604-875-4111 local 68607 facdev@interchange.ubc.ca604-875-4111 local 68607 facdev@interchange.ubc.ca

Number Nine • October 2003

Office for Faculty Developmentand Educational Support

855 West 10th Avenue, Third floorVancouver, B.C. V5Z 1L7604-875-4396604-875-5370 faxfacdev@interchange.ubc.cawww.facdev.med.ubc.ca

Editor: Dr. Leslie SadownikDesign: Deanna Bracewell

We aim to make Education Matters asrelevant and informative as possible. Toachieve this, we welcome articles,photographs, letters, feedback and othersubmissions. Please send submissions tofacdev@interchange.ubc.ca.

Spotlight on Formal Instruction

www.facdev.med.ubc.ca 604.875.4396

Technology Series I:Introduction to Lecture Delivery in the

Distributed CurriculumWednesday November 12 2003 and

Wednesday December 10 200308:00-09:30

Technology Series IV:Videoconferencing 101 - An Introduction

Tuesday November 18 200315:00 - 17:00

Ideas for Experienced PBL TutorsThursday November 20 2003

15:00 - 17:00

Medical Education Grand RoundsEvidence-based Practice in the

Undergraduate CurriculumFriday November 21 2003

10:00 - 11:00

Medical Education Research GroupFriday November 21 2003

11:15 - 12:00

Technology Series V: Creating Web-based Presentations

Tuesday November 25 200314:30 - 16:30

Assessment II: Assessment ofStudents in PBL Tutorials

Wednesday December 03 200315:00 - 16:30

Leading Effective DiscussionsThursday December 04 2003

14:00 - 17:00

PBL Tutor Training WorkshopTuesday December 09 2003 and Thursday

December 11 200309:00 – 12:00

ABC Educational Primer for PhysiciansModule A: Thursday December 11 2003

09:00 - 12:00Module B: Thursday December 11 2003

13:00 - 16:00Module C: Friday December 12 2003

09:00 - 12:00

Calendar Corner:Upcoming Faculty

Development EventsThe Faculty Development Programs andServices Catalogue, available fordownload on the home page. This year’sedition has 24 pages of free facultydevelopment events for medical faculty,new advanced workshops, anexpanded technology series, and astudent assessment series.

Medical Education Grand Round topicsare now posted.

Current and previous editions of theEducation Matters newsletter can bedownloaded. Themes of past issuesinclude Assessment, Teaching andLearning with Technology, and TeacherRecognition and Reward.

The ABC Educational Primerfor Physiciansis Launched!

On the Faculty DevelopmentWebsite this month

you can find ...

Review of Program Evaluation for the MD Undergraduate ProgramAn Interview with Dr. David Kaufman

Editor’s note: This issue of our FacultyDevelopment newsletter includes articleswhich focus on the formal teaching that takesplace in the first two years of the

undergraduate curriculum. The leading articlepresents Dr. Kaufman’s review of the programevaluation system in the Medical School. Ournext newsletter will focus on Medical Education

Research. Submissions of related articles forthe next edition will be warmly accepted byour office until January 15th 2004.

In 1994 a Strategic Plan for Revising theCurriculum was completed and the UBCMedical and Dental School used this as a roadmap for major curricular revisions. Thecurriculum reform involved major changes tothe curriculum format and content andtremendous human and financial resourceswere used to implement these changes. Wasit worth it? What are the strengths andweaknesses of our current program? Howare we evaluating the overall performance ofour educational program?

To help answer these questions, Dr. DavidKaufman from SFU conducted a review ofthe program evaluation process for the MDUndergraduate Medical Program at UBC. Frommid-April through early July 2003, heconducted interviews, focus groups and anemail survey to solicit input from key individualsand groups. His report reviews currentliterature and presents conclusions andrecommendations resulting from the study. Thefollowing is an excerpt from the 32-pagereport.

Key FindingsThe many internal program evaluationdocuments, together with extensivediscussions with representatives from schoolfaculty, administration, staff and students,suggest that at least some leaders, facultyand others have a high level of awarenessand knowledge about effective medical schoolprogram evaluation. For example, UBC is aleader in defining graduate competencies and

in using the sophisticated Web eVAL system tosupport extensive student input into its

evaluation process. It is also clear that there isa detailed, well-defined, consistent process inplace for formative evaluation of the first twoyears of the undergraduate curriculum; thisconsistency adds clarity to the process forstudents and faculty and should help to makeanalysis and comparisons across programsegments more straightforward.

