AMEE GUIDE NO 36
Faculty development: Yesterday, today and tomorrow
MICHELLE MCLEAN1, FRANCOIS CILLIERS2 & JACQUELINE M. VAN WYK3
1University of the United Arab Emirates, 2University of Stellenbosch, South Africa, 3University of KwaZulu-Natal, South Africa
Abstract
의학교육은 그 자체가 하나의 학문으로서 진호하였다. Medical faculty에게 요구되는 사회적 책무와 함께 가르치는 일에 대해서도 professionalization의 압박이 커지고 있다. 프로페셔널하고 역량있는 선생, 교육자, 연구자, 리더를 키우기 위해서는 교수개발(faculty development, FD)가 필요하다. 그러나 FD는 쉬운 일이 아디나. 조직 차원에서의 지지가 필요하고, 적절한 자원의 배분과 우수한 교육자를 인정해주는 것이 필요하다.
Medical education has evolved to become a discipline in its own right. With demands on medical faculties to be socially responsible and accountable, there is now increasing pressure for the professionalisation of teaching practice. Developing a cadre of professional and competent teachers, educators, researchers and leaders for their new roles and responsibilities in medical education requires faculty development. Faculty development is, however, not an easy task. It requires supportive institutional leadership, appropriate resource allocation and recognition for teaching excellence.
이 가이드는 의학분야 뿐만 아니라 관련된 보건분야를 막라하여 교육에 대한 교수의 새로운 역할을 위한 FD를 담당하고 있는 사람들을 위해 만들어졌다. FD 개발의 역사적 관점을 보여주고 FD 프로그램을 만들기 위해서 도움이 될 만한 프레임워크를 제공하고자 했다. 이 프레임워크는 FD 담당자들이 계획을 세우고, 도입하고, 평가하는데 도움을 줄 것이다.
This guide is designed to assist those charged with preparing faculty for their many new roles in teaching and education in both medical and allied health science education. It provides a historical perspective of faculty development and draws on the medical, health science and higher education literature to provide a number of frameworks that may be useful for designing tailored faculty development programmes. These frameworks can be used by faculty developers to systematically plan, implement and evaluate their staff development programmes.
마지막으로 이 가이드는 미래 FD를 이끌어나갈 주요 트렌드와 원동력을 짚어보았다.
This guide concludes with some of the major trends and driving forces in medical education that we believe will shape future faculty development.
효과적이고 지속가능한 FD의 구성요소는?
What constitutes ‘effective’ and sustainable faculty development?
우리는 '효과적'이라는 단어를 신중하게 사용하고자 하는데, 그 이유는 많은 프로그램들이 participation이나 satisfaction 수준만 평가할 뿐 학생의 학습에 효과가 있었다는 등의 장기적인 성과는 보고하고 있지 않기 때문이다. CME에 있어서도 비슷하게 '의미있는 성과'에 대한 보고가 부족하다.
We, however, reserve the use of the word ‘effective’ since the reported success of many programmes relates to faculty participation and satisfaction rather than long-term outcomes such as changed practice or improved student learning (Prebble et al. 2004; Steinert et al. 2006; Knight et al. 2007; Williams et al. 2007). A similar paucity of ‘‘meaningful outcomes’’ has also plagued continuing medical education programmes for the same reasons (Tian et al. 2007).
Steinert등과 Tian등은 Kirkpatrick의 평가모델을 gold standard로 삼았다. 참여자들의 만족과 스스로 응답한 변화/향상 등이 가장 흔히 보고되는데 이것들은 모두 Kirkpatrick scale에서 낮은 레벨에 대한 것들이다. Kirkpatrick의 모델에서 intervention의 효과는 다음의 네 단계로 평가 가능하다.
In reaching their conclusions, Steinert et al. (2006) and Tian et al. (2007) used Kirkpatrick’s (1994) levels of evaluation as the gold standard for assessing the outcomes. Participant satisfaction and self-reported changes or improvements were most commonly reported, which are both lower order levels of outcomes on the Kirkpatrick (1994) scale (Table 3). In Kirkpatrick’s (1994) model, effectiveness of an intervention is considered at four levels:
(1) 반응 reaction of participants (e.g. participant satisfaction);
(2) 학습 learning (in terms of knowledge, skills and attitudes);
(3) 행동 behavioural changes (willingness to transfer learning to educational environment); and
(4) 결과 results (impact on learners, trainees, patients, organizational culture).
