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J Dent Educ. 70(9): 948-955 2006
© 2006 American Dental Education Association
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Faculty Development

Development and Implementation of a Comprehensive Faculty Development Program in PBL Core Skills

Kirsten R. Dalrymple, Ph.D.; Carol Wuenschell, Ph.D.; Charles F. Shuler, D.M.D., Ph.D.

Key words: faculty development, problem-based learning, curriculum change, facilitator

Submitted for publication 02/03/06; accepted 05/11/06


   Abstract
 Top
 Abstract
 Methods
 Results
 Discussion
 Conclusion
 References
 
Large curricular changes associated with changes in teaching and learning methods should be accompanied by faculty development programs linked to the new pedagogy. This article describes a framework for the development and implementation of a program designed to assist faculty with the transition of the dental curriculum to a problem-based learning (PBL) pedagogy. A faculty committee created a PBL core skills program based on experiential, developmentally appropriate approaches that resulted in constructive and social learning opportunities for the faculty participants. Nearly 70 percent of faculty members have participated in the facilitation preparation workshops and contributed to the D.D.S. curriculum as small-group, inquiry-based learning facilitators. Faculty development programs geared toward acquisition of specific teaching skills and based on adult learning principles can be devised locally and result in increased participation in a new curriculum.


The need to formally instruct educators in learning theories and instructional methods has long been recognized in primary and secondary education. But, despite advances in cognitive psychology and instructional design, instructors in the health professions have often based their instructional methods on the teaching they observed when they were students. Recently, health care professions faculty have been asked to take on increasingly diverse and complex responsibilities in their institutions, including the introduction of novel teaching and learning methodologies. Most have not had a formal background in the educational theory that serves as the basis for new approaches to health care teaching.1

In response to the need to support faculty in assuming new roles and improving existing skills, health professions schools have begun to develop programs to improve teaching and learning practices. Reports in the literature suggest that faculty development programs have had positive impacts on participants, including self-reported, durable changes in teaching behaviors, improved evaluations by students, and increased levels of grant funding and committee involvement.24 Despite the promising merit of these findings, faculty development programs are not uniform in organizational structure or scope. These programs are often diluted as they come to encompass a broad set of goals that can include promotion and tenure matters, IT training, research skills training, and education skills training.47 Few programs committed exclusively to improving teaching and learning practices have been reported in the dental education literature.

A better understanding of teaching and learning practices is critical when major curricular or pedagogical change takes place at an institution. Institutions that have embarked on major curricular reform point out the importance of faculty development in the process.8 Schatzer, for example, stated, "A lesson that should have been anticipated rather than learned through experience was that planners should not assume that all faculty are skillful in teaching methods to which they are not accustomed."9

The University of Southern California School of Dentistry (USCSD) went through two major curricular reforms aimed at improving learning outcomes for students, first in 1995 when a small, pilot problem-based learning (PBL) program was initiated and then in 2001 when the entire D.D.S. program transitioned to a PBL pedagogy.1014 Both changes required the initiation of faculty development programs. Small-scale approaches, similar to those described by Barrows, were used at USCSD to provide pilot program faculty experience with PBL-specific skills.15 Faculty involved in the implementation of the pilot program voluntarily assumed the new roles demanded by a pedagogy centered on small-group, inquiry-based, student-centered learning.

In 2000 the decision was made to convert the entire USCSD D.D.S. curriculum to a problem-based learning pedagogy. In fall 2001, the first full class of 144 matriculated who would use PBL as the primary pedagogy of the dental curriculum. The importance of creating a large-scale and comprehensive PBL faculty development program was a clear requirement when the decision was made to implement PBL schoolwide. To underscore the importance of understanding the instructional method, the role of the tutor, and participation in the education of D.D.S. students, a faculty development program was identified as a component in the school’s Strategic Plan for Education and Learning. The plan stated that the school should "ensure that there are sufficient qualified and effective USCSD faculty to support the PBL education program." A commitment of resources was made by the dental school administration that included the creation of a Curriculum Committee Subcommittee on Faculty Development, Mentoring, and Evaluation (FDME). The subcommittee was driven by a faculty PBL certification requirement established by the dental school administration.

