교수개발을 통하여 더 인간적인 의학교육을: 자기인식과 교육스킬(Med Educ, 2005)

교수개발을 통하여 더 인간적인 의학교육을: 자기인식과 교육스킬(Med Educ, 2005)

Humanising medical education through faculty development: linking self-awareness and teaching skills

Linda H Pololi1 & Richard M Frankel2

도입

INTRODUCTION

상당한 FD 문헌은 teaching improvement가 의대 교수진의 최적 성과를위한 요구requirement 사항이라고 지적했다. 1-3 이러한 기술을 습득하는 것 만큼이나, 비공식적인 커리큘럼을 다루는 문제라든가, 안전하고 신뢰할 수있는 커뮤니티를 만드는 것과 같은 의학교육의 다른 차원은 무시되거나, 별개의 문제로 취급되었다.

Considerable faculty development literature has identified teaching improvement as a requirement for optimal performance of medical school faculty mem- bers.1–3 As important as mastering these skills is, other dimensions of medical education, such as addressing the  informal curriculum  and creating safe and trustworthy communities in which to learn, have been ignored or treated as separate issues.

안전하고 신뢰할만한 학습 공동체를 창출하지 못하게하는 많은 요소가 있습니다. 경제 영역만 국한해서 보자면, 상환 조정reimbursement adjustments 으로 인해 전국의  AHC의 재정적 안전이 위태로워 져서 임상 교수진이 교육 시간을 포기하고 임상 수입을 늘리기 위해 더 많은 환자를 볼 것을 요구받았다. 이로 인해 교육과 연구에 드는 시간과 노력이 줄어들 었으며, 많은 교수진이 고립되고 지원받지 못하는 느낌을받습니다 .4 의대 교수진은 왜 개인의 성취만 장려하는 이 곳에 남아야 하는지, 그리고 academic medicine에 처음 발을 들여놓은 이유인 교육과 연구를 하는 것에 대해서 왜 오히려 패널티를 받는지에 대해 끊임없이 질문하고 있다.

Many factors militate against creating safe and trust- worthy learning communities. In the economic realm alone, reimbursement adjustments have jeopardised the financial security of US academic health centres nationwide, resulting in mounting pressure on clinical faculty to give up teaching time and see more patients in order to increase clinical income. This has resulted in reduction of time and effort devoted to education and scholarship, and has also left many faculty feeling isolated and unsupported.4 Medical faculty increasingly ask themselves why they should remain in systems that promote only individual performance and essentially penalise them for doing what drew them to academic medicine in the first place ) teaching and scholarship.

프로그램의 설계를위한 이론적 근거

RATIONALE FOR DESIGN OF THE PROGRAMME

이전 연구에서 우리는 의학 교육에서 학습자 중심의 접근법이 상대적으로 희귀하다는 것을 알았으며 자기인식 및 커뮤니티 형성 (관계 형성)과 결합 될 때 여전히 희귀합니다.

From prior studies5 we had learned that learner-centred approaches in medical education were relatively rare, and rarer still when combined with self-awareness and community building (rela- tionship formation).

자기 인식은 자신의 인생 경험과 감정적 인 구성이 다른 사람과의 상호 작용에 어떻게 영향을 주는지에 대한 통찰력입니다. 자기 인식이 발전함으로써 효과적인 환자 치료에 도움이되고 학습자의 요구를 충족시키는 데 도움이되는 의사 및 교사에게 유용합니다. 또한, 관계 형성과 지역 사회 참여는 의사와 환자 간의 치료 적 관계를 수립하는 데 핵심적입니다.

Self-awareness is insight into how one’s life experi- ences and emotional make-up affect one’s interac- tions with others. The development of self-awareness is valuable for doctors and for teachers as it aids in effective patient care6,7 and in meeting the needs of learners. Additionally, relationship formation and community participation are key to establishing therapeutic relationships between doctors and pa- tients.8

성인 학습 이론에도 부합하듯, Stein10은 참가자가 자신의 목표를 설정하고, 자신의 학습을 계획하고, 소그룹으로 체험 학습을 사용하고, 자신의 목표 달성과 관련하여 결과를 평가할 때 FD가 가장 효과적이라는 것을 발견했습니다.