However, it is also clear that the presentprocess’ emphasis on many, frequent, detailedquestionnaires is tending to alienate frequently-surveyed students and overuse scarcefaculty and administration resources at the“front end” of the process. Completion of thefeedback and program improvement loop doesnot appear to occur reliably, or, if it occurs, itis not clearly communicated to programstakeholders. In addition, the year-long lack ofa Program Evaluation Committee chair has lefta serious gap in leadership, and many facultydo not appear motivated to participate onprogram evaluation committees.

The result is widespread frustration with theprogram evaluation process and a sense onthe part of program participants that (1) it istime to step back and refocus the processmore broadly on program goals and outcomes,(2) evaluation results need to be fed back andused for program improvement more broadly,and (3) communication processes andleadership resources related to programevaluation need to be improved.

continued on page 4

Reminder:

Program Directors WorkshopThursday November 20 2003

08:00 – 15:30BC Women’s and Children’s Hospital

Chan Education Centre

Dr. David Kaufman

Checklist for an effective clinical teacher:

Create a supportive learning environmentBe a role model as well as a teacherFocus on the clinical reasoning skills oflearnersProvide timely and useful feedback

Need Help? The ABC Educational Primer forPhysicians will introduce you to practicalteaching strategies including:

How to set up your office and integratethe learnerHow to develop a simple educational planfor each learnerHow to refine your questioning techniquesHow to use the One Minute Preceptor as ateaching strategyHow to use the OPEN feedback modelAnd more!

The next ABC Educational Primer for Physiciansis running as a short course over 1.5 days onThursday December 11 (9-4) and FridayDecember 12 (9-12). Contact our office for moreinformation and to register for this special event!

08:00 Registration08:15 CaRMS: Are you ready?09:00 Effective feedback: What is it? Is ithappening in my program?10:15 Break10:30 How to assess clinical performance12:00 Lunch13:00 Physician support program: Is therehelp out there?13:30 SOS: Challenging situations forProgram Directors

For more information, contact the MDPostgraduate Office at 604.875.4834.

604-875-4111 local 68607 facdev@interchange.ubc.ca604-875-4111 local 68607 facdev@interchange.ubc.cawwwwwwwwwwwwwww.f.f.f.f.facdeacdeacdeacdeacdevvvvv.med.ubc.med.ubc.med.ubc.med.ubc.med.ubc.ca.ca.ca.ca.ca fffffacdeacdeacdeacdeacdev@interv@interv@interv@interv@interccccchanghanghanghanghangeeeee.ubc.ubc.ubc.ubc.ubc.ca.ca.ca.ca.ca

2 7

It seems that each day we hear more abouttechnology-enabled teaching and learningincluding Internet and web-based courses andother innovative teaching and learningstrategies. What’s all the hype about anyway?Is web-based teaching and learning about torevolutionize the delivery of your course?

Many of today’s web-based courses areorganized within one of two learningmanagement systems (LMS). WebCT(www.webct.com) and Blackboard Inc.(www.blackboard.com) are commercialsoftware programs that provide a ready-madeframework for course development. “Non-programmers” can use these programs todevelop web-based courses complete withdiscussion boards, chat rooms and onlinequizzes.

What’s Good about Web-Based?Proponents of web-based teaching andlearning define its potential in terms of usingteaching time more effectively, improving thequality of learning, achieving new learninggoals, and realizing more flexibility for studentsand teachers (Bates & Poole, in press).Computers require students’ knowledge to berepresented in logically discrete (butinterrelated) units, making it possible to identifywhat students know or don’t know based on aset of tasks. Ultimately, instructional technologymay allow for instruction to be individualized tobest meet students’ needs.

What are the Challenges?However, there are issues that teachers andlearners must consider before entering thecyber classroom. These include suchchallenges as:• Fostering a sense of community without

face-to-face communication

• Learning a new modality and increasing one’stechnological competence

• Developing curricular content appropriate forthe medium so that the medium best supportslearning

Further, technological infrastructure disparitiesacross institutions and/or regions may presentbarriers to taking advantage of web-based tools.

“Where to” Next?Perpetual innovation in web-based technologiesseeks to address these issues and barriers.The following discussion highlights newdevelopments that bring more human interactioninto the web-based teaching and learning andameliorate bandwidth limitations.

Synchronous CollaborationAs web-based learning moves to increasesynchronous interaction, the development ofnew web-based tools has allowed forinnovative approaches to web-based courses.The OneMBA program is such an example. ThisExecutive MBA program was developed by fiveschools based in the USA, Mexico, Brazil, HongKong and the Netherlands. OneMBA features acombination of collaboration tools that enablestudent work teams across continents. Theprogram’s toolbox consists of Blackboard’s LMSfor asynchronous discussion forums andcourse material distribution, CentraOne forsynchronous collaboration, session recordingsand virtual student presentations, and email forasynchronous collaboration. Similar web-basedtools are becoming increasingly instituted andused in Brit ish Columbia, expanding thepossibilities for interactive and personalizedweb-based instruction.

