Abstract
The aim of this study was to assess the status of faculty development in North American dental schools in 2016. This research project was designed to update and expand upon a 2001 study that reported the first comprehensive results on similar topics and to compare the 2001 and 2016 results. In this study, survey responses were received from 57 of 75 U.S. and Canadian dental schools for an overall response rate of 76%. The results showed a sizeable expansion of faculty development efforts across schools. Twenty-three schools (40%) reported the existence of an Office of Faculty Affairs and/or Professional/Faculty Development with 12 offices established within the past five years, a sixfold increase. Other entities that demonstrated increased participation in dental faculty development were Offices of Academic Affairs, Department Chairs, and Offices of the Dean. Activities with the highest increases in involvement over the past 15 years were faculty development planning, assisting with educational research, assessment of teaching, conflict resolution, team-building, and leadership training. The mean number of full-time equivalents devoted to faculty or professional development in these dental schools was 2.67.
- dental education
- faculty
- dental faculty
- faculty development
- educational preparation
- professional development
- faculty recruitment
- faculty retention
- faculty training
Dental faculty members assume multiple roles: clinician, teacher, administrator, researcher, and provider of service to their schools and the larger community. To assist faculty members with these diverse responsibilities, dental schools offer faculty development that encompasses a wide range of programs from orientation of new faculty to teaching skills workshops to career development.
The expansion of dental faculty roles and responsibilities and the accompanying need for skill development are due to a number of factors. There is increased recognition that health professions educators need specific training in how people learn and how to best facilitate that learning.1,2 The growing complexity of instructional modalities and student requests for flexibility and technology-supported learning opportunities are motivating dental faculty members to augment their skill sets. The current land scape features new dental schools, increased class sizes, faculty shortages in some areas, heightened performance expectations for faculty, and challenges with obtaining tenure and promotion.3 In addition, faculty members often lack training for an academic career, specifically in teaching and/or research. Dental schools frequently rely on clinicians coming to teaching at later points in their careers. While these new faculty members bring a wealth of experience to the job, they present unique development needs to their institutions. Therefore, it is important to consider the impact of retiring practitioners, use of part-time instructors, presence of international dentists in teaching positions, and declines in tenure track/tenured faculty on faculty development.4,5 Moreover, the Commission on Dental Accreditation (CODA) standard mandating faculty development states that “ongoing faculty development is a requirement to improve teaching and learning, to foster curricular change, to enhance retention and job satisfaction of faculty, and to maintain the vitality of academic dentistry as the wellspring of a learned profession.”6
In 1986, Garbee et al. published the results of their survey of 68 U.S. and Canadian dental schools and reported that just over half conducted formal faculty development programs with an appointed or elected faculty development committee providing oversight.7 In 2001, O’Neill and Taylor published the results of their comprehensive study to explore “the means by which dental faculty fulfill their development needs and how their institutions assist them.”8 In their study, the largest percentage (36%; n=14) of responding schools reported that the Office of Academic Affairs was primarily responsible for professional development. The next largest entity responsible was the individual department chair (23%; n=9), and only four (11%) of the 39 responding schools reported Offices of Professional Development at the time.
In 2001, O’Neill and Taylor recommended that research “be initiated to investigate the impact of faculty development upon faculty” and to explore related concerns or issues.8 In 2016, Steinert et al. published a systematic review of medical faculty development initiatives that documented the profound growth of faculty development activities and the increased rigor of the attendant research since 2006.9 In dental education, a plethora of individual studies, perspectives articles, and reports have been published on faculty development outcomes at individual institutions,10–12 faculty development’s role in the recruitment, orientation, retention, and promotion of faculty,5,13 curriculum development,14–17 and faculty involvement in educational and clinical research projects.18–20 Other topics include leadership development,21,22 targeted faculty development for underrepresented minorities,23,24 and faculty development in the areas of interprofessional education,25,26 evidence-based dentistry,27 community-based dental education,28 and technology and dental informatics.29,30 Other articles are directed toward the need for thorough needs assessments to inform dental faculty development.31,32
The aim of this study was to assess the status of faculty development in North American dental schools in 2016. We also sought to compare the 2001 and 2016 results and thus to document the evolution of dental faculty development activities, to map administrative structures in the past 15 years, and to identify emerging trends that may not have been present at the time of the 2001 study.