To provide an adequate pool of competent facilitators, the FDME developed a series of working objectives and enabling activities. The working objectives of the program for facilitator training were: 1) to provide instruction, discussion, and practice opportunities for PBL core skill areas, utilizing methods consistent with adult learning theory and good practice principles outlined in previously implemented faculty development programs for health professions educators in PBL; 2) to expand the program to include faculty roles not typically addressed in previous PBL faculty development programs; and 3) to create an evaluation strategy and tools to determine the impact of the faculty development program on the faculty and students. Consequently, the FDME developed a program based on defined educational theories to accomplish the faculty development necessary for the implementation of PBL schoolwide.1,1618 This article describes the approach taken by members of the USCSD community to develop, implement, and begin evaluation of a PBL core skills faculty development program.


   Methods
 Top
 Abstract
 Methods
 Results
 Discussion
 Conclusion
 References
 
The Subcommittee on Faculty Development, Mentoring, and Evaluation (FDME) was charged with developing and implementing a curriculum aimed at improving teaching and learning practices at USCSD. The FDME subcommittee had faculty representatives from each of the school’s five academic divisions. The cochairs of the subcommittee were selected by the associate dean of academic affairs and the chair of the curriculum committee, based on their experience with the PBL pedagogy. Members of the FDME and a small group of other faculty with PBL experience constructed a plan in spring 2001. The first level of effort was geared at defining the core skills needed by faculty to work with students. In the process, the target audience for the faculty development curriculum was identified, and the methods of content delivery and program evaluation were determined.

Definition and Sequencing of Core Skills
Based on discussions and a review of faculty development and PBL program implementation literature, the planners defined four core skill areas. These four areas were judged essential for a faculty member to understand and practice the roles and responsibilities associated with facilitating learning in the PBL pedagogy.15,17,18 The faculty development curriculum consisted of four workshops, each targeting one of the identified core skill areas (Table 1Go).


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Table 1. PBL core skills faculty development program sequence, themes, titles, and duration
 
The FDME group concluded that faculty needed to first understand how student learning takes place in the context of the learner-centered, small-group, inquiry-based pedagogy. As understanding these processes was central to building a core understanding for faculty, the PBL process became the first core skill covered in the first workshop in the curriculum. The second area of curriculum development focused on the facilitator/tutor role played by faculty in a PBL curriculum. Many faculty members are not familiar or comfortable with the facilitator role. Thus, the responsibilities and skills associated with facilitation were covered in the second workshop in the sequence for faculty development. Faculty members in the PBL program are expected to assess student achievement in the small-group learning environment, so the PBL facilitator role assessing students is an important yet distinct responsibility. This topic was covered in the third workshop in the PBL core skills sequence. The fourth workshop was an exploration of PBL application in the clinical environment. This workshop focused on issues related to the impact of PBL on student preparedness, approaches to learning, and faculty interactions with students in the clinic.

The FDME recommended that the PBL process workshop be taken first, the facilitation of learning workshop second, and the assessment and feedback workshop last, followed by the PBL in the clinical environment workshop for those faculty with primary roles in clinical teaching. The FDME group suggested that participants observe a full PBL case and then facilitate a case independently. Participants were advised that this should be done in close proximity to the completion of the workshops so that experiences from the workshops could be applied in practice.

General Workshop Formats and Attendance
The FDME followed a general instructional template in the development of each of the PBL core skills workshops (Table 2Go). Learning objectives were set for each of the workshops and were shared with participants, along with introductory information and methods to be utilized during the course of the workshop.16 All courses were completed with a survey to allow participants to evaluate the faculty development workshop.


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Table 2. PBL core skills instructional template
 
Each workshop was designed to provide background information, engage faculty attitudes toward teaching and PBL, and provide pedagogy-relevant participation opportunities. Developing knowledge about PBL-specific instructional methods and program policies was approached primarily by the use of short, introductory seminars and scenario-based discussions. Skills development was typically accomplished by observation and discussion of role-modeled behavior based on specific criteria. This observation element was followed by participant role-playing with subsequent criteria-based feedback from the entire workshop group.

