3 International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 Editorial: Faculty Development in Medical Education: What, Why and How. Salam A1, Abdelhalim AT2, Begum H3, Pasha MA4. Keywords: Faculty development, Medical, What, Why, How. Correspondence to: Dr Abdus Salam, Medical Educationalist and Public Health Specialist, Associate Professor and Head of Medical Education Unit, Faculty of Medicine, Widad University College, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia. Email: abdussalam.dr@gmail.com ORCID iD: https://orcid.org/0000-0003-0266-9747 1. Abdus Salam, Medical Education Unit, Faculty of Medicine, Widad University College (WUC), Kuantan, Malaysia. 2. Abdelbaset Taher Abdelhalim, Paediatric Unit and Pharmacology Unit, Faculty of Medicine, WUC, Kuantan, Malaysia 3. Hamida Begum, Obstetrics and Gynaecology Unit, Faculty of Medicine, WUC, Kuantan, Malaysia 4. Mehboob Alam Pasha, Surgery Unit, Faculty of Medicine, WUC, Kuantan, Malaysia Faculty Development in Medical Education: What, Why, How. Introduction Higher education has a great role in the continued development of a community. Teachers form the bulk of the human resource by virtue of their training, education and other activities like acquisition of knowledge through participation in workshops, seminars, paper presentations at conferences, research and community services. In essence, the teaching profession can be considered to be the mother of all professions1. Most universities have missions to accomplish and faculty members are essential resources2,3. In medical school, faculty members facilitate the teaching and learning process, clinical and health services, research and scholarly activities to fulfill the mission and vision of the medical school or institution. The various roles of the faculty member have to be acknowledged in order to develop the faculty3,4. Faculty development also includes proper selection, evaluation and management of the faculty2. In higher education, faculty development is very important to enable the faculty to accomplish their roles and responsibilities2. WHAT Medical education has evolved from a teacher- centric approach to a student-centric approach, creating new demands and responsibilities on the part of faculty members5. The newer transformations involve integrated teaching, problem-based learning, community-based learning6, and simulation-based learning7. Also, the assessment methodology has transformed into multiple choice questions (MCQ), Modified essay questions (MEQ), Short answer questions (SAQ), Objective structured practical examination (OSPE), Objective structured Clinical examination (OSCE). Besides use of Log books, mini clinical evaluation exercises (miniCEX), mimicking real life scenarios, directly observed procedural skills (DOPS), portfolio assessment, and self-assessment have also been introduced as part of assessment process6.8. In the current transformed medical education system, many roles and responsibilities are played by the medical faculty. Harden & Crosby (2000)6 has recommended twelve roles of medical teachers, grouped in six areas as showed in Table-1. International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 Page : 3-7 DOI: http://dx.doi.org/10.31344/ijhhs.v7i1.489 mailto:abdussalam.dr@gmail.com https://orcid.org/0000-0003-0266-9747 International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 4 Table-1. The twelve roles of the medical teacher grouped under six areas No. Role of Medical Teacher 1 Information provider in the lecture and clinical context 2 Role model on-the-job and in formal teaching setting 3 Facilitator as mentor and learning facilitator 4 Student assessment and curriculum evaluator 5 Curriculum and course planner 6 Resource material creator and study guide producer Faculty development is defined as “a planned program, or set of programs, designed to prepare institutions and faculty members for their various roles, to improve individual instructors’ knowledge and skills in the areas of teaching, research, service and administration”9. It includes the actions taken to improve the knowledge and skills such as teaching skills, research skills, administrative skills etc., in medical education which are vital to carry out the performance of a faculty member in an academic institution10,11. To meet the need of the student, faculty, and institution, faculty development programs are essential to modify the attitudes, skills, and behavior of faculty members and thereby to increase their competence3. A well- organized faculty development program should be able to enhance faculties’ skills in all the five desired domains, i.e., teaching, assessment, curriculum support, organizational leadership and mentoring12. WHY Formerly, faculty development programs were designed to improve the teaching roles only. But in present