Maximising thepotential of part-timeclinical teachersPhilip Patston, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry,University of Illinois at Chicago, Chicago, USADavid Holmes, Department of Family Dentistry, College of Dentistry, University of Iowa,Iowa City, USAAhmad Maalhagh-Fard, Department of Prosthodontics, School of Dentistry, Universityof Detroit Mercy, Detroit, USAKang Ting, Department of Orthodontics, School of Dentistry, University of California,Los Angeles, USAVincent B. Ziccardi, Department of Oral and Maxillofacial Surgery, New Jersey DentalSchool, University of Medicine and Dentistry of New Jersey, New Jersey, USA

SUMMARYBackground: A problem faced byhealth professions educationthroughout the world is a lack offull-time clinical teachers. This isparticularly serious in dentistryand nursing, but is increasinglyalso true in medicine. To make upfor this shortfall there is a grow-ing reliance on part-time clinicalteachers.Context: Part-time clinicalteachers are essential for theeducation of students. However,

compared with their full-timecounterparts, the part-timeteachers are often not adequatelyprepared for their roles as edu-cators within the context of theclinical curriculum. They mightnot be trained in the latesteducational practices, and maybe unprepared for the timeneeded to excel as teachers andmentors.Implications: As part-timeteachers take on more responsi-bility, it is important that they

take part in orientation andtraining sessions to assist themin developing the skills theyneed to succeed. This willrequire a significant commitmentfrom the institution as well asthe part-time teacher, but iscritical for maintaining theacademic quality of the clinicaltraining programmes. This alsorepresents an untapped area forresearch into how to ensure thesuccess of part-time clinicalteachers.

Part-timeteachers areoften notadequatelyprepared fortheir roles aseducators

Developingteachers

� Blackwell Publishing Ltd 2010. THE CLINICAL TEACHER 2010; 7: 247–250 247

INTRODUCTION

Acommon problem in healthprofessions educationaround the globe is the lack

of enough full-time clinicalteachers. This is especially true indentistry and nursing, although itaffects medicine too. This puts asignificant strain on the educa-tional system and the full-timeteachers. As budgets tighten, andas academia lags in competitivesalaries, the situation is onlylikely to get worse. For example,the American Dental EducationAssociation (ADEA) has trackedthe North American dental schoolworkforce for a number of years,and there has been a consistentshortage of 300 teachers, themajority of whom are needed inclinical disciplines.1 A similarproblem exists in British dentalschools,2 and North Americanmedical and pharmacy schools.3–5

To make up for the shortfall, thereis an increasing reliance on part-time teachers. For example, in2002 it was estimated that46 per cent of North Americandental educators were workingpart-time.6 The numbers of part-time teachers are also increasingin nursing,7 as well as in highereducation in general.8,9 In thispaper we will consider some of thespecial needs of part-time teach-ers and discuss strategies tooptimise their effectiveness asteachers.

THE CHALLENGES OF BEINGA PART-TIME TEACHER

The reality of clinical education,in all its diverse disciplines, isthat part-time clinical teachersare integral to the educationalsuccess of the programmes, yetvery few studies have addressed ina quantitative way whether theseteachers are as effective as theirfull-time counterparts.10 A casehas been made for the benefits ofhaving a part-time appointmentfor the flexibility it gives and thequality-of-life benefits.11,12 Butthere is significantly more to

being a part-time teacher thanjust giving a lecture or running ateaching lab a few times a week.Anyone wishing to become a part-time teacher should give seriousconsideration to the commitmentit will take in order to excel, andshould make themselves aware ofwhat it will entail.13,14 Full-timeteachers are likely to beacquainted with developments incurriculum and changes in peda-gogy within their school. This isless likely to be true of thoseworking part-time, especiallythose who supervise students inclinics but are not involved inother teaching or administrativeresponsibilities. Changes havebeen taking place in higher edu-cation and in the health sciencesfor many years, such as thegrowing use of problem-basedlearning (PBL),15 and other smallgroup activities, an emphasison critical thinking and use ofevidence, and the huge impact ofinformation technology. In addi-tion, there are changes in studentevaluation (such as formativeassessment rather than summa-tive assessment, and better eval-uation of competence), and incontent (such as better integra-tion of biomedical sciences withclinical sciences). As new educa-tional methodologies are imple-mented, there will be a criticalneed for training and develop-ment of all those involved,including the part-time teachers.This is essential to ensure that the

expected educational outcomesare achieved and the competen-cies required of the students arefully understood. This is particu-larly important for the part-timeteachers who had not beeninvolved in curriculum planningand development, or who maynot have had any prior trainingin the educational methods nowin use.

