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					Maximal Teaching Impact on a
      Minimal Budget

              Roger W. Geiss, M.D.
University of Illinois College of Medicine - Peoria
               CDS Plenary Session
              Colorado Springs, CO
                   July 18, 2007
Characteristics of the University of Illinois
 College of Medicine – Peoria (UICOMP)
• Community-based medical school
  – One of four campuses of U of I College of Medicine
  – ~50 students/class (M2-M4)
  – High degree of dependence on clinical (volunteer) faculty
• Low level of state support
How low is it?
   University of Illinois College of Medicine
(a division of the University of Illinois - Chicago)

                   Admission: ~300 students/class/year




Year 1      Chicago track (175)      UPR track (125)
               Chicago campus        Urbana campus


Years 2-4   Chicago campus (175)                 Urbana campus (25)


                                                 Peoria campus (50)


                                                Rockford campus (50)
  UICOMP Department of Pathology
• Path Faculty      • Contact hours (2006-7)
  – full-time:  2     – full-time path faculty: 103
  – part-time: 1      – part-time path faculty: 27
  – volunteer: 23     – volunteer path faculty: 50
                      – other faculty:           10
• FTEs                TOTAL:                    190
  – 1996-7: 3.5
  – 2006-7: 2.5
  – 2007-8: 2.3
                    “Challenges”
• Full-time faculty
   – decrease in number
   – increased pressure to engage in research
• Clinical (volunteer) faculty
   – increased pressure to generate clinical income
   – authority over volunteer faculty rests with hospitals and private
     practice groups
• Perceived attitude that “teaching will take care of itself”
• Very limited funds for critical needs
   – faculty development
   – maintenance of equipment and facilities
• Need to “make up” for deficiencies in M1 year
• No pathology residency program
• Possible future expansion of class size (50  62)
UICOMP
OSF – ST FRANCIS MEDICAL CENTER




           860 BEDS
METHODIST MEDICAL CENTER OF ILLINOIS   PROCTOR HOSPITAL




             360 BEDS                       165 BEDS




           PEKIN HOSPITAL              GRAHAM HOSPITAL




              125 BEDS                     140 BEDS
UICOMP
                    “Challenges”
• Full-time faculty
   – decrease in number
   – increased pressure to engage in research
• Clinical (volunteer) faculty
   – increased pressure to generate clinical income
   – authority over volunteer faculty rests with hospitals and private
     practice groups
• Perceived attitude that “teaching will take care of itself”
• Very limited funds for critical needs
   – faculty development
   – maintenance of equipment and facilities
• Need to “make up” for deficiencies in M1 year
• No pathology residency program
• Possible future expansion of class size (50  62)
   University of Illinois College of Medicine
(a division of the University of Illinois - Chicago)

                   Admission: ~300 students/class/year




Year 1      Chicago track (175)      UPR track (125)
               Chicago campus        Urbana campus


Years 2-4   Chicago campus (175)                 Urbana campus (25)


                                                 Peoria campus (50)