비록 Freeth등은 Kirkpatrick의 레벨이 위계가 있다고 보지는 않았지만, '결과'에 해당하는 성과를 측정하는 것은 대단히 어렵다.
Although Freeth et al. (2002) do not view Kirkpatrick’s levels as hierarchical, outcomes become increasingly difficult to measure as one moves from reaction to results.
Guskey는 조직의 리더들과 Faculty developer들이 같은 찬송가를 부르기 위해서는(즉 조화를 이루기 위해서는) '효과적인' FD가 무엇인지에 대한 의견의 일치가 있어야 한다. 우리의 관점에서 효과성은 'FD프로그램의 일차적 목적' 등을 비롯한 몇 가지 요인에 따라 달라지는 것으로 보인다.
Guskey (2003) advises us that in order for institutional leaders and faculty developers to sing from the same hymn sheet, we should agree on what constitutes ‘effective’ faculty development. In our view, effectiveness will, however, depend on a number of factors, including the primary aim of the faculty development activity or programme.
Prebble 등이 지적한 바와 같이 학생이 향상되었다는 식의 성과를 측정하기 어려운 중요한 이유 중 하나는 FD와 학생성과간에 연결이 간접적 또는 두 단계를 거치기 때문이다.
As Prebble et al. (2004) have pointed out, the difficulty in measuring improved student outcomes may stem, in part, from the fact that the link between faculty development and student outcomes is an indirect or two-step process
앞서 지적한 바와 같이, 여러 문헌들로부터 teaching practice를 향상시켜서 student learning을 향상시키는 것이 가능하다는 것이 보고되고 있고, 이는 교수들의 '학습에 대한 개념 변화'를 촉진시킴으로서 가능할 수 있다.
As alluded to earlier, the literature informs us that it is possible to promote student learning by improving teaching practice, which may be facilitated by changing teachers’ conceptions of learning (Prosser & Trigwell 1997; Prebble et al. 2004; Richardson 2005).
그러나 어떻게 교육의 'transformative conception'을 향상시키는 FD프로그램을 만들 수 있으며, '의학교육이 그 어느 때보다도 다양해진', '의학교육이 절대로 가만히 있지 않는' 이 때에 어떻게 teaching practice를 바꿀 수 있을 것인가?
But, how do we develop faculty development programmes that promote more transformative conceptions of teaching and learning and how do we change teaching practice when ‘Medical education is probably as diverse as it has ever been’ (Pritchard 2004) and when ‘Medical education seems to be in a perpetual state of unrest’ (Cooke et al. 2006)?
크게 세 분류로 나눠서 제언을 할 수 있을 것이다. (후반부에 다뤄짐)
We have chosen to group these recommendations into three main categories: effective change management strategies, effective educational practice and accountable practice.
상주하고 있는 FD전문가 Resident faculty development experts.
자문위원을 초청하여 단기간의 훈련 코스를 요청하거나 faculty를 다른 기관으로 보내 (종종 큰 비용을 들여) 수행하는 것은 지속가능하지 못하다. 성공적인 FD는 faculty teaching과 student learning의 장기적 성과에 달려 있다.
The once popular practice of inviting consultants to offer short training courses or sending faculty to other institutions, often at great cost, is not sustainable. Successful faculty development depends on its long-term outcomes for faculty teaching and student learning
우리가 보기에, faculty가 무엇을 필요하는지 잘 알고, 즉각적으로 자문을 해 줄 수 있는 MEU/Dept of ME의 스테프들이 필요하다.
In our view, this necessitates a medical education unit/department staffed with appropriately trained professionals who are sensitive to the needs of faculty and readily available for consultation (Hitchcock et al. 1993, Davis et al. 2005).