times, due to expanding faculty roles, the range of faculty development activities also changed, aiming to assist faculty with their scholarship, leadership, and career development needs, in addition to their teaching skills12. It plays an important role in organizational and curricular change, in promoting teaching as a scholarly activity and in constructing an educational environment that encourages and rewards educational leadership, innovation and excellence13. The faculty development strengthens their role in higher education and positively affects the institution14. The many roles played by the faculty leads to stress unless they possess or are provided by the resources and strategies to relieve the stress15. This was highlighted in a study which showed that stress and conflicts arise from heavy workload, conflicting demands from colleagues and superiors, incompatible demands from different personal and organizational roles, insufficient resource materials to optimize performance, inadequate competency, inadequate autonomy for decision making, or a feeling of underutilization15. With regard to physicians, clinical competency was equated with professional competency16. However good communication skill was noted to be a measure of good clinical practice and hence was incorporated in the curriculum of medical schools globally17. As a result of the transformation leading to different roles and responsibilities to the faculty and the stress following it, many medical schools felt the need for faculty development programs3,12. Lack of objectivity, overloaded content, improper organization of curricular content resulting in improper content delivery, inappropriate assessment procedures, insufficient orientation of new recruits, and teacher-centered mindset with autocratic faculty leaderships are major issues in medical education that affects the quality of a curriculum and consequently the quality of an institution.18,19,20. There should be seamless integration between planned curriculum, taught curriculum, and learned curriculum. This is highly dependent on appropriate faculty development19,21. A well developed program can improve the quality of faculty, resulting in improved quality of curriculum and the higher education institution22. Lack of funding and limited budget resources is one of the major challenges22. Improper time management caused by heavy workload and other commitments also present a challenge22,23. Other factors preventing faculty from participating in faculty development programs can be lack of motivation, lack of financial reward and recognition of teaching excellence and high volume of workload23. Generation gap, resistance to newer concepts, work or institutional culture are also identifiable challenges22. Traditionally medical teachers are assumed to be teachers by virtue of content knowledge, or prior experience rather than having formal training21. These concerns have to be overcome by good institutional leadership, resource provision, 5 International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 recognition for research and teaching excellence24. Efficiency of faculty development program can also be improved by assessment of specific need, knowledge and priorities of teaching staff25. Studies have shown that in spite of regular faculty development programs, some concerns remain as to standards of the programs. This needs to be addressed by the leaders of the respective educational organizations26. HOW The faculty development model identifies programs that fulfill faculties’ needs, and academic and institutional demands22. Wilkerson and Irby27 suggest that the faculty development program is based on (i) faculty members’ professional development, (ii) instructional development, (iii) leadership development and (iv) organizational development. A good leader must plan well- designed curricula and academic programs and advance medical education. Organizational development with appropriate policies and procedures supports and rewards the faculty, so that faculty members exhibit their roles as educators27. Ambarsarie et al.22 have developed a faculty development model consisting of: content, process and system. The content component includes materials needed to be delivered, such as instructional development, professional development, leadership skills, soft skills, and spiritual development. The process component includes the aspects required for implementing the faculty development program, from needs analysis, preparation, and execution to the evaluation at the end of the program. The system component includes the aspect of the educational system that affects the faculty development program, which are leadership, institutional policy and the availability of experts22. Input, process and output are the system approach in education, where identification