Published December 29, 2016
UB recently marked the 10-year anniversary of its collaboration with London’s Royal College of Physicians (RCP) on a one-of-a-kind program that trains clinical educators for the demands of teaching medical students and residents.
Since its launch in 2006, the accredited UB Royal College of Physicians Educator Program has trained 120 clinical educators and administrators from the Jacobs School of Medicine and Biomedical Sciences in evidence-based strategies to enhance their clinical teaching skills.
It remains the only such partnership between a U.S. medical school and RCP, the nearly 500-year-old British professional body dedicated to improving the practice of medicine.
The innovative UB/RCP program took root in the spring of 2006, when Roseanne C. Berger, MD, senior associate dean for graduate medical education, attended the national meeting of the Accreditation Council for Graduate Medical Education.
Impressed with a teacher-training workshop she attended, Berger approached the presenter — RCP’s executive director of education, Winnie Wade — about developing a similar program for UB.
Wade and two RCP colleagues — David Parry and Roger Barton, MD — traveled to Buffalo later that year to teach the inaugural cohort.
The annual program has been going strong ever since, attracting UB medical school faculty across all disciplines and at various stages in their careers.
“This program draws faculty who are in leadership roles in education — program directors, clerkship directors and front-line teachers who are interested in developing their skills and networking with those who share the same interests,” says Berger, associate professor of family medicine.
The program fills a critical need for clinical educators, Berger says.
“In the U.K., there’s a central body authorized to mandate training for clinicians in teaching roles. We don’t have a similar situation here. In the United States, clinical educators are passionate about sharing their knowledge with trainees but often have no formal preparation in teaching skills and principles of adult learning.”
Surveys that UB’s Office of Graduate Medical Education distributes consistently reveal that medical students and residents rank teaching as one of the most important factors they consider when evaluating training programs.
“Expectations for educators in clinical settings have increased over time,” Berger notes. “Professionalism, health disparities, quality and efficiency must be addressed in addition to diagnosis and treatment.
“As demands in in clinical workload increase, it becomes critical for faculty to use the precious time for teaching effectively and capitalizing on ‘teachable moments.’”
As the UB/RCP program has evolved, so, too, has UB’s participation in it.
“When we designed the initial program, the faculty were all from the U.K.,” Berger says. “But over time a core group of UB faculty who participated in it became instructors, and they’re now involved with teaching and delivering more than 50 percent of the program.”
UB faculty leaders, in addition to Berger, include:
They have incorporated topics into the program that, while not unique to American medical education, receive special attention in domestic curricula — subjects such as quality improvement, patient safety, health disparities and unconscious bias.
Other program graduates contribute by mentoring participants, Berger points out.
“Medical education is becoming a global enterprise,” she says. “Part of the appeal of this program is learning, through collaboration, about medical education in another country.
“As we learn about the system and priorities in the U.K., our partners learn about trends in the U.S.
“Everyone benefits from sharing best practices.”
Among the UB/RCP participants-turned-faculty, Sheehan says that the evidence-based techniques he learned in the program inform and enrich every aspect of his teaching.
“I started teaching back in 1988 as a PhD candidate at UB, but what I’d learned up until I started the RCP program had been through trial and error,” says Sheehan, clinical associate professor of pediatrics.
“Now, I approach every teaching session in a structured way to make sure I’m addressing the audience and delivering the ‘must knows’ they need to leave the session with,” he adds.
“The RCP program looks at where you’re teaching, whom you’re teaching, how to initially engage your learners and how to actively re-engage them.”
Sheehan also has benefited from the program’s training in delivering feedback.
“No one likes to give feedback, because all you focus on is how you’re going to deliver that negative feedback,” he says. “But through the program, I’ve learned how to deliver feedback that encourages self-reflection on the part of the trainee.”
As a UB/RCP instructor, Sheehan co-teaches two modules with Wilkins — one on session planning and another on teaching in the clinical setting.