또 다른 권장사항은 '교육적으로 영향력이 있는' 사람을 파견보내는 것이다. 이 사람들이 동료로부터 존경받는 사람인지 여부가 중요하다. Simpson 등은 faculty developer를 'risk-taking role model'이라고 묘사하면서, 교육적 불완전함과 실수를 다함께 공유하고, 거기서 배운 교훈을 공유하면서 교육의 진전을 이루는 사람이라 칭했다.
Also recommended is the practice of seconding ‘educationally influential’ colleagues as role models and advocates, such as those who have been rewarded for teaching (Kaufman et al. 1999; Rogers 2005; Williams et al. 2007). It is critical, however, that these individuals are respected by their colleagues (Steinert 2005). Simpson et al. (2006) have described faculty developers who are ‘risk-taking role models’, whose behaviour advances education through public sharing of educational imperfections and mistakes, through lessons learnt and as individuals who are able to modify faculty development to engage participants.
새로운 것을 만드는 것에 집착하지 말기 Avoid reinventing the wheel.
새로운 프로그램을 만드는 것에 시간과 에너지를 쏟기 보다는 이미 성공이 증명된 프로그램이 사용한 전략을 도입하는 것이 좋다. 이를 위해서 Wong과 Agisheva는 지역과 기관의 맥락을 잘 파악하여 한 문화권에서 다른 문화권으로 FD프로그램을 도입시키는데 성공했다.
Rather than expending time and energy on de novo programmes, it makes sense to adopt strategies from programmes with proven success. To this end, Wong and Agisheva (2007) successfully transposed of a well designed and successful faculty programme from one culture to another, taking cognisance of local contextual and institutional factors.
의학교육 외 영역과 협동하기 Collaboration with and beyond the medical education arena.
조직의 자원은 대개 한정되어 있으므로 변화와 밀접히 관련이 된 사람들의 협동이 필요하다.
As institutional resources are generally finite, it is not surprising that ‘Co-operation has emerged a key theme amongst academics closely involved in change
지역간 협동은 매우 성과가 좋다. AMEE, ASME, AAMC 등.
Collaboration between regional institutions can be very productive (Kent & Gibbs 2004). AMEE (Association for Medical Education in Europe), ASME (Association for the Study of Medical Education) in Europe and the AAMC (Association of American Medical Colleges) in the USA have served important networking roles regionally and internationally. (Western Cape Branch of the South African Association for Health Educationists.)
국제적 수준에서 보면, FAIMER는 잘 사는 국가와 저소득 국가간 협력을 촉진하고 네트워크를 구축해서 의학교육의 리더십과 역량을 키우고자 했다.
On a global scale, FAIMER is contributing to building capacity and leadership in medical education across the globe by fostering co-operation and establishing networks between more and less developed nations (Burdick et al. 2006).
FD에서의 협동은 의학을 넘어 다른 보건의료직과 이루어져야 한다.
Collaboration in faculty development should also extend beyond medicine and the health professions.
변화의 원동력으로 FD를 활용하기 Faculty development as change.
모든 FD프로그램은 변화를 일으키고 지속시켜야 한다.
Any faculty development programme should endeavour to initiate and sustain change
Context가 변화에 중요하기 때문에, 열린 조직문화, 학습을 조장하는(Conducive) 조직문화가 장려되어야 한다.
As context is important for change, an open, conducive organizational culture of learning should be fostered (Eckhert 2002).
만약 FD가 변화를 위한 것이라면 Farmer는 CAS를 사용하기를 권고한다. CAS이론에 따르면 강력한 변화과정을 만들어내려면 macro 전략에 집중하기보다는 micro한 수준에 더 집중해야 한다.
If faculty development is about change, then Farmer (2004) suggests using the Complex Adaptive Systems (CAS) theory to inform our practice. The CAS Theory, rather than focusing on the ‘macro’ strategic level of an organization, purports that it is at the ‘micro’ level that the most powerful change processes take place.
이러한 측면에서 네 조건이 맞아야 한다.
변화를 위한 열망,
무엇을 어떻게 할 것인가에 대한 지식,
지지적 환경,
변화를 수용하는 포상.
In this regard, four conditions need to be met: a desire to change, the knowledge of what to do and how to do it, a supportive work environment and reward for embracing change
모든 FD프로그램은 변화관리원칙에 기반한 최선의 practice를 해야 한다.
