M edical Teacher, Vol. 22, No.

1, 2000

Faculty development in the new millennium: key challenges and future directions
YVONNE STEINERT
Department of Family Medicine, Sir Mortimer B. Davis Jewish General Hospital and Faculty of Medicine, McGill University, Canada

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Faculty developm ent initiatives in the year 2000 will need to respond to changes in m edical education and health care delivery, to build on the achievements and accom plishm ents of the past, and to continue to adapt to the evolving roles of faculty m embers. To rem ain at the forefront, faculty developm ent prog ram s will need to broaden their focus, consider diverse training methods and form ats, conduct m ore rigorous prog ram evaluations, and foster new partnerships and collaborations. Academ ic vitality is dependent upon faculty mem bers interest and expertise; faculty developm ent has a critical role to play in prom oting academ ic excellence and innovation.
SUM M AR Y

Faculty development has becom e an increasingly important com ponent of m edical education. Faculty developm ent activities have been designed to improve teacher effectiveness at all levels of th e e ducational continu um (e.g. undergraduate, postgraduate and continuing medical education) and diverse programs have been offered to health care professionals at m any levels (e.g. institutional, regional and national). As we approach the new millennium, what lessons have we learned from the past 20 years? What challenges lie ahead? The goal of this article is to discuss key challenges and future directions in four main areas: the focus of faculty development (i.e. key content areas); training methods and formats (i.e. processes); program evaluation (i.e. research); and opportunities for collaboration (i.e. partnerships). In addition, a num ber of important principles underlying successful faculty development program s will be enum erated. For the purpose of this discussion, faculty development refers to that broad range of activities that institutions use to renew or assist faculty in their roles (Centra, 1978). That is, faculty development is considered to be any planned activity designed to improve an individuals knowledge and skills in areas considered essential to the performance of a faculty member, including teaching, research and administration (Sheets & Schwenk, 1990). M oreover, faculty development includes those programs designed to prepare institutions and faculty m embers for their various roles and to sustain their productivity and vitality (Bland et al., 1990).
The focus of faculty developm ent

other faculty development initiatives have been described, most notably in the area of research (e.g. Hekelman et al., 1995; Holloway et al., 1988), there has clearly been an over-emphasis on teaching improvement and instructional effectiveness, and m ore comprehensive programs should be considered. In particular, faculty development programs designed to enhance leadership and m anagem ent skills, professional academic skills, and organizational development should be added to the `menu of teaching improvement programs. In addition, we should offer program s that focus on the teaching of specic content areas (e.g. information technology; professionalism; evidence-based medicine) and `educating the educators.

Leadership and m anagement skills

Ex traordin ar y c hanges in he alth c are delive r y have signicantly altered faculty roles and rewards (Bland & Simpson, 1997). In response to internal and external forces, physicians are being asked to take on increasing administrative and leadership roles, and yet, how do we formally prepare our faculty members for these challenges? Several programs designed to address this need have been described (e.g. M cGaghie et al., 1981; M orahan et al., 1998; Steinert et al., 1997a); however, an increased emphasis on leadership, m an age m ent, and adm inistrative skill d eve lopm ent is essential in these tim es of change. Content areas for such program s m ight include : und erstan ding `for m al and `inform al organizational structures; analyzing current economic, political, and organizational pressures and trends; leadership and management skills; conict management and negotiation; time management; performance appraisal; and nancial management (Bogdewic et al., 1997; Burke et al., 1997; Irby, 1996). As Bogdewic and colleagues (1997) have said, organizational and leadership skills can no longer be though t of as an adjunct to the traditional roles of teaching, research, and service. These skills are of central importance.