Registration of participants and monitoring of faculty development activities were coordinated between the offices of Outcomes Assessment and Continuing Education. Attendance records were kept for all workshops for the purposes of awarding continuing education credit, monitoring and reporting progress toward PBL core skills certification, and program evaluation. Reports of faculty participation were periodically sent to division chairs. Division chairs encouraged faculty to participate in subsequent workshops to complete the entire series. Since all full-time faculty and part-time faculty with an appointment greater than 40 percent were required to participate, monitoring attendance was an important responsibility of both the division chairs and associate deans.

Certification and Evaluation
The PBL faculty development curriculum was linked to a schoolwide requirement for PBL certification. Certification status was included as a component of the annual faculty review. The certification process was designed to ensure that faculty members would have exposure to how students learn in the PBL pedagogy and how faculty members facilitate learning, both in didactic and clinical environments. Faculty members were considered certified and sufficiently prepared to begin facilitation of PBL cases once they had completed the PBL process, facilitation of learning, and assessment and feedback workshops. Faculty members involved in clinical supervision of students were also required to attend the PBL in the clinical environment workshop to be considered certified.

Three streams of data were designated to be included as a part of the overall faculty development program evaluation process. These were 1) faculty perceptions of workshop effectiveness, 2) faculty confidence in their ability to utilize new PBL skills, and 3) student perceptions of the effectiveness of facilitator performance.


   Results
 Top
 Abstract
 Methods
 Results
 Discussion
 Conclusion
 References
 
The PBL core skills workshops commenced in the summer of 2003 and are ongoing. A total of 182 faculty members were identified as candidates for the faculty development program in PBL core skills. At the time of this writing, 106 of these individuals had attended the PBL process workshop, 119 had attended the facilitation of learning workshop, and 117 had attended the PBL assessment and feedback workshop. Clinical teaching was a primary responsibility of 161 of the identified faculty, and seventy-two of them had participated in the PBL in the clinical environment workshop (Table 3Go).


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Table 3. Faculty PBL core skills attendance levels, spring 2003-fall 2004
 
Waivers were granted for the PBL process workshop to nineteen faculty members who had previously received informal training and had ample PBL process experience by the time the workshop series was implemented. Twenty-one faculty were not required to complete the PBL in the clinical environment workshop because they did not have D.D.S. degrees and were not involved in supervision of clinical education activities.

Through December 2004, 69.8 percent of the targeted faculty who had not received a waiver had satisfied their requirement for taking the PBL process workshop, 68.1 percent had satisfied the requirement for the facilitation of learning workshop, 67.0 percent had met the requirement for the PBL assessment and feedback workshop, and 55.5 percent of full-time faculty had attended the PBL in the clinical environment workshop.

In the course of nineteen months, each workshop has been conducted, on average, ten times. To achieve the greatest level of participation as well as provide scheduling flexibility for participants, the workshops were offered on multiple days during the summer, fall, and spring trimesters between May 2003 and April 2004. Thereafter, the workshop series was offered once per trimester. The highest levels of participation occurred during the first trimester when multiple workshop dates were offered. Based on total participation as of December 2004, the first trimester had 64.6 percent of PBL process participants, 58 percent of the facilitation of learning participants, and 51.4 percent of the assessment and feedback participants. Although the number of participants taking a particular workshop varied between five and twenty-five, the typical number of attendees averaged nine.

As of December 2004, 54.4 percent of the targeted faculty members were designated as certified in the PBL core skills directly related to facilitation of the cases; 19.2 percent of the targeted faculty had partially completed their preparation for facilitation of cases; 23.6 percent had not taken any of the workshops; and 2.8 percent were noted as "Not Applicable" by nature of their indirect link to the school. Of the certified faculty, 41.2 percent have started or continued facilitating student groups. Remaining faculty members demonstrated workshop and case facilitation participation profiles that varied (Table 4Go). The average faculty member who has completed the PBL core skills workshops has facilitated 1.63 cases per trimester (SD±1.37).


