviewed after PBL classes. Data were analyzed using dimensional and comparative analysis based on Strauss and Corbin's grounded theory.

RESULTS

Findings were organized into phases of participants' experiences with facilitators during PBL classes. They faced interpersonal relationship challenges with facilitators as they moved through the three phases of the continuum: feeling uneasy, overcoming the uneasiness, and valuing the help of the facilitator. In the beginning, uneasiness resulted from proximity to the facilitator. However, seven strategies were derived to respond to the uneasiness during the continuum: (a) searching for information about the facilitator, (b) making efforts to build a positive impression with the facilitator, (c) wanting facilitation, (d) weighing own experiences with facilitator against others' experiences, (e) following facilitator's guidance, (f) reflecting on facilitation experience, and (g) retaining facilitator's remarks.

CONCLUSION

Participants overcame the uneasiness and accepted the facilitator as an advisor. These results are significant in providing optimal facilitation for students in PBL classes because they are based on the PBL participants' perspectives of facilitation. Further studies related to facilitators' experiences in the PBL are recommended.

Dynamic Systems (Complexity) theory as a new conceptual model for researching PBL in dental education

Although problem-based learning (PBL) was introduced into dental education some 20 years ago, there have been relatively few well-designed studies carried out to clarify whether, how or why it works in a dental context. This paper introduces the Dynamic Systems (Complexity) theory as a new and potentially productive theoretical framework for researching PBL in dental education. This framework emphasises the importance of emergent self-organisation, perception and brain plasticity in learning. In this paper, a brief overview of the history of PBL in dentistry is presented and then the fundamentals of a Dynamic Systems Approach (DSA) are explained, drawing on two recently published papers advocating the DSA in medical education and teacher education. We focus on three key points related to this new approach: emergent self-organisation rather than simple construction of knowledge; the notion that perception drives the learning process; and the brain as the substrate of all learning. The paper also suggests how the DSA can help us move forward, both in terms of the future application of PBL in dental education and also in relation to posing new types of research questions.

Changing the curriculum and the role of the teacher and the students in the classroom--an analysis of the process of reforming a course in oral microbiology

In 2005, a new curriculum was introduced at the School of Dentistry at the University of Copenhagen. Amongst many changes, the pedagogical concept behind theoretical teaching was changed. The main emphasis was previously on lectures and teacher controlled teaching, but the emphasis has now shifted to a more dialogue-based teaching style for smaller groups where the students became much more active. Thus, the learning principle was now given the pride of place. The present article focuses on the pedagogical reorganisation of the course in oral microbiology where, based on interviews with students and teachers, an evaluation is made regarding how the changes were implemented and developed. Despite the fact that the students themselves wanted to abandon the lecture-based teaching style, there was great dissatisfaction with the new dialogue-based teaching style as the students did not think that it was possible for them to take responsibility for their learning. They would much rather listen to teachers who know the material. Initially, the teachers were very surprised by the negative attitude of the students and had to change the teaching style to more traditional teaching in groups whilst still maintaining the dialogue principle to a certain degree. In this article, the need to enter into a teaching contract between students and teachers prior to introducing new pedagogical principles is discussed.

Online teaching tool simplifies faculty use of multimedia and improves student interest and knowledge in science

Digital technologies can improve student interest and knowledge in science. However, researching the vast number of websites devoted to science education and integrating them into undergraduate curricula is time-consuming. We developed an Adobe ColdFusion- and Adobe Flash-based system for simplifying the construction, use, and delivery of electronic educational materials in science. The Online Multimedia Teaching Tool (OMTT) in Neuroscience was constructed from a ColdFusion-based online interface, which reduced the need for programming skills and the time for curriculum development. The OMTT in Neuroscience was used by faculty to enhance their lectures in existing curricula. Students had unlimited online access to encourage user-centered exploration. We found the OMTT was rapidly adapted by multiple professors, and its use by undergraduate students was consistent with the interpretation that the OMTT improved performance on exams and increased interest in the field of neuroscience.

