At the one-day or one-and-a-half-day sessions, participants are familiarized with a framework for analyzing clinical teaching. In addition, they participate in selected modules covering two or three of the seven components of clinical teaching derived from educational principles and empirical study of clinical instruction. The workshops use an interactive seminar format designed to accomplish three general goals: enhancing participants' versatility as teachers, enabling the participants to use a seven-component educational framework to analyze clinical teaching, and providing a forum for collegial exchange among teachers regarding teaching improvement. Multiple educational methods are used to accomplish these goals:
Because of the complexity of the clinical teaching process, the seminars embody a non-prescriptive behavioral approach for improving teaching. Faculty must be able to select effective teaching strategies while taking into account many variables simultaneously, including the content, the learners, and the context in which the teaching is taking place. Thus, the seminars focus on principles, guidelines, and behavioral alternatives that faculty can use to improve their teaching effectiveness. The behavioral approach is based on the belief that intellectual understanding of principles and processes are not sufficient to improve teaching. Knowledge and acquisition of teaching skills are essential. Although the content of teaching (e.g., the medical topic being taught) may be discussed in the seminars, the primary focus of the seminars is on the process of teaching. The seminars also incorporate the philosophy that teaching improvement programs should not be seen as remedial efforts, rather that teachers of all levels of experience and expertise can benefit from an organized review of their teaching.
Evaluation data from 282 participants (49% community- and 51% university-based faculty) has been analyzed. Participants used Likert ratings to assess workshop quality, facilitator effectiveness , and rewards for and barriers to teaching in their clinics. Using retrospective pre- and post-intervention ratings, participants also assessed workshop impacts on teacher knowledge, attitudes and skills. Finally, participants completed open-ended questions to identify recommended changes to improve their clinic as an educational site for students and residents. Results showed that there was excellent participation in the workshops by both community and university internists. Participants' ratings indicated that the program structure was effective in enhancing teacher knowledge, attitudes, and skills while also increasing desire to teach, collegiality and affiliation with the home-site institution.
This project demonstrates that co-sponsored community-based teaching-improvement programs, with support from professional organizations such as the ACP, can be an effective way of promoting (a) the improvement of teaching and (b) the collaboration between community-based teachers and academic centers. Using regionally-based trained physician-facilitators provides an effective method for training large groups of community faculty nationally.