                                                Rockford campus (50)
                    “Challenges”
• Full-time faculty
   – decrease in number
   – increased pressure to engage in research
• Clinical (volunteer) faculty
   – increased pressure to generate clinical income
   – authority over volunteer faculty rests with hospitals and private
     practice groups
• Perceived attitude that “teaching will take care of itself”
• Very limited funds for critical needs
   – faculty development
   – maintenance of equipment and facilities
• Need to “make up” for deficiencies in M1 year
• No pathology residency program
• Possible future expansion of class size (50  62)
                          “Solutions”
• Past/present
   – longer work hours for full-time faculty
   – lecture-heavy curriculum
       •   lectures:        122 hours
       •   laboratories:     66 hours
       •   small-groups:      2 hours
       •   independent study: 1 hour
   – use of multiheaded microscopes in laboratories to minimize
     number of lab instructors needed
   – engagement of non-pathologist faculty to teach pathology
   – use of teaching assistants (M3, M4 students) in laboratories
• Future (some “culture change” required)
   – team-based learning
   – expanding/strengthening use of learning objectives
       • faculty and student “guidance”
       • promotion of independent study
• Wish list
   – additional full-time faculty
   – additional equipment
   – increased involvement by (certain segments of) volunteer faculty
                          “Solutions”
• Past/present
   – longer work hours for full-time faculty
   – lecture-heavy curriculum
       •   lectures:        122 hours
       •   laboratories:     66 hours
       •   small-groups:      2 hours
       •   independent study: 1 hour
   – use of multiheaded microscopes in laboratories to minimize
     number of lab instructors needed
   – engagement of non-pathologist faculty to teach pathology
   – use of teaching assistants (M3, M4 students) in laboratories
• Future (some “culture change” required)
   – team-based learning
   – expanding/strengthening use of learning objectives
       • faculty and student “guidance”
       • promotion of independent study
• Wish list
   – additional full-time faculty
   – additional equipment
   – increased involvement by (certain segments of) volunteer faculty
              Incentivizing volunteer faculty
• Intangible incentives
   – main incentive
        • personal satisfaction and fulfillment
        • student-teacher interaction
   –   refreshment of knowledge base
   –   respect from colleagues for teaching medical students
   –   help in recruiting into specialty
   –   clinical faculty appointment itself
• Tangible incentives
   – CME for teaching
   – faculty privileges (“perks”)
        • library privileges
        • on-campus parking
        • discounts, reimbursements
   – faculty development opportunities
   – inclusion in departmental/institutional social events
   – recognition (institutional and/or departmental level)
        •   eligibility for teaching awards from students, faculty
        •   specific awards for community-based faculty
        •   symbolic award: plaque, certificate, etc.
        •   recognition at departmental/institutional events
        •   “pat on back”
   – payment for teaching
             Incentivizing volunteer faculty
• Intangible incentives
   – main incentive
        • personal satisfaction and fulfillment
        • student-teacher interaction
   –   refreshment of knowledge base
   –   respect from colleagues for teaching medical students
   –   help in recruiting into specialty
   –   clinical faculty appointment itself
• Tangible incentives
   – CME for teaching
   – faculty privileges (“perks”)
        • library privileges
        • on-campus parking
        • discounts, reimbursements
   – faculty development opportunities
   – inclusion in departmental/institutional social events
   – recognition (institutional and/or departmental level)
        •   eligibility for teaching awards from students, faculty
        •   specific awards for community-based faculty
        •   symbolic award: plaque, certificate, etc.
        •   recognition at departmental/institutional events
        •   “pat on back”
   – payment for teaching
                  The Bottom Line
• Volunteer faculty possess a wide variety of needs
  and desires.
• A “menu” approach to support, whereby the
  individual can select the type or types of support
  most useful to her/him, would address the
  problem of diversity of needs.
• Careful selection of a program of support will
  need to be based on the value to the individual
  and the resources available.

Ref: Langlois JP: Support of community preceptors: what do they need?
      Family Medicine 1995; 27: 641-645.
     Additional references on incentivizing
                volunteer faculty
1.    Dodson MC: Motivation and reward factors that affect private
      physician involvement in an obstetrics and gynecology clerkship.
      Obstetrics & Gynecology 1998; 92:628-633.

2.    Fulkerson PK, Wang-Cheng R: Community-based faculty:
      motivation and rewards. Family Medicine 1997; 29:105-107.

3.    Kumar A, Kallen DJ, Mathew T: Volunteer faculty: what rewards
      or incentives do they prefer? Teaching and Learning in Medicine
      2002; 14:119-123.

4.    Pessar LF, Levine RE, Bernstein CA, et al: Recruiting and
      rewarding faculty for medical student teaching. Academic
      Psychiatry 2006; 30:126-129.

5.    Vath BE, Schneeweiss R, Scott CS: Volunteer physician faculty
      and the changing face of medicine. Western Journal of Medicine
      2001; 174:242-246.
QUESTIONS?
QUESTIONS?

ANSWERS?
“What is the minimally acceptable
 level that you can provide, and
     still live with yourself?”
               --C. Pillinger, M.D.
                     1/13/07

				
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