cmedbd.comcmedbd.com/cmed-admin/upload/ppts//Twelev_Roles_of_a_Lecturer.pdf · Brew and Boud (1998) have highlighted the more complex demands now being placed on university teachers

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This AMEE Education Guide was first published in Medical Teacher: Harden R M and Crosby J R (2000).AMEE Education Guide No 20: The good teacher is more than a lecturer – the twelve roles of the teacher.Medical Teacher 22(4): 334-347.

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R M Harden is Director of the Centre for Medical Education and Teaching Dean in the Faculty of Medicine,Dentistry and Nursing at the University of Dundee. He is also Director of the Education Development Unit(Scottish Council for Postgraduate Medical & Dental Education), Dundee, UK

Joy Crosby is Lecturer in Medical Education in the Faculty of Medicine, Dentistry and Nursing,University of Dundee, UK

Guide Series Editor: Pat Lilley

Desktop Publishing: Lynn Bell

© AMEE 2000

Copies of this guide are available from:

AMEE, Centre for Medical Education, University of Dundee, 484 Perth Road, Dundee DD2 1LR,Scotland, UK.Tel: +44 (0)1382 631953 Fax: +44 (0)1382 645748 E-mail: [email protected]

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��Teaching is demanding and complex task. This guidelooks at teaching and what it involves. Implicit inthe widely accepted and far-reaching changes inmedical education is a changing role for the medicalteacher. Twelve roles have been identified and thesecan be grouped in six areas in the model presented:

1 The information provider in the lecture, and inthe clinical context

2 The role model on-the-job, and in more formalteaching settings

3 The facilitator as a mentor and learning facilitator

4 The student assessor and curriculum evaluator

5 The curriculum and course planner, and

6 The resource material creator, and study guideproducer.

As presented in the model, some roles require moremedical expertise and others more educationalexpertise. Some roles have more direct face-to-facecontact with students and others less. The roles arepresented in a ‘competing values’ framework – they

may convey conflicting messages, eg providinginformation or encouraging independent learning,helping the student or examining their competence.

The role model framework is of use in the assessmentof the needs for staff to implement a curriculum, inthe appointment and promotion of teachers and inthe organisation of a staff development programme.

Some teachers will have only one role. Most teacherswill have several roles. All roles, however, need tobe represented in an institution or teachingorganisation. This has implications for theappointment of staff and for staff training. Wherethere are insuff icient numbers of appropriatelytrained existing staff to meet a role requirement, staffmust be reassigned to the role, where this is possible,and the necessary training provided. Alternatively ifthis is not possible or deemed desirable, additionalstaff need to be recruited for the specific purpose offulfilling the role identified. A ‘role profile’ needsto be negotiated and agreed with staff at the time oftheir appointment and this should be reviewed on aregular basis.

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Medical education has seen major changes over thepast decade. Integrated teaching, problem-basedlearning, community-based learning, core curriculawith electives or options and more systematiccurriculum planning have been advocated (Walton1993, General Medical Council 1993, Harden et al1984, Harden 1986a, Harden and Davis 1995).Increasing emphasis is being placed on self directedstudy with students expected to take moreresponsibility for their own learning (Rowntree1990). The application of new learning technologieshas supported this move. New directions can beidentif ied too in the area of assessment withincreased emphasis on performance assessment, theuse of techniques such as the objective structuredclinical examination, the use of standardised patients,log books, portfolio assessment and self assessment(Scherpbier et al 1997).

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The increasing emphasis on student autonomy inmedical education has moved the centre of gravityaway from the teacher and closer to the student.

Indeed it has become fashionable to talk aboutlearning and learners rather than teaching and theteacher. This increased attention to the learner maybe seen by teachers as a loss of control and powerwhich can lead to feelings of uncertainty, inadequacyand anxiety (Bashir 1998). The shift may even beseen as, in some way, a devaluing of the role of theteacher. It has to be recognised, however, that this isnot true, that teaching and learning are closely relatedand that the purpose of teaching is to enhancelearning. It is important to ensure that the changingrole of the teacher is not neglected in discussionsabout new educational strategies and approaches tocurriculum development.