Any faculty development programme should therefore conform to best practice regarding change management principles (Kirkpatrick 1994; Gale & Grant 1997; Bascia & Hargreaves 2000; Bland et al. 2000).
적절한 태도와 행동과 롤모델을 통해서, faculty developer는 change agent로서의 역할을 할 수 있다.
Through appropriate attitudes and behaviour and role modeling, faculty developers have the potential to act as change agents.
책임있는 행동으로서 FD Faculty development as accountable practice.
FD가 좀더 현실에 기반을 둔 접근법을 따르기 위해서는, 진행되고 있는 많은 프로그램들에 대한 적절한 평가와 보고가 중요하다.
If faculty development practice is to promote a more grounded approach, the myriad of initiatives underway across the globe should be appropriately evaluated and reported
평가를 더 잘 해야한다는 오래된 요구에도 불구하고, 최근의 보고를 보면 이런 측면에서의 질적 데이터가 여전히 부족하다. 시간, 자금, 인력이 부족한 것이 그 이유로 꼽힌다.
Despite long-standing calls for better evaluation of practice, recent reviews still lament a lack of quality data in this regard (Prebble et al. 2004; Steinert et al. 2006). Lack of time, money and staff have been most frequently cited as factors preventing systematic evaluation of faculty development (Kreber & Brook 2001).
이러한 측면에서 두 개의 유용한 프레임워크가 있다.
Two useful frameworks relating to accountable practice are provided by Gray and Radloff (2006) and Otto et al. (2006).
In Gray and Radloff’s (2006) framework for quality management in academic development in higher education, change is viewed as faculty development moving from remediation to transformation of practice. Quality management spans faculty development from the perspective of the academic developer to that of institutional management. Otto et al. (2006) describe the application of the programme logic model (borrowed from the Kellogg Foundation) to measure the contribution of faculty affairs and development offices to the recruitment, retention and development of a medical school’s faculty. These documents are well worth reading.
FD의 순응성 Adaptability of faculty development.
개개인의 교수들이 조직적 차원과 사회적 요구에 맞게 발전하기 위해서는 FD활동은 그에 맞춰 바뀌어야 한다.
As the roles and responsibilities of individual faculty members continue to evolve in terms of institutional and societal needs, faculty development activities must be modified accordingly.
FD를 다듬기
Tailoring faculty development
FD의 단계
Levels of faculty development
(1) 새로운 staff member를 조직 문화로 끌어들이기
(2) 조직의 중요한 사건(새로운 평가법 도입 등)에 따른 별개의 기술을 개발하기
(3) 교육의 Professionalization
(4) Educational scholarship의 개발
(5) Educational leadership의 개발
(1) orienting new staff members into the academic culture of the institution;
(2) developing discrete skills, which may be precipitated by a key event in the life of an institution, such as the implementation of new assessment methods or online learning;
(3) professionalizing teaching, by enhancing and extending the educational practice of academics in different
disciplines;
(4) developing educational scholarship, by supporting individuals who will extend the field of medical education research; and
(5) developing educational leadership, by supporting faculty members who wish to become policy-makers, chairs of educational committees or deans of faculty.
Benor의 2020 vision으로부터 위의 레벨을 가져왔다.
We have adapted these levels from Benor’s (2000) 2020 vision of multiphasic faculty development and teacher accreditation, in which he proposed four phases of staff development
모든 교수들은 일반적인 교육 기술을 가지고 있어야 하고, 임상 교수들은 좀 더 구체적인 기술들을 가져야 한다.
All teachers would also require a repertoire of generic teaching skills (e.g. teaching in small groups), while clinical teachers need more specific skills (e.g. teaching ethically with patients or supervising residents).
Carroll은 Levinson 등의 묘사를 활용하여 FD프로그램은 개개인의 transition point(새로 임용된, 승진을 앞둔, 테뉴어를 앞둔, 집행부를 맡은, 정년을 앞둔) 에 있는 교수들을 타겟으로 해야 한다고 제안하였다.