Complexity theory as an approach to explanation in healthcare: a critical discussion

The reception of complexity theory in health care is characterised by a tendency to reify the idea of a complex system, which is basically an abstraction. This paper argues for three principal theses: first, to invoke complexity, to refer to complex systems, is to proffer a form of explanation; second, in the context of the social sciences, the form of explanation that complexity represents belongs to a family of explanations which the recent theoretical literature associates with social mechanisms; and, third, complexity explanations refer to a specific type of social mechanism, whose features differentiate it from the other members of the family. The most significant of these features is the jettisoning of the default link between order and design, which is precisely the principle omitted by an influential series of papers in the BMJ. Having defended these claims, the paper presents a brief case study illustrating the analysis.

Preparing faculty for the future: AAVMC members' perceptions of professional development needs

Our purpose in this study was to determine professional development needs of faculty in the Association of American Veterinary Medical Colleges' (AAVMC's) member institutions, including those needs associated with current and emerging issues and leadership development. The survey asked respondents to report their level of job satisfaction and their perceptions of professional development as they related to support and resources, teaching, research, career planning, and administration. Five hundred and sixty-five individuals from 49 member institutions responded to an online professional development needs survey. We found that job satisfaction was associated with a variety of workplace variables correlated with academic rank, with those of higher academic rank expressing greater levels of satisfaction. Respondents with tenure also expressed generally higher levels of satisfaction. Most of the respondents expressed interest in learning more about topics related to teaching (e.g., effective questioning, giving feedback, principles of learning and motivation), research (e.g., research design, writing grants), career planning (e.g., mentoring, time management), and administration (e.g., fostering innovation, enhancing productivity, improving the work environment). Just more than half of the respondents indicated moderate to high interest in an AAVMC multi-phase leadership training program. The study suggests topics for which AAVMC should provide professional development opportunities either at existing meetings or through new programming. The study also suggests directions for individual institutions as they seek to implement professional development activities at the local level.

The financial costs of delivering problem-based learning in a new, graduate-entry medical programme

CONTEXT

In discussions of the merits and limitations of problem-based learning (PBL) as an educational methodology, the cost of its delivery is often cited as a significant issue. Although there appears to be no shortage of opinion as to the perceived cost of PBL, we know of no institution that has accurately measured its cost, even in financial terms. Where factual information is lacking, opinion and misconception tend to proliferate. In setting up a new, graduate-entry medical programme on a greenfield site at the University of Limerick, we took the opportunity to calculate both the initial and recurring costs of our particular approach to the delivery of PBL.

METHODS

We calculated the initial cost of providing purpose-built facilities to deliver PBL to 240 students in the first 2 years of our 4-year programme. We also calculated the annual recurring costs of delivering PBL, based on having a student : tutor ratio of 8 : 1 and on having tutors who are all medically qualified, who are reasonably well remunerated for their work and who each deliver 5 hours of PBL tutoring per week.

RESULTS

The initial cost of delivering PBL was calculated as euro 1,526,952 (equivalent to pound sterling 1,369,138 or US$2,050,375). The annual recurring cost of PBL approximates euro 664,000/year (at time of writing equivalent to pound sterling 527,000 and US$988,000). This recurring cost equates to euro 2767/student/year, 89% of which relates to tutor salaries.

CONCLUSIONS

Although the cost of delivering PBL will be greatly influenced by the approach taken at different institutions, we hope that a breakdown of costs at our institution will contribute to the ongoing debate on the strengths and weaknesses of PBL.

Problem-based learning tutors' conceptions of their development as tutors

BACKGROUND

The quality of student learning in hybrid problem-based learning (PBL) programs depends on PBL tutors' being effective in their role.

AIMS

To explore PBL tutors' conceptions of their role and how they grow and develop as tutors, and map tutors' views to an emergent hierarchy of conceptions.

METHOD

Participants were 29 tutors who had tutored in at least one 'block' of study in academic years 1-2 in the first half of 2007 in a 4-year, graduate-entry hybrid PBL medical program. Qualitative phenomenographic analysis was used to categorize tutors' written responses.