of objectives and selection of contents based on objectives considered -as input; choosing appropriate methods of content delivery -as process; and deciding relevant assessment -as to measure output, are very important which should interrelate or align with each other19. The value of a good teacher is to know how to do academic planning or scheduling and following it, what to include and what not to include in the syllabus, where to begin and leave out, and by what stages to lead a student to mastery of the subject28. A global shortage of qualified medical teacher has been reported29,30. Moreover, ongoing challenges has been observed on cultural diversity issue causing ethnical minority to feel discrimination having negative experience and negative impact on educational environment31. Teaching and evaluation by intimidation hinders to frame own professional identities and prevent future ethical leadership development. Emphasis has been given to culturally competent faculty to educate culturally competent physicians who can work with diverse group of patient population and communities32. A good knowledge of cultural background and a good role modelling in faculty members affect students’ insight33. Hence, understanding of educational environment is very important, and educators must strive to maintain a multicultural environment in instructional methodologies to lead and promote a sustainable organisational development34. Leadership role of the managers has a great role on the organization and its success through staff motivation, execution of the strategies to achieve the goal and objectives35. Good leadership prioritizes the faculty development program through their understanding and commitment to faculty development. Institutional policies determine the programs’ necessity and finally, the availability of experts make it feasible to implement a faculty development program22. With the need of medical faculties to be socially accountable, there is growing pressure for teaching excellence and professionalization of teaching practices24. To be talented teachers, mentors, educators, researchers and leaders, medical education requires faculty development, which is not an easy task. It needs supportive institutional leadership, appropriate resource allocation and recognition for teaching and research excellence24. Workable faculty development requires a medical education department operated by respected faculty developers who are academic role models. Faculty development should be methodical involving planning, implementation and evaluation. It should be task oriented and tailored to suit the needs of individuals, disciplines and the institution and strive for collaboration across medical disciplines, and across professions24. The activities included in the faculty development program are designed to improve the efficiency of the faculty members’ work and also to achieve both personal goals and institutional objectives3. The most common faculty development program includes instructional material to improve teaching in lectures, small group discussion, teaching International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 6 in the hospital and in community settings, and honest feedback and evaluation 9,36. Other areas include personal and professional development of teachers, educational leadership, or organizational development and change. Organizational and leadership skills are necessary to promote more productive educational environments. Effective leadership providing educational mentorship is critical for sustained development of the organization. Professional academic skills include understanding the underlying values, norms, and expectations of academia, good career development and good networking with skills in information technology9.22 . Faculty development program varies from independent learning to formal program through seminar, workshop, continuing education program and organizational development strategies such as curriculum development, professional development programs etc22. The common form of faculty development program includes seminars, workshops, short courses, fellowships, observations of workplace teaching followed by feedback and integrated longitudinal programs, decentralized activities, peer coaching, mentoring, self-directed learning, and computer-aided instruction3,9,12 Conclusion Higher education is important for the development of a community. This is dependent on a knowledgeable and highly trained workforce or faculty. Medical education has transformed over time from a teacher centric to a student centric approach. This led to challenges to the faculty by way of increased workload and greater number of roles in teaching with consequent work-related stress. These and other concerns have led to development of programs to improve the faculty. These faculty development programs are designed to overcome the many challenges facing medical education today. It is hoped that their successful implementation will see an improvement in the education and quality of the medical institutions. Funding No funding was received for this paper. Conflict of Interest: Nil. Authors’ Contribution All authors participated ably in the preparation of this paper and approved the final version for submission to the Journal for publication. 