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Background: The long-term impact of longitudinal faculty development programs (FDPs) is not well understood.
Objective: To follow up past participants in the Johns Hopkins Faculty Development Program in Teaching Skills and members of a comparison group in an effort to describe the long-term impact of the program.
Design and Participants: In July 2002, we surveyed all 242 participants in the program from 1987 through 2000, and 121 members of a comparison group selected by participants as they entered the program from 1988 through 1995.
Measurements: Professional characteristics, scholarly activity, teaching activity, teaching proficiency, and teaching behaviors.
Results: Two hundred participants (83%) and 99 nonparticipants (82%) responded. When participants and nonparticipants from 1988 to 1995 were compared, participants were more likely to have taught medical students and house officers in the last year (both P<.05). Participants rated their proficiency for giving feedback more highly (P<.05). Participants scored higher than nonparticipants for 14 out of 15 behaviors related to being learner centered, building a supportive learning environment, giving and receiving feedback, and being effective leaders, half of which were statistically significant (P<.05). When remote and recent participants from 1987 through 2000 were compared with each other, few differences were found.
Conclusions: Participation in the longitudinal FDP was associated with continued teaching activities, desirable teaching behaviors, and higher self-assessments related to giving feedback and learner centeredness. Institutions should consider supporting faculty wishing to participate in FDPs in teaching skills.
In this country, millions of dollars1 and thousands of hours of faculty time continue to be invested each year on faculty development programs (FDPs). Many of these educational programs are designed to enhance the teaching skills of clinicians, with an emphasis on community physicians and junior faculty members.2 Program types are varied and include brief workshops, teaching evaluations with consultation, and longitudinal courses, sometimes called part-time “fellowships.”3 Despite the significant national investment in faculty development, only a limited number of teaching hospitals offer FDPs, and most are limited in length or only offered sporadically.4
Longitudinal programs have the benefit of allowing time for reflection, practice, feedback, and self-directed learning methods that may impart a more lasting impact than do the more succinct courses.5 Several evaluations of longitudinal programs have occurred immediately or soon after the conclusion of the intervention.6–10 Some studies have examined the impact of these programs on the skills and behaviors of participants at a later date,11–17 but they have usually reported about a limited numbers of participants,12–14,17 and only one manuscript described long-term outcomes in a case–control manner.11
The Johns Hopkins Faculty Development Program in Teaching Skills (JHFDP/TS) is a 9-month, 1 half-day per week course that has been offered annually since 1987. The participants have included faculty and fellows associated with Johns Hopkins Medical Institutions and other institutions in the Baltimore–Washington region. Nearly 300 learners have participated in the program since the JHFDP/TS began in 1987, including general internists, family physicians, pediatricians, psychiatrists, and behavioral scientists. We conducted a study to better understand the long-term impact of the JHFDP/TS on its participants' professional lives and teaching roles, skills, and behaviors.
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Seven to 15 years elapsed between the time of JHFDP/TS participation and this study and yet we found several important differences between participants' and nonparticipants' self-assessed teaching skills and behaviors that might be attributed to a lasting influence from the program. The sustained impact is further highlighted by the few differences found when recent and remote participants were compared.
While similar numbers of participants and nonparticipants reported that they had taught or mentored any type of learner in the year prior to the study, participants were more likely to be teaching medical students and house officers in academic settings than nonparticipants. Additionally, more past participants have won national teaching or education-related awards. Although it is not an explicit objective of the JHFDP/TS for its participants to pursue academic careers, the program may have imparted participants with a greater interest in teaching or greater motivation to teach effectively.
This study is unique when compared with most prior long-term follow-up studies of FDPs, which have primarily focused on objective markers of academic success such as presentations, publications, and leadership positions.11–15,17 Instead, we evaluated participants' perceptions of their teaching. Educators value the ability to provide feedback and be learner centered.19,20 We are aware of several studies evaluating the feedback skills of participants in faculty training programs21–31 but only one that explicitly comments on the enhanced learner centeredness of its participants.16 Like others, we evaluated feedback skills, but we additionally assessed learner centeredness. Our past participants rated their abilities to show respect and support for learners, to be learner centered, and to give feedback significantly higher than nonparticipants, suggesting that the emphasis and methods of our FDP were effective and have had a lasting impact.
Several limitations of this study should be considered. First, we used a nonrandomized control group, and our self-selected participants may have had a greater interest in teaching. However, nonparticipants rated themselves significantly higher at baseline than participants for all teaching skills assessed,6 and have themselves pursued significant amounts of training in teaching skills. Second, the generalizability of the study's findings may be limited because it focuses on a single FDP; however, most past participants are currently in settings remote from Johns Hopkins University, which suggests that the JHFDP/TS has instilled learning with broad applicability. Finally, this study was dependent on self-assessment, and participants may have been “primed” by virtue of their participation to rate themselves more highly than nonparticipants. This effect is somewhat minimized by the amount of time elapsed since program participation. Very few evaluations of FDPs have been based on objective evidence, such as actual or videotaped observations of participants' teaching encounters,26,30,32,33 and it would not be feasible to conduct such a study with a population as large as ours. Studies based on learner or peer evaluations of FDP participants are also unusual.8,27,29,30,34 Self-assessments by participants in FDPs have been shown to correlate positively with trainee ratings,27 and clinician teachers may even underestimate their abilities when compared with learners' assessments.35
Our study represents one of the largest and longest follow-up studies to date of participants in a FDP in teaching skills. The length of the program, its emphasis on self-directed learning, and its use of reflection and experiential learning methods likely contributed to its lasting effect on participants' perceptions of their abilities to give feedback, support learners, and be learner centered. The apparent sustained impact of the JHFDP/TS on its participants, when compared with a group of nonparticipants, suggests that this longitudinal model for faculty development is effective. These findings support continued investment in FDPs to improve the skills of the medical educators who will be teaching the physicians of tomorrow.