Aligned with adult learning theory, Stein10 found that faculty develop- ment is most effective when participants set their own goals, plan their own learning, use experiential learning in small groups, and evaluate outcomes in terms of achievement of their own goals.

American Academy on Physician and Patient (AAPP)는 자기 인식 문제를 의학적 인터뷰를 가르치는 교수법 개발과 통합하는 교수 개발 모델을지지합니다 .11

The American Academy on Physician and Patient (AAPP) advocates a faculty development model that integrates self-awareness issues with the development of teaching skills to teach medical interviewing.11

문헌은 교수 기술과 자기인식 영역에서 의학 교수진 개발의 필요성을 분명히 밝히고 있지만,이 2 가지 기술 세트는 별도의 학습 스트림으로 간주됩니다.

While the literature clearly identifies the need for medical faculty development in the areas of teach- ing skills and self-awareness,6,12 these 2 skill sets are viewed as separate learning streams.

우리는 1 학년 프로그램의 경험, 즉 Academic Faculty Development Programme : Teaching (LT) 리더십을보고합니다.

We report here the first year’s experience with our programme, entitled  Academic Faculty Development Programme: Leadership in Teaching (LT) .

프로그램 철학

PHILOSOPHY OF THE PROGRAMME

Carl Rogers는 학습 촉진을 위해 중요한 자질과 태도를 광범위하게 기록했습니다 .13 그는 효과적인 교사는 수용적이며, 학습자를 존중하고 감정적으로 congruent and genuine하며, 적극적으로 공감 적 이해를 경청하는 사람으로 묘사합니다. 

Carl Rogers has written extensively on the qualities and attitudes important for the facilitation of learning.13 He describes the effective teacher as one who 

• demonstrates accept- ance, 

• cares and respects the learner, 

• is emotionally congruent and genuine, and 

• actively listens with empathic understanding. 

학습자 중심 학습 (성인 학습 이론)은 학습자가 자신의 학습 요구와 목표를 확인하고, 학습 활동을 계획하며 (도움을 구할 수 있음) 자신의 결과를 평가하는 교육 방법입니다. 이 교육 방법은 Knowles14와 Brookfield.15의 작업을 기반으로합니다.

Learner-centred learning (adult learning theory) is an educational approach whereby learners identify their own learning needs and objectives, plan their learning activities (for which they may seek help) and assess their own results. This educational approach is based on the work of Knowles14 and Brookfield.15

교육 방법

INSTRUCTIONAL METHODS

우리의 교수 방법은 지식 습득과 기술 개발, 자기 반성과 인식, 그리고 관계 형성과 같은 학습의 중요한 구성 요소를 증진시키기 위해 선정되었습니다. 기술 및 지식은 연습 및 토론 그룹, 워크샵 및 개별화 된 피드백을 통해 해결되었습니다.

Our instructional methods were selected to promote critical components of learning: knowledge acquisi- tion and skill development, self-reflection and awareness, and relationship formation. Skills and knowledge were addressed through practice and discussion groups, workshops and individualised feedback.

워크숍

Workshops

These sessions were conducted to model approaches to learner-centred and experiential learning in larger group settings. (Appendix 1).

스킬그룹

Skills groups

Participants were divided into 2 groups to practise and discuss teaching techniques. The 2 groups remained distinct from one another throughout the year-long programme and each was facilitated by an in-house facilitator trained in Rogerian non-directive process.

성찰그룹

Reflection groups

During each day-long session, the 2 skills groups would combine to form a reflection group. The goal of the 75-minute reflection group sessions was to create a safe, supportive environment for participants to explore feelings evoked by working with patients, students and colleagues.

프로젝트 그룹

Project groups

Self-selected groups of participants worked on special projects identified during a brainstorming session. These groups were intended to provide participants with an opportunity to explore areas of learning with others sharing similar interests, but with a limited timeframe.