A further consideration is thatas a member of a university thereis an expectation of productivityin research and scholarship.Although part-time teacherswould probably be exempt fromsuch an expectation, it wouldbecome increasingly difficult tosustain a research enterprisewithout people devoting at leastsome of their time to research.The pressures to obtain fundingfor biomedical and clinicalresearch already limit the timethat many people can devote toteaching, yet without a strongresearch presence the quality ofthe academic programmes will bediminished.

STRATEGIES TO MAXIMISETHE POTENTIAL OF PART-TIME TEACHERS

An important component in thesuccess of any health professionsteacher is that of job satisfac-tion.16–19 Meaningful and fulfill-ing work is important to prevent

Part-timeclinical teachers

are integral tothe educational

success of theprogrammes

248 � Blackwell Publishing Ltd 2010. THE CLINICAL TEACHER 2010; 7: 247–250

burnout.20,21 It follows that inorder for the part-time teachers toexcel in their roles as educators,and for their experience to bepersonally and professionallyrewarding, there has to be acommitment from both the tea-cher and the department, schoolor college that every effort will bemade to achieve success.22,23 Thepart-time teacher must under-stand that this will entail workbeyond just the hours in theclassroom. There should be ori-entation programmes and hand-books that discuss and describethe curriculum in detail, and theteaching and student assessmentmethods used.24–26 This should bepart of ongoing mentoring,training and development for allteachers, not just those workingpart-time.27–29 In disciplines suchas dentistry there is a significantsubjective component to theevaluation and grading of theclinical skills demonstrated bythe student. Standardisation (orcalibration) of those who assessthe student’s work is essen-tial,30,31 so as to avoidvariations based on the teachersown training, experience andbiases.

We believe that if theseresponsibilities are taken seri-ously by the department, schoolor college, and by the part-timeteachers, both parties will benefitenormously. The department,school or college will benefitbecause it will be carrying outpositive steps to compensate forthe shortages of full-time teach-ers. The part-time teachers willbenefit by being more integratedinto the life of the department,school or college, in a way thatshould be both interesting andfulfilling. There would be a needto develop suitable outcomeassessment measures to ensurethat the steps taken have apositive impact, such as surveyspertaining to job satisfaction, andstudent surveys evaluating theirlearning environment and satis-faction in their interaction withteachers.

CONCLUSIONS

In this paper we have brieflydiscussed some of the challengesand opportunities for part-timeteachers in health professionseducation. Part-time teachersplay an increasingly importantrole in clinical education, andsimilar issues exist across disci-plines such as dentistry, medicineand nursing. Although every sit-uation will be unique, there is noneed to re-invent the wheel as thevarious orientation and trainingprogrammes cited here are excel-lent starting points for a depart-ment, school or college which isgrappling with how to get thebest from the part-time teachers.In spite of this there is a dearth ofresearch specifically addressingthe needs of part-time teachers,how to ensure their success, andthe implication for the future ofhealth professions education. Thisrepresents an opportunity forserious investigation, one inwhich the part-time teachersmight also participate.

REFERENCES

1. Chmar JE, Weaver RG, Valachovic RW.

Dental school vacant budgeted fac-

ulty positions, academic years 2005–

06 and 2006–07. J Dent Educ

2008;72:370–385.

2. Murray JJ. Pressures on dental edu-

cation—a personal view. Br Dent J

2002;192:433–435.

3. Linzer M, Warde C, Alexander RW,

Demarco DM, Haupt A, Hicks L,

Kutner J, Mangione CM, Mechaber H,

Rentz M, Riley J, Schuster B, Solo-

mon GD, Volberding P, Ibrahim T.

Part-time careers in academic inter-

nal medicine: a report from the

association of specialty professors

part-time careers task force on

behalf of the alliance for academic

internal medicine. Acad Med

2009;84:1395–1400.

4. Helitzer D. Missing the elephant in

my office: recommendations for

part-time careers in academic medi-

cine. Acad Med 2009;84:1330–1332.

5. Smesny AL, Williams JS, Brazeau GA,

Weber RJ, Matthews HW, Das SK.

Barriers to scholarship in dentistry,

medicine, nursing, and pharmacy

practice faculty. Am J Pharm Edu

2007;71:1–9.

6. Holmes DC, Boston DW, Budenz AW,

Licari FW. Predoctoral clinical cur-

riculum models at U.S. and Canadian

dental schools. J Dent Educ

2003;67:1302–1311.

7. Creech CJ. Are we moving toward an

expanded role for part-time faculty?

Nurse Educ 2008;33:31–34.

8. Institute of Educational Sciences,

National Center for Educational

Statistics, US Department of Education.

Digest of Education Statistics: 2007.

Available at http://nces.ed.gov/

programs/digest/d07/index.asp

Accessed on 16 March 2010.

