key: cord-0714771-jz7t7f3x authors: Im, Ji Hyun; Kim, Ju Whi; Park, Wan Beom; Han, Ilkyu; Lee, Seung Hee; Shin, Jwa Seop; Yoon, Hyun Bae title: Is it feasible and effective to provide faculty development programs online for clinical teachers? date: 2021-05-26 journal: Korean J Med Educ DOI: 10.3946/kjme.2021.195 sha: 6ee1aaf3097be626c10bfb0d5c00a9461228757d doc_id: 714771 cord_uid: jz7t7f3x PURPOSE: Seoul National University College of Medicine operates a faculty development program for clinical teachers at multiple affiliated teaching hospitals. In 2020, the program was moved online due to coronavirus disease 2019. The purpose of this study was to determine whether it is feasible and effective to provide faculty development programs online in terms of clinical teachers’ participation and satisfaction in comparison with offline programs. METHODS: Clinical teachers participated in the clinical teaching methods programs offline in 2019 and online in 2020. We analyzed participation rate and satisfaction level. All surveys items were rated on a 5-point Likert scale. We also interviewed instructors about the advantages and drawbacks of the online program. RESULTS: The participation rate of the online program (89.5%) was significantly higher than that of the offline program (67.8%). The overall satisfaction level for the online program (4.37) was similar to that for the offline program (4.50). CONCLUSION: Faculty development programs online are feasible and effective in medical education. We need to design training content that fits online programs, consider various online training methods to reinforce the strengths of online programs, and support participants to make good use of these programs. Clinical teaching is the most important component of basic medical education. Based on the knowledge learned from lectures, students acquire basic clinical skills and communication skills for patient care, and understand the organization of the hospital where they will work in the future. Clinical teaching for students is unpredictable and unstructured in clinical settings; therefore, both students and clinical teachers need to be familiar with the objectives and methods of clinical teaching. Clinical teachers should also provide opportunities and feedback for students to participate in clinical teaching [1] . This is important because students' learning experience, which depend on choices made in clinical instruction, have a significant impact on their lives as doctors afterwards. The importance of clinical teaching and the role of clinical teachers underscores the importance of faculty development programs for clinical teachers. Faculty development can provide a conceptual framework for teaching, help clinical teachers adopt and adapt specific teaching behaviors to real clinical settings, and introduce teachers to a community of medical instructors interested in furthering clinical teaching and learning [2] . Formal faculty development programs in clinical teaching may be desirable if a clinician wishes to be an effective clinical teacher. Nevertheless, most clinical teachers have not been trained to teach, and faculty development for clinical teachers is undermined by poor attendance, inadequate knowledge transfer, and unsustainability [3] . Therefore, faculty development programs should be designed to account for the characteristics of clinical teachers and the clinical environment in which they work. Seoul National University College of Medicine has emphasized the importance of clinical teaching and has developed related faculty development programs. As the clinical teaching environment changes, the concept of site-specific teaching has emerged as important in establishing the learning objectives for each setting, such as the clinic, the inpatient ward, and the operating room [4] scenarios were shown and participants were asked to evaluate and discuss. In addition, they were asked to role-play in small groups as clinical teachers and students. They used flip charts and paper worksheets for group activities. In 2020, the non-face-to-face program used online platforms for 2.5 hours. The contents and the instructor were almost the same as the offline program. However, the program was delivered through an online platform, Zoom (Zoom Video Communications Inc., San Jose, USA). Zoom is a convenient online tool that supports online meetings or trainings. Lectures were given on the content of the offline lectures through real-time video, and Zoom's small group function was used to divide participants into groups with a tutor in each group to enable real-time discussions. The practice sessions were the same, except for the role-play. We produced one more video about the one-minute preceptor, and further discussion was held about this case instead of the role play. Participants used online files and screen sharing or chatting functions for group activities. Participants' participation and satisfaction for online program in 2020 were compared with offline program in 2019. Participation was compared between the offline and online programs using the attendance rate. At the offline programs in 2019, when the teachers entered the seminar room, they signed the attendance sheet only once. Therefore, regardless of how long they were actually present, they were considered to have completed the program. For the online program in 2020, attendance was checked by the online real-time video lecture access history and the face shown on the screen. Therefore, completion was evaluated using accurate access records on the online platform. The completion criterion was presence during 90% of the online sessions. We held an interview with the instructors and facilitators of the programs. The offline program in 2019 was attended by 40 For the offline program, completion was equated to attendance (i.e., there was no separate measure for completion). (Table 1 ). No statistically significant differences were found between the participants who attended the offline program in 2019 and those who attended the online program in 2020 in terms of all items evaluating satisfaction ( Table 2 ). The participants who attended the online program in 2020 stated that they were satisfied, with mean scores of (Table 3) ." Instructors responded the advantages and drawbacks of the online programs by comparing offline programs. As an advantage of the online program, the instructors first stated that participants' preparation for the program was high because almost all participants had clinical teaching training experience. Therefore, many participants could actively participate. This advantage was also present for the offline program. Second, physical opportunity costs such as travel time, distance, and assistant staff were reduced in the online program, whereas the offline program was inconvenient in terms of time and space. Third, the atmosphere of the online program was better than offline. In particular, the junior participants felt less pressure and stated that the atmosphere enabled a freer exchange of opinions than was possible in the offline program. Nonetheless, the instructors pointed out some drawbacks of the online program. First, the content of offline program had to be reconstructed to be suitable for the online platform, and there were also restrictions on some practice components, such as role-play conducted offline. Second, the instructors were not familiar with the online platform, which caused anxiety, and they needed extensive preparation time such as prerehearsals. Third, mental fatigue was rather higher than was the case for the offline program, because the instructors were concerned that they would need to deal with unexpected situations such as technical problems. In fact, technical problems (e.g., difficulty accessing the platform) often occurred. Finally, some things can only be shown face to face. It is difficult for instructors to recognize participants' immediate responses or to show emotions such as passion. Offline programs may be more advantageous in this regard. When asked about their overall opinion on online programs, they responded that there was no significant difference between offline and online settings for activities such as lectures and discussions. They stated that they were worried at first, but ultimately felt that it was "worth doing" after careful practice and repeated sessions. The participation rate of the clinical teaching methods showed that it was rather difficult for students to interact with their peers [6] . However, since clinical teachers have top-down relationships in hospitals, this study seems to have shown better interactions online. Rapport had already been formed between the instructors and participants, so they felt that the atmosphere was safe; it was easy to turn each camera on and hold smooth discussions. These findings are implying that online faculty development is relatively easier than online student education. provides time to complete course activities [7] . In order to implement online education well, we will need to have guidelines about the design and teaching of online courses for instructors and facilitators [8] . In conclusion, our study analyzed participation and Funding: No financial support was received for this study. No potential conflict of interest relevant to this article was reported. Author contributions: HBY conceived and designed the study. JHI drafted the initial version of the manuscript and analyzed the data. WBB and JHK provided critical comments. All authors discussed and approved the final manuscript. 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