BandwidthWith limited bandwidth (i.e., capacity for high-speed Internet connection) available, slow

Web-Based Teaching and LearningLuke Ferdinands and Helen Novak Lauscher

Division of Continuing Medical Education

modems and other connection issues hamperthe delivery of multimedia content in the onlineclass environment. Low bandwidth limits thetypes of files that can be used. Large files likedetailed images, audio and video files are oftensacrificed for transmission time. One solutionbeing explored is adjusting from a web-baseddistance learning class to a Web/CD hybriddelivery method, which uses the advantagesof each separate delivery format. The onlinecourse component can access the CD for largefiles to eliminate download times.

What’s Out There?A quick Internet search yields a multitude ofexamples of online teaching and learninginitiatives. In Canada, McMaster University isdelivering some Problem Based Learningclasses entirely online. In partnership withMemorial University, UBC Continuing MedicalEducation (CME) offers an online OsteoporosisMainPro C course. In addition, CME researchersat UBC are developing an online continuingprofessional development curriculum incollaboration with other national andinternational universities.

If you would like to learn more aboutopportunities for web-based teaching andlearning here at UBC, visit the DistanceEducation and Technology website atdet.ubc.ca.

For related reading:Bates, A.W. & Poole, G. (2003). Effectiveteaching with technology in higher education:Foundations for success. San Francisco:Jossey-Bass.

Palloff, R.M. & Pratt, K. (2001). Lessons fromthe cyberspace classroom: The realities ofonline teaching. San Francisco: Jossey-Bass.

Bernhard Siegfried Albinus, an 18th centuryanatomy professor at Leiden, gained such famethat his lectures often drew crowds of“fashionable folk”, like those portrayed in thisengraving. While times have changed and thepublic no longer wanders through our lecturehalls looking for entertainment, the lectureremains as a core teaching strategy in medicalschool. It is estimated that the average medicalstudent has sat through hundreds of hours oflectures by the end of their medical career.They have seen “the good, the bad and theugly” when it comes tolecturing styles.

What are thecharacteristics of a“good” lecture?

The AMEE MedicalEducation Guide No.22: RefreshingLecturing: A guide forlectures by GeorgeBrown and MichaelManogue provides anexcellent overview ofthe research onlecturing, outlines amodel of the process oflecturing, givessuggestions forimproving lecturing,explains how peoplelearn from lectures andoffers ways ofevaluating lectures.Below is a summary offive key characteristicsof good lecturesdiscussed in this Guide.

1. Clarity : Goodlectures aredistinguished bytheir clarity. Thelecturer explicitlystates the purposeof the lecture and what the students areexpected to learn from the lecture.

2. Interest : The lecturer makes thepresentation interesting. They may do thisby explaining why the content is importantfor the learners to know. They may useproblems or cases throughout thepresentation. They may share clinicalanecdotes to make the material “real”.Good lecturers realize that students’attention levels drop dramatically after 20minutes so they introduce mini-breaks orchange the activity level every 20 minutes.We know that students are more

interested if they have a chance to interactwith the lecturer or the material. Thisinteraction can be achieved with questionand answer periods or by breaking outinto small groups to discuss aspects ofthe presentation. See sidebar: MakingLectures Interactive.

3. Easy to follow: A clear and easy-to-followstructure to the lecture and a well-pacedand audible delivery is essential. From thestudents’ point of view, “less is more”.

Lecturers tend to overestimate the amountof material that they can cover in a settime and end up rushing their presentationor skipping over slides that are “not asimportant”. A lecture which takes 35minutes in self-rehearsal may take 55minutes in the lecture hall. Handouts canbe used to guide students. The AMEEGuide outlines five types of handouts.Outlines provide a one-page summary ofthe lecture with key references.Interactive handouts contain key points,diagrams and a skeletal outline of thepresentation. There is room for the

students to add in their own notes andcomplete the handout.Key information handouts providecomplex diagrams, charts, quotationsetc…Full handouts are virtually a transcriptionof the lecture – unfortunately manystudents assume if they have the handoutin their files, they have the knowledge intheir heads!Tasks and Problem handouts state thetasks or problems that will be addressed

in the lecture. Evidencesuggests that interactivehandouts are better thanc o m p r e h e n s i v ehandouts for aiding recalland understanding.

4. T h o u g h tprovoking : A goodpresentation makes astudent think andmotivates them to learnmore. The use ofproblems and questionsinterspersed throughoutthe presentation willstimulate the students’thinking. Comparing andcontrasting conceptscan be an effectivetechnique. A formaldebate betweendifferent presenters canbe exciting. Even anexplanation about how abasic science or clinicalconcept can havebroader psychosocial orethical implications canstimulate thinking.