Using Levinson et al.’s (1978) description of life as a series of transitions and plateaus at different stages in academic life, Carroll (1993) suggested that faculty development programmes should be aimed at individual faculty members at transition points (which may be regarded as phases) in their career, such as initial appointment, promotion, tenure, assumption of supervisory or leadership duties and, finally retirement.
FD의 현 상태를 고려하면, 대부분의 교수들은 아마도 level 1이나 level 2에 해당하는 훈련만 받고 있을 것이다. 국제적 표준을 따르라는 압박이 세지고 인증기관들이 professional teaching requirement를 도입함에 따라서 모든 교수들은 최소 level 3에 도달해야 한다.
Considering the global status quo in faculty development, most faculty members probably receive Level 1 and possibly Level 2 training only (Table 5). As the pressure to implement global standards gains momentum and as accreditation bodies implement professional teaching requirements, it may come to pass that all teachers would be expected to attain Level 3 as a minimum requirement.
일부 대학들은 의학교육을 전공하는 대학원생들을 educational researcher가 되게 하거나 leader로 키우고자 할 것이다(level 4). 그러나 개발도상국과 같이 자원이 풍족하지 않은 조직에서는 level 2를 달성하는 것 조차 어려울 수 있다. FAIMER의 역할은 아프리카, 아시아, 남아메리카에 의학교육자들의 집단을 키워내서 이 지역에 역량을 키울 수 있도록 기여하는 것이다.
Some academics may choose or be encouraged to undertake post-graduate studies in medical education to become educational researchers and perhaps leaders and administrators (Level 4). It should, however, be borne in mind that for under-resourced institutions, as is the case in many developing countries, achieving Level 2 would be difficult. FAIMER’s role in creating a cadre of medical educators in Africa, Asia and South America will contribute greatly to developing this capacity in these regions.
단기과정 vs 지속과정
Short courses vs. ongoing faculty development
단기 코스는 행동이나 교육행동을 바꾸는데 한계가 있어 보인다.
it would appear that short training courses (e.g. one-off seminars, workshops) have a limited impact on changing teaching behaviour or practice (Prebble et al. 2004).
단기 코스는 낮은 비용으로 다수의 그룹에 정보를 알리는데 효과가 있어서 FD에서 많이 사용되어왔지만, 조직의 요구에 바로 들어맞는 '시기에 딱 맞는' 훈련을 위해서도 가치가 있다.
Short courses have been used extensively in faculty development as they are cost-effective for disseminating information to large groups. Short courses should also valuable for ‘just-in-time’ training, which may dovetail with institutional needs,
지속적인 FD가 필요하다는 연구 결과가 축적되고 있다.
While the evidence leading to such a conclusion is currently insufficient, the gradual accumulation of research data suggests that for sustainable faculty development, such interventions may be necessary (Prebble et al. 2004; Steinert et al. 2006).
지속적인 프로그램은 certification이나 accreditation과도 연관이 되어서 개인적인 요구 뿐만 아니라 학문적, 기관 차원의 요구에도 잘 맞는다.
Continuous programmes may also lead to certification or accreditation, which may meet both the personal and professional needs of individual faculty members as well as those of the discipline and the institution.
Med Teach. 2008;30(6):555-84. doi: 10.1080/01421590802109834.
Faculty development: yesterday, today and tomorrow.
Abstract
Medical education has evolved to become a discipline in its own right. With demands on medical faculties to be socially responsible and accountable, there is now increasing pressure for the professionalisation of teaching practice. Developing a cadre of professional and competent teachers, educators, researchers and leaders for their new roles and responsibilities in medical education requires faculty development. Faculty development is, however, not an easy task. It requires supportive institutional leadership, appropriate resource allocation and recognition for teaching excellence. This guide is designed to assist those charged with preparing faculty for their many new roles in teaching and education in both medical and allied health science education. It provides a historical perspective of faculty development and draws on the medical, health science and higher education literature to provide a number of frameworks that may be useful for designing tailored faculty development programmes. These frameworks can be used byfaculty developers to systematically plan, implement and evaluate their staff development programmes. This guide concludes with some of the major trends and driving forces in medical education that we believe will shape future faculty development.
- PMID:
- 18677659
- [PubMed - indexed for MEDLINE]