Professional academ ic skills

To date, the majority of faculty developm ent program s have focused on the improvem ent of faculty members teaching skills (Hitchcock et al ., 1993; Irby, 1996), with minimal attention being paid to the personal development of faculty mem bers or organizational elem ents such as decisionmaking or the change process (Lipetz et al., 1986). Although 44

P ro fe ssion al ac ad em ic skills e nc om pass th e valu es, knowledge, and collegial relations needed to succeed as an academic (Morzinski et al., 1996). These skills include an understanding of the underlying values, norms and expectations of academ ia, knowing how to m anage a productive
Correspondence: D r Yvonne Steinert, Faculty of M edicine, M cGill University, 3655 D rumm ond Street, M ontreal, Q uebce, Canada, H 3G 1Y6. Tel: (514) 398 2698; fax: (51 4) 398 8211; em ail: steinert@med.mcgill.ca

ISSN 0142-159X print/ISSN 1466-187X online/00/010044-07 2000 Taylor & Francis Ltd

Faculty developm ent in the new m illennium : key challenges and future directions

career, and establishing a network of experienced and knowledgeable professional colleagues (Bland et al., 1990; Wilkerson & Irby, 1998). Although some of these content areas are included in orientation programs for junior faculty, they are m ore frequently conveyed in a haphaza rd fashion. It is time to redress this trend and target these skills more systematically. Examples of topics to be addressed include: how to achieve academ ic prom otion; how to identify and work with a mentor; how to work with colleagues; and how to develop professional networks (Bland et al., 1990; Hitchcock et al., 1997).
Organizational developm ent

literature; planning and delivering lesson plans and presentations; using com puters for research and writing; and integrating computers into clinical practice. Although m any individuals acquire these skills on their own initiative, and diverse providers offer computer courses, faculty developm ent initiatives should target those areas that enhance teaching and learning , and that are not taught elsewhere (e.g. using computers for feedback and practice; conducting on-line discussions and quizzes). Teaching students and residents how to incorporate computers into their practice and research endeavors will also become a priority for faculty development.
Educating the educators

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Faculty development has an impor tant 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. Several authors have suggested that changes in organizational systems and leadership strategies may be needed to promote more productive educational environm ents (Bland et al., 1990; Bogdewic et al., 1997). However, although organizational developm ent became part of the language of faculty development in the 1980s (Ramsey & Hitchcock, 1980), few faculty development efforts have specically targeted this content area. Initiatives in this domain should include efforts to create participative and empowering organizational policies and structures; procedures to evaluate and reward teaching excellence; and programs to enhance curriculum administration and collaboration across departmental boundaries (Irby, 1 99 6 ). Lipetz an d colleag ue s (1 9 86 ) have posed an interesting question: W ho is the client in faculty development? Clearly, we need to link individual and organizational needs (Bland & Simpson, 1997), and we should pair organizational developm ent with individual skill development (Baxley et al., 1999).
The teaching of specic content areas

Faculty developers have succeeded in delivering program s designed to enhance individual teachers instr uctional effectiveness. It is now time, however, to further develop individuals wh o will be ab le to provide leadersh ip to educational programs, act as `educational mentors, and design and deliver innovative faculty developm ent programs. An interesting model for disseminating faculty development expertise has been described by Skeff and his colleagues (1992). We must build on this initiative and develop new programs to `train trainers. As Cusimano & David (1998) have stated, there is an enormous need for more health care professionals trained in m ethods of educating others so that medical education will continue to be responsive to driving forces of change. We must also work to encourage the developm ent of educational scholars, individuals who approach education with questions about the process and outcome of teaching and curricula (Wilkerson & Irby, 1998) and who conduct research in m edical education. The longterm success of our faculty developm ent initiatives to date is depend ent upon a n ew gen eration of leaders and `cham pions who will be motivated to promote educational innovation and excellence.
Training m ethods and form ats