5. Relevant tocourse: In order for apresentation to berelevant, the lecturerneeds to be aware of the

learners’ background knowledge and mustexplain to the learners how the newmaterial builds upon this knowledge. Thelecturer should also explain how thismaterial relates to the other material in theircourse.—how does the lecture enhancethe learning that is taking place elsewhere?The lecturer will need to be familiar withthe examination for the course and ensurethat the learning objectives for the lectureare reflected by the course exam. Do notsay something will be on the exam if youdo not know what will be on the exam.

The Art of LecturingDr. Leslie Sadownik

Director, Faculty Development and Educational Support

in Lyons, Albert S. and R. Joseph Petrucelli, II.Medicine: An Illustrated History. New York: Harry N. Abrams, 1978.

Teaching Skills forCommunity BasedPreceptors Booklet

This booklet was developed by the Office forFaculty Development with assistance from theDepartment of Family Practice. This 21-pagereference is a succinct overview of clinicalteaching challenges and practical strategiesfor the busy clinical teacher. A first draft wasdistributed to Phase III Rural Practice Preceptorsthis summer. We are currently revising thebooklet based on their feedback and hope tohave booklet available in spring 2004. Below isan excerpt from the booklet. If you would likemore information about this project pleasecontact our office.

Question: I have just received a request tohave a third year medical student in my office. Ifeel I am too busy! Learners take too long withpatients! What can I do?

Answer: While it can take time to get to know alearner, develop an educational plan, observethe learner, and provide constructive feedback,there are ways to limit the impact of this in youroffice schedule.

Quick Tips: Time Savers

The learner does not need to see everypatient.The case can be presented in front of thepatient.

The learner does not need to do thehistory, physical and counseling for eachpatient.The physical exam can be performedtogether or components can be checkedby the physician while the learner writesup the case.Have the learner see one patient whileyou see another.Teach with patients rather than in betweenpatients.Take time off from teaching! Allow thelearner to participate in other learningopportunities in your community that aresuitable for their level of medical training.Try different teaching techniques suchas the One Minute Preceptor.

Continued on page 3

604-875-4111 local 68607 facdev@interchange.ubc.ca604-875-4111 local 68607 facdev@interchange.ubc.cawwwwwwwwwwwwwww.f.f.f.f.facdeacdeacdeacdeacdevvvvv.med.ubc.med.ubc.med.ubc.med.ubc.med.ubc.ca.ca.ca.ca.ca fffffacdeacdeacdeacdeacdev@interv@interv@interv@interv@interccccchanghanghanghanghangeeeee.ubc.ubc.ubc.ubc.ubc.ca.ca.ca.ca.ca

36

Under the guidance of the MD UndergraduateExpansion Task Force and the CurriculumSubcommittee Years 1 and 2, we have spentthe last 10 months examining e-learningtechnology options for the distributedprogram. Starting with the learningactivities and delivery modalities involved,we explored different technologiesavailable based on the extent ofinteractivity, complexity and cost.Examples of learning activit ies arelectures, tutorials, workshops and self-studies in small and large groups. Deliverymodalities can range from real-time to pre-recorded, local to distributed, andProblem-Based Learning (PBL) tutorialdiscussion to case wrap-up. The level ofinteractivity can vary from such meansas one-way transmission to three-wayinteraction, or asynchronous onlinediscussion. The e-learning technologyoptions can include video and multimediaconferencing, groupware, Web-baseddiscussion and simulation software.

Current efforts underway include thePrototypical Week (PTW) on Host Defences andInfection (HDI) block planned for January 23-30 2004, as well as a series of e-learning pilotsto enhance our technology readiness leadingto the PTW and beyond. The PTW consists ofsix lectures, three PBL sessions, one PBL casewrap-up, and one session each of DPAS,Clinical Skills and Family Practice Continuum.There are also self-study periods wherestudents are expected to access MEDICOL foronline learning resources such as learningobjectives, self-assessment quizzes, lecturenotes, and references.

A series of trial lectures/tutorials are alsounderway to encourage faculty to start usingtechnologies as part of their delivery. Forexample, Dr. Amil Shah led the case wrap-upfor the Neoplasia week via videoconferencefrom Banff. During this session, Dr. Shah usedvideoconferencing to be ‘virtually’ present inWoodward Instructional Resource Centre (IRC)6 as well as to see and communicate with theclass. At the same time, Dr. Shah usedNetMeeting, a computer conferencing tool, topresent his case summary slides. Dr. DavidOwen was physically present in IRC 6 andassisted in facilitating this session. Studentsparticipated by going to the microphones at thefront of the class, using NetMeeting, or speakingfrom their seats. Dr. Owen ensured Dr. Shahheard all questions by repeating those notasked from the microphones.

