Shaping Tomorrow Together: Transforming the Faculty Role

ShapingTomorrowTogether:TransformingtheFacultyRolefromCliniciantoAcademician

ADEA Annual SessionMarch 13, 2016Denver, CO

PanelPresenters• Geralyn Crain, DDS, PhD, Assistant Dean for Educational Support and Faculty Development, East Carolina University School of Dental Medicine

• Frank Licari, DDS, MPH, MBA, Dean, Roseman University of Health Sciences College of Dental Medicine

• William Carroll, BS, DDS, FACD, FICD, FAGD, ABGD, Associate Dean for Academic Affairs, Roseman University of Health Sciences College of Dental Medicine

• Todd Watkins, DMD, Assistant Dean for Dental Education and Informatics, East Carolina University School of Dental Medicine

LearningObjectives1. Delineate the need for transformation of the role of 

faculty from clinician to academician.

2. Describe the importance of an organizational assessment, complimented by a needs assessment for faculty development.

3. Identify elements integral to transitioning from clinician to academician including an understanding of students, the learning environment, assessment processes, culture within the school/university, and career paths within academic dentistry.

FromCliniciantoAcademician

• “When I became a dental educator, I knew the dentistry, but didn’t realize there was an entire science of education.”

Dr. Paul Lindauer, Ret. Navy; East Carolina University, Division Director, Endodontics; Completing a Certificate in Health Professions Education

• William Gies’ 1926 vision of a “dental educator” as a distinct professional, different from “a dentist who happens to teach”. 

FromCliniciantoAcademician

Drisko and Whittaker: Review of 75 years of JDE publications around faculty development, educational methodologies, faculty recruitment and retention, and faculty members’ perceptions of the academic work environment. 

Trower: Dental faculty who join academia after a private practice career have little experience with university culture, structure, policies, procedures, and general expectations of the academic environment. 

Drisko CL, Whittaker LP. Dental school faculty and the academic environment from 1936 to 2011: familiar features in a new context. J Dent Educ. 76(1):65‐74.

Trower CA. Making Academic Dentistry More Attractive to New Teacher‐Scholars. J Dent Educ. 71: 601‐605.

FromCliniciantoAcademician

• New dental faculty, often with little to no formal education training, may experience challenges associated with adapting to a new role as educator and to an academic career. 

• Shifting from expert clinician to novice educator can be challenging as competent practitioners learn new roles, processes and procedures associated with a successful academic career.

TaleofTwoSchoolsECU

• Full accreditation status August 2015

• Public undergraduate and graduate university

• Class size 52 students

• 49 full‐time; 11 part‐time faculty

• Majority non tenure track faculty (for now); 3‐5 year contract

• Mix of faculty/junior faculty from other institutions; some directly from private practice/military background; most general dentists 

Roseman

• Full accreditation status August 2015

• Private, non‐profit health sciences university

• Class size 82 students

• 38 full‐time; 40 part‐time faculty

• No Tenure (2‐year continuous contract/5‐year contract)

• Majority faculty with background as clinicians ~90% 

• Most faculty general dentists

TheNeedforTransformation

FromCliniciantoAcademician• Your own academic foundation often leads to teaching the way you were taught.

• Teaching vs. Learning• We can’t party like it’s 1985!!  • Using technology to do “the same old thing” is not the answer. 

• WWIMH• Wax/Amalgam   • Technique Learning vs. High Fidelity Case‐Based Instruction• Teaching is more than providing information… • Roseman “Mastery Learning” (active learning, Pass/No Pass) 

FromCliniciantoAcademician

• Novice, Beginner, Competent, Proficient, Expert Learning (Dreyfus Model of Skill Acquisition). 

• Why do we need to Calibrate/Standardize Faculty?

The Four Stages of Learning

UNCONSCIOUSLY INCOMPETENTYou don’t know what your problems are, and you don’t know how to identify them. (Starting point of learners)

CONSCIOUSLY INCOMPETENTYou see a lot of your problems, but you don’t know how to correct them.  (Need the help of Experts/Remediation)

CONSCIOUSLY COMPETENTYou know how to correct your problems, but it will take time and practice. (Self‐Assessment)

UNCONSCIOUSLY COMPETENTYou perform well without thinking about it! (Proficient‐Expert)

FromCliniciantoAcademician

• How that role changes within the life of a dental student. 