Whereas continuing m edical education traditionally focuses on specic content areas and the upgrading of clinical skills, faculty members will need to improve their ability to teach a n um ber of co nte nt are as, inc lud ing pro fe ssion alism , communications skills and evidence-based medicine. Faculty skills in infor m ation technology will also n eed to be upgrad ed. Cruess & Cruess (1997a,b) have highlighted the need to teach professionalism at all levels of medical education in response to changing societal expectations. Comm unication skills are also not receiving the attention they deserve. Although these subjects have traditionally been addressed through apprenticeship and role m odeling , the current context for health care delivery negates the potential of these training methods, and we need to consider more `formal, systematic m ethodolog ies for addressing these content areas. At the same time, computers and inform ation technologies are transforming m any aspects of our personal and professional lives (Irby & Hekelman, 1997). As a result, the demand for training in this area will increase signicantly in the next decade. C randall and colleagues (1997) outline a series of skills that might be included in such faculty developm ent initiatives: accessing and m anaging the m edical

The most com mon formats for faculty development include workshops and seminars, short courses, sabbaticals, and fellowships (Hitchcock et al., 1993; Reid et al., 1997; Sheets & Schwenk, 1990). Other initiatives include peer consultations, individual preceptorships, and mentorship program s. Although the majority of comm on form ats appear relatively equal in effect, based on participant satisfaction or selfrating of knowledge and skills (Sheets & Schwenk, 1990), it is time to build on these methods and expand our horizons. In particular, we should consider the development of `formal mentorships, integrated longitudinal programs, decentraliz ed ac tivities, se lf-dire cte d lear n ing initiative s, an d computer-based faculty developm ent.
`Form al m entorships

M entoring is a common strategy to prom ote the socialization, development, and maturation of academic medical faculty (Bland et al., 1990). It has also been recommended as a faculty development strategy by a number of educators (Bower et al., 1998; Longhurst, 1994; M orzinski et al., 1994, 1996). However, mentorship programs are presently an underutilized training format that should be offered in a more formal and systematic fashion. 45

Yvonne Steinert

Daloz (1986) has described a mentorship model that balances three key elem ents: support, challenge, and a vision of the individuals future career. Su ppo rt refers to those activities that affirm the value of the individual or try to reduce uncertainty or anxiety (Bower et al., 1998). M entors challenge their colleagues by encouraging them to check out their assumptions and reect on their values and competencies; and they foster career vision through role modeling or guided discussion. By balancing these three components, mentors create a tension essential for change and growth. The value of role models and m entors has been highlighted since Oslers tim e, and we should not forget the benets of this m eth od of professional developm ent despite new technologies and methodologies.

Self-directed lear ning initiatives

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Integ rated, longitudinal program s

The importance of self-directed learning approaches to professional development has been highlighted in both the CM E and faculty development literature (Candy, 1995; Davis & Fox, 1995; Ullian & Stritter, 1997). As Ullian & Stritter (1997) have said, faculty must be encouraged and taught to determine their own needs through self-reflection, student evaluation, and peer feedback, and they must learn to design their ow n developm ent activities. Efforts made in this area in continu ing m ed ical education should be considered by faculty developers, and self-directed learning program s should be fostered. Harris and colleagues (1995) have underscored the value of reection as a method of improving teaching effectiveness; indeed, we should take advantage of the increasing attention paid to reection as a method of personal growth (Schon, 1987) in faculty development initiatives as well.
Com puter-based faculty developm ent

Fellowship programs, while successful, are becoming increasingly unattainable for faculty m embers because of their potential cost and time requirements. Indeed, funding for fellowship prog ram s is diminishing and recruitm ent is becoming more difficult (Sheets & Schwenk, 1990). Several authors (e.g. Elliott et al ., 19 99; G elula, 1997) have highlighted the value of `integrated, longitudinal programs such as the Teaching Scholars Program in North Carolina (Stritter et al., 1994) and at M cGill University, and we should build on this new faculty development practice. Integrated, longitudinal prog ram s allow physicians to maintain many of their clinical, research, and adm inistrative responsibilities wh ile fur thering their own professional development. They also enable the immediate application of newly acquired skills. Program components might include university courses, monthly scholars meetings, individual consultations, independent research projects, and involvement in a variety of faculty development activities. Although the majority of these programs to date have focused on the educational role of faculty members, such program s could easily be designed to promote expertise in administration, management, and research.

