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Barriers to Effective Teaching

DaRosa, Debra A. PhD; Skeff, Kelley MD, PhD; Friedland, Joan A. MD, MPH; Coburn, Michael MD; Cox, Susan MD; Pollart, Susan MD; O'Connell, Mark MD; Smith, Sandy PhD

doi: 10.1097/ACM.0b013e31820defbe
Faculty Development

Medical school faculty members are charged with the critical responsibility of preparing the future physician and medical scientist workforce. Recent reports suggest that medical school curricula have not kept pace with societal needs and that medical schools are graduating students who lack the knowledge and skills needed to practice effectively in the 21st century. The majority of faculty members want to be effective teachers and graduate well-prepared medical students, but multiple and complex factors—curricular, cultural, environmental, and financial—impede their efforts. Curricular impediments to effective teaching include unclear definitions of and disagreement on learning needs, misunderstood or unstated goals and objectives, and curriculum sequencing challenges. Student and faculty attitudes, too few faculty development opportunities, and the lack of an award system for teaching all are major culture-based barriers. Environmental barriers, such as time limitations, the setting, and the physical space in which medical education takes place, and financial barriers, such as limited education budgets, also pose serious challenges to even the most committed teachers. This article delineates the barriers to effective teaching as noted in the literature and recommends action items, some of which are incremental whereas others represent major change. Physicians-in-training, medical faculty, and society are depending on medical education leaders to address these barriers to effect the changes needed to enhance teaching and learning.

Dr. DaRosa is professor of surgery and vice chair for education, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Dr. Skeff is professor of medicine and codirector, Stanford Faculty Development Center, Stanford University, Palo Alto, California.

Dr. Friedland is associate professor of medicine, Baylor College of Medicine, Houston, Texas, and associate chief of medicine, Michael E. DeBakey Veterans' Affairs Medical Center, Houston, Texas.

Dr. Coburn is professor of surgery and interim chair, Department of Urology, Baylor College of Medicine, Houston, Texas.

Dr. Cox is professor of obstetrics and gynecology and associate dean for medical education, University of Texas Southwestern Medical Center, Dallas, Texas.

Dr. Pollart is associate professor of family medicine and associate dean for faculty development, University of Virginia, Charlottesville, Virginia.

Dr. O'Connell is associate professor of medicine and senior associate dean for medical education, University of Miami, Miami, Florida.

Dr. Smith is senior research associate and senior medical educator, University of Chicago, Chicago, Illinois.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. DaRosa, Northwestern University Feinberg School of Medicine, 251 E. Huron, Galter 3-150, Chicago, IL 60611; telephone: (312) 926-7274; e-mail: ddarosa@nmh.org.

First published online February 21, 2011

© 2011 Association of American Medical Colleges