• Novice teachers make mistakes, and that’s ok! 

• Faculty calibration (Standardization) 

• There is a need for the intentional development of faculty as educators

NeedsAssessment

NeedsAssessment

• Organizational Assessment• First, you have to understand the organization; who, what, why and how it operates.

• Faculty Development Needs Assessment• In terms of faculty, ask yourself, who do we have and what are their backgrounds, strengths and deficiencies? 

FacultyDevelopmentatRoseman

A M E R I C A N D E N TA L E D U C AT I O N A S S O C I AT I O N

NeedsatRosemanATaleofTwoSurveys• At least twice the national average of private practitioners ‐ over 80%

• Over the past year two surveys were sent to our faculty.

• Confirmed what we were seeing.•• Surveys assessed “ comfortability” of faculty in a number of academic and clinical areas.

• Shaped and structured our faculty development program, accordingly.  

NeedsAssessment

• Both surveys were built upon desired outcomes identified by the faculty in our initial faculty workshop series.

• First survey (41 responses ) ‐ sent to all faculty members ‐ full time and adjunct. 

• Clinical and academic in scope.

• 22 questions ranging from prior academic experience to how comfortable faculty were with a cross section of standard academic requirements.

NeedsAssessment• Data ‐ eye opening, but not surprising, given the lack of experience of  our faculty in academia. 

• The survey used a scale of 1 to 5: 1 ‐ was not comfortable2 ‐ slightly comfortable3 ‐ comfortable 4 ‐ moderately comfortable 5 ‐ extremely comfortable.

• On facilitating small group discussions, 57 %  of the faculty were either slightly comfortable or not comfortable at all

• On lecture based and interactive teaching, 42% felt uncomfortable or slightly comfortable

• These are at the core of our own Mastery Learning Model

NeedsAssessment• Performing Student Assessments 73% of the faculty felt uncomfortable or slightly comfortable.

• Lecturing 46% of our faculty were either slightly comfortable or not comfortable at all.

• Developing Formative and Summative Evaluations 38% were either slightly comfortable or not comfortable. 

• Facilitating Critical Analysis 73% felt uncomfortable or slightly comfortable.

• Even more telling, 51% felt either uncomfortable or slightly comfortable with their didactic and clinical teaching skills 

How comfortable do you feel doing the following?

Facilitating small group discussions:

Facilitating critical analysis sessions:

Student Assessments:

Evidence Based vs. Fact Based Teaching:

OurSecondSurvey• Sent out to our faculty by the Co Directors of Clinical General Dental Education: Drs. Soffe and Black.

• Consisted of 5 questions:1.  How familiar are you with creating a 

treatment plan in axiUm?2.  How would you rate your self in diagnosis and  

in classification of periodontal disease?3.  How comfortable do you feel supervising and

managing the dental care of a pediatric patient on the    the 4th floor?

4.  How comfortable are you supervising a removable partial denture case in the clinic?

5.  How comfortable are you supervising a complete denture in the clinic?

OurSecondSurvey

• Of interest was that despite the clinical experience of our faculty, many of them did not feel comfortable in an academic clinical setting. 

• 45% were either slightly or not at all comfortable with creating a treatment plan in axiUm.

• Close to 30% were slightly or not at all comfortable managing the care of a pediatric patient. 

WhatWeFoundwithBothStudies

• Bottom line: Faculty are not comfortable with anything they do not know or understand.

• A spectrum from “high tech” to  treatment planning with axiUm. 

• …Even with our own Mastery Learning model

Q1 How familiar are you with creatinga treatment plan in axiUm?