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Table 4. Full-time faculty PBL core skills certification and case facilitation status
 

   Discussion
 Top
 Abstract
 Methods
 Results
 Discussion
 Conclusion
 References
 
When reflecting on the major goal set by the administration that USCSD would create the means to "ensure that there are sufficient qualified and effective USCSD faculty to support the PBL education program," it appears that substantive progress has been made. Specifically, this progress has been made in the following three areas: 1) preparing faculty to take on new small-group learning facilitation roles; 2) increasing the pool of available facilitators; and 3) creating a system for faculty development to enhance teaching skills. Secondary benefits and unanticipated challenges have arisen from the implementation of the program.

Nearly 70 percent of the targeted faculty at USCSD completed the various PBL core skills workshops designed to prepare them for facilitation of PBL cases in the nineteen months covered by this study. Participation by faculty members in teaching skills training programs reported in the literature has varied; however, in most cases these have been offered on a voluntary basis.8 A survey of national faculty development teaching programs for hospital medical educators demonstrated voluntary participation levels of less than 50 percent.7 Additionally, time to program implementation averaged eighteen months and reached a range of between ten and nineteen faculty members.19 Our program reached a significant percentage of the dental school faculty in a relatively short time frame. Voluntary participation in faculty development programs focused on teaching skills predominantly attracts individuals motivated to change their teaching approach. Our situation required a high level of participation as the change in pedagogy required the development of new teaching skills. Instructional techniques that were not a part of the average faculty member’s teaching repertoire had to be developed, regardless of the initial interest of the individual faculty member. Motivating participation in faculty development programs requires a tradeoff between the strictly voluntary and required attendance situations. While mandatory attendance is clearly not the ideal motivating environment, the faculty member’s "need to know" represents an adult learning principle that moderates the situation.16 New teaching expectations also represent a positive internal motivator for faculty members as do the external factors related to the provision of release time by the administration, the awarding of continuing education credits, and the achievement of PBL certification.

Participation in the PBL core skills program was particularly robust during the first months the workshops were offered. The combination of required certification, accommodation by the leadership to provide "time" to participate, and the need to acquire new skills worked together to explain this robust level of early participation. The subsequent declines in participation can be explained both by the reduced numbers of targeted faculty members left to enroll and the scheduling of fewer workshops as the program entered the second year, making attendance difficult for some. Rubeck and Witzke highlight busy faculty schedules as a major variable affecting faculty attendance in training programs.8

The faculty development program met the goal of expanding the pool of potential small-group learning facilitators. Although the pool of facilitators has increased, the average number of small-group learning events facilitated per faculty member remains low (1.63 per trimester). The standard deviation for this mean number of PBL cases facilitated is rather high, but reflective of a wide range in the number of PBL cases facilitated by individual faculty members. That the average number of PBL cases remains low means that there are sufficient faculty to accomplish the PBL pedagogy in the school of dentistry without unduly impacting the other activities required of individual faculty members. There is also a group of PBL certified but not yet facilitating faculty members who represent a reserve to continue to buffer the requirements of small-group facilitation with the other requirements of the faculty. Since the introduction of PBL at USCSD was phased-in while simultaneously phasing-out the existing curriculum, there were faculty members with significant teaching activity who were eligible for PBL facilitation late in 2004. The question of how to meet the teaching needs of the curriculum while satisfying individual faculty members’ interests and strengths remains a challenge.

The process of developing a comprehensive faculty development program on PBL core skills resulted in a number of achievements. First, the FDME served as an adequate organizational structure and involved faculty from all five academic divisions and all clinical disciplines. Coverage by workshops of topics related to PBL case assessment and PBL in the clinical setting addressed two previously unmet needs critical to the success of the curriculum modification. The experience of the FDME allowed the formulation of important objectives based on the perceived needs of new facilitators and clinicians supervising students educated with the PBL method. FDME members who were initially less experienced with PBL were also able to liaise informally with their colleagues on the clinic floor to communicate the goals of the faculty development program. To the extent that their efforts represent a meaningful increase in involvement by the faculty in the PBL program, the subcommittee structure was again positive.

