Applying team-based learning in primary care residency programs to increase patient alcohol screenings and brief interventions.

PURPOSE: Educational research demonstrates little evidence of long-term retention from traditional lectures in residency programs. Team-based learning (TBL), an alternative, active learning technique, incites competition and generates discussion. This report presents data evaluating the ability of TBL to reinforce and enhance concepts taught during initial training in a National Institutes of Health-funded alcohol screening and brief intervention (SBI) program conducted in eight residency programs from 2005 to 2007 under the auspices of Mercer University School of Medicine. METHOD: After initial training of three hours, the authors conducted three TBL booster sessions of one and a quarter hours, spaced four months apart at each site. They assessed feasibility through the amount of preparation time for faculty and staff, residents' evaluations of their training, self-reported use of SBI, residents' performance on individual quizzes compared with group quizzes, booster session evaluations, and levels of confidence in conducting SBI. RESULTS: After initial training and three TBL reinforcement sessions, 42 residents (63%) reported that they performed SBI and that their levels of confidence in performing interventions in their current and future practices was moderately high. Participants preferred TBL formats over lectures. Group performance was superior to individual performance on initial assessments. When invited to select a model for conducting SBI in current and future practices, all residents opted for procedures that included clinician involvement. Faculty found TBL to be efficient but labor-intensive for training large groups. CONCLUSIONS: TBL was well received by residents and helped maintain a newly learned clinical skill. Future research should compare TBL to other learning methods.

Academic competencies for medical faculty.

INTRODUCTION: Physicians and basic scientists join medical school faculties after years of education. These individuals are then required to function in roles for which they have had little preparation. While competencies needed to perform in medical school, residency, and practice are defined, there is little guidance for faculty. METHODS: An expert advisory group of the Faculty Futures Initiative developed a document delineating competencies required for successful medical faculty. The proportion of time faculty in various roles should allocate to activities related to each competency was also identified. Competencies and time allocations were developed for various teacher/administrators, teacher/educators, teacher/researchers, and teacher/clinicians. This work was validated by multiple reviews by an external panel. RESULTS: Trial implementation of the products has occurred in faculty development programs at four medical schools to guide in planning, career guidance, and evaluations of faculty fellows. DISCUSSION: The competencies and time allocations presented here help faculty and institutions define skills needed for particular faculty roles, plan for faculty evaluation, mentoring and advancement, and design faculty development programs based on identified needs.

Lessons learned from implementing multidisciplinary health professions educational models in community settings.

This article addresses sustainability elements for multidisciplinary health professions education in communities. The results are based on a 5 year program involving multiple health professions education institutions in seven states within the USA. We offer observations and suggestions to others who plan and implement multidisciplinary programs for health professions educators. Our findings are based on the outcomes of the Community Partnerships in Health Professions Education (CPHPE) initiative funded by the W. K. Kellogg Foundation. Data sources included pre and post surveys of students and faculty, site visits, published evaluations and site reports, and a 2 year follow-up evaluation after the external funding phase. Elements of the partnership that facilitated the sustainability of the models were: leadership, complementary missions, curriculum that mirrors clinical community practice, change from outside in, partnership boards, and faculty development. Those elements that were barriers to sustaining the efforts were: professional identities and territorial boundaries, structural differences, costs, and unclear goals. The multidisciplinary components of the community partnership initiative were the most challenging. However, in most programs, they did succeed and are currently in place. By paying attention to the elements that enhance and detract from teaming, one can plan for more successful multidisciplinary education.

Facilitating academic institutional change: redefining scholarship.

BACKGROUND AND OBJECTIVES: Academic institutions are typically resistant to change. Redefining scholarship is an important issue for academic health care institutions. This study examines the change process at institutions that have attempted to change the definition of scholarship. METHODS: Five medical schools were identified that had recently redesigned their promotion and tenure systems based on expanded definitions of scholarship. Interviews were conducted with a key leader in this effort. The interviews were designed to identify the forces and barriers involved in change, activities designed to secure faculty "buy-in, "factors needed to sustain change, and advice that would help others who might be considering such an effort at their academic health centers. We organized the results of the interviews within a change leadership and management model. RESULTS: The responses to the survey questions fit well into the change model. Many of the responses were felt to be applicable to multiple stages of the change model. CONCLUSIONS: The leaders of change from the study institutions, either by intention or intuition, identified key factors of their change process that fit well with the study model. Change leaders should include plans that follow an established model for institutional change in their strategy to change the definition of scholarship at their institution.