Methods
This study was approved by New York University’s Institutional Review Board as exempt research (IRB# 15-10761). We consulted with O’Neill and Taylor regarding their 2001 study, and they agreed their survey instrument could serve as the foundation for the new study.8,33 Our literature search revealed few recent wide-ranging survey studies on faculty development in other health professions in North America.34,35 The literature search also confirmed the continuing relevance of the topics from O’Neill and Taylor’s study.8 To capture current trends, we added survey items informed by Sonnino et al.’s follow-up study of U.S. medical school Offices of Faculty Affairs and Faculty Development, published in 2013.35 Based on these resources and consultations with four faculty developers, the following additional faculty development activities were included in the new survey instrument: calibration, faculty career planning, programs for junior, mid-level, and senior faculty,36,37 faculty recognition/awards, dedicated website, interprofessional education programming, and academies.38 In addition, the faculty development-sponsoring entities were expanded beyond the five original entities (Academic Affairs, Department Chair, Faculty Development Committee, Office of the Dean, and Office of Professional/Faculty Development) in the 2001 survey to include four new entities: Faculty Affairs, Human Resources, Outside Consultant, and Parent University Center for Teaching.
The survey instrument included 11 multiple-choice, multiple answer, and open-ended questions. Participants were able to provide comments for several multiple-choice, multiple answer questions. Items asked for information about unit(s) performing faculty development activities; sponsor of academies; number, background, title, and type of support personnel responsible for faculty development activities; and existence, time of establishment, designation, and budget of offices dedicated to faculty or professional development. The survey instrument was reviewed by an expert panel for content validity and ease of use.
In early 2016, the final 22-question survey was distributed three times to the ADEA Faculty Development listserv as well as by sending individual emails to faculty developers at dental schools: the person who seemed to be most knowledgeable about the school’s faculty development/affairs activities listed in the American Dental Education Association (ADEA) Directory of Institutional Members39 or on the school’s website. The survey responses were collected via Qualtrics or by telephone if preferred. If there was no response to the initial request, personal contacts of the authors or from institutional websites were used to forward the survey to the appropriate persons. Two follow-up reminder emails were sent to non-respondents.
Respondents could indicate that more than one entity shared responsibility for a certain faculty development activity. For example, “Preparing for promotion and tenure” could be overseen by both Department Chairs and Offices of Professional Development. For this reason, some activities elicited many more responses (overall responses) than the total number of survey respondents.
Confidence intervals (CIs) were used to test whether the difference between results at the two survey time points (2001 and 2016) for a particular faculty development activity was statistically significant. 95% CIs of the difference in proportions were calculated using the Agresti-Croull method.40 CIs that did not contain zero indicated a statistically significant change (p<0.05) across the two time points. For analyzing the new survey items, descriptive statistics were used.
Results
Survey responses were received from 57 of 75 U.S. and Canadian dental schools for an overall response rate of 76%. Out of 65 U.S. schools, 52 responded for an 80% U.S. response rate, and five of ten Canadian schools responded for a 50% Canadian response rate. In the case of duplicate responses (four schools), the most complete survey version was used. Twenty-seven dental schools (or almost half of the respondents) participated in both the 2001 and 2016 surveys.
Overall trends showed an increase in the number of offices dedicated to faculty development. Such an office, according to O’Neill and Taylor, is a “separate office dedicated to faculty development or faculty affairs”; more specifically, these offices have “permanent staff that ensure programs are well developed, timely, and consistent in their implementation” and are involved in most of the 18 original activities.8 Twenty-three of the 57 responding schools (40.4%) reported having an Office of Faculty Affairs and/or Office of Professional/Faculty Development. In 2001, only four of the 39 respondents reported a dedicated office. Of the 23 schools in 2016 with such offices, 12 (52%) reported that they were established within the past five years. Only two schools out of 57 (3.5%) identified a Faculty Development Committee as primarily responsible for activities, whereas, in 2001, six of the 39 responding schools (15%) reported faculty development committees having primary responsibility.