미팅 주기

Interim meetings

Participants met once at lunchtime for 75 minutes in between monthly, day-long meetings to support and reinforce one another, and to discuss what they were learning.

학습 추적 시스템

Learning tracking system

Participants were asked to identify and record their own learning objectives prior to starting the year-long programme (pre-programme learning objectives). We also put in place an anonymous tracking system whereby participants could identify and follow their own learning objectives and achievements through- out the year.

성찰일기Journal 옵션

Journal option

Participants were encouraged to keep a journal throughout the programme and beyond in order to promote reflection and to enhance the overall gains from the course.

구체적 프로그램

PROGRAMME SPECIFICS

The LT programme involved 9, monthly, day-long sessions (held off-site), plus a monthly, 75-minute booster session held over lunch at the medical school (a total of 93 content hours). The Office of Faculty Development assumed all tuition costs.

참가자

Participants

Eleven clinical faculty were recruited into the initial programme. The group consisted of faculty from 6 different clinical departments . Five of theparticipants were women, 6 were men and 1 was an under-represented minority member. 

모집

Recruitment

A prerequisite for participation in LT was prior completion of a 3-day programme  Teaching Skills for the Medical Educator  (reported elsewhere5). That course had a similar structure to LT but was of shorter duration and had somewhat different goals.5 Enrolment in LT was by self-nomination. Application forms had to be co-signed by the section head and department chairperson for each applicant.

일일 일과

The daily schedule

Each 1-day session began with a brief orientation to the topic and overview of the schedule, a 90-minute workshop, and a 2-hour, small-group skills training session. After lunch the entire group gath- ered for a 75-minute reflection group followed by another 2-hour, small-group skills training session, a 30-minute wrap-up and summary, and an opportunity to meet in project groups.

교수진

Programme faculty

Facilitators for the course were a combination of 2 in-house trained faculty, whose participation ensured continuity, and nationally recognised visiting faculty for about half of the sessions. Visiting faculty were recruited based on their expertise in learner-centred learning, facilitation skills and experience in the content focus of the day.

평가

EVALUATION

The evaluation consisted of a longitudinal assessment of participants’ learning objectives and achievements from each session, individual written responses to questions as a summary of experiences, and an interactive paired interview using a semistructured interview guide conducted at the final session (Appendix 2). The rationale for having participants interview one another was to make the evaluation process transparent, collaborative and of immediate use. With the permission of the participants, the interviews were audio-taped and transcribed verbatim. Each participant selected a code name for themselves to ensure anonymity of the written materials (learning objectives and written responses to evaluation questions at the final session) Table 1.

The blueprint for analysis of the evaluation material involved an inductive, iterative process of data explo- ration, reduction, categorisation of the narrative data and identifying data categories and themes. Some themes, such as the completeness of setting learning objectives, were direct and obvious. Others, such as the focus on relationships, were emergent and arose from responses to questions that were not directly related to the theme. Project objectives framed the qualitative analysis. As such we used each type of data we collected to look for evidence of impact on the 3 major foci of the LT programme: self-awareness, increased enthusiasm for and mastery of teaching skills, and enhanced relationship formation.

자기인식

Self-awareness

짝지은 인터뷰의 녹취록 (Appenix 2)을 사용하여, 우리는 자기 인식의 증거를 하나의 주제로 봤습니다. 인터뷰 질문에서 자기 인식에 대한 직접적인 언급이 없었 음이 주목할 만합니다. 그러나 각 참가자는 자신의 반응에서 적어도 한 번 이상 증가 된 자기 인식의 가치를 확인했습니다. 각 참가자에 대해 질문 된 9 개의 반 구조적 질문 중 4 개는 자기 인식에 관한 모든 의견을 설명했습니다. 참가자의 절반 이상 (n = 6)이 자기 인식의 중요성에 대해 논평했다.

