A systematic review of faculty development activities in family medicine

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Practice points

Most FDs are focused on teaching skills; the challenge is to provide faculty with new/tailored opportunities and advanced programmes (contextual or individualised). Need for clarity of the theoretical approach. Evaluation is mostly at level 2 (learning) with over reliance on self-assessment. We propose a triangulation of evaluation. Success of FD activities depends on contextual approach, adaptability, evaluation and adequate funding (resources/time).

Figure 1. Literature search and selection of articles for review.

Box 1 Strength of findings based on methodological quality

1 – No clear conclusions can be drawn. Not significant.

2 – Results are ambiguous, but there appears to be a trend.

3 – Conclusions can probably be based on the results.

4 – Results are clear and very likely to be true.

5 – Results are unequivocal.

Figure 2. Distribution of publications at five-year intervals.

Table 1  Topics covered in faculty development activities

Topic Number of studies
Instructional	30 (65%)
Philosophy/theories of education Concepts in adult education Scholarship of teaching Clinical teaching models Writing objectives and designing instruction Transforming the learning environment Assessment and feedback Formal presentation skills Choosing educational strategies
Clinical/communication skills	28 (61%)
Communication skills Culturally appropriate communication strategies Family medicine dynamics Specific skills, e.g. teaching substance abuse Models of medical care
Professional/personal	24 (52%)
Curriculum design/needs assessment Portfolios Mentoring Peer observation and evaluation Programme evaluation Reflective practice Leadership Career progression Quality assurance
Research	15 (33%)
Literature search/databases Educational research Research design Ethics in research Research methods Data analysis
Technology	12 (26%)
EBM databases Tools – e-mail, Internet, face book, etc. Visual aids
Organisational/administrative	11 (24%)
Time management Planning and organising Teamwork Project management

Table 2  Evaluation of outcomes using Freeth et al.'s (2003) adaptation of Kirkpatrick's (1994) model for evaluating outcomes.*

Kirkpatrick level		Description	Number of studies (%)
Level 1	Reaction	Participants’ views on the learning experience, its organisation, presentation, content, teaching methods and quality of instruction	28 (61) Five studies evaluated at level 1 only
Level 2a	Learning Change in attitudes	Changes in the attitudes or perceptions among participant groups towards teaching and learning	10 (22)
Level 2b	Learning Modification of knowledge or skills	For knowledge, this relates to the acquisition of concepts, procedures and principles; for skills, this relates to the acquisition of thinking/problem-solving, psychomotor and social skills	20 (43)
Level 3	Behaviour Change in behaviours	Documents the transfer of learning to the workplace or willingness of learners to apply new knowledge and skills	23 (50)
Level 4a	Results Change in the system/organisational practice	Refers to wider changes in the organisation, attributable to the educational programme	10 (22)
Level 4b	Results Change among the participants’ learners or patients	Refers to improvement in student learning/performance as a direct result of the educational intervention	0 (0)

Note: *This model was further adapted for this review to include learners and patients at level 4b.

Figure 3. Evaluation triangulation: minimum evaluation domains.

Freeth D, Hammick M, Koppel I, Reeves S, Barr H, 2003. A critical review of evaluations of interprofessional education [Online]. [Accessed 21 March 2012] Available from: London, Higher Education Academy Learning and Teaching Support Network for Health Sciences and Practice, http://www.health.ltsn.ac.uk/publications/occasionalpaper/occasionalpaper02.pdf

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Kirkpatrick D. Evaluating training programs: The four levels. Berrett-Koehler Publishers, San Francisco, CA 1994

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