Clinical Teaching Program

Each year six medical faculty were selected to attend the Stanford Faculty Development Program for training as Clinical Teaching seminar facilitators. The 1-month training, held annually or semi-annually, provided participants with background knowledge and seminar leadership skills required to deliver a series of seven 2-hour seminars to their colleagues and to residents. Extensive opportunities to practice teaching skills were provided.

The facilitator-training program offered career development opportunties for individual faculty participants, and simultaneously provided a mechanism for institutional improvement.

The seminars are designed to:

• Enhance participants' versatility as teachers
• Enhance their ability to analyze clinical teaching using an educational framework
• Provide a forum for collegial exchange.

The seminars consist of didactic presentations, group discussions, application exercises (role plays, worksheets), video vignette review, and personal and institutional goal setting. During a follow-up session, participants are encouraged to develop a set of recommendations for improving their institution's environment for clinical teaching.

In acknowledgment of the complexity of teaching, the seminars embody a non-prescriptive behavioral approach for improving teaching. Faculty must be able to select effective teaching strategies while taking into account many variables simultaneously, including the content, the learners, and the context in which the teaching takes place. Thus, the seminars focus on principles, guidelines, and behavioral alternatives that teachers can use to improve their teaching effectiveness. The behavioral approach stems from the belief that intellectual understanding of general principles and processes is not necessarily sufficient to improve teaching. Knowledge and practice of teaching skills are essential. Although the content of teaching (e.g., the subject matter being taught) may be discussed during the seminars, the primary focus is on the process of teaching.

The seminars also embrace the philosophy that teaching improvement programs do not have to be primarily remedial in function. Alternatively, these seminars reflect the belief that teachers at all levels of experience and expertise can benefit from an organized review of their teaching.

Training activities at Stanford included:

• Instruction in the Clinical Teaching curriculum by SFDC faculty
• Review of background education literature
• Presentations by Stanford School of Education faculty
• Review and practice of the seminars, focusing on mastering the seminar content and process
• Practice teaching of the seminars to local faculty, fellows, and residents
• Sessions on homesite program implementation and data collection for program evaluation
  

Program Faculty: Kelley Skeff, MD, PhD; Georgette Stratos, PhD; and program alumni.

Trained CT Facilitators 1986 - 2018 & Institutional Affiliations at Time of Training

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The teaching of seminars in subsequent years is based on the size and need of individual home site institutions. Trained facilitators deliver seminars at their home sites to meet local faculty development needs. They also serve as regional and national faculty development resources for instructional improvement.

• Participants highly recommended the seminars to other faculty.
• Participants reported increased teaching ability across several settings (inpatient, outpatient, lecturing).
• Participants reported enhanced teaching performance across all seven educational categories.

Several factors contribute to the success of the program. First, the framework for clinical teaching has proven to be valid, durable, and accepted by faculty and housestaff as a means to analyze their teaching methods. [S]econd ... is the ability of the SFDC to address the ongoing needs of the participants, providing support, problem solving, and networking. A third feature is the meticulous attention to details of the process of faculty development and its outcomes; at each step of the way, the program has been assessed, modifications made, and the program improved. A final critical factor is the uniqueness of the faculty coordinating the SFDP. They were enthusiastic four years ago, and that enthusiasm has increased. Their commitment, willingness to share and allow participants ownership of the program at their own institution, while maintaining strong collegial and resource support, have been important in the program's success." "While I was going through the ... course at Stanford I was getting a great deal of insight, not only into teaching but also into behavioral psychology, my own limitations as a teacher and as a human being, and learner limitations as human beings. The overall effect was extremely stimulating and very insightful ... one of the most significant events in my life."

"On a personal level, the training has also given me some incredibly powerful tools for analysis of my own teaching, and I find myself regularly more cognizant of why one method or technique may be successful and another may not in any given teaching circumstance. The tools of analyzing effectiveness seem to cross over into non-teaching settings and I think have afforded me with some additional communication and administrative skills."

The course made me effectively analyze the set of behaviors that make up effective teaching. Previously, I envisioned effective teaching as a 'gift' that you either had or didn't."

"I thoroughly enjoyed the role plays and thought they were most helpful."

"Having a framework for what was merely intuitive before is very helpful."

"The framework gave me a ... systematic way to 'experiment' in various teaching settings."

"Enhancing cooperative interactions was very special because in our institution this provided rare and positive interaction between departments."

"Helped build self confidence and collegial atmosphere."

It was the first time that someone had talked to me about teaching, what it means to be a teacher, and how to do it."

"To see oneself on videotape and to see all the mannerisms and the interactions, and even the failure of interactions, I thought was very valuable. It was powerful in the seminar to look at (teaching) behaviors and to have the opportunity to see one's own behaviors, to reflect on them, and then to reproduce them in a better way."

"The seminars gave me a vocabulary and the concepts to understand and describe what goes on in my teaching and I think that a more specific vocabulary yields a more precise and a richer understanding."

"The role play was the most valuable. It really became evident when one tried to apply what had been talked about; it really underscored the points that were taught and made it much more interesting. It ingrained it much more deeply. And, for me, it was fun to do that."

"It was a learning experience in the sense of learning how to be more self-aware and how to be more conscious of what I do (as a teacher)."