Using transcripts of the paired interviews (Appen- dix 2), we looked for evidence of self-awareness as a theme. It is noteworthy that no direct mention of self- awareness was made in any of the interview questions; yet, each participant identified the value of increased self-awareness at least once in their responses. Of the 9 semistructured questions asked of each participant, 4 accounted for all of the comments about self- awareness. More than half the participants (n ¼ 6) commented on the importance of self-awareness

참여자의 거의 절반이 자기인식을 미래의 중요한 요소로 확인했습니다. 일반적인 응답은 다음과 같습니다.

almost half the participants identified self-awareness as an important element in their future. A typical response was:

 나는 이제 더 많은 통찰력을 가지고있다. 나는 내가하고있는 일을 왜 생각하는지 생각해 본다. 또한 배우고, 가르치고, 즐겁게하기 위해 사용할 수있는 매우 구체적인 기술에 대한 통찰력을 가지고 있습니다. "(Participant Hogan)

 I now have more insight. I think of what I mdoing and why I’m doing it. Plus I have insight into very specific techniques that can be used to facilitate learning, teaching and enjoyment.’ (Participant  Hogan )

3 명의 참가자는 질문에 대한 응답으로 자기 인식의 측면을 확인했습니다. 코스에 예상치 못한 놀라움이 있었습니까?

Three participants identified aspects of self-awareness in response to the question:  Were there any unan- ticipated surprises in the course, positive or negative? 

 이 코스가 내게 유도한 내적 성찰 결코 기대하지 않았다. 나는 정말로 내 자신을보고 내 자신의 방법이 무엇인지 알기 위해 효과적이거나 효과가없는 것을 분석하려고 노력해야한다. (참가자 올리브)

 I never really expected the amount of introspec- tion that this course promoted for me. I really got to look at myself and try to get to know what my own methods are and to analyse what is effective about them or ineffective.  (Participant  Olive )

 나는 이것이 ... 자기 탐험을 포함하는 과정이라고 말할 것이다. 개인적으로 문제를 사람들과 나누기 위해 배운 것 같습니다. 그리고 그것은 매우 의미있는 것이 었습니다. 나는 그것이 내가 친구와 가족 및 다른 사람들을 다룰 때 도움이되었다고 생각한다. (참여자 샘)

 I will say that this was a course that included …self- exploration. I think I learned on a personal level to separate issues from people. and to me that was very meaningful. I think it helped me deal with friends and family and everybody else.  (Participant  Sam )

전반적으로, 참가자의 의견은 자기인식이 대체로 예상했던 것은 아니었지만 상당한 긍정적 인 영향을 미쳤다 고 시사했다. 문헌과 우리가 추측 한 것처럼, 몇몇 참가자들은 자신의 자기 인식과 학생들과 함께하는 교육적 도전 사이의 유사점을 보았습니다. 참여자들은 본질적으로 자신의 개별 경험을 교실에 일반화 할 수 있다고보고했다. 또한, 그들은 새롭지 만 눈에 띄는 학습 경험이 프로그램 과정과 결과에 미칠 수있는 긍정적 인 영향을 이해하는 것처럼 보였습니다.

Overall, the participants’ comments suggested that self-awareness was largely unanticipated but had significant positive impact. As the literature and we had speculated, several participants saw the parallel between their own self-awareness and the educational challenges of working with students. The partici- pants, in essence, reported being able to generalise their own individual experiences to the classroom. Moreover, they seemed to understand the positive impact that novel but salient learning experiences can have on programme process and outcomes.

가르침에 대한 열정과 숙달 증가

Increased enthusiasm for and mastery of teaching

우리는 LT에서 배운 것을 실제 교실이나 머리맡에 어떻게 적용했는지에 초점을 둔 광범위한 질문에 대한 참가자의 서면 답변을 사용했습니다 (부록 3). 거의 모든 응답에는 새로운 열정과 숙달 증가 요소가 포함되었습니다. 다양성을 보인 것은 강조점이었습니다

We used participants’ written responses to broad questions that focused on how they had applied what they learned in LT to the real world of the classroom or bedside (Appendix 3). Virtually all the responses contained elements of renewed enthusiasm and increased mastery. What tended to vary was their emphasis.

