A Survey of Faculty Development in U.S. and Canadian Dental Schools: Types of Activities and Institutional Entity with Responsibility

Discussion

Our study found that the responsibility for faculty development was widely distributed in North American dental schools, often with multiple entities sharing responsibility for different activities. Similar to Sonnino et al.’s study of medical faculty development,³⁵ our study documented the overall expansion of faculty development in dental schools since 2001. Indeed, 15 of the 18 original faculty development endeavors showed significant increases since the O’Neill and Taylor study.⁸

In our study, 40% of the respondents (23 schools) indicated a dedicated (separate) office of professional/faculty development and/or faculty affairs. This was a remarkable increase since 2001 when only four responding schools reported an office devoted to this function. In our survey, 12 of the 23 schools reporting such offices indicated that their office was established within the past five years. It is possible that the need for faculty development, especially for those entering academia after years of private practice and to implement the new CODA standard mandating faculty development, played a role in this rise.⁶ Even so, most increases in faculty development activities were reported to be conducted by dental schools’ Offices of Academic Affairs, Department Chairs, and Offices of the Dean.

In particular, Department Chairs and Offices of Academic Affairs continued to play a substantial role in schools’ faculty development efforts. Twelve activities showed statistically significant increases with Academic Affairs’ participation. Not surprisingly, six of these were in the teaching realm. Seven activities showed statistically significant increases by both Department Chairs and Deans. It is noteworthy that four of these activities (assessment of teaching, team-building, conflict resolution, and leadership development) showed statistically significant increases by both Chairs and Deans.

In 1986, Garbee et al. reported that 36 dental schools (53% of respondents) had an elected or appointed committee that was chiefly responsible for faculty development.⁷ In 2001, O’Neill and Taylor reported that six schools (15% of respondents) had committees that held principal responsibility.⁸ As these committees are generally staffed with a rotating group of faculty members, offices with dedicated personnel likely provide more consistency and stability. Perhaps not surprisingly, in 2016, only two respondents (3.5%) reported that committees were the main provider of faculty development at their schools.

Faculty development planning and leadership development activities received the highest number of total responses: 126 and 121, respectively, from all nine entities. The ADEA Policy Statements: Recommendations and Guidelines for Academic Dental Institutions specify that teaching, research, and service—the three pillars of an academic career—are areas for faculty development.⁴¹ Our survey found that planning for faculty development activities had the most responses overall, and these were shared by multiple entities, most often Academic Affairs/Education, Offices of the Dean, and Offices of Faculty/Professional Development.

In a 2017 study of North American leadership development programs at academic health centers, Lucas et al. surveyed deans of faculty development/affairs and found that all 94 respondents except one provided some form of leadership training, with more than half (61) providing a formal internal leadership program.⁴² Our findings verified a significant increase in activities and entities focused on leadership development in dental education, including team-building and conflict resolution.

Since 2001, the time of the O’Neill and Taylor study, the focus on interprofessional education (IPE) in dental education has risen dramatically. The Institute of Medicine (IOM)’s recent report on collaborative practice promoted collaborations among multiple health care professionals in an effort to improve patient care.⁴³ Indeed, according to Reeves et al.’s systematic review, the growing IPE evidence base suggests that students are positive about IPE, reporting improvements in attitudes as well as collaborative knowledge and skills; there was more limited, but growing, evidence related to behavioral changes, organizational practice, and benefits to patients.⁴⁴ Hence, interprofessional faculty development efforts may be on the rise due to this evidence as well as a CODA standard that requires dental schools to show verification of interactions with other components of the health care delivery system.⁶ In our study, 92 responses were in this category. Furthermore, in the comments section, some respondents indicated that such faculty development programs were often cosponsored with their affiliated medical school or that their faculty had access to them. These efforts may also save resources and expand opportunities for collaboration.

As dental schools embrace community-based experiences for their students and engage clinicians as adjunct faculty in off-site locations, the creation of more online and technology-supported faculty development programming seems likely. Indeed, we found a statistically significant increase in this area conducted by Offices of Academic Affairs since 2001.

In the report of their study, O’Neill and Taylor called for an ADEA Special Interest Group (SIG) on faculty development.⁸ While there is still no faculty development SIG, there is a very active SIG dedicated to the Scholarship of Teaching and Learning (SoTL SIG) that was created since publication of the 2001 article. The SoTL SIG focuses on the growing recognition of teaching as scholarship in dental education. In addition, there is an active although informal Faculty Development group with its own listserv that attends the Faculty Development Marketplace offered at the ADEA Annual Session & Exhibition. This marketplace features short talks in which speakers describe a faculty development initiative at their institution and how it is assessed. These five-minute presentations enable participants to provide updates about exciting developments and share ideas, and they foster collaborations among institutions. According to the coordinator of the sessions (coauthor ZH), from 2013 to 2016, an average of 16 presenters participated each year. In the past two years, due to an unprecedented number of submissions, ADEA supported two sessions with 29 presenters in 2017 and 23 presenters in 2018. In all, 170 attendees participated in one or both of the two sessions in 2017. These annual activities and the results of our survey would seem to justify the creation of a Faculty Development SIG to support collaborations and formalize the reporting of activities of faculty development personnel at North American dental schools.

Our survey found evidence of 17 established academies dedicated to the teaching mission of health professionals. Four were reported to be within a dental school, and the others were affiliated with their medical center or parent institution. The academy movement in health professions schools over the past 15 years enhances the educational mission and supports and recognizes the work of educators in these institutions.⁴⁵

Overall, our study found that, even though most dental schools still did not have a dedicated Office of Faculty/Professional Development or Faculty Affairs, there had been an almost sixfold rise in the number of these offices since 2001. In addition, this study found increased involvement of other entities, most notably Department Chairs, Academic Affairs, and Offices of the Dean in faculty development matters. This increase was no doubt due to both internal and external influences to provide development activities that not only focus on the teaching mission, but also extend to the leadership, scholarship, and career development needs of faculty.

Even with this heightened emphasis on professional development, it is somewhat worrisome that only ten of the respondents provided specific budgetary information; another five reported that it was in the dean’s office budget; and the rest either did not answer the question or reported not knowing how monies were allocated for faculty development. These responses suggest that funds for faculty development might be provided on a more flexible basis in most schools and could even be reallocated in times of financial difficulties. According to Steinert et al., sustained financial support is instrumental in the success of faculty development efforts.⁹

Strengths of this project include the relatively high response rate (76% of all U.S. and Canadian dental schools at the time) and the careful construction of the survey instrument. The authors of the original survey were consulted for input into the development of the new survey in conjunction with an extensive literature review that informed the final instrument. In addition, pilot testing for content validity and ease of use with four faculty development experts was employed. The inclusion of more entities and development activities provided more granular information about schools’ faculty development efforts than in the previous survey.

Limitations of this study include the possibility of respondent errors and potential self-selection and reporting bias. To increase response rate, the survey was designed to not force responses for every question. Therefore, not every respondent answered all the questions fully. Analyses of the responses of those 27 schools that participated in both the 2001 and 2016 surveys were not matched, so we cannot draw direct conclusions about increases in professional development activities at those schools. Even though we searched the websites of the 18 schools (24%) that did not respond to our survey, we do not know the full extent of faculty development efforts at these non-participating schools. In addition, a French version of the survey was not provided to the Canadian schools and thus possibly limited their participation. Future research should include a systematic review of research done on dental faculty development initiatives; more rigorous research designs to evaluate faculty development program effectiveness, including exploring its impact on individual participants and the institution; focus groups or interviews with faculty and/or faculty developers to gain qualitative evidence; and comparison studies of dental faculty development practices in other countries.