Tim e for individual involvement in faculty development has neve r been m ore lim ited (B lan d & Sim pson , 1 99 7). Com puter-b ased faculty developm ent would allow for ind ivid ualiz ed program s ta rge te d to spec ic ne ed s. M oreover, the technology is now in place so that interactive instructional programs can be created in all domains of faculty development (Westberg & W hitman, 1997). In addition, com puter-based program s would allow us to share resources and avoid duplication more effectively, as long as we do not lose sight of the value and importance of working in context, with our colleagues.

Program evaluation

D ecentralized activities

Faculty development program s, many of which started in Family Medicine, are often departmentally based or centrally organized (i.e. faculty-wide). Given the increasing use of com munity preceptors and ambulatory sites for teaching, we should now `export faculty developm ent program s outside of the university setting (e.g. Anderson et al., 1991; Baxley et al., 1999; Bing-You et al., 1999; DeW itt et al., 1993). We must also work harder to address the differing needs of junior and senior faculty m embers (Burke et al., 1997; Lipetz et al., 1999), m inority faculty m em bers (Johnson et al., 1998; Rust et al., 1998), and individuals who work in underserviced settings (Freem an et al., 1998). Our focus to date may have been too limited. Decentralized activities also have the added advantage of reaching individuals who may not otherwise attend faculty developm ent activities, and they can help to develop a departmental or program -based culture of self-improvement (Baxley et al. , 1999). 46

Despite num erous descriptions of faculty developm ent programs, there has been a paucity of research demonstrating the effectiveness of m ost faculty development activities (Hitchcock et al. , 1993; Sheets & Schwenk, 1990). Few programs have conducted com prehensive evaluations to ascertain what effect the program is having on faculty (Nayer, 1995) and data to support the efficacy of these initiatives have been lacking (Benor & M ahler, 1989). Moreover, of the studies that have been conducted in this area, the majority have relied on the assessment of participant satisfaction. Few have assessed the impact of faculty development activities on cognitive learning or perform ance, and even fewer have looked at the long-term impact of these interventions (Nasmith et al., 1997). In addition, most of the research has relied on self-report rather than objective outcome m easures or observations of change (Sheets & Schwenk, 1990). The challenge in this area is to conduct more rigorous evaluations of faculty development initiatives from the outset, to consider other models of program evaluation, to make use of qualitative research methods, and to broaden the focus of the evaluation itself. In no other area is the need to collaborate or transcend disciplinary boundaries greater.
M ore rigorous prog ram evaluations

M ethods to evaluate faculty developm ent programs have included end-of session evaluations, follow-up surveys, preand post-assessments that tap cognitive or attitudinal change,

Faculty developm ent in the new m illennium : key challenges and future directions

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direct observations of teaching behavior, and student evaluations and faculty self-ratings of post-training performance (Nasmith et al., 1997; Nayer, 1995; Skeff et al. , 1997a). Com m on problem s have included a lack of control or comparison groups, heavy reliance on self-report measures of change, and small sample sizes. W henever possible, we should tr y to conduct m ore exp erimentally rigo rous research studies and work to overcome com monly encountered design problem s. We should consider the use of randomized controlled studies more frequently, and we should try to use m ultiple assessment methods (e.g. Benor & M ahler, 1989; Sheets & Henry, 1988) that move beyond participant satisfaction to include objective outcom e measures. Program s should docum ent lear ning by par tic ipants, and when ever possible, the programs effect on the participants students, colleagues, and institution (Skeff et al. , 1997b). For example, in the assessment of activities designed to improve teacher effectiveness, we must continue to seek evidence of a relationship between changes in faculty members teaching behaviors and student learning (Wilkerson & Irby, 1998). At the sam e tim e, we should re-assess the value of participant satisfaction data. Although researchers have de no unc ed th e valu e o f th is sourc e o f infor m ation , participant satisfaction rem ains an important variable if faculty m embers are to be motivated to learn and to recommend faculty development initiatives to their colleagues. Participant satisfaction also gives valuable feedback to program planners.
Other m odels of prog ram evaluation