가르침에 대한 열정

Enthusiasm for teaching

 처음 세션에서 돌아온 후 나는 3 학년 11 또는 12 명의 학생들과 함께 그룹으로 수업을 진행했습니다. 저는 학습자 중심의 형식으로 수업을 구성하고 학생들에게 선호도에 따라 형식을 변경하고 싶은지 물었습니다. 관찰 할 수있는 흥분과 감사의 마음을 보았습니다. 제가 가르치는 것을 배우는 운동에서 그들을 더 많이 인정한다는 사실을 알았습니다. 거의 모든 학생들이 저의 대화식 세션에서 질문을했습니다. 농담도 있었습니다. 며칠 후 학생들 중 한 명이 내게 와서 말했습니다. "나는 정말 당신의 강의를 즐겼습니다. 재미있었습니다. "(참가자 호간)

 After returning fromthe initial session I had a class with third year students ) a group of 11 or 12. I structured my teaching in a learner-centred format … and asked the students if they would like to change the format to their preference … I could see an observable excitement and appreciation in their eyes for the fact that I recognised them as more in that teaching-learning exercise… Almost every student asked me questions during that extremely interactive session ) with some jokes as well. A few days later one of the students came up to me and said, ‘‘I really enjoyed your lecture. It was fun.’’  (Participant  Hogan )

숙달

Mastery

대부분의 응용 사례에는 숙달 요소가 포함되었습니다 (즉, 과정 참가자는 LT에서 배운 초점 기술을 시험해보고 새로운 상황에서 적용).

Most of the application stories contained elements of mastery (i.e. course participants trying out a focal skill learned in LT and applying it in a new context).

자기 인식과 마찬가지로, 우리는 실험실에서 새로운 기술을 배운 참가자 (LT)가 성공적/자기강화적 결과와 함께 자신의 기술을 실제 세계로 이전하려고 시도하는 것을 보았습니다. 그러한 교육 효과성에 관한 이야기들은 성인 학습의 전수가 성공하고 실패하는 영토를 매핑하는 데 도움이됩니다. 또한 결과에 관계없이 새로운 방법을 시도하려는 열정과 의지가 있음을 보여주는 증거가 됩니다

As with self-awareness, we see participants who have learned a new skill in the laboratory (LT) attempt to transfer that skill to the real world of the classroom with successful and self-reinforcing results. Such stories of teaching effectiveness help to map the territory in which the transfer of adult learning succeeds and fails. There is also evidence of renewed enthusiasm and willingness to try new methods regardless of the outcome.

교육에 대한 열의의 또 다른 표시는 참가자들이 교실 또는 임상 교육에 대한 동료 평가 시스템을 프로그램 디렉터와 공동 개발 한 결과입니다. 이 역량 기반 접근 방식에는 참가자 쌍이 실제 교육을 관찰하고 비디오 테이프로 녹화 한 다음 중간 (booster) 회의에서 피드백을 제공하는 그룹이 참여했습니다.

Another marker of enthusiasm for teaching came from participants’ co-development with the pro- gramme director of a system of peer review of classroom or clinical teaching. This competency- based approach involved pairs of participants obser- ving and videotaping actual teaching followed by the group providing feedback during the interim (boos- ter) meetings.

교육에 관한 도전

Teaching challenges

전반적으로 참가자들은 자신의 학습 목표를 잘 작성했지만 소수의 참가자만 모든 세션의 학습 목표를 확인했습니다. 참가자들이 학습 목표를 작성하는 데 어려움이 있다는 것을 생각할 때, 우리는 학생들과 협력하는 교수로서의 역할에서 학습자가 학습 목표를 명확하게 식별하는 것이 어렵다는 것을 인식해야합니다. 참가자들이 학습 목표를 설정하는 것을 도와줄 필요가 있다는 것은 스킬 그룹 세션에서 의제 또는 객관적 설정이 반복적으로 나타난다는 관찰에 의해 뒷받침되었습니다.