Key Findings by Activities Compared to 2001
Respondents were asked to indicate whether or not a particular entity (for example, Academic Affairs) was involved in a particular development activity. Fifteen of the 18 original activities demonstrated statistically significant increases since 2001. Table 1 lists these activities by the four most active entities (Academic Affairs, Department Chair, Office of the Dean, and Office of Professional/Faculty Development). Among the activities, faculty development planning (126) and leadership development (121) received the highest number of total responses by all nine entities. (Respondents could indicate that multiple entities shared responsibility for a particular activity.)
Faculty development activities with statistically significant increases from 2001 to 2016 by the four most active institutional entities
There was increased diversity of entities responsible for faculty development since 2001. Activities with the largest increases in involvement by multiple entities since 2001 were assisting with educational research, assessment of teaching, conflict resolution, faculty development planning, team-building, and leadership development.
Key Findings by Entities
Academic Affairs/Education
There was significant growth in faculty development efforts on the part of this entity since 2001 with 12 of the 18 original categories showing significant increases: methods of teaching, assessment of teaching, peer review of teaching, course development, program/course evaluation, teaching with instructional technologies, assisting with educational research, providing expertise on teaching and evaluation, fostering and advising on mentoring, conflict resolution, and leadership development (Table 2). Only one category (preparing for post-tenure review) showed a decline in activity, but this was not significant. Overall responses (including activities in the nine added categories) totaled 559 for this entity (Table 3).
Number of activities conducted by each institutional entity: comparison of 2001 (N=39) and 2016 (N=57)
Comparison of activities conducted by Offices of Academic Affairs in participating schools in 2001 (N=39) and 2016 (N=57)
Department Chair
There was a significant increase since 2001 in the following seven activities by this entity: assessment of teaching, course development, educational research, team-building, conflict resolution, post-tenure review, and leadership development (Table 4). The total number of responses for all 27 activities was 660 for department chairs’ involvement.
Comparison of activities conducted by Department Chairs in participating schools in 2001 (N=39) and 2016 (N=57)
Faculty Development Committees
Twelve of the 18 original activities managed by committees showed declines since 2001, but only one (program/course evaluation) declined significantly (Table 5). Five categories showed essentially the same level of involvement by committees since 2001. The overall number of responses for all 27 activities was 214 for this entity.
Comparison of activities conducted by Faculty Development Committees in participating schools in 2001 (N=39) and 2016 (N=57)
Offices of the Dean
These entities showed statistically significant increases in seven out of the 18 original faculty development activities: assessment of teaching, fostering and advising on mentoring, team-building, conflict resolution, consultation on salary equity, faculty development planning, and leadership development (Table 6). The overall number of responses for all 27 activities was 302 for this entity.
Comparison of activities conducted by Offices of the Dean in participating schools in 2001 (N=39) and 2016 (N=57)
Offices of Faculty/Professional Development
These offices showed significant increases in the following since 2001: assisting with educational research, faculty development planning, and leadership development (Table 7). The overall number of responses was 303 for this entity.
Comparison of activities conducted by Offices of Faculty/Professional Development in participating schools in 2001 (N=39) and 2016 (N=57)
Offices of Faculty Affairs
The overall number of responses for all 27 activities was 123 for this entity. When the Offices of Faculty Affairs total responses were combined with those of Offices of Faculty/Professional Development, the number of responses was 426 for the combined entities.
Key activities of added entities (yielding more than ten responses each)
Human resources units were reported to oversee aspects of new faculty orientation, provide service or support for conflict resolution, and assist with addressing salary equity. Outside consultants were most often utilized for team-building efforts and leadership training. If a dental school was situated within a university setting, the university’s Center for Teaching and Learning was reportedly utilized for additional training in teaching methodologies, teaching with technology, and teaching and evaluation, as well as programs for junior, mid-level, and senior faculty.
