By Kevin Walsh
As Tufts’ commitment to teaching and educational scholarship continues to grow even stronger, the importance of effective leadership on each of the three campuses is becoming more apparent. This month’s feature takes us to the School of Medicine where Dr. Janet Hafler and Dr. Keith White run some key educational development initiatives involving faculty development and evaluation.
Dr. Hafler was appointed dean for educational development at the School of Medicine in 2006 after spending 17 years at Harvard Medical School, and in the spring of 2007 Dr. White signed on to work alongside her as director of evaluation and assessment. Together they have helped build upon the Educational Strategic Plan for faculty development by understanding that the chance for physicians to establish themselves as teaching faculty members actually begins when they are students.
“The aspect of teaching has to be integrated into everything we do,” Dr. Hafler says. “Teaching to promote learning happens in the workplace all the time, for instance. Faculty are role-models; they’re being observed by students and they are always teaching whether it’s implicit or explicit.”
So with this idea, Dr. Hafler has helped TUSM implement a faculty development program that begins when medical students take their first elective course on education, moves to address both clinical and classroom teaching, then helps residents develop teaching skills in clerkships, and finally aids faculty members in their continuing development. Her approach is that feedback on teaching and learning should be open, honest and should come from multiple sources.
“What existed when I came on board were student and faculty evaluations of courses, just one dimension,” she says, “so we are exploring other dimensions in asking, ‘How can we really enhance the program?’”
For example, they are exploring how to develop a peer-review process of teaching in addition to the student evaluations. Dr. Scott Epstein, the new dean for educational affairs has restructured the Curriculum Committee to create a “feedback loop” where faculty and student reviews are synthesized with the Curriculum Committee’s decisions on evaluation and assessment as part of regular advances in the development of both the faculty and the TUSM curriculum.
“So the vision is longitudinal and comprehensive and part of that will be imbedding the evaluation and assessment of how teaching promotes learning,” Dr. Hafler says.
“What we are doing is putting a very innovative, creative curriculum in place that will have assessment measures that will be very clearly based on what the goals are,” she says.
One of the biggest challenges they face is helping students, residents, and faculty budget their time. A major difference between teaching in the clinical arena and that of a more traditional classroom is the notion of ‘teaching in the workplace.’ Graduate students are teaching and caring for patients, all while learning and staying abreast of the latest medical topics, Dr. Hafler says.
“As they move through this developmental phase, they’re also doing a lot for our hospitals,” she says. “At the heart of it, they are caring for people and their families.”
So both Dr. Hafler and Dr. White recognize the use of the latest technology as their “bread and butter” in helping students, residents, and faculty budget their time accordingly.
“We see assessment as something that should be part of the learning process, so electronic-based assessment really helps us to facilitate the budgeting of time and it cuts down on infrastructure management,” Dr. White says. “We mix together the qualitative information with the quantitative data and are getting some really interesting and beneficial results.”
Dr. White notes that there is such a thing as being “data rich and information poor,” but with the technological advances of the Tufts University Sciences Knowledgebase (TUSK) they are able to sort out the information that they need to promote teaching and learning.
All of this points toward the OEA’s belief that observation and constant, constructive feedback are critical to developing students as teachers and leaders, while also ensuring that current faculty have the necessary tools to continue to improve their skills. That’s why the Objective Structured Clinical Examination (OSCE) is an effective strategy to assess student’s learning. It is a requirement for graduation, and involves trained actors (called Standardized Patients) simulating different medical conditions as realistically and consistently as possible based on their training. These Standardized Patients, along with faculty members are also trained to give standardized feedback as evaluators of a student’s performance on the OSCE.
“I think that the most powerful tool for assessment is observation,” Dr. Hafler says. “The more that we can help faculty to really observe their students, feedback can then become a very safe step in not feeling that you’re being evaluated, but rather having conversations in a critical way saying, ‘What did I do well? And what can I improve on?’”
Continuous development is their goal, and Dr. Hafler and Dr. White seem to be well on their way to success.