While overall, participants did well in writing their own learning objectives, only a minority of partici- pants identified learning objectives for all sessions. As we reflect on the difficulty that participants had in writing learning objectives, we believe that in their role as faculty working with students, they too need to recognise that it is difficult for learners to clearly identify learning objectives for themselves. The understanding we gained of needing to help partic- ipants set learning objectives was supported by our observation that agenda or objective setting emerged repeatedly in the skills groups sessions.

관계 형성

Relationship formation

LT에 중점을 둔 부분은 팀 반영 및 협업과 그룹 성찰이었습니다. 방문 팀과 방문 교수진을 가르치는 교수 팀은 종종 파트너십과 협력 관계를 모델링하는 데 사용되었습니다. 또한 과정 참가자는 상호 이익을 기반으로 그룹 프로젝트를 개발할 수있는 기회를 얻었습니다.

Much of the focus in LT was on teamwork and collaboration as well as group reflection. Faculty team teaching employing in-house and visiting faculty was often used to model partnerships and collaborative relationships. In addition, course par- ticipants had an opportunity to develop group projects based on mutual interest.

도구적 관계

Instrumental

한 참가자는 전문적인 성공을 촉진하기 위해 참가자들이 개발한 관계의 중요성에 대해 설명했습니다. 이 개인에게는 비슷한 마음가짐과 도구적인 초점을 가진 사람들을 갖는 것이 중요했습니다.

One course participant described the importance of the relationships the participants had developed in terms of facilitating professional success. For this individual, having others of like mind and with an instrumental focus was important:

 우리가 프로젝트 그룹에서 이 코스를 시작했을 때의 목표는 출판이었고, 우리는 교육책무를 맡고 있는 임삭교수진이 있었으나, 나에게는 연구를 할 시간은 없었습니다.

 In my project group, our goal when we started this course, was to have a publication and so for me, we had primarily clinical faculty members with edu- cation responsibilities but not any time for research.

기 계적 목표에 중점을 두는 것 외에도이 참가자는 강좌 중에 개발 된 지지적 관계의 중요성에 주목했다.

It is worth noting that in addition to a focus on instrumental goals, this participant also noted the importance of the supportive relationships developed during the course:

한 다른 참가자는 도구 적 및 개인적 가치를 지녔다고 관계의 유사한 견해를 인정했습니다. 나머지 참가자 (9 명)는 그들이 형성 한 관계의 지지적 측면에 중점을 두었다.

One other participant endorsed a similar view of relationships as having instrumental and personal value; all the remaining participants (9) focused on the supportive aspect of the relationships they had formed.

 나는 [과정에 참석 한 모든 사람들]에 가깝게 느낀다. 그리고 나는 그들과 일대일로 이야기하기를 망설이지도 않고 그들의 그룹 안에서도 서로 다른 것들에 대한 나의 진정한 감정을 말할 수 있다. 오랜 시간 신뢰를 쌓아왔기 때문이다. 그리고 우리는 그룹의 모든 사람들에게 도움이되는 태도를 경험했기 때문에 이 과정에 참여하지 않은 사람이나 우리 그룹에 속하지 않은 사람과 이야기하기보다는 더 개방적으로 대할 수 있다. 따라서 일정 기간 동안 우리가 구축 한 관계와 같습니다. 그리고 그것은 저에게 그것은 실제로 매우 중요합니다. 그것은 나에게 가장 의미가있다. "

 I just feel kind of closer to [all the people who attended the course] and I won t hesitate to kind of talk to them one-on-one, or even in their group, to tell my true feelings about different things, in the workplace or personal issues because I know over a period of time we have developed a trust. And, since we have experienced that helpful attitude of everyone in the group, I’mmore willing to be more open about it rather than talking with somebody who did not participate in this course and who is not in our group. So it’s just like some relationship we have built over a period of time. and that, that to me is kind of very important, actually. and that is most meaningful to me.’