Entities most responsible for added activities
The added faculty development activities in 2016 were often shared among several units in a dental school. Department Chairs were reported to oversee calibrations (25/84 total responses), faculty career planning (43/101 total responses), and programs for junior (21/97 total responses), mid-level (22/97 total responses), and senior faculty (19/90 total responses). Offices of Faculty Affairs/Professional Development or Offices of Faculty Affairs were reported to offer dedicated websites of the school’s faculty development offerings (22/54 total responses). Respondents reported that Offices of the Dean administered faculty recognition and awards (37/110 total responses). Finally, respondents reported that Offices of Academic Affairs offered calibrations (36/84 total responses) and training related to interprofessional education (28/92 total responses).
Professional Development Personnel
The mean number of full-time equivalents (full-time employees) representing time that is primarily dedicated to professional development across schools was 2.67 (range 1-10).
Leadership of professional development
Twenty-seven (59%) of the 46 schools that responded to this question reported either a Dean of Faculty Affairs or Faculty/Professional Development with most (21) possessing a dental degree (DDS/DMD); five had either a PhD or EdD; three had master’s in education degrees; and seven had master’s degrees in other disciplines. Eighteen (nearly 40%) respondents reported having a director, and eight of the 18 directors had faculty-level positions. Thirty-six schools (78%) had at least one administrative support person, and 29 (63%) had at least one educational specialist staff person.
Budget
Only 23 of the 57 respondents (40%) answered the budgetary questions. Five respondents (22%) reported that their schools’ faculty development budget was in the dean’s office, and eight respondents (35%) did not know budget information. Two schools reported budgets less than $50,000; five reported $50,000-99,999; one reported $100,000-200,000; and two reported greater than $200,000. The budgetary information was exclusive of salaries.
Academies
Four of the responding dental schools (7%) in this study indicated that they had their own academy (housed solely within the dental school) to recognize and reward exemplary teaching. The University of California, San Francisco in 1998 and the Harvard Medical School in 2000 each formed an “Academy” comprised of a community of faculty supportive of their school’s teaching mission.38 On our survey, 13 schools indicated the existence of academies in their medical school or parent institution. Five U.S. and one Canadian dental schools indicated that their medical school sponsored an academy, and seven U.S. dental schools indicated that their parent university sponsored an academy.
Eighteen dental schools did not respond to the survey. The ADEA Directory of Institutional Members and the schools’ websites were searched for information about the non-responding schools and their faculty development programs. According to the information publicly available in those sources, there were no offices dedicated solely to faculty or professional development/affairs at these 18 schools. At these schools, dedicated personnel in faculty development appeared to include one dean with additional responsibilities, one director, one director who was also director of research, and two assistant directors reporting to other offices. Two of the 14 non-responding schools were less than ten years old.
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.
Conclusion
Between 2001 and 2016, this study found significant growth in faculty development in dental education. This evolution shows that the field has emerged from ad hoc activities into systematic offerings at the institutional level that engage multiple players. The 2016 survey mapped how the administrative structures had evolved since 2001. In addition, our study identified emerging trends in response to new faculty development needs (interprofessional education, faculty development for subgroups of faculty, and incentives for recognition, just to name a few). Providing quality faculty development programming has the potential to enhance the capacity of faculty members to not only accomplish their academic responsibilities, but also increase their satisfaction in their roles. This study has established a new baseline of faculty development structures and activities at U.S. and Canadian dental schools, showing complexity and diversity in how schools manage this important function. There has been growth in the number of dedicated offices, increased involvement by a variety of entities, and expansion of development activities over the past 15 years. In addition to these developments, institutional support, including funds or release time, is critical to the creation of an organizational culture that champions continuous improvement of all aspects of its faculty’s growing responsibilities.
Acknowledgments
The authors would like to express their gratitude to the individuals from participating schools who completed our survey. We would also like to thank Drs. Paula O’Neill and David Taylor for sharing the original survey instrument with us; Ms. Rebecca Abromitis, MLS, Reference Librarian, University of Pittsburgh Health Sciences Library System, for her extensive help with the literature review; and Drs. Heiko Spallek and Seth Weinberg for providing feedback on the survey instrument and statistical analysis. We also thank Ms. Mackenzie Rogers, undergraduate student at the University of Pittsburgh, for her help in obtaining references.
REFERENCES
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