On November 3rd, Dr. Barry Mason will lead asecond e-learning pilot. In this trial, Dr. Masonwill present to a large group of approximately

140 students in IRC with a small group ofstudents (~8) participating from a remotelocation (in this case, just a different room inthe same building). Dr. Mason’s lecture on

Electrophysiology will include the use ofvideoconferencing equipment, a documentcamera for overheads and NetMeeting for thepresentation of his PowerPoint slides.

Other technologies being considered includeSilicon Chalk as a high-end interactivecommunication and collaboration software tool,Mediasite Live as a real-time archival andwebcasting tool, and head-mounted camerasfor distributed laboratory sessions in anatomyand pathology. On the Audio-Visual (AV) sidewe have shifted from ISDN to IP-basedvideoconferencing in order to reduce costs.There is a plan to build special lecterns with asimple control interface as prototypes for useby instructors in lecture theatres. The Officefor Faculty Development and EducationalSupport has organized 14 workshops over thenext eight months to introduce varioustechnologies to the faculty for use in theirteaching and delivery. For more information onthese sessions, visit their website atwww.facdev.med.ubc.ca.

The MD Undergraduate Expansion is a highlycomplex, evolving, and developmental processwith many committees, faculty and staffworking dil igently together to create adistributed learning environment that is trulyunique in Canada. It is inevitable that there willbe many challenges, bumps and bruises alongthe way. But with the right dose of collaborativespirit, relationship building, and genuine respectfor each other, we will succeed in this boldlyuncharted journey toward a world-classdistributed MD undergraduate program for theProvince of British Columbia.

e-Learning Technologies for MDUndergraduate Expansion

Dr. Francis Lau, Charlene Walsh, Marc Broudoe-Learning Subcommittee

Do you have ideas of how to use computer,Internet, personal digital assistants, or othercomputing technologies creatively in medicalteaching or practice? Would you like to bounce

your ideas around with a group of facultymembers who share your mutual interest?Would you like to be involved in acommittee that seeks to try out the latestways of e-learning and e-healthapplications? Would you like to exchangethoughts and network with others in ourfaculty who see computing technologiesas one of the important tools for educationand research in health?

The e-medicine focus group consists ofFaculty members who are interested in oractively engaged in using electronictechnologies for medical teaching andresearch. Please join us to brainstorminnovations, participate in online committeemeetings, listen for ideas, or just simplyhave fun! Our group usually meets on thesecond Wednesday of every month from07:00 to 08:30 at UBC and virtually online.

Please e-mail Kendall Ho, Associate Dean CMEand e-medicine focus group co-chair, atkho@cehs.ubc.ca for more information. Wehope to hear from you!

e-Medicine FocusGroup

Why are these characteristicsimportant?

In a lecture the lecturer transmits informationverbally and non-verbally and the student (wehope!) receives this information and stores it inshort- and then long-term memory. What theyreceive is determined in part by what theyalready know, what they are interested in andtheir levels of attention and arousal. Messagesthat are received and stored in short-termmemory are forgotten after about 30 secondsif they are not dutifully recorded or transferredto the long-term memory. The long-term memorystores information more easily when it fits intoconcepts and facts which are already stored.Thus, ideas and facts that are presented mustbe able to be readily assimilated into thestudents’ existing store of knowledge andunderstanding.

How can I improve my lecturing?

1. Read more about it! Start with the AMEEguide for a great overview of lecturingcoupled with practical suggestionsContact our Faculty Development Officefor a copy.

2. Enroll in a Faculty Instructional SkillsWorkshop offered through the UBC Centrefor Teaching and Academic Growth. Formore information visit www.tag.ubc.ca orcall 604.822.9149.

3. Rehearse by yourself or in front of a peer.Contact our office for a sample lectureobservation form which can be used toevaluate your performance.

AMEE Medical Education Guide No. 22:Refreshing lecturing: a guide for lecturers.Med Teach. 2001 May;23(3):231-244.

For additional information, request the TeachingLarge Classes resource package from UBCTeaching & Academic Growth atwww.tag.ubc.ca. Or, download the full AMEEarticle from the UBC Library website’s e-journals at www.library.ubc.ca.

The following excerpt is from the AMEE MedicalEducation Guide No. 22, p. 241.

Making Lectures Interactive

1. Set a question or problem to be discussedin ‘buzz’ groups.

2. Show a video clip—with instructions onwhat to look for.

3. Demonstrate a task—with instructions onwhat to look for.

4. Set a brief multiple-choice questionnaire.Present it on a transparency.

5. Ask the students to frame questions inrelation to data or to make estimates (e.g.incidences of various diseases, costs ofoperations, risks of infection).