7 International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 References: 1. Salam A. TEA to entertain outcome-based education for 21st century educators to produce safe human capitals for a sustainable global development. International Journal of Human and Health Sciences 2022; 06(02): 153-154. DOI: http://dx.doi. org/10.31344/ijhhs.v6i2.437. 2. Fooladvand M, Changiz T, Yousefy A. Developing indicators for preparation of faculty description in a medical university. Procedia Social and Behavioral Sciences 2011; 15: 2387–2390. https://doi. org/10.1016/j.sbspro.2011.04.113. 3. Ahmady S. Faculty Development in Medical Education: A Comprehensive Approach. Published by Karolinska Institutet. Printed by Universitetsservice US-AB. 2009. 4. Salam A, Begum H, Zakaria H, Allaw BAQ, Han T, Algantri KR, Mofta AG, Elmahi MEB, Mohamed EME, Elkhalifa MAA, Zainol J. Core values of professionalism among fresh medical gin a Malaysian private university. International Journal of Human and Health Sciences 2021; 05(04): 463-472. DOI: http://dx.doi.org/10.31344/ijhhs.v5i4.358 5. Abolbashari S, Moonaghi HK, Bazzaz MM. Medical faculties’ view about the importance of educational roles. Adv Med Educ Pract. 2018; 9:417-422. doi: 10.2147/AMEP.S163218. 6. Harden RM, Crosby J. AMEE Guide No 20: The good teacher is more than a lecturer - the twelve roles of the teacher. Medical Teacher 2000, 22: 334-347. https://doi.org/10.1080/014215900409429. 7. Salam A, Saiboon IM, Jaafar MJ, Hamzah FA, Balakrishnian, Kamarudin MA, et al. Tutors perception on a training workshop on simulation based medical education. Bangladesh Journal of Medical Science 2016; 15(02):195-20. 8. Salam A, Yousuf R, Bakar SMA. Multiple Choice Questions in Medical Education: How to Construct High Quality Questions. International Journal of Human and Health Sciences 2020; 04(02): 79-88. DOI: http://dx.doi.org/10.31344/ijhhs.v4i2.180 9. Steinert Y, Mann KV. Faculty Development: Principles and Practices. J Vet Med Educ 2006; 33(3): 317-324. DOI: 10.3138/jvme.33.3.317 10. Bilal, Guraya SY, Chen S. The impact and effectiveness of faculty development program in fostering the faculty’s knowledge, skills, and professional competence: A systematic review and meta-analysis. Saudi Journal of Biological Sciences 2019; 26 (4): 688-697. https://doi.org/10.1016/j. sjbs.2017.10.024 11. Kwan D, Barker K, Richardson D, Wagner S, Austin Z. Effectiveness of a faculty development program in fostering interprofessional education competencies. J. Res. Interprof. Pract. Educ 2009; 1(1): 24-41. https:// doi.org/10.22230/jripe.2009v1n1a4 12. Leslie K, Baker L, Egan-Lee E, Esdaile M, Reeves S. Advancing Faculty Development in Medical Education: A Systematic Review. Acad Med. 2013; 88:1038–1045. doi: 10.1097/ ACM.0b013e318294fd29 13. Steinert Y. Perspectives on faculty development: aiming for 6/6 by 2020. Perspect Med Educ 2012; 1:31–42. DOI 10.1007/s40037-012-0006- 14. Guraya SY, Guraya,SS, Mahabbat NA, Fallatah KY, Al-Ahmadi BA, Alalawi HH. The Desired concept maps and goal setting for assessing professionalism in medicine. J. Clin. Diagn. Res 2016; 10: JE01-JE05. doi: 10.7860/JCDR/2016/19917.7832. 15. Ahmady S, Changiz T, Masiello I, Brommels M. Organizational role stress among medical school faculty members in Iran: dealing with role conflict. BMC Medical Education 2007; 7:14. doi:10.1186/1472-6920-7-14. 16. Salam A, Allaw BAQ, Begum H, Abdelhalim AT, Alsharkawy A, Hassan KM, Satwi S, Zainol J. Audit on clinical competency of fresh medical graduates in a Malaysian private university using Kirkpatrick level-1 evaluation model. Education in Medicine Journal 2021;13(4): 57–70. https://doi.org/10.21315/ eimj2021.13.4.5 17. Salam A, Zakaria H, Abdelhalim AT, Choon LC, Alsharkawy A, Taibi MKBM, Satwi S, Hassan KM, Zainol J. Communication Skills of Fresh Medical Graduates in a Malaysian Private University. Bangladesh Journal of Medical Science 2022; 21(02): 404-412. DOI: http://doi.org/10.3329/bjms. v21i2.58074 18. Salam A. Issues of objectives, content, methods and assessment in the development of relevant curriculum in medical schools. Malaysian Medical Association (MMA) News 2010; 22-24. 19. Salam A. Input, process and output: system approach in education to assure the quality and excellence in performance. Bangladesh Journal of Medical Science 2015; 14(01): 1-2. 