d evelopm ent program s an d ac tivities, an d th ey have highlighted the value of adding qualitative methodologies to more traditional assessments (Freeman et al., 1992; Hitchcock et al., 1993; Skeff et al., 1997b). Focus groups, semistructured interviews, and nominal groups could provide valuable insights on how faculty development activities kindle interest in professional development or what elem ents of faculty developm ent programs are most effective. In addition, qualitative studies would help us to gather perceptions from diverse groups and ascertain the impact of participation in faculty development activities on the participants, their trainees and colleagues, and other key stakeholders.
B roader focus of evaluation

The educational literature is rich with models of program evaluation, many of which have not been system atically considered in faculty developm ent. Incorporating aspects of these m odels (Popham, 1975; Wholey et al., 1994) into our evaluation schem a would now be worthwhile. For example, the application of a goal attainment model (e.g. Tyler, 1942) would force us to clarify our program goals and ensure that we are assessing the attainment of our objectives; this model would also help us to consider unanticipated consequences, which occur frequently in this domain. A judgmental model (e.g. Scriven, 1974) would have value if faculty development programs were to becom e part of the accreditation process and receive feedback on program design and implementation from a group of peers and experts. The C IPP m odel (Stufflebeam , 1974 ) could be useful for examining the faculty development literature (Meurer & M orzinski, 1997) and for decision-making in times of budgetary restraint. CIPP is an acronym representing four levels of evaluation: the program objectives and the basis for those objectives ( C ontext); the educational strategies and how they were chosen ( I nput); the actual implem entation and how it compares with planned activities ( P rocess); and how well the needs of the target population were met ( P roduct). By focusing on the context in which the faculty development program occurs, its input, the process, and the product, this m odel moves us beyond goal attainment and the measurement of outcome variables alone.
Qualitative m ethods

As we move into other content areas in faculty development, it will be important to move beyond the evaluation of teaching effectiveness. For example, in the assessm ent of initiatives designed to target leadership and management skills, or organizational developm ent, we must assess change at a much broader level. Indeed, in all situations, it would be worthwhile to assess change at the impact level, trying to identify whether faculty developm ent activities have had an impact on the system at large or on individuals career paths. We should also consider the question of academic dissemination (e.g. presentations and publications), product developm ent (e.g. training m aterials and m anuals), and implementation (Blumberg & Deveau, 1995). Finally, it would be worthwhile to focus on the assessment of longer-term change. It is essential for us to m ove beyond imm ediate short-term outcom e measures. Too few studies have assessed change at 6 months or longer (Nasmith et al., 1997). To date, faculty development activities have been rated highly by the participants. The m ajority rate the experience as useful and recomm end participation to their colleagues (Nayer, 1995; Skeff et al ., 1997a,b). Available evaluation m easures also sh ow th at such prog ram s can im prove teachers knowledge, skills, and attitudes; however generalizable co nclu sion s are lim ite d bec au se of the above mentioned problems. As M cLeod and colleagues (1997) have stated, we must double our efforts to evaluate the effectiveness of our practices.
Par tnersh ips

A number of authors have noted the limitations of quantitative m ethods in evaluating the effectiveness of faculty

Collaboration is becoming increasingly important in the current environm ent of limited resources and nancial constraints. Indeed, partnership is possible at a num ber of levels: am ong academic institutions; between academic institutions and professional societies and organizations; between faculty development and continuing medical education (CM E); and at an international level. T he ne ed for c ollab o ration am ong and w ithin academic institutions has been highlighted in the area of program planning, delivery and evaluation (Steinert et al., 1997b). Skeff and his colleagues (1997b) have also pointed out the need to coordinate faculty development activities that are offered at regional and national scientic meetings hosted by various professional organizations. The time to consolidate available activities, and avoid duplication, is upon us. W ithin institutions, collaboration between CM E and faculty development is timely. Much progress has been made 47

