Experiential learning, collaboration and reflection: key ingredients in longitudinal faculty development.

BACKGROUND: Longitudinal faculty development (LFD) may allow for increased uptake of teaching skills, especially in a forum where teachers can reflect individually and collectively on the new skills. However, the exact processes by which such interventions are effective need further exploration. METHODS: This qualitative study examined an LFD initiative teaching a novel feedback approach attended by five family practice physicians. The initiative began with two 1.5-hour workshops: Goal-Oriented Feedback (as the teaching skill to be developed) and Narrative Reflection (as the tool to support personal reflection on the skill being learned). Over the subsequent six-months, the five participants iteratively applied the feedback approach in their teaching and engaged in narrative reflection at four 1-hour group sessions. Transcripts from the group discussions and exit interviews were analyzed using thematic analysis. RESULTS: Iteratively trialing, individually reflecting on, and collectively exploring efforts to implement the new feedback approach resulted in the development of a learning community among the group. This sense of community created a safe space for reflection, while motivating ongoing efforts to learn the skill. Individual pre-reflection prepared individuals for group co-reflection; however, written narratives were not essential. CONCLUSION: LFD initiatives should include an emphasis on ensuring opportunities for iterative attempts of teaching skills, guided self-reflection, and collaborative group reflection and learning to ensure sustainable change to teaching practices.

CONTEXTE: La formation professorale longitudinale (FPL) peut faciliter l'acquisition d'habiletés pédagogiques, surtout dans le cadre d'un forum où les enseignants peuvent réfléchir individuellement et collectivement à ces nouvelles habiletés. Cependant, les processus exacts qui rendent ces interventions efficaces doivent être explorés davantage. MÉTHODES: Cette étude qualitative examine une initiative de FPL qui comprend l'enseignement d'une nouvelle approche de rétroaction à laquelle ont participé cinq médecins de famille. L'initiative a commencé avec la tenue de deux ateliers d'une heure et demie, le premier sur la rétroaction axée sur les objectifs (l'habileté d'enseignement à développer) et le deuxième sur la réflexion narrative (comme outil pour soutenir la réflexion personnelle sur cette habileté en apprentissage). Au cours des six mois suivants, les cinq participants ont appliqué de manière itérative l'approche de la rétroaction dans leur enseignement et se sont livrés à une réflexion narrative lors de quatre séances de groupe d'une heure. Des transcriptions des discussions de groupe et des entretiens de clôture ont fait l'objet d'une analyse thématique. RÉSULTATS: L'expérimentation itérative, la réflexion individuelle et l'exploration collective des efforts de mise en œuvre de la nouvelle approche de rétroaction ont permis de développer une communauté d'apprentissage au sein du groupe. Ce sentiment de communauté a créé un environnement sûr pour la réflexion, tout en motivant les efforts continus pour apprendre l'habileté. La préréflexion individuelle préparait les participants à la co-réflexion de groupe; cependant, les récits écrits n'étaient pas essentiels. CONCLUSION: Les initiatives de FPL devraient mettre l'emphase sur les occasions de mise en application itérative des habiletés d'enseignement, d'autoréflexion guidée et de réflexion et d'apprentissage collaboratifs en groupe pour assurer un changement durable des pratiques d'enseignement.

Your Goals, My Goals, Our Goals: The Complexity of Coconstructing Goals with Learners in Medical Education.

Phenomenon: Despite a long-standing recognition of the importance of learning goals in feedback, there has been relatively little research on how to address mismatches between learner goals and preceptor goals in medical education. Our study addresses this gap by reporting on challenges and strategies around goal coconstruction as identified by clinical educators who were learning and attempting to implement a goal-oriented feedback approach in their own teaching contexts. Approach: We employed a qualitative, design-based research methodology to study how 5 clinician educators incorporated goal-oriented feedback into their teaching practice. Participants attended workshops on goal-oriented feedback and reflective writing. They then narratively reflected over a 6-month period on their attempts with goal-oriented feedback and shared these reflections in periodic facilitated group discussions. Themes were developed using iterative thematic analysis of group discussions and individual exit interviews. Findings: Participants identified several benefits of goal setting in all environments. They perceived improved rapport with learners and developed empathy for the vastness of learner goals. However, they experienced several struggles especially when learner and preceptor goals did not match. These included (a) how to address learner goals that were not easily amenable to a coconstruction, (b) how to coconstruct goals while actively running a clinical practice, and (c) how to remain learner centered while raising preceptor goals based on perceived gaps. Insights: Mismatches between learner and preceptor goals are inevitable and frequent. Preceptors must find ways to coconstruct goals with learners in various learning environments. That said, in enacting goal-oriented feedback, preceptors are effectively using feedback throughout the teaching and learning interaction to coconstruct the learning environment, resulting in improved rapport with learners and emphasizing why it is important to focus feedback around goals.