The Institution: Faculty/Instructors and Students
This section focuses on preparing faculty and classroom and clinical instructors and selecting and supporting students. It includes a discussion of faculty training and development, continuing professional development (CPD), and faculty retention. The discussion of students looks at issues related to selection and assessment.
Ensure faculty and classroom and clinical instructors have effective teaching and instructional design competencies as the foundation of faculty development. It is critical to improve faculty and preceptor’s ability to facilitate and assess learning and to apply instructional design principles when creating learning and assessment tools. Help faculty more objectively assess student performance by implementing objective structured clinical examinations (OSCE) and validated knowledge assessments. Use either ModCAL for Training Skills or the Effective Teaching materials to update faculty and preceptors in effective teaching.
Encourage and support faculty excellence. Addressing faculty-related issues is key to improving the quality of graduates (Mullan, et al. 2010). Several strategies are suggested for supporting faculty excellence. Faculty who excel should be recognized, either through the provision of career pathways, faculty development, advancement opportunities for women, and mentoring, and/or constructive feedback (WHO 2006).
Provide technical updates to faculty and classroom and clinical instructors. Faculty need up-to-date clinical skills and continued opportunities to maintain clinical proficiency (Smith and Hyre 2009). Educational systems need to establish a mechanism to ensure clinical skill maintenance for faculty. Work with professional councils or stakeholders to ensure processes are implemented for faculty to maintain clinical expertise and teaching skills and to access the resources needed to provide practical, competency-based education. A range of evidence-based clinical updates and courses may be used to ensure faculty and preceptors have the necessary clinical skills.
Train, sustain, and retain faculty. The theme of the WHO Working Together for Health report, “train, sustain, and retain,” also extends to faculty (WHO 2006). Many suggestions for retaining workers may be applied to faculty: provide adequate information and communication and provide adequate infrastructure and a living wage that is paid on time (WHO 2006). Provision of a good and safe working environment and adequate infrastructure helps increase retention (WHO, 2010). Each country should develop its own strategy for recruitment, deployment, and retention. The WHO Retention Guidelines outline strategies for addressing faculty retention.
Review institutional level student selection criteria to ensure that students will meet the desired goals for competency and post-graduation deployment. An appropriate range of selection criteria, including student investment in their community, understanding and interest in the profession, as well as cognitive ability to succeed, will lead to increased academic success, deployment, and retention (Dal Poz, et al. 2009; WHO 2006, WHO 2010). It is important to synchronize institutional selection criteria with national criteria. Work with key stakeholders to review and revise the selection criteria, if needed, particularly if the program has significantly revised the expected scope of practice or deployment strategies.
Emphasize student performance assessment in interventions. One of the most difficult tasks, assessing clinical competence, powerfully impacts how students learn (Howley 2004). Assessing memorization skills does not help develop the clinical decision-making skills required for competence and results in graduates who are not clinically competent or “ready to work” (Howley 2004). Formative assessment (for learning and feedback) is equally important as summative assessment (for making decisions about progress) and should be strengthened to ensure graduates develop desired clinical competence (University of Otago 2007). During pre-service education, teaching self-assessment and accountability is vital and self-evaluation of performance is an essential competency for every student midwife. In practice, midwives need to recognize when and how to seek help. Integrate self-assessment into student performance assessment. The Student Performance Assessment workshop materials offer resources for updating faculty or preceptors on assessment principles and practical methodologies, including how to develop and implement objective structured clinical examinations (OSCE).
Integrate use of objective assessment tools for learning and assessment. Assessment tools must be objective and logically linked to desired competencies and focus on the most important competencies (University of Otago, 2007). Work with institutions to improve faculty and preceptor abilities to develop and use objective assessment tools both to help students learn and assess their progress. An often overlooked, but critical step is ensuring that faculty and classroom and clinical instructors have checklists for providing feedback based on objective criteria and best practices. Help faculty more objectively assess student performance by implementing the use of OSCE and validated knowledge assessments. Many checklists are currently available for use on the MCHIP website.
Lessons Learned: The Institution
• It is critical to ensure basic computer literacy and provision of internet access to allow faculty and students to access information and resources.
• Help implement clinical assessment strategies, such as use of objective structured clinical examination (OSCE), checklists or other means.
• Invite faculty, classroom and clinical instructors to key stakeholder meetings, teaching and technical skill updates, and activities to set or implement educational standards.