Yvonne Steinert

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in CM E in the past decade, and in many ways, program evaluation and outcome studies in CM E have surpassed the accomplishm ents noted in faculty development (Davis et al. , 1995a,b). In addition, as Ullian & Stritter (1996, 1997) have noted, more cooperative efforts are needed between CME and faculty development, either by adding traditional faculty developm ent topics to existing CM E program s, or CME topics to faculty development activities. International partnerships also hold g reat prom ise. Medical schools in many countries wish to start academ ic medical programs but do not have specically trained faculty available. Given the expertise in faculty development in North America and in Europe, successful models should be shared. For example, Johnson & Zammit-M ontebello (1990) describe an interesting program to train M altese general practitioners in M alta with a visiting professor of Fam ily Medicine. Thompson & Spann (1997) provide an example of a faculty development program they developed for Latin American physicians, conducted in Spanish in an American University.These models for enhancing academic skills could also be exported to other settings.

the psychological barrier of admitting need (Rubeck & Witzke, 1998). As faculty developers, it is our challenge to overcom e these potential obstacles and to market our `product in such a way that resistance becom es a resource to learning.

4. Offer diverse prog rams and m ethods

The need for diverse approaches to faculty development has been highlighted by many authors (Rubeck & W itzke, 1998; Steinert et al., 1997b). As discussed earlier, we must design programs that are sensitive to the needs of different faculty m embers. We must also consider differing faculty roles and address the various developmental stages of faculty members. Adult preferences for learning vary signicantly, and we should try to offer a variety of methods and content areas, tailored to individual and organizational needs.

5. Incorporate pr inciples of adult lear ning and other relevant theoretical fram eworks

U nderlying principles

The last 20 years have shown a remarkable growth in faculty developm ent programs and activities. M any valuable lessons have been learned in this time, and they should be retained as we approach the next millennium. Some of these lessons include the following:

1. U nderstand and work w ithin the institutions context/culture

Facu lty de velo pm e nt pro g ram s n eed to m atc h th e institutions culture and be responsive to its needs (Rubeck & W itzke, 1 998 ). They sh ould also capitalize on th e organizations strengths and work with the leadership to ensure success. In addition, we should rem ember that the current context can be used to prom ote or enhance faculty development efforts. For exam ple, faculty development activities during times of substantial educational or curricular reform can take on added importance. As Rubeck & W itzke (1998) have stated, we should always remember to look for natural opportunities.

2. E nsure that prog rams and activities are based on needs

Faculty development programs should anticipateand base themselves on the needs of faculty m embers as well as the institution in which they work. Student needs, patient needs, and societal needs, as well as organizational demands and challenges, should be considered in th e design of all programs, for faculty development should aim to renew and assist faculty in their diverse roles and help to m eet the needs of the organization in which they work.

To date, principles of adult education have greatly influenced the approach used by many faculty developm ent programs. A s C ar ro ll (1 99 3) has said , inc or po ration of th ese educational principles into the design of faculty development program s has enhanced their reception by faculty members and has increased their value to the institution. In many ways, these principles, best articulated by Knowles (1980), should continue to guide the developm ent and implem entation of all faculty developm ent program s, irrespective of their focus or format. That is, we should remember that physicians dem onstrate a high degree of self-direction and that they possess many experiences that should be used as a learning resource; that adults will only become ready to learn after a `need to know is experienced; and that faculty development programs should be taskcentered, with an emphasis on experiential learning and imm ediacy of application (Carroll, 1993). Other theoretical frameworks (e.g. Kaufm an et al. , 1999; Regeher & Norman, 1996) should also be incorporated into faculty development activities. As Turnbull (1999) has so eloquently said, until recently those of us responsible for educating future physicians have emphasized the art of m e dical edu cation and have te nd ed to ign ore th e fundam ental science of lear ning underlying our ba sic practice.The same can be said of faculty development activities.