Answered: 35 Skipped: 0

30 / 5

Extremely Comfortable

Very Comfortable

Moderately Comfortable

Slightly Comfortable

Not at all Comfortable

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

CE Needs Assessment Survey SurveyMonkey

Answer Choices Responses

Extremely Comfortable 8.57% 3

Very Comfortable 22.86% 8

Moderately Comfortable 22.86% 8

Slightly Comfortable 11.43% 4

Not at all Comfortable 34.29% 12

Total 35

31 / 5

Q2 How would rate yourself indiagnosis and classification of

periodontal disease?Answered: 35 Skipped: 0

Extremely Comfortable

Very Comfortable

Moderately Comfortable

Slightly Comfortable

Not at all Comfortable

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

CE Needs Assessment Survey SurveyMonkey

Answer Choices Responses

Extremely Comfortable 14.29% 5

Very Comfortable 37.14% 13

Moderately Comfortable 37.14% 13

Slightly Comfortable 8.57% 3

Not at all Comfortable 2.86% 1

Total 35

Q3 How comfortable do you feel supervising and managing the dental care of a pediatric patient on the 4th

floor?Answered: 35 Skipped: 0

32 / 5

Extremely Comfortable

Very Comfortable

Moderately Comfortable

Slightly Comfortable

Not at all Comfortable

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

CE Needs Assessment Survey SurveyMonkey

Answer Choices Responses

Extremely Comfortable 8.57% 3

Very Comfortable 20.00% 7

Moderately Comfortable 42.86% 15

Slightly Comfortable 20.00% 7

Not at all Comfortable 8.57% 3

Total 35

Q4 How comfortable are yousupervising a removable partial

denture case in the clinic?Answered: 35 Skipped: 0

33 / 5

Extremely Comfortable

Very Comfortable

Moderately Comfortable

Slightly Comfortable

Not at all Comfortable

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

CE Needs Assessment Survey SurveyMonkey

Answer Choices Responses

Extremely Comfortable 22.86% 8

Very Comfortable 25.71% 9

Moderately Comfortable 31.43% 11

Slightly Comfortable 11.43% 4

Not at all Comfortable 8.57% 3

Total 35

Q5 How comfortable are yousupervising a complete denture case

in the clinic?Answered: 35 Skipped: 0

34 / 5

Extremely Comfortable

Very Comfortable

Moderately Comfortable

Slightly Comfortable

Not at all Comfortable

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

CE Needs Assessment Survey SurveyMonkey

Answer Choices Responses

Extremely Comfortable 17.14% 6

Very Comfortable 22.86% 8

Moderately Comfortable 37.14% 13

Slightly Comfortable 11.43% 4

Not at all Comfortable 11.43% 4

Total 35

NeedsAssessment– Roseman

• Barry PogorelEach of us relies on certain strengths, talents, and skills to succeed. This is how we produce all our successes. What is not so obvious is that these same powers also define what is possible and what is not, what can and cannot be done. While providing results, they also limit–an invisible barrier to anything beyond them.

NeedsAssessment– Roseman

• Barry Pogorel

Barry worked with 51 faculty members in transcending these familiar ways of functioning, with their inherent constraints, and opening up a realm in which they now are able to accomplish what was considered impossible. 

The faculty are now required to be in a state of intense presence, free of past thinking and action.

In this state, there are no constraints. Ultimate performance as a leader. Taking on something extraordinary and making it happen.

Current Educator Paradigm Master Educator Paradigm

Teaching-Centric Imparting knowledge

Expertise in information Experience

I know/You don’t I teach/You Learn I cause Learning

Stored knowledge from the past

Formulaic: “tried and true” Safe—risk-adverse

Magical Transformation at Graduation (Immediate Transformation from

Student/Doctor)

Preacher/speaker Evangelical Teaching

Captive Audience you Perform for Superior/Showing Off Best

Liked/Adored Admired

Responsibility for delivering lectures and providing information

Respected…for what the Educator knows and has experienced Comes from pride in what is already known and

experienced

STAR

Celebrate the product and information gained

Learning is assumed in the students

Failure-Blame relationship to others: “the students…

-Don’t Study -Aren’t interested -Aren’t High-Attainers

Complacency, and a self-concern to look good and not look bad, image self-protection Viewing the educational experience from the stands Keep teacher-student distance