6. Solve a problem collectively.7. Ask the students to discuss briefly (in

groups of two or three) a case, aresearch design or set of findings.

8. Ask the students to invent examples andcompare them with those of anotherstudent.

9. Ask the students to consider briefly likelyadvantages and disadvantages, orstrengths and weaknesses, of aprocedure or theory. Then outline theadvantages and disadvantages so theycan compare their views with yours.

10. Towards the end of the lecture ask themto review the key points that they havelearnt or need to learn and share themwith their neighbours. This active reviewaids recall and probably understanding.

First, a confession: Teaching in the Doctor/Dentist, Patient and Society course (DPAS) isprobably the most difficult challenge I have takenon in my teaching career. Why should this beso? We introduce topics of pressingimportance to highly motivated and intelligentstudents. What could be easier?

The truth is that there are many things thatmake teaching in DPAS a challenge. For thoseof us who help run the course, there is hardlya teaching style that isn’t called upon.Lecturing, introducing guests, facilitatingpanels, tutoring small groups, all of these arepart of DPAS. It is a complex course that tacklesa wide array of intense topics that are notgiven concentrated attention elsewhere in thecurriculum; if it is not a body system issue, it isprobably DPAS. The former course director,Dr. Christine Loock, believed strongly thatDPAS issues should be pervasive throughoutthe curriculum, and I would agree. We are stillworking on that one.DPAS topics include such things as domesticviolence, addiction medicine, ethics, andcomplementary and alternative therapies. Ihave called DPAS topics “important” and“intense.” But do students always agree?

Another significant challenge of the course isto help students understand how fundamentalthese issues are to the practice of medicineand dentistry. Current course director Dr.Michael Whitfield captures this challenge wellwhen he talks about “putting old heads on youngshoulders.” Once students gain clinicalexperience, the relevance of DPAS becomesclear. However, can we wait until they are“blindsided” by some of these issues beforeintroducing them? Hardly.

This brings us to the teaching issue that makesDPAS so challenging for me. How does oneunderscore the relevance of a topic before thelearner has experienced it first-hand? One wayis to tell the learner emphatically that a topic isimportant, “Believe me, people, this is going tobe a big deal for you some day.” In myexperience, this is a marginally effectivestrategy at best. Another is to present oneselfas a model. “I didn’t think this was a big dealwhen I was a student sitting where you are,but now I know differently.” Slightly better, inthat there is at least a bit of empathy in thestrategy. Another is to bring in someone elsewho is close to the topic and have them providetestimony as to its relevance. “Don’t take my

word for it. Dr. Bloggs here is going to tell youthat the topic is important for her too. And sheshould know. She is an internationallyrecognized expert.” Not bad, provided that Dr.Bloggs is captivating, credible and clear.

Of course, we use all these strategies in DPAS.However, none of them is entirely effective. Inthe end, nothing replaces letting the studentsget close to the topic themselves. This is whyeverything changes when patients visit ourclass. It is why the course assignments thatsend students into the community, to askpatients about the impact of a condition ontheir lives, or practitioners about the realitiesof a given alternative therapy, are so valuable.

The bottom line? It might be convenient oreven gratifying for us if students simply tookour word for it when we told them somethingwas going to be important. However, curiousand intelligent people don’t tend to take otherpeople’s words for things. Our students havebeen asked to do this for many years beforemedical and dental school. Now, they need tobe shown and experience the issues, not told.Herein lies one of the biggest challenges forDPAS and, I believe, for everyone working inprofessional schools.

Doctor/Dentist, Patient and SocietyDr. Gary Poole

Director, UBC Centre for Teaching and Academic Growth

Continued from page 2

Faculty Development has aNew Home

Over the summer, the Faculty DevelopmentOffice moved to a new location at VancouverGeneral Hospital. We are now located on thethird floor of 855 West 10th Avenue, betweenLaurel and Willow Streets, beside the Skin CareCentre. Our updated contact information islisted on the back page.

604-875-4111 local 68607 facdev@interchange.ubc.ca604-875-4111 local 68607 facdev@interchange.ubc.cawwwwwwwwwwwwwww.f.f.f.f.facdeacdeacdeacdeacdevvvvv.med.ubc.med.ubc.med.ubc.med.ubc.med.ubc.ca.ca.ca.ca.ca fffffacdeacdeacdeacdeacdev@interv@interv@interv@interv@interccccchanghanghanghanghangeeeee.ubc.ubc.ubc.ubc.ubc.ca.ca.ca.ca.ca

Kaufman Interview

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On October 17th, Dr. Kaufman presented thefindings from his report at our monthly MedicalEducation Grand Rounds. The FacultyDevelopment Office spoke with Dr. Kaufmanfollowing the rounds about the report.

FD: What was your greatest challenge inwriting this report?