이 의견에서 우리는 교수진이 함께 성장하고 함께 학습 할 수있는 안전하고 협력적인 환경을 갖는 것이 중요하다는 점을이 참여자가 보증하는 것을 보았습니다. 몇몇 참가자는 LT에서 경험한 안전하고 지지적인 환경이 학생들에게 비슷한 학습 환경을 조성하도록 촉구 할 것이라는 점을 지적하면서, 교수의 학습 환경과 학생의 학습 환경을 더 긴밀하게 연결했습니다. 어쩌면 과소 평가되었던 점은 대다수의 교수 참여자에게 도구적 관계보다 지지적 관계가 가장 중요하다는 점이다.

In this comment we see the endorsement by this participant of the importance of having a safe, supportive environment in which faculty can grow and learn together. Several participants drew a further connection between the type of learning environment faculty operated in and the environ- ment for trainees, noting that the safety and support they experienced in LT would prompt them to try to create similar learning environments for their stu- dents. It is striking to note that supportive rather than instrumental relationships were of most importance to the majority of faculty participants, a fact that we and other researchers have recognised, but perhaps underestimated.

고찰

DISCUSSION

예를 들어 참가자들에게 프로그램에 대한 학장과 가장 소통하고자 하는 것이 무엇인지 물었을 때, 자기 인식이 가장 빈번하게 설명되었습니다. 쉽게 이해되면서도, 예기치 못한 것이었다.

For example, when participants were asked what they would most wish to communicate to a dean about the programme, self-awareness was described most frequently. While easily understood, the strength of this finding was unanticipated.

참가자들이 LT 프로그램의 학습 내용을 교실로 옮길 수 있다는 직접적인 증거가 있습니다. 새로이 배운 교수법의 성공 여부를 평가할 수 있었다는 증거도 있습니다. 참가자들이 자기 인식과 자기 반성에 중점을 두면서 Freire17이 말하는 프락시스(praxis)와 비슷한, 행동과 성찰의 주기적 반복에 기반한 학습을 ​​봅니다. 이러한 결과를 바탕으로 우리는 성인 학습 원칙과 개인 인식을 결합한 추가 실험이 필요하다고 결론 내립니다.

There is direct evidence, at least by self-report, that participants were able to transfer their learning from the LT programme into the classroom. There is also evidence that they were able to assess the success of these newly learned teaching methods. Taken together with the participants’ emphasis on self- awareness and self-reflection, we see a cycle similar to what Freire17 calls  praxis , or learning that is based on iterative cycles of action and reflection. On the basis of these findings we conclude that further experiments combining adult learning principles and personal awareness are warranted.

우리의 접근 방식의 한 가지 강점은 한 의과 대학의 여러 부서에서 온 참가자들의 조합입니다. 의학 학교 환경에서 전통적으로 관계를 표시 할 수있는 지위, 집중력 및 힘의 차이에도 불구하고 우리는 부서 경계를 넘어서는 이해와 collegiality의 의미있는 향상을 보았습니다.

A singular strength of our approach is the combina- tion of participants from different departments in a single medical school. Despite the differences in status, focus and power that might conventionally mark relationships in a medical school setting, we saw significant enhancement of understanding and col- legiality across departmental boundaries.

관계에 관해서는 프로그램에 긍정적 인 영향이 있다는 증거도 있습니다. 대다수의 참가자들이지지하는 관계의 가치가 LT 경험에 가장 두드러지게 나타 났기 때문에 의학은 인간이 보살 피고 인간적인 환경이 번성하도록 요구하는 과학이라는 사실을 말해줍니다. 우리는 관계가 학습을 용이하게하고 대형 의료 센터에서 일하는 것에 대한 고립과 스트레스를 줄이는 많은 사례를 관찰했습니다. 환자 안전과 오류 감소 분야에서 의사와 의사 및 팀 소통이 핵심이므로, 학생들이 이러한 관계가 성공적으로 모델링 된 것을 확인할 수 있게 하는 것이 중요합니다.