6. Rem ain relevant and practical

3. Prom ote `buy in and m arket effectively

The decision to participate in faculty development is not as simple as it might at rst appear. It involves the individuals reaction to a particular faculty development offering, motivation to develop or enhance a specic skill, being available at the time of the faculty developm ent session, and overcoming 48

Although it is important that theory inform practice, faculty developm ent activities and programs must remain relevant and practical. As stated above, experiential learning is key. The teaching of concepts and skills in this area must also remain clear and simple. Although the domains for faculty developm ent are complex (Rubeck & Witzke, 1998), faculty members want sim ple messages, concepts, and directions, and it is our responsibility to avoid complexity and prom ote practicality. We must also ensure that we acknowledge the participants culture and context, and that we use their experience as a foundation for learning and development.

Faculty developm ent in the new m illennium : key challenges and future directions

7.Work to overcome comm on problems

C om m on implem entation problem s include a lack of institutional support, limited resources, and limited faculty tim e (Steinert et al., 1997b). Faculty developers m ust work to overcom e these problem s through creative prog ramm ing, skilled m arketing, targeted fundraising , and the delivery of high quality programs. Flexible scheduling and collaborative program ming , which address clearly identified needs, will also help to ensure success at a system s level.

H ospital, is the Director of Faculty Developm ent and International Projects in the Departm ent of Family Medicine and Associate Dean for Faculty Developm ent in the Faculty of M edicine at M cGill U niversity in Montreal, Quebec.

R efe rences
A NDER SON , J., H ESS , G., R ODY, N. & S M ITH , W. (1991 ) Improving a com munity preceptorship through a clinical faculty developm ent program, Family Medicine, 23(5) , pp. 387388. B AXLEY , E.G., P RO BST , J.C ., S C HELL , B.J., B OG DEW IC , S.P. & C LEG H OR N , G.D. (1999 ) Program-centered education: a new model for faculty developm ent, Teachin g and Lear ning in M edicine, 11(2), pp. 9499. B ENOR , D.E. & M AHLER , S. (1989 ) Training m edical teachers: rationale and outcom es, in: H.G. S C HM IDT , M . L IPKIN , M .W. D E V R IES & J.M . G REEP (Eds) New Directions for M edica l Education : Problembased Lear ning and Community O riented M edica l Education, pp. 248 270. B ING -YOU , R.G., R ENFREW , R.A. & H AM PTON , S.H . (1999 ) Faculty development of com m unity-based preceptors through a collegial site-visit program, Teaching and Learning in Medicine, 11(2) , pp.100 104. B LAND , C.J., S CH M ITZ , C.C., S TRITTER , F.T., H ENR Y, R.C . & A LU ISE, J.J. (1990) Successful Faculty in A cademic M edicine (N ew York, Springer-Verlag). B LAND , C.J. & S IM PSON , D. (1997 ) Future faculty developm ent in fam ily m edicine, Family Medicine, 29(4) , pp. 290293. B LU M BERG , P. & D EVEAU , E.J. (1995 ) Using a practical program evaluation model to chart the outcom es of an educational initiative: problem -based learning, Medical Teache r, 17(2) , pp. 205 214. B OG DEW IC , S.P., B AXLEY, E.G. & JAM ISO N , P.K. (1997 ) Leadership and organizational skills in academic m edicine, Family M edicine, 29(4) , pp. 262265 . B OWER , D.J., D IEHR , S., M ORZINSK I, J.A. & S IM PSON , D.E. (1998 ) Supportchallengevision: a m odel for faculty mentoring , Medical Teacher, 20, pp. 595597. B U RKE , R., B RAGG , D. & R U ISW YK , J.V. (1997 ) Faculty developm ent: w hat academ ic prim ary care physicians need to know and w hat they want to know, Teaching and Lear ning in M edicine, 9(3), pp. 204 208. C ANDY , P. (1995 ) Physician teach thyself: the place of self-directed learning in CM E, Jour nal of Continuing Education in the H ealth Professions, 15, pp. 8090. C AR ROLL , R.G . (1993 ) Implications of adult education theories for m edical school faculty developm ent program mes, M edical Teache r, 15(2/3), pp. 163 170. C ENTRA , J.A . (1978 ) Types of faculty developm ent program s, Journal of Higher Education, 49(2), pp. 151162. C RANDAL L , S., E LSO N , R. & M C L AU G HLIN , C. (1997 ) Managing and com municating information in a new era, Family Medicine, 29(4), pp.270 274. C R U ESS , R.L. & C R U ESS , S.R. (1997a) Teaching m edicine as a profession in the service of healing, A cademic M edicine, 72, pp. 941 952. C RU ESS , R.L. & C R UESS, S.R. (1997b ) Professionalism must be taught, B ritish Medica l Journal, 315, pp. 16741677. C U SIM ANO , M .D. & D AVID , M.A. (1998 ) A com pendium of higher education opportunities in health professions education, Academ ic M edicine, 73, pp. 12551259. D ALOZ , L.A. (1986 ) Effective Teachin g and Mentorship: Realizing the Transformational Power of A dult Lear ning Experiences (San Francisco, Jossey-Bass). D AVIS , D.A. & F OX , R.D. (Eds) (1995a ) The Physician as Learner: Linking R esearch to Practice (C hicago: The Am erican M edical Association). D AVIS , D.A., T HOM SON , M .A., O XM AN , A.D. & H AYNES , B. (1995b) C hanging physician pe rform ance: a system atic review of th e continuing medical education strategies, JAM A, 274, pp. 700705. D E W ITT , T.G., G OLDBERG , R.L. & R OBER TS , K.B. (1993 ) Developing com munity faculty: principles, practice, and evaluation, Amer ican Jour nal of Diseases of Children, 147, pp. 4953. E LLIOT , D.L., S KEFF , K.M . & S TRATOS , G .A. (1999 ) H ow do you get