DK: I would say the short timeline. I started thereport in mid-April and finished it in earlyJuly, so it took two and a half months. Itwas a short timeline to take a really in-depth look at what was actually going on.Not to mention that I have a fairlydemanding day job as well, so I spent alot of evenings and weekends on thisreview.

FD: Were there any differencesbetween this review and otherprogram evaluations that you havedone?

DK: I’d have to say the unique thing aboutthe UBC review is that it seemed that thetime was absolutely perfect for this study.People were ready. There was a degreeof frustration and a sense that things arenot working in this area, but at the sametime a tremendously positive attitude ofwanting to help and wanting to make thisprocess better. Pretty much everythingpeople said to me — although, sure, theypointed out problems — was constructive.I’ve been in program evaluations that havebeen so negative, you have to be carefulwhat you say, and you feel like you are walkingon egg shells all of the time.

FD: Are you saying that if theenvironment is a negative one, thereview process can actually bedestructive?

DK: Not only can the process be destructive,evaluators can sometimes find themselves inan untenable position, having to take sides.This was not the case here; there was a sensethat everybody I talked to had ideas how tomake it better and had a lot of suggestions.Also strangely enough — and that’s why I thinkit was a good time to do this — there was asense of real optimism in this study. Sometimesyou get cynicism in a study, where people think“What’s the point? Nothing is going to happenanyway”. But I somehow have the sense thatthis report is going to be a positive thing andlead to change. I think the timing was right.

FD: In your Medical Education GrandRounds presentation, you talked about

key findings from the report. What onechange, if implemented, do you thinkwould have the largest impact on the MDUndergraduate Program?

DK: I’m going to give you an answer that wetend to give in almost every domain of life -better communication. UBC’s Faculty ofMedicine is a big and complex organization.People are incredibly busy. There is so muchgoing on that people don’t know about, and ifthey did, they would probably be a lot happier

and a lot more positive. We have this problemin most medical schools, but UBC’s is particularlybig and complex.

So how did we resolve this issue at Dalhousie,for example? We had a new Dean come in(who formerly had been UBC faculty - Dr. JohnRudy) who quickly recognized the sameproblem. He set up a Director ofCommunications with a staff member or two.This office distributed a newsletter and postedinformation online, and developed the medicalschool’s image to the public. Enhancing theschool’s communication this way made it easyfor people to find out what was going on, andgave them the sense that they were part of anorganization all working together as a team.

FD: How much time did it take for thischange to make a significant differenceat Dalhousie?

DK: Within about a year people noticed thedifference - they were aware of theCommunications Office and its publications,

they were informed about what washappening in the faculty, and the Office soonbecame institutionalized in the medical school.The problem is that when a program gets reallysuccessful, people want more of it and so thereis pressure on the program for more resources.When this office got incredibly busy andoverwhelmed, they came up with some creativesolutions. One solution was to hire co-opCommunications students from the localuniversity to help manage the workload, whichresulted in benefits for both parties.

FD: Thank you very much for speaking withus. I can’t tell you how pleased I am thatthis whole process came about and I dothink it will breathe new life into the facultyand change will happen.

Following is a summary of the 12recommendations from the report.

1. Establish a new Program EvaluationCommittee (PEC) as soon as possible, andprovide it with resources to better conductits activit ies (e.g. student researchassistants, sustenance for late afternoonor early morning meetings).

2. Appoint a faculty member as Director,Program Evaluation, and provide thisperson with a one day per week releaseallowance and a budget to support theirwork (e.g. part-time secretarial support).

3. Revisit the original principles, rationaleand goals in the Strategic Plan forRevising the Curriculum document(1994).

4. Revisit the Framework for ProgramEvaluation document (1997).

5. Broaden the scope of program evaluationin the M.D. Undergraduate Program toinclude a broader range of methodologies,participants, program goals,competencies, and data sources, suchas the MCC qualifying exam (Part I and II)results, CAPER data on residencyplacements, practice locations andspecialties, peer reviews, etc.

6. Work to better harmonize the programevaluation and student assessmentsystems across the M.D. UndergraduateProgram.

7. Obtain a one-time approval from the UBCResearch Ethics Board (REB) to use theevaluation data collected for education

research purposes, and obtain(whenever possible) a signed consentform from program participants (i.e.incoming students, faculty).

8. Create a UBC-UNBC-UVic programevaluation working group (working closelywith the PEC) to prepare a plan as soonas possible for evaluation of the newdistributed curriculum.

