Learning Experiences for Cardiology Fellowship Faculty Boot Camp for Cardiology Fellowship Directors ACC.12 Chicago, Il

1. Learning Experiences for Cardiology Fellowship FacultyBoot Camp for Cardiology Fellowship Directors ACC.12 Chicago, Illinois Joseph S. Green, PhD Marcia J. Jackson, PhD

2. Goals for this Session • Present data from ACC.11 Boot Camp survey regarding perceived competency of your faculty educators • Describe ACCF competency-based curriculum activities • Describe proposed competency-based faculty development at ACCF • Consider ways in which ACCF might support faculty development for training programs

4. Milestones & Lifelong Learning Core Competencies • Kick-off September 2010 • Parallel development throughout 2010-2011 • Milestones • LLL competencies • 12 content categories completed: generation 1, v1 • ABIM supports effort and was represented throughout

5. ACCF Competency-based System Competency-based Curriculum Competencies Assessment and Outcomes Reporting System Faculty and Other Professional Development

6. Where We Are Now Competencies not associated with documented gaps Educational programming formats not always appropriate Budget organized around formats, not priority-based No standard assessments & outcomes measures Competencies exist, but not organized into a curriculum Content dictated by history, funding, spec. requests No content coordination between or within formats/topic areas No training for educators, contributors, staff

7. Where We Are Going Content driven by validated competence & performance gaps Annual learning plan specifies priorities & desired outcomes Competency-based curriculum in place accessed by web-based, toolbox Competency-based training academy for educators, contributors, staff Appropriate formats based on intended outcomes & six ACGME domains Budget & funding requests organized around annual learning plan priorities Robust assessment system using common data sets/outcome measures Annual update process maintains competencies and curriculum

8. Competency-based Curriculum for Faculty Development • Faculty must support you in transitioning to a competency-based training program • Same principle: faculty competence essential to fulfill this role • Clinical competence ≠ educational competence

9. Competency-based Faculty Development: A Process • Delineate required educational competencies • Create a program assessment plan • Identify adequate educational resources • Articulate a thorough educational plan • Design a comprehensive faculty development program

10. Levels of Educational Outcomes • Participation • Satisfaction • Learning • Knows • Knows how • Shows how • Performance • Patient Health • Community health

11. Competency-based Faculty Development: Creating a Program • Determine the required educational competencies of fellowship faculty • Assess gaps in knowledge and performance of fellowship faculty in their role as educators • Provide self assessment opportunities for faculty to guide their development curriculum • Develop blended learning activities to meet the varied individual needs of faculty

12. Gap in Competence What ought to be What is

13. Survey at 2011 TPD Boot Camp • TPD perceptions of faculty: current and desired ability • Designing a competency-based curriculum • Evaluating fellows’ competency-based performance • 6 ACGME competency areas • Medical knowledge • Patient care and procedural skills • Practice-based learning and improvement • Interpersonal and communication skills • Systems-based practice • Professionalism

14. Results for Curriculum Planning • Current ability • Strongest in medical knowledge • Weakest in practice-based learning and improvement • Desired ability • Generally high in each area • Highest a tie between medical knowledge and practice-based learning and improvement • Lowest in professionalism • Difference between current and desired is greatest for interpersonal and communication skills

15. Results for Evaluation • Current ability • Strongest in medical knowledge • Weakest in systems-based practice • Desired ability • Generally high in each area • Highest a tie between medical knowledge and practice-based learning and improvement • Lowest in systems-based practice • Difference between current and desired is greatest for patient care, practice-based learning and improvement, and systems-based practice

16. Barriers to Change in Curriculum Development • Lack of faculty time due to clinical demands • Lack of desire to participate • Lack of interest • Not well-versed in the competency concepts • Lack of knowledge of best educational methods to promote learning, especially in SBP and Professionalism • Resistance to change: “doing it the way I was trained” • Lack of knowledge/models in curriculum planning • Low priority on the part of faculty

17. Barriers to Change in Evaluation • Evaluations are largely not objective—no formal measures • Grade inflation • Lack of time to participate and give constructive feedback • Conflict “avoidance” in giving useful consultative feedback that might be perceived as negative • Easier to let poor performance slide • Don’t understand competencies • Lack of knowledge as to how to do this type of assessment • Faculty don’t observe performance—no time on rounds

18. Conclusions from Survey • An assessment tool to measure faculty competence must be brief and easily completed • Certain barriers cannot be easily addressed, e.g., lack of time • Training programs could benefit from ACCF faculty development materials in the following areas: • Operational definitions of ACGME competency areas • Practical operations manual on principles and methods associated with competency-based evaluation • Descriptions and models of “best practice” strategies to promote learning in such areas as SBP and professionalism • Practice in providing constructive feedback to fellows

19. Faculty Needs Assessment • Focus on your faculty’s ability to assist • competency-based curriculum planning • Emphasis on interpersonal and communication skills and systems-based practice (ACGME) • competency-based evaluation • Emphasis on patient care and procedural skills, practice-based learning and improvement and systems based practice (ACGME)

20. Fellowship Faculty Educational Competencies • Working with learners • Working with a competency-based curriculum • Using assessment • Selecting and using effective teaching methods and formats • Creating a productive learning environment

21. Working with Learners • Using principles of adult learning • Motivating learners • Giving feedback on learning • Being sensitive to the cultural context • Involving learners • Keeping learner attention • Adding other learning resources • Interaction with content, faculty and other learners

22. Working with a Competency-based Curriculum • Selecting appropriate content based on learner/group needs • Selecting and creating key learning outcomes • Sequencing of content • Assuring objectivity of content