RESULTS

Four qualitatively different categories of conception of the PBL tutor role emerged. Categories increased in complexity and more complex conceptions included the preceding view. Analysis of tutors' conceptions of how they grow and develop as tutors also revealed four categories of increasing complexity. There was homogeneity in the relations between levels of sophistication in conceptions of the tutor role and developing as a tutor.

CONCLUSIONS

To help tutors become more effective in their role, development programs may need to engage tutors in thinking about how they develop as teachers, and in particular encourage them to solicit their own face-to-face student feedback.

Faculty development: yesterday, today and tomorrow

Medical education has evolved to become a discipline in its own right. With demands on medical faculties to be socially responsible and accountable, there is now increasing pressure for the professionalisation of teaching practice. Developing a cadre of professional and competent teachers, educators, researchers and leaders for their new roles and responsibilities in medical education requires faculty development. Faculty development is, however, not an easy task. It requires supportive institutional leadership, appropriate resource allocation and recognition for teaching excellence. This guide is designed to assist those charged with preparing faculty for their many new roles in teaching and education in both medical and allied health science education. It provides a historical perspective of faculty development and draws on the medical, health science and higher education literature to provide a number of frameworks that may be useful for designing tailored faculty development programmes. These frameworks can be used by faculty developers to systematically plan, implement and evaluate their staff development programmes. This guide concludes with some of the major trends and driving forces in medical education that we believe will shape future faculty development.

Global paradigm shift in medical education: issues of concern for Africa

INTRODUCTION

When medical education became established in Africa, many curricula were adopted from the West so as to achieve comparable standards in training. Over the last half a century however, major global pedagogical shifts have occurred in medical education without African keeping pace.

METHODS

This article reviews key pedagogical changes and other innovations in medical education that have occurred over the last half a century as reported in the literature and identifies some of the issues that need to be addressed in Africa.

DISCUSSION AND CONCLUSION

Socioeconomic and political instability, failure to rapidly overcome the inertia for change by substituting the old curriculum with a more problem, system and student-based one and redefining the goals of medical education are some of the issues of concern for Africa, and its ability to keep up in the dynamic world of medical education. There are only few faculty and school managers with effective medical education backgrounds to initiate, evaluate and sustain these changes. African medical academics, national governments and the international community need to come together to assist Africa to rise up to these challenges to ensure attainment and sustenance of global standards in medical training.

Complex adaptive systems and nursing

There have been numerous references to complexity theory and complex systems in the recent healthcare literature, including nursing. However, exaggerated claims have (in my view) been made about how they can be applied to health service delivery, and there is a widespread tendency to misunderstand some of the concepts associated with complexity thinking (usually justified by describing the misconception as a metaphor). These concepts can be extended to systems and structures in healthcare organisations but, at this stage in the development of complexity science, only in a modest and very cautious way. In this paper I first outline some of the key ideas in the theory of complex adaptive systems, and then suggest that they have been distorted by a series of influential articles in the medical literature. I go on to present a simple case study of my own and undertake a complexity analysis of it. In the conclusion I suggest that we should beware of some outdated ideas being trotted out in the guise of complexity - an exciting and diverse area of enquiry that those old ideas do not, in fact, resemble.

Using enquiry in learning: from vision to reality in higher education

This paper reports on the contribution of six nurse educators to embed enquiry-led learning in a pre-registration nursing programme. Their focus was to evaluate student and facilitator perspectives of a hybrid model of problem-based learning, a form of enquiry-based learning and to focus on facilitators' perceptions of its longer-term utility with large student groups. Problem-based learning is an established learning strategy in healthcare internationally; however, insufficient evidence of its effectiveness with large groups of pre-registration students exists. Fourth Generation Evaluation was used, applying the Nominal Group Technique and Focus Group interviews, for data collection. In total, four groups representing different branches of pre-registration students (n = 121) and 15 facilitators participated. Students identified seven strengths and six areas for development related to problem-based learning. Equally, analysis of facilitators' discussions revealed several themes related to strengths and challenges. The consensus was that using enquiry aided the development of independent learning and encouraged deeper exploration of nursing and allied subject material. However, problems and frustrations were identified in relation to large numbers of groups, group dynamics, room and library resources and personal development. The implications of these findings for longer-term utility with large student groups are discussed.