Learning-Centric

Guiding student discovery Expertise in developing thinking

Managing the conditions of learning and participates in it

Student and Educator learning together

Current in science and patient care Innovative

Courageous in the face of fear Graduation is a milestone marking the

Foundation for life-long learning

A profound listener

Inspired by the opportunity and privilege to work with students so students are enrolled

and inspired by the learning opportunity Focus on learning

Responsibility for student’s learning Open to possibilities

Discovery of new knowledge

Respected and appreciated for guidance, challenging thinking, and modeling curiosity,

openness to the new, and commitment to mastery of learning

Comes from “not-knowing, discovering” LEADER CAUSING LEADERS

Eager to adapt to change Members of a team willing to participate in

achieving goals higher that the individual can achieve alone

Celebrate the progress of the student

Co and equal Partner in learning Liberator of Discovery

Guide on the students journey of discovery

Attitude towards the students: “they are exceptional people, drawn to dentistry

to make a difference in people’s health and well-being…it is a privilege to work with them”

Joy Authenticity

Honest about what works and what doesn’t

Profound relationship with the students

FacultyDevelopmentProgramming‐ Roseman

In the beginning: we started with what most would considera reasonable faculty development template:

Calibration sessions during Summer break.Training at faculty meetings. Weekly clinical calibrations that included active learning sessions with the faculty.  AAL: both the ADEA/AAL Institute for Teaching and Learning (ADEA/AAL ITL) Masters Program and the ADEA/Colgate/AAL IAHE series. UCSD School of Medicine Community Medicine certificate program – IPE and Public  Health.Active encouragement of our faculty to join ADEA, IADR and other professional organizations that support dental educationBut were they meeting our faculty’s needs?

OurProgramisMoreFocused

• As mentioned earlier, we used two surveys based on  outcomes  developed  by the faculty to create our current faculty development program.

• Needs identified in the surveys are the focus of these faculty workshops.   

SnapshotofOurFacultyDevelopmentProgram• This past week, a two day standardization workshop to address the clinical education needs identified in the second survey. 

• ½  day faculty workshops each month that meet the identified needs in dental education.

• A  2 ½ day group session this summer with Barry Pogorel on how to effectively manage time and schedules.  (open to all faculty and staff).   

• Of note, our first workshop  was conducted by our Dean on “How do we learn?”. Among the topics discussed was the  Dreyfus Model of Skill Acquisition.

• As with our own students, utilizing the Roseman Interactive Education Mastery Learning model that utilizes teams and facilitates active discussion works best.

FacultyDevelopmentatECU

NeedsAssessment– ECU

• Faculty Development Advisory Committee• Needs Assessment Survey

• Three areas of need identified:1. Teaching and Learning**2. Research and Scholarship3. State of the Art Dentistry

Faculty Development Sessions 

‐Active learning methods‐PowerPoint presentation

‐Speech and communication‐Assessment‐Learning

Faculty Development Workshops

I. AAL: Clinical Instruction

II. AAL+Certificate Participants: Learning

Graduate Certificate in Health Professions 

Education‐Adult Learning 

Theory/Instructional Design

‐Program and Individual Assessment

‐Learning

FacultyDevelopmentProgramming‐ ECU

FromCliniciantoAcademician• What is the program and the curriculum?

• Every faculty member needs to understand (and appreciate) the requirements (such as CODA) for a dental program.

• Leave 1978 in 1978; dental education is harder than it used to be.

• Leave “at my previous institution” at the door; every school is changing.

• You cannot avoid understanding the educational terminology• You are as responsible for  knowing educational concepts as you are the dental concepts.

• You cannot avoid becoming technologically capable• The computer “stuff” took the place of staff, so you are responsible for learning informatics like you are responsible for keeping up with advances in dentistry.

FromCliniciantoAcademician

• Where do I fit into the curriculum?

• If teaching didactic course, how does my course relate to overall competence?

• If teaching a seminar course, how does my participation work with others?

• If teaching full time in clinic, what are my responsibilities as a team leader?

• If teaching part‐time in clinic, what is my role and what are my responsibilities?

• Faculty need to care about more than their areas

FromCliniciantoAcademician

• What is my relationship with the student?

• You are not a “teacher”; you are a “facilitator of learning.”