8. Evaluate and demonstrate effectiveness

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The need to evaluate our programs and activities has been highlighted in a separate section. H owever, we m ust rem ember that the evaluation of faculty development is more than an academic exercise. Research m ust inform practice, and our ndings must be used in the design, delivery and marketing of our programs. It has been stated earlier that faculty development m ust strive to promote education as a scholarly activity; we must role model this approach in all that we do.

C onclu sion

As one millennium ends, and another approaches, there is the irresistible urge to use this milestone to reect on the past and to focus on the challenges of the future. At the same time, however, we m ust remember that a millennium includes a thousand years, and that we can only look forward a few years at a time. As we enter the new m illennium , we must acknowledge the many valuable lessons that we have learned and build on our successes, rather than start anew. We m ust also continue to recognize that our faculty members are our most valuable resource (Bland & Sim pson, 1997), and that faculty developm ent targeted to the m ultiple roles of faculty members is the key to academic vitality (Bland et al ., 1990). Our challenge in the next decade will be to broaden the focus of what we do in faculty development, to consider diverse training methods, to encourage program evaluation at all levels, and to develop new partnerships and collaborations. We should also continue to provide faculty development activities for multiple reasons: to enhance teaching and learning; to promote scholarship and academic success; to develop leaders and innovators; and to inuence the culture in which we work. The changing roles of faculty members will continue to drive the changing nature of faculty development practices, as will the evolution of the organizations in which we work. As Wilkerson & Irby (1998) have stated, organizational vitality depends upon the commitment of resources to the ongo ing developm ent of those persons on whom the educational mission of the institution depends the faculty members and their trainees. The system atic design and delivery of innovative faculty development programs and activities is one way to prom ote and maintain academic growth and excellence.

No tes on contributor
Y VONNE S TEINER T , Ph.D., a clinical psychologist in the Departm ent of Fam ily M edicine at the Sir M ortimer B. Davis Jewish G eneral

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Yvonne Steinert

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