As regards relationship, there is also evidence of positive impact from the programme. The fact that the majority of participants affirmed the value of supportive relationships as most salient to their LT experience speaks of the fact that medicine is a human science that requires a caring and humane environment to thrive. We observed many instances where relationships facilitated learning and reduced the isolation and stress of working in a large medical centre. As doctor-to-doctor and teamcommunication have rightly taken centre stage in the area of patient safety and error reduction, it will be important for students to see such relationships modelled success- fully.

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핵심 영역

APPENDIX 1

Focus areas of each of the 9 days of the Leadership in Teaching programme

• Small group dynamics

• Learner-centred learning

• Giving and receiving effective feedback

• Common challenges in small group teaching

• Time management

• Teaching in the ambulatory care setting (2 days)

• Teaching on the in-patient service

• Being appreciative and ending groups

짝지은 인터뷰

APPENDIX 2

Paired participant interviews at the end of the course. 

1 At the beginning of the course, what did you think you were getting into?

2 Were there any unanticipated surprises in the course (positive or negative)?

3 What prompted you to keep coming to the course even though you have a lot of important work to do?

4 If you had 1 minute to describe this course to the dean of another medical school ⁄ a group of interested faculty at another school, what would you say?

5 How would you describe what is most meaningful about this course to the dean or department chairperson at another medical school?

6 Tell me about relationships you have developed during this programme and their importance to you as a teacher.

7 Tell me how you view your future learning based on what you have experienced in the course.

8 Is there anything I haven’t asked you that you’d like to share?

9 How would you describe what was most meaningful about the course to your best friend?

지필형 응답

APPENDIX 3

At the end of the programme, participants wrote responses to the following questions:

1 What were your principal concerns or challenges as a teacher when you started this course?

2 How have these changed since the beginning of the course?

3 Can you recall and describe a meaningful learning experience you had in the course?

4 Now that the course is over, what do you value most about having been a participant?

5 In terms of my professional development thus far, this course has … and

6 How could the programme be improved? 

Participants also wrote about an example of how they had applied new learning from the course.

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Med Educ. 2005 Feb;39(2):154-62.

Humanising medical education through faculty development: linking self-awareness and teaching skills.

Pololi LH1, Frankel RM.

Author information

• 1Women's Studies Research Center, Brandeis University, Waltham, MA 02454, USA. pololi@brandeis.edu

Abstract

BACKGROUND:

We conducted a longitudinal faculty development programme for medical school faculty, focused on enhancing learner-centred teaching skills, by integrating traditional elements of education, focusing on knowledge, skills and attitudes, with the non-traditional process elements of community building, self-awareness and relationship formation.

METHODS:

This year-long programme enrolled faculty from a range of clinical departments at a single institution. The participants gathered for day-long sessions in each of 9 months and also met at lunchtime once a month for "booster" meetings. Sessions were organised according to content areas identified as relevant to enhancing teaching skills. In addition to each content area, a variety of experiential and process learning methods were incorporated and modelled in each session. The impact of the programme was assessed using self-report data after each session, and together with paired interviews at the completion of the programme.

EVALUATION:

Programme attendance was 97%. Qualitative thematic and content analysis showed that faculty reported renewed energy and enthusiasm for teaching, as well as skills mastery. Faculty also reported significant improvements in self-awareness and habits of lifelong learning. Many faculty members felt that a singular benefit of the programme was developing and nurturing personal as opposed to instrumental relationships.

CONCLUSIONS:

It is feasible to successfully convene clinical faculty from different departments in the same faculty development programme with little or no concern for competition and conflict. The key to success is integrating content and process dimensions into a framework of community building and collective engagement. From the participants' perspective, skills and confidence, which by self-report increased for all participants, was less consequential than the opportunity to learn about themselves and their relationships to others in a safe environment. We have conducted this programme for 5 successive years.

PMID:

 

15679682

 

DOI:

 

10.1111/j.1365-2929.2004.02065.x

[PubMed - indexed for MEDLINE]