9. Further develop the Web eVAL systemand expand its use in the M.D.Undergraduate Program evaluationprocess.

10. Improve the communication processacross the medical school around programevaluation (e.g., communicate goals,competencies, curriculum structure, keyfindings, actions taken). Specifically:

a. Better emphasize to students their“professional behaviour” obligations in theprogram evaluation process, and reinforcethis throughout all four years of theprogram.

b. Provide training to students in givingconstructive feedback.

c. Maintain anonymity in the quantitativestudent ratings of their instructors, buthave students sign their open-endedcomments. Signatures should be removedby staff before being passed along tofaculty. Ensure that unsigned studentcomments are not passed along to faculty,are not retained, and cannot be used onteaching dossiers/portfolios.

d. Set up a student feedback system run bystudents and driven by the learningobjectives/competencies.

e. Redefine the program evaluation processfor each block/course from a one-wayreporting to the Block Chair/CourseDirector to a two-way dialogue with thePEC.

f . Use communication mechanisms (e.g.,newsletter, web, email) to inform facultyand students about whom to contactabout specific issues and to report onactions taken to change the program,based on the feedback received.

11. Implement a formal set of policies andprocedures for faculty to prepare a

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teaching dossier/portfolio for purposes ofreappointment, promotion and tenure.

12. Implement a formal process to evaluatethe work of the Program EvaluationCommittee, including its process,recommendations, and action on itsrecommendations taken by the medicalschool undergraduate program.

A copy of the full report is available bycontacting Dr. Angela Towle, Associate Dean,MD Undergraduate Program, at 604.875.4111local 55153.

David M. Kaufman, M.Eng., Ed.D.From 1991-2001, Dr. David Kaufman served inthe roles of Director of the Medical EducationUnit, Professor of Medical Education, andDirector of Faculty Development in DalhousieUniversity’s Faculty of Medicine. With hiscolleagues, he was responsible forimplementing and evaluating the new PBLcurriculum. In July 2001, he was appointedDirector of the Learning and InstructionalDevelopment Centre at Simon Fraser University,and later as Professor in the Faculty ofEducation.

The Roche Oncology Award for Excellence inTeaching Clinical Skills was recently set up toacknowledge and promote excellence inteaching Clinical Skills. This annual award isgiven to both first and second year Clinical Skillstutors. Tutors are nominated by their first andsecond year medical and dental students.

Congratulations to the inaugural winners!It is our privilege to announce that Dr. AndrewIgnaszewski (Cardiology, Department ofMedicine) and Dr. Nasreen Khalil (RespiratoryMedicine, Department of Medicine) have beenjointly awarded the Roche Oncology Awardfor Excellence in Teaching first year ClinicalSkills. Dr. Gary Redekop (Neurosurgery,Department of Surgery), has been awardedthe Roche Oncology Award for Excellence inTeaching second year Clinical Skills.

Certificates of Merit were awarded to thefollowing individuals to recognise theiroutstanding contributions to the Clinical Skillsprogramme: Dr. Angela Price (Neurosurgery,Department of Surgery); Dr. Pankaj Dhawan(Physical Medicine & Rehabilitation, Departmentof Medicine) and Dr. Lindsay Lawson(Respiratory Medicine, Department ofMedicine).

New!Roche Oncology Award for

Excellence in TeachingClinical Skills

The Clinical Faculty Award for Excellence inTeaching is intended to provide recognition andencouragement to excellent teachers. Theaward consists of a financial prize of $1,000and membership in the Canadian Association.Three awards are offered annually.

Candidates for this award will possess a ClinicalFaculty appointment within the Faculty ofMedicine in one of the Clinical Departments orProfessional schools. Candidates should havea sustained record over several years ofeffective teaching performance. The awardswill be based upon excellence in teaching asevidenced by evaluations of students and/orresidents and/or peers. Consideration will begiven to a record of the development of effectiveteaching methods or materials for clinicalteaching and involvement in curricular or coursedevelopment.

The Career Award in Clinical Teaching isintended to provide recognition andencouragement to excellent teachers. Theaward consists of a financial prize of $2,500.The purpose of this award is to recognise long-time members of the Faculty, who over theircareer have a record and reputation forexcellence in clinical teaching.

Candidates for this award include any seniorfull time, part time, and clinical members of theFaculty would be eligible for this award. Theseare the teachers who typically function on aone on one basis with residents and studentsin the context of caring for patients, and whohave a major impact on their career choice andtheir acquisition of clinical knowledge and skills.It is often difficult for such teachers to providethe formal documentation of this form of teachingas required for the Killam Award, and as manyof these teachers are not clinical appointees,they are not eligible for the new Clinical TeacherAwards.

Nominations for the Clinical Faculty and CareerAwards will be due early in 2004. Watch ourwebsite, www.facdev.med.ubc.ca, for furtherdetails.

Clinical Faculty Award forExcellence in Teaching

2003 - 2004 Call for NominationsCareer Award inClinical Teaching

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