Chapter 45 For the purpose of this discussion, staff development will refer to that broad range of activities that institutions use to renew or assist faculty in their roles (Centra 1978). That is, staff development is a planned activity designed to prepare institutions and faculty members for their various roles (Bland et al 1990) and to improve an individual’s knowledge and skills in the areas of teaching, research and administration (Sheets & Schwenk 1990). The goal of staff development is to teach faculty members the skills relevant to their institutional and faculty position, and to sustain their vitality, both now and in the future. The majority of staff development programmes focus on teaching improvement. That is, they aim to improve teachers’ skills in clinical teaching, small-group facilitation, large-group presentations, feedback and evaluation (Steinert et al 2006). They also target specific core competencies (e.g. the teaching and evaluation of professionalism), emerging educational priorities (e.g. social accountability; cultural awareness and humility; patient safety), curriculum design and development and the use of technology in teaching and learning. In fact, many of the chapters in this book can become the focus of a staff development programme. At the same time, less attention has been paid to the personal development of healthcare professionals, educational leadership and scholarship and organizational development and change. Although instructional effectiveness at the individual level is critically important, a more comprehensive approach to staff development should be considered. That is, we need to develop individuals who will be able to provide leadership to educational programmes, act as educational mentors and design and deliver innovative educational programmes. Staff development also has a significant role to play in promoting teaching as a scholarly activity and in creating an educational climate that encourages and rewards educational leadership, innovation and excellence. Irrespective of the specific focus, we should remember that staff development can serve as a useful instrument in the promotion of organizational change and that medical schools can play a fundamental role in the design and delivery of this essential activity. As McLean and colleagues (2008) have said, ‘Faculty development is not a luxury. It is an imperative for every medical school.’ The most common staff development formats include workshops and seminars, short courses, sabbaticals and fellowships (Steinert et al 2006). Workshops are one of the most popular formats because of their inherent flexibility and promotion of active learning. In fact, faculty members value a variety of teaching methods within this format, including interactive lectures, small-group discussions, individual exercises, role plays and simulations, and experiential learning. However, given the ever-changing needs and priorities of medical schools and healthcare professionals, we should consider a variety of formats for staff development, including integrated longitudinal programmes, decentralized activities, peer coaching, mentoring, self-directed learning and computer-aided instruction, all of which are outlined below. We should also remember that staff development can occur along two dimensions: from individual (independent) experiences to group (collective) learning, and from informal approaches to more formal ones (Steinert 2010). That is, many healthcare professionals learn through experience, by ‘doing’ and reflecting on that experience; others learn from peer or student feedback, while work-based learning and belonging to a community of practice is key for others. Although the medical school (as an institution) is primarily responsible for the organization of more formal (structured) activities, we must be aware of the powerful learning that can occur in informal settings. Integrated longitudinal programmes have been developed as an alternative to fellowship programmes. These programmes, in which faculty members commit 10–20% of their time over 1–2 years, allow healthcare professionals to maintain most of their clinical, research and administrative responsibilities while furthering their own professional development. Programme components typically consist of a variety of methods: including university courses, monthly seminars, independent research projects and involvement in a variety of staff development activities. Integrated longitudinal programmes, such as a Teaching Scholars Program (Steinert et al 2003), have particular appeal because teachers can continue to practise and teach while improving their educational knowledge and skills. As well, these programmes allow for the development of educational leadership and scholarly activity in medical education. Peer coaching as a method of faculty development has been described extensively in the educational literature. Key elements of peer coaching include the identification of individual learning goals (e.g. improving specific teaching skills), focused observation of teaching by colleagues, and the provision of feedback, analysis and support (Flynn et al 1994). This underutilized approach, sometimes called co-teaching or peer observation, has particular appeal because it occurs in the teacher’s own practice setting, enables individualized learning and fosters collaboration. It also allows healthcare professionals to learn about each other as they teach together. Mentoring is a common strategy to promote the socialization, development and maturation of academic medical faculty (Bland et al 1990). It is also a valuable, but underutilized, staff development strategy. Daloz (1986) has described a mentorship model that balances three key elements: support, challenge and a vision of the individual’s future career. This model can serve as a helpful framework in staff development. The value of role models and mentors has been highlighted since Osler’s time, and we should not forget the benefits of this method of professional development despite new technologies and methodologies. Self-directed learning initiatives are not frequently described in the staff development literature. However, there is clearly a place for self-directed learning that promotes ‘reflection in action’ and ‘reflection on action’, skills that are critical to effective teaching and learning (Schön 1983). As Ullian and Stritter (1997) have said, teachers should be encouraged to determine their own needs through self-reflection, student evaluation and peer feedback, and they should learn to design their own development activities. Self-directed learning activities have been used extensively in continuing medical education (CME); staff development programmes should build on these experiences.
Staff development
Introduction
Common practices and challenges
Key content areas
Educational formats
Integrated longitudinal programmes
Peer coaching
Mentorship
Self-directed learning
“It goes without saying that no man can teach successfully who is not at the same time a student.”
“The one task that is distinctively related to being a faculty member is teaching; all other tasks can be pursued in other settings; and yet, paradoxically, the central responsibility of faculty members is typically the one for which they are least prepared.”
“The greatest difficulty in life is to make knowledge effective, to convert it into practical wisdom.”
“Mentoring is vital to create new leaders and new kinds of leadership.”
“We must find new ways to help faculty adapt to their new roles and responsibilities while coping with the day-to-day demands that these changes bring.”
