Using the findings from this study, suggestions are given to faculty developers for activities to increase physician identity as teacher.
This study examined teacher and student perceptions during the first 2 years of a complete transition from a conventional to a problem-based learning (PBL) curriculum at Dalhousie University. Teaching staff who had tutored in the two pre-clinical years (n = 88) completed a questionnaire at the end of the 1993-94 academic year, and student assessments of their tutors were collated for all nine units (n = 597). Seven research questions were addressed in the study which examined the faculty, student and administrative aspects of tutoring. The results showed that faculty tutors rated PBL more highly than traditional medical school methods on eight of the nine items. Teaching staff were very satisfied with their tutoring experience, but expressed a need for further training in group facilitation, questioning, handling 'difficult' situations and evaluating students. They reported that their workload outside tutorials was cut almost in half in their second year of tutoring. Students expected a tutor to be a skilled group facilitator who would guide them in their learning, while helping to maintain a positive group climate. They did not want the tutor to teach the content as they perceived the task of learning to be their responsibility. Several major administrative factors affected tutors' and students' perceptions of tutorials, including: changing tutorial group composition and tutor every 8-10 weeks; team tutoring; end-of-unit exam; conflicting demands of basic science 'vertical' units and ongoing 'horizontal' units; departmental budgetary requirements for basic medical education; recognition of tutoring in promotion and tenure decisions; and recruitment of tutors.
This study addressed three questions: (1) Do content-expert tutors differ from non-expert tutors in the extent to which they present/explain case content? (2) Do tutors who present/explain case content differ from those who almost never do in their ratings of various outcomes of a PBL curriculum? (3) Are tutors who present/explain case content rated differently by students from tutors who almost never do? Data were gathered from 88 tutors and 168 students in the first 2 years of a PBL medical curriculum. Students assessed their tutor after each unit, and tutors completed a questionnaire near the end of the academic year. In this study, 'content expertise' was defined operationally as tutors' self-ratings on the question 'To what extent could you teach (at the Med I level) the material covered in the cases?' Less than half of the tutors reported that they almost never presented/explained case content. As tutors' content expertise increased, they tended to present/explain case content more frequently. Tutors who almost never presented/explained case content rated PBL more highly than traditional methods. No differences were found in student ratings of tutors who almost never presented/explained case content, compared to tutors who did. The results suggest that tutors who are content experts find it difficult to maintain the 'facilitator' role, but that those who maintain this role are more satisfied with PBL. It appears that other tutor behaviours may have a greater influence on students' ratings of their tutors.
Objectives Our study explored community preceptors’ perceptions of their teaching role, to better understand effective ambulatory and community‐based teaching. Methods Bandura’s social cognitive theory and Schön’s notion of reflective practice guided conceptual development of an interview exploring preceptors’ views of their role, teaching goals, teaching techniques, student assessment practices, factors affecting teaching and learning, and balance of patient and student needs. Preceptors reflected also on a significant personal teaching experience. A total of 17 highly student‐rated preceptors participated. A trained interviewer conducted each interview; all were transcribed and subjected to content analysis. Results Preceptors (male, 14; female, 3) described learner‐centred approaches, setting goals jointly with the student. Demonstration, guided practice, observation and feedback were integral to the experience. Preceptors saw student comfort in the environment as key to effective learning; they attempted to maximize students’ learning and breadth of experience. They wanted students to understand content, ‘know‐how’ and ‘being a family physician’. Patients remained the primary responsibility, but learners’ needs were viewed as compatible with that responsibility. Many preceptors perceived a professional responsibility as ‘role models’. Conclusions Preceptors recognized the dynamic environment in which they taught students, and they described strategies which demonstrated how they adapted their teaching to meet the needs of the learner in that environment. These teachers combined learner‐centred approaches with sound educational practices, broad learning experiences, attention to student learning and concern for development of professional expertise and judgement. These findings may assist faculty development in family medicine, and other disciplines, in providing effective ambulatory care teaching.
Undergraduate medical curricula have become increasingly innovative in order to better prepare their graduates to enter practice, with the most notable innovation being the introduction of problem-based learning (PBL). This paper describes Dalhousie University's transition to PBL, from a teacher development perspective. The paper reinforces the need for a well-designed teacher development process that is carefully implemented and evaluated in order to ensure a successful curriculum change. A seven-stage process for teacher development of tutors at Dalhousie is described, and programme evaluation data are reported from both students' and teachers' points of view. The results from the evaluation are very positive and suggest ways of improving the teacher development process. These improvements are described, as well as future plans in this area.
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