“One of the wonderful things about UB/RCP is that I have met passionate clinical educators across UB that I would not have met otherwise because of geographical and departmental silos,” Sheehan says.
In his capacity as an associate dean, Sheehan frequently taps UB/RCP graduates to contribute their expertise to the curriculum.
“The UB/RCP program is a great opportunity to network and learn across boundaries,” he says.
The UB/RCP program requires all participants to complete a final project, applying the skills they’ve acquired in the course to an educational initiative that they incorporate into their teaching.
Many of these final projects — which UB/RCP faculty must approve for participants to receive continuing medical education credit — have become permanent fixtures in UB’s teaching and training curriculum.
Sheehan, for example, developed “CSI Buffalo” — short for “Cough Scene Investigation” — a training session that aims to improve the history-taking and diagnostic skills of medical students and residents rotating through the Lung Center at Women and Children’s Hospital of Buffalo.
Another example: Last spring, UB piloted a capstone elective to prepare fourth-year medical students for the transition to residency. The case-based, patient-centered course is modeled after an intern “boot camp” developed by UB/RCP alumna Clairice A. Cooper, MD, assistant professor of surgery.
Developed by Paula A. Del Regno, MD, associate director of psychiatry residency training, and Cynthia A. Pristach, MD, director, the specialized track emphasizes clinical and didactic teaching skills, curriculum development and educational research.
“We were so enthusiastic about what we learned through the RCP program that we wanted to bring it to our residents,” Del Regno explains, noting that the medical educator track is geared for residents interested in pursuing an academic career.
“This track is based on the Royal College of Physicians Program. Its goal is to make residents better teachers at an earlier point in their professional development.”
Since the track debuted in 2009, more than 25 residents have participated in it, Del Regno says, noting that it has emerged as a powerful recruiting tool.
“When we conduct our interviews for recruitment, a lot of applicants tell us that they’re interested in this track, and that they find it a unique strength of our program,” says Del Regno.
“Then, when our graduating residents interview for fellowships, the faculty interviewing them tell them that they’re impressed that they’ve participated in this track. So, it’s clearly making our graduates more competitive for fellowships.”
Like the UB/RCP program, the medical educator track requires participating residents to complete a scholarly project, which they’re encouraged to present and publish.
These projects have significantly increased scholarly productivity within the psychiatry department.
“It would be accurate to say that scholarly work has nearly doubled since we started the track,” Del Regno says. “We have also had significantly more faculty members involved in mentoring residents on publications and poster presentations.
“We didn’t know what kind of impact we’d see in scholarship, but this has been a very pleasant benefit to introducing this track.”
It gratifies Del Regno that the next generation of clinical educators is benefiting from the valuable lessons she learned in the UB/RCP program.
“The RCP program helps you realize that there is so much more to education than some of us realize,” she says. “Many people put together a lecture but don’t really understand how to make objectives for the lecture and how to measure that your learners are achieving what you want them to.
“This program helps you develop concrete methods focused on learning goals, which makes you a more effective teacher.”
Although the UB/RCP program targeted newer faculty members when it launched in 2006, coordinators have been pleasantly surprised at the number of veteran faculty who have enrolled in it over the decade.
“More experienced faculty come to solidify their understanding of the basics and to refine their skills,” explains Susan Orrange, PhD, assistant dean for education and resident services.
“They often have heard things here and there, and maybe they’ve attended a workshop, but they want a package that ties everything together.”
Take Pristach, for example. She enrolled in the program in 2008, two decades after she started teaching in the medical school.
“The teachers who run the Royal College program were so inspiring,” she says. “They opened my eyes to different methods of teaching and new insights into session planning, managing teaching sessions and different ways to engage learners.”
Since participating, Pristach finds she organizes her teaching sessions more effectively and engages learners better.
The year after she completed the program, Pristach says, she received a teaching award from the psychiatry residents.
“I’ve won teaching awards before,” she points out, “but this one was definitely in response to my participation in the Royal College program.”