The drawbacks of a committee as a means to innovate and implement faculty development efforts have been reported by O’Neill and Taylor.6 These limitations are primarily related to the questionable sustainability of efforts generated by individuals who have substantive obligations in arenas more directly related to their interests and own personal career development. Sufficient release time for active subcommittee members was made informally through arrangements with division chairs. Future innovations to the faculty development program may require more formal arrangements for faculty release time.

The success of the program was also dependent on support from the dental school administration. The commitment of the dean’s office, associate dean of academic affairs, and division chairs was critical. Their support provided the financial means and staff support to enable the workshops to be advertised, organized, and run. Direct contact with the FDME and access to faculty attendance records allowed the administration and the division chairs to provide further encouragement to the faculty to complete the PBL core skills certification process.

The establishment of our faculty development program was based on recommendations in the medical education and adult learning literature.1,1618 While dental education has distinct differences with medical education, the educational learning theories have many commonalities. Importantly, it was recognized that a sequential, developmentally appropriate program was needed to introduce the basic PBL teaching skills set.1 This was essential to the organization of subsequent programs that provided our faculty members multiple opportunities to actively draw from and reflect on prior teaching and learning experiences in a social environment.1,16,20

The largely experiential methods employed appeared to have been effective in engaging the faculty in discussions and a safe practice environment for exploring the skills associated with student investigation of a PBL case. Reports in the medical education literature point to the importance of providing collegial, active learning environments that promote faculty interaction with these learning environments.21 Provision of collegial environments for faculty has the added value of being linked to institutional vitality.22 Not only did the opportunity to interact and learn with one’s peers emerge from our faculty development program, but as similarly noted in the findings by Rubeck and Witzke, the venue was frequently a place where faculty communicated suggestions for how the student PBL program could be improved.8

Reports from medical institutions point out that there are specific challenges when considering the change to schoolwide use of PBL. First among these is the general finding that the transition from the traditional lecturer role to the facilitator of learning role is difficult for many faculty members. Established personal identities as educators and the sense of a loss of control over the curriculum have frequently been noted as barriers to a change in pedagogy.17,18 We observed that the workshop environment permitted faculty to express concern about personal development and the effects of the addition of new roles and/or replacement of old roles. Future efforts of the faculty development program could be enhanced by specifically addressing these concerns.


   Conclusion
 Top
 Abstract
 Methods
 Results
 Discussion
 Conclusion
 References
 
This article has described the structure for a comprehensive faculty development program linked with a significant shift in pedagogy in our dental curriculum. To achieve a strategic objective defined by our school, a faculty committee created and implemented a problem-based learning core skills faculty development program. Nearly 70 percent of the faculty have participated in the program, enhancing the pool of faculty with the necessary skills to effectively facilitate small-group learning. The series of workshops was based on active, developmentally appropriate approaches that provided constructive and social learning opportunities for the faculty participants. The specific features of the individual workshops will be described in detail in subsequent articles.


   Acknowledgments
 
The authors would like to thank the subcommittee members, past and present, of the Curriculum Subcommittee on Faculty Development, Mentoring, and Evaluation: Drs. Alvin Rosenblum, Hsing Chi Wang, Michael Paine, Timothy Saunders, Loris Abedi, Tae Jun Ahn, and Payem Sanjideh, as well as Drs. David Crowe, Shirley Wong, and Marian Bradford for their efforts in creating, organizing, and implementing the PBL core skills program.


   Footnotes
 
Dr. Dalrymple is Assistant Professor, Division of Diagnostic Sciences; Dr. Wuenschell is Assistant Professor, Division of Craniofacial Sciences and Therapeutics; and Dr. Shuler is Associate Dean of Student Life and Academic Affairs and George and Mary Lou Boone Professor of Craniofacial Molecular Biology—all at the University of Southern California School of Dentistry. Direct correspondence and requests for reprints to Dr. Charles F. Shuler, Office of Academic Affairs, University of Southern California, School of Dentistry, 925 W. 34th Street, Room 218, Los Angeles, CA 90089-0641; 213-740-1001 phone; 213-740-2376 fax; shuler{at}usc.edu.


   REFERENCES
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