Maximizing the value of feedback for individual facilitator and faculty development in a problem-based learning curriculum

BACKGROUND

Recruiting and retaining facilitators in problem-based learning requires considerable staff development. Providing meaningful feedback to individual facilitators should contribute to improved management of the tutorial group.

AIM

To ascertain the value ascribed by facilitators to feedback they received (based on student input) regarding their performance in the small group tutorial in a new problem-based learning curriculum.

METHODS

Thirty-seven facilitators from a purposive sample, selected for their facilitation experience during the 2001-2003 period, completed a comprehensive survey regarding their experiences. The aspect currently being reported deals with the perceived usefulness of the feedback they received from students and from Faculty following the evaluation of their participation in the small group tutorial. Data are reported for medically qualified and non-medically qualified facilitators.

RESULTS

Both clinical (50%) but more notably the non-clinical (70%) facilitators found the feedback (individual facilitator and general report) useful. Facilitators generally preferred the qualitative comments provided by students in the open-ended section of the evaluation to the Likert scale items. Student comments were valued for the specific direction they offered facilitators to reflect and improve on their management of the small group. For this feedback to be more useful, however, facilitators believed that it needed to be completed by more students who took time to critically engage with the criteria and reflect more honestly on their experiences. In addition, facilitators requested for feedback reports to be made available sooner such that they could improve their facilitation skills for the next group of students.

CONCLUSIONS

Both qualitative and quantitative feedback are important for facilitator development and training. While quantitative feedback is important for summative purposes (e.g. quality assurance and promotion), individual student comments provide more formative feedback, allowing facilitators to reflect on and improve their management of the small group. In order for the feedback to be valid, the majority of students had to participate. Facilitators should receive feedback in time to allow them to modify their activities for the new group.

Why invest in an educational fellowship program?

Expanding and refining the repertoire of medical school teaching faculty is required by the many current and changing demands of medical education. To meet this challenge academic medical institutions have begun to establish programs--including educational fellowship programs--to improve the teaching toolboxes of faculty and to empower them to assume leadership roles within both institutional and educational arenas. In this article, the authors (1) provide historical background on educational fellowship programs; (2) describe the prevalence and focus of these programs in North American medical schools, based on data from a recent (2005) survey; and (3) give a brief overview of the nine fellowship programs that are discussed fully in other articles in this issue of Academic Medicine. These articles describe very different types of educational fellowships that, nevertheless, share common features: a cohort of faculty members who are selected to participate in a longitudinal set of faculty development activities to improve participants' teaching skills and to build a cadre of educational leaders for the institution. Evaluation of educational fellowships remains a challenging issue, but the authors contend that one way to evaluate the programs' effectiveness is to look at the educational improvements that have been instigated by program graduates. The authors hope that the various program descriptions will help readers to improve their existing programs and/or to initiate new programs.

Challenges facing PBL tutors: 12 tips for successful group facilitation

One of the main tasks of a problem-based learning (PBL) tutor is to facilitate group discussion. Group facilitation is about process rather than content. In this process, a tutor helps the group increase their skills and progress in their discussion. Several studies have highlighted strategies and training used in preparing PBL tutors. However, PBL tutors usually feel that it is not that easy to change their teaching style to the PBL format. They are sometimes unsure about their role or what strategy they might use to facilitate their students' discussion. This article in the '12 Tips' series is a detailed description of, and provides answers to, common challenges faced by PBL tutors. The tips provided in this manuscript should help tutors with practical answers. The article may be useful to PBL tutors, medical and health educators and those responsible for PBL training workshops.

Charting a global future for education in physiology

The 2005 Claude Bernard Distinguished Lecture was presented at the XXXV International Congress of Physiological Sciences (IUPS) in San Diego, CA, by Ann J. Sefton. Dr. Sefton is an Emeritus Professor of Physiology of the University of Sydney and co-Chair of the IUPS Education Committee. A full profile of Dr. Sefton is included in this issue's The Physiology Teacher.