(Archived by WebCite� at http://

www.webcitation.org/5bGwTkPN0)

9. Jameson J, Hillier Y. ‘‘Nothing Will

Prevent Me from Doing a Good Job’’.

The Professionalisation of Part-Time

Teaching Staff in Further and Adult

Education. Research in Post-Compul-

sory Education 2008;13:39–53.

10. Allison-Jones LL, Hirt JB. Comparing

the teaching effectiveness of

part-time & full-time clinical nurse

faculty. Nurs Educ Perspect

2004;25:238–243.

11. Harrison RA, Gregg JL. A time for

change: an exploration of attitudes

toward part-time work in academia

among women internists and their

division chiefs. Acad Med 2009;84:

80–86.

12. Palda VA, Levinson W. Commentary:

the right time to rethink part-time

careers. Acad Med 2009;84:9–10.

13. Glaskin-Clay B. Part-time Instruc-

tors: Closing the Quality Loop.

College Quarterly 2007;10:1–11.

14. Ziehm S, Fontaine DK. Clinical fac-

ulty: tips for joining the ranks. AACN

Adv Crit Care 2009;20:71–81.

15. Neville AJ. Problem-based learning

and medical education forty years

on. A review of its effects on

knowledge and clinical performance.

Med Princ Pract 2009;18:1–9.

16. Swafford LG, Legg JS. Determinants

of job satisfaction among radiation

therapy faculty. J Allied Health

2009;38:163–169.

17. Froeschle ML, Sinkford JC. Full-time

dental faculty perceptions of satis-

faction with the academic work

environment. J Dent Educ 2009;73:

1153–1170.

18. Gui L, Barriball KL, While AE. Job

satisfaction of nurse teachers: a lit-

erature review. Part I: Measurement,

levels and components. Nurse Educ

Today 2009;29:469–476.

19. Gui L, Barriball KL, While AE. Job

satisfaction of nurse teachers: a

There has to bea commitmentfrom both theteacher and thedepartment,school orcollege thatevery effort willbe made toachieve success

� Blackwell Publishing Ltd 2010. THE CLINICAL TEACHER 2010; 7: 247–250 249

literature review. Part II: Effects and

related factors. Nurse Educ Today

2009;29:477–487.

20. Lieff SJ. The missing link in academic

career planning and development:

pursuit of meaningful and aligned

work. Acad Med 2009;84:1383–1388.

21. Shanafelt TD, West CP, Sloan JA,

Novotny PJ, Poland GA, Menaker R,

Rummans TA, Dyrbye LN. Career

fit and burnout among academic

faculty. Arch Intern Med

2009;169:990–995.

22. Groeneveld H. How to promote the

involvement of part-time teachers to

best advantage. Eur J Dent Educ

1999;3:94–98.

23. West MM, Borden C, Bermudez M,

Hanson-Zalot M, Amorim F, Marmion

R. Enhancing the clinical adjunct

role to benefit students. J Contin

Educ Nurs 2009;40:305–310.

24. Hand MW. Formalized new-faculty

orientation programs: necessity or

luxury? Nurse Educ 2008;33:63–66.

25. Pierangeli L. Developing a clinical

teaching handbook and reference

manual for part-time clinical faculty.

Nurse Educ 2006;31:183–185.

26. Holyfield LJ, Berry CW. Designing an

orientation program for new faculty.

J Dent Educ 2008;72:1531–1543.

27. Friedman PK, Arena C, Atchison K,

Beemsterboer PL, Farsai P, Giusti JB,

Haden NK, Martin ME, Sanders CF Jr,

Sudzina MR, Tedesco LA, Williams

JN, Zinser N, Valachovic RW, Mintz

JS, Sandmeyer MS. Report of the

ADEA President’s Commission on

Mentoring. J Dent Educ

2004;68:390–396.

28. Peters MA, Boylston M. Mentoring

adjunct faculty: innovative

solutions. Nurse Educ 2006;31:

61–64.

29. McLean M, Cilliers F, Van Wyk JM.

Faculty development: yesterday,

today and tomorrow. Med Teach

2008;30:555–584.

30. Haj-Ali R, Feil P. Rater reliability:

short- and long-term effects of

calibration training. J Dent Educ

2006;70:428–433.

31. Park RD, Susarla SM, Howell TH,

Karimbux NY. Differences in clinical

grading associated with instructor

status. Eur J Dent Educ 2009;13:

31–38.

Corresponding author’s contact details: Philip Patston, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University ofIllinois at Chicago, 801 S. Paulina, Chicago, IL 60612, USA. E-mail: Patston@uic.edu

Funding: No external funding was required.

Conflict of interest: None.

Ethical approval: This paper does not describe research on human subjects and therefore ethical approval was not necessary.

250 � Blackwell Publishing Ltd 2010. THE CLINICAL TEACHER 2010; 7: 247–250