• You are responsible for holding the graduate to the same standard as a competent general dentist. If the student is not performing the task to that standard, they need more formative feedback, more time or they should fail.

• You cannot make value judgments without data; having “good hands” vs. demonstrating Competency.

FromCliniciantoAcademician• What is my relationship with the student?

• You have to work VERY HARD to leave your biases at the door. You have the LEGAL and ethical obligation to treat every student the same way = blind grading where possible.

• Separate the personality of the student from the task that you are assessing. 

• You are not responsible for the student’s graduation. You are responsible to the profession to assess whetherthe student meets the standard.

FromCliniciantoAcademician• What is my relationship with other faculty?

• Calibration between faculty cannot be assumed. Being known as the “hard grader” or “easy grader” is not the goal; the goal is to be in calibration.

• Your responsibility is to work toward standardization ofthe program.• This is particularly true between specialty and general dentistry. Every pre‐doctoral program defines what a general dentist is. There must be a constant dialogue between the specialists and the general dentists to be on the same page; programs suffers when faculty “mark their territory.”

FromCliniciantoAcademician• What is a Clinical Skills Assessment?

• Often misnamed as a “Competency Exam”

• Assessment rubrics are key; rubric development is not difficult, but it is a very important skill for every clinical faculty member.• Requires that the faculty member can break down a complex clinical skill into testable components.

• Rubric development helps with instruction. You know what you want students to achieve, and so do they.

• Rubric development can help with faculty calibration.• Sound and consistent assessment methods helps in legal matters…

FromCliniciantoAcademician• What is an OSCE?

• Objective Structured Clinical Exam – two types: Free‐Response (short answer/essay) and Multi‐Response (Canadian).

• Used to assess clinical reasoning skills; much better than multiple‐choice and more consistent than patient based. 

• Requires significant faculty development and trial and error.• They will change the way you teach, so be prepared for it to rock your world.

• Be prepared for massive student failures. Don’t worry, it will be OK! 

FromCliniciantoAcademician• What is a Portfolio?

• Just like OSCE, Portfolios are coming like a train!• Documented clinical cases; again, rubrics are key• Faculty must agree about comprehensive patient records and the value of treatment planning. This is harder than it sounds.

• Some faculty members do not know the basic sciences for the health history data.

• Some faculty members came from schools that did not treatment plan their own periodontal treatment or other disciplines. MAJOR DEVELOPMENT NEEDED HERE.

FromCliniciantoAcademician

• Don’t aim for perfection or simplicity.

• Avoid the “all they really need to know in order to practice” trap.

• When you innovate, some things will fail. Don’t take failure personally. Do not take failure or difficulty as a reason notto innovate.

• Perform a “post‐mortem” and do not wait for faculty evaluations to learn from the process.

FacultyEvaluation

FacultyEvaluation

• Assess what you value.

• Reward positive behavior.

• Offer support and development where needed.

FacultyEvaluationAs a new school, this is a work in progress…

Teaching ExpectationsPeer Observation

‐ Classroom‐ Lab/Clinic‐ Discussion Platform (PBL/CBL)

Student Perception of InstructionStudent Outcomes in: 

‐ Program Assessments (faculty generated assessments) ‐Milestone Assessments (national boards and regional licensure)

Guidelines for professional advancement for all faculty

AcademicCareerAdvancement

• All faculty should pursue career advancement; whether they are on a tenure track, or not.

• Learn the steps, the criteria, and what is valued for advancement in your institution.

• Gather a “constellation” of mentors.• Life mentor• Teaching mentor• Research mentor

• Follow your passion!!!

SummaryRemarks

1. Faculty Development needs to be intentional and customized (beginning with orientation and calibration) around teaching and learning, and academic career development.

2. Dental Education = Evidence Based Dentistry + Evidence Based Education.

3. Interprofessional EducationShifting paradigm from siloed to team based patient‐centered health care; is not an “add on” but underlies all that we do in the classroom and the clinic.

GroupDiscussion

Whatorganizationalorfacultydevelopmentneedshaveyouidentified,ormightyouanticipate,

inyourinstitutionwhenshiftingthefacultyparadigmfromclinician toacademician?

Discussion