23. Using Assessment • Assessing learning needs • Delineating gaps in knowledge and performance • Seeking feedback on faculty performance from learners • Monitoring learning • Identifying barriers to using content in clinical practice

24. Selecting and Using Teaching Methods and Formats • Using various formats and technologies to enhance learning • Meeting critical success factors in selected faculty roles • Practicing key faculty roles and receiving feedback on performance

25. Creating a Productive Learning Environment • Working with staff, other faculty and available resources • Gathering information concerning potential learning environments • Creating ideal learning environments • Successfully managing time in faculty role as assigned by TD

27. ACCF Professional Development Program: Start-up • Need • Maintain pipeline of talented, expert physician contributors to ACCF education • Goal • identify early career physicians and prepare them to become ACCF education leaders • Desired Outcomes • Participant satisfaction • Improved teaching skills • Demonstrate competence • Contribute to ACCF education programming/committees • Format • “Teaching Skills Workshop for Emerging Faculty”

28. ACCF Professional Development Program: Emerging Faculty • Target Audience • Fellows of the ACC • FT academic position with house staff and medical students • Not yet attained the rank of professor • Selection Process • Call for nominations • Letter from division chief (or equivalent) • One supporting letter • One-page letter from the applicant • Selection Criteria • Exceptional talent and dedication to assisting/supporting the learning process • Selected by workshop faculty

29. ACCF Professional Development Program: Emerging Faculty • Value to participants • Participation in professional development workshop to improve skills • Mentored by ACCF education leaders • Cohort of like-minded peers/professional networking • 4 cohorts • ~20/group

30. ACCF Professional Development Program: Emerging Faculty • Workshop objectives • Apply principles of physician learning and behavior change in planning/delivering education • Apply ID principles in planning/delivering education • Be effective presenters in face-to-face settings • Differentiate between appropriate and inappropriate content • Envision creative ways in which to use emerging technology to further learning • Be informed as to the range of ACCF education activities • Participate enthusiastically and effectively as educators in at least one future ACCF activity

31. ACCF Professional Development Program: LEAD • Expanded professional development • Target audience • program directors/e-learning contributors/international faculty • Model the process of “backwards planning” • Outcomes • Competencies • Content • Formats and methods • Emphasizes learner involvement, motivation, “ownership” of quality programming

32. ACCF Professional Development Program: Proposed Future Plans • Professional development activities • Based on identified competencies • Create a pool of competency-based, self-assessment items • Modular curriculum linked to competencies • Varied delivery methods • Supplemental resources • References • Tools for learning activities • Pocket guides • “field manuals” • Mentors/coaches

34. Barriers to Change in Curriculum Development • Lack of faculty time due to clinical demands • Lack of desire to participate • Lack of interest • Not well-versed in the competency concepts • Lack of knowledge of best educational methods to promote learning, especially in SBP and Professionalism • Resistance to change: “doing it the way I was trained” • Lack of knowledge/models in curriculum planning • Low priority on the part of faculty

35. Barriers to Change in Evaluation • Evaluations are largely not objective—no formal measures • Grade inflation • Lack of time to participate and give constructive feedback • Conflict “avoidance” in giving useful consultative feedback that might be perceived as negative • Easier to let poor performance slide • Don’t understand competencies • Lack of knowledge as to how to do this type of assessment • Faculty don’t observe performance—no time on rounds

36. Conclusions from Survey • An assessment tool to measure faculty competence must be brief and easily completed • Certain barriers cannot be easily addressed, e.g., lack of time • Training programs could benefit from ACCF faculty development materials in the following areas: • Operational definitions of ACGME competency areas • Practical operations manual on principles and methods associated with competency-based evaluation • Descriptions and models of “best practice” strategies to promote learning in such areas as SBP and professionalism • Practice in providing constructive feedback to fellows

37. ACCF Support for Training Programs: Ideas • Design a needs assessment form that you can use with your faculty (similar to what we gave you last year) • Provide scoring of the instrument for your fellows and comparison data with other programs • Provide a national training experience for TD’s on creating a local competency-based faculty development program • Provide content and experts for use at the regional level in faculty development • Develop on-line content for local use

38. Table Activity • Spend 5 minutes at your table discussing • Which of our proposed ideas would be of value to you in your training program? • Which of our proposed ideas would not be of value to you in your training program? • What other tools might ACCF provide to assist you in faculty development activities?

39. References • Moore DE, Green JS and Gallis HA, Achieving Desired Results and Improved Outcomes: Integrating Planning and Assessment Throughout Learning Activities, Journal of Continuing Education in the Health Professions, 29(1):1-14, 2009. • Fox R. and Miner C., Motivation and the Facilitation of Change, Learning, and Participation in Educational Programs for Health Professionals. Journal of Continuing Education in the Health Professions Volume 19, Number 3, Summer 1999 • Fox, R. D., "Discrepancy Analysis in Continuing Medical Education: A Conceptual Model." Mobius, Vol. 3, No. 3, 1983, pp. 37-44. • De Boer, P.G. and Green, J.S.(editors), AO Principles of Teaching and Learning, AO Publishing, Thieme, Switzerland, December, 2004.

40. References (con’t) • Moore, Green, et al, "Creating a New Paradigm for CME: Seizing Opportunities within the Health Care Revolution", The Journal of Continuing Education in the Health Professions, Vol. 14, pp. 261-272, 1994. • Green, J.S., Grosswald, S.J., Suter E. and Walthall D.B. III (Editors). Continuing Education for the Health Professions: Developing, Managing, and Evaluating Programs for Maximum Impact on Patient Care. San Francisco: Jossey-Bass Publishing Co., 1984. • Davis, D., Barnes, B., Fox, R. eds., The Continuing Professional Development of Physicians: From Research to Practice, AMA Press, 2003.