20. Zhang Z, Wu Q, Zhang X, Xiong J, Zhang L, Le H. Barriers to obtaining reliable results from evaluations http://dx.doi.org/10.31344/ijhhs.v6i2.437 http://dx.doi.org/10.31344/ijhhs.v6i2.437 https://doi.org/10.1016/j.sbspro.2011.04.113 https://doi.org/10.1016/j.sbspro.2011.04.113 http://dx.doi.org/10.31344/ijhhs.v5i4.358 https://doi.org/10.1080/014215900409429 http://dx.doi.org/10.31344/ijhhs.v4i2.180 https://doi.org/10.1016/j.sjbs.2017.10.024 https://doi.org/10.1016/j.sjbs.2017.10.024 https://doi.org/10.22230/jripe.2009v1n1a4 https://doi.org/10.22230/jripe.2009v1n1a4 https://doi.org/10.21315/eimj2021.13.4.5 https://doi.org/10.21315/eimj2021.13.4.5 http://doi.org/10.3329/bjms.v21i2.58074 http://doi.org/10.3329/bjms.v21i2.58074 International Journal of Human and Health Sciences Vol. 07 No. 01 January’23 8 of teaching quality in undergraduate medical education. BMC Medical Education 2020; 20:333. https://doi.org/10.1186/s12909-020-02227-w. 21. Salam A, Mohamad MB. Teachers’ perception on what makes teaching excellence: impact of faculty development programme. International Medical Journal 2020; 27(1): 1-4 22. Ambarsarie R, Mustika R, Soemantri D. Formulating a need-based faculty development model for medical schools in Indonesia. Malays J Med Sci. 2019;26(6):90–100. https://doi.org/10.21315/ mjms2019.26.6.9 23. Steinert Y, McLeod PJ, Boillat M, Meterissian S, Elizov M, Macdonald ME. Faculty development: a ‘field of dreams’? Med Educ. 2009;43(1):42-9. doi: 10.1111/j.1365-2923.2008.03246.x. 24. McLean M, Cilliers F, Van Wyk JM. Faculty development: yesterday, today and tomorrow. Med Teach. 2008;30(6):555-84. doi: 10.1080/01421590802109834 25. Opre A, Zaharie M, Opre D. Faculty development: teaching staff needs, knowledge and priorities. Cognition, Brain, Behavior 2008; 12(1): 29-43. 26. Salam A, Yaman MN, Hashim R, Suhaimi FH, Zakaria Z, Mohamad N. Analysis of problems posed in problem-based learning cases: nature, sequence of discloser and connectivity with learning issues. Bangladesh Journal of Medical Science 2018;17(03):417-423. DOI: http://dx.doi. org/10.3329/bjms.v17i3.36997 27. Wilkerson L, Irby DM. Strategies for improving teaching practices: a comprehensive approach to faculty development. Academic Medicine 1998; 73(4): 387-396. 28. Salam A. Best teaching method used, very good in teaching, the best lecturer ever: secrets of teaching online during COVID-19 pandemic. International Journal of Human and Health Sciences 2021; 05(04): 377-380. DOI: http://dx.doi.org/10.31344/ijhhs. v5i4.34 29. Ali SMI, Talukder MHK, Khatun M, Khanom RA, Miah MA, Ahmed MW, et al. Views of Medical Teachers Regarding the Need of Training or Course on Medical Education. Bangladesh Journal of Medical Education 2014; 2 (2): 2011: 7-11. DOI:10.3329/ bjme.v2i2.18135. 30. Ping CS, Jing RTS, Yan LW. Improving the Quality of Medical Education in Malaysia. Policy Brief POL- 2021-02. Malaysian Medics International 2021. Retrieved on 12 November from: Policy-2021-02- Medical-Education.pdf (squarespace.com). 31. Forrest D, George S, Stewart V, Dutta N, McConville K, Pope L, et al. Cultural diversity and inclusion in UK medical schools. Clin Teach. 2022;19(3):213– 220. 10.1111/tct.13472. 32. Sorensen J, Norredam M, Dogra N, Essink-Bot ML, Suurmond J, Krasnik A. Enhancing cultural competence in medical education. Int J Med Educ. 2017;8:28-30. doi: 10.5116/ijme.587a.0333. 33. Dutta N, Maini A, Afolabi F, Forrest D, Golding B, Salami RK, Kumar S. Promoting cultural diversity and inclusion in undergraduate primary care education, Education for Primary Care 2021; 32(4):192-197, DOI: 10.1080/14739879.2021.1900749. 34. Salam A, Akram A, Mohamad N, Siraj HH. Measures of Educational Environment in a Higher Educational Institution Using Dundee Ready Educational Environment Measure -DREEM. International Medical Journal 2015; 22(2): 98-102. 35. Akparep Y, Jengre E, Mogre AA. The Influence of Leadership Style on John Organizational Performance at TumaKavi Development Association, Tamale, Northern Region of Ghana. Open Journal of Leadership 2019; 8 (1): 1-22. DOI: 10.4236/ ojl.2019.81001. 36. Steinert Y. Faculty development in the new millennium: key challenges and future directions. Med Teach 2000; 22:44–50. https://doi.org/10.1080/01421590078814 https://doi.org/10.1186/s12909-020-02227-w https://doi.org/10.21315/mjms2019.26.6.9 https://doi.org/10.21315/mjms2019.26.6.9 http://dx.doi.org/10.3329/bjms.v17i3.36997 http://dx.doi.org/10.3329/bjms.v17i3.36997 http://dx.doi.org/10.31344/ijhhs.v5i4.346 http://dx.doi.org/10.31344/ijhhs.v5i4.346 https://static1.squarespace.com/static/5e477eb18ae6b644167d06ab/t/6043d5e56856623a539759b3/1615358675970/Policy-2021-02-Medical-Education.pdf https://static1.squarespace.com/static/5e477eb18ae6b644167d06ab/t/6043d5e56856623a539759b3/1615358675970/Policy-2021-02-Medical-Education.pdf https://doi.org/10.1080/01421590078814