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The changing role of the teacher may cause uneaseamong those entrenched in traditional approachesto education. The Rt. Hon. Sir Rhodes Boyson MP(1996), former headmaster of Highbury GroveComprehensive in North London, wrote “Too often,the teacher has degenerated into an uneasy mixtureof classroom chum, social worker and amateurcounsellor” (p44).

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Brew and Boud (1998) have highlighted the morecomplex demands now being placed on universityteachers and the changing nature of their work tasks,with new academic roles and the diversification ofexisting ones. “There has been a significant shift”they suggest “from thinking that clever people cando everything to a recognition of the complexity andrange of academic work” (p18). The tasks facing ateacher are not simple or easy. “Teaching” suggestedBrookfield (1990) “is the educational equivalent ofwhite water rafting”.

While the Dearing report on higher education (1997)praised British universities for their world classrecord, it highlighted the pressures on teachers andthe poor quality of their teaching. “There is nodoubt”, Dearing suggested, “about the increasedpressures facing staff in higher education”. Boldpredictions about the impact of technology onteaching methods have not been realised and theadoption of recommended new approaches inmedical education have been disappointing (GeneralMedical Council, 1993). Why is this? Much of theresponsibility for these failures rest with the teachers.Teachers have been slow to identify with and embracethe new roles expected of them. The result has beento hold back many changes in medical education.

One change in higher and continuing education isthe acceptance of distance learning as a significantapproach. The embedding of distance learning inmainstream medical education involves the adoptionof an approach to learners and learning which isdifferent from the one with which medical teachershave experience. Concern has been expressed thatthe consequences will be “the likely underminingof the respect, prestige and authority that goes withthe teacher’s role as ‘director of learning’ and theloss of their ability to engage their students intointellectual conversations and debates” (Bashir1998). If the adoption of distance learning is toflourish in medical education then teachers mustaccept the different roles for the teachers implicit inthis approach to teaching and learning.

What is certain, irrespective of whether we have face-to-face or distance learning and whatever theeducational strategy implemented, the teacher willplay a key role in student learning. In all phases ofeducation, student achievement correlates with thequality of the teacher. Terry Dozier (1998), an adviserto the U S Secretary of Education, emphasised that“if we don’t focus on the quality of teaching, otherreform efforts won’t bring us what we’re hoping for”.The availability of a good teacher, for example, mayhave a greater effect on improving studentachievement than other, much publicised factorssuch as class size.

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The question arises as to what is a good teacher. Agood teacher can be defined as a teacher who helpsthe student to learn. He or she contributes to this ina number of ways. The teacher’s role goes wellbeyond information giving, with the teacher havinga range of key roles to play in the education process.What one sees as good teaching, suggests Biggs(1999), depends on what conception of teaching onehas. Two concepts are based on the strategies ofteacher-centred and student-centred education(Harden et al 1984). Teacher-centred strategies arefocussed on the teacher as a transmitter ofinformation, with information passing from theexpert teacher to the novice learner. Student-centredstrategies, in contrast, see the focus as being onchanges in students’ learning and on what studentsdo to achieve this rather than on what the teacherdoes. “If students are to learn desired outcomes in areasonably effective manner”, Shuell (1986)suggests “then the teacher’s fundamental task is toget students to engage in learning activities that arelikely to result in their achieving those outcomes. Itis helpful to remember that what the student does isactually more important in determining what islearned than what the teacher does”. Biggs goes onto describe the art of teaching as the communicationto students of the need to learn. “Motivation”, hesuggests “is the product of good teaching not itsprerequisite” (p61).

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A key question is: what is the role of the teacher inthe context of the developments taking place inmedical education? There has been little sustainedanalysis of the role of the teacher (Squires 1999). Ingeneral, we have been preoccupied with the detailsof curriculum planning, with the content of theteaching programme and with the range of educationstrategies adopted. We have failed to take a broaderview of the role of the teacher in these tasks.

What are teachers for in our institution? For whatwould they be most missed if they were not there? Itis likely that, faced with these questions, membersof staff would give a range of answers. Uncertaintyand difficulty with the range of roles expected of ateacher is illustrated in the following extracts of lettersfrom teachers regarding their own roles andresponsibilities.

“I was appointed to the University as alecturer to enthuse students about my subjectand to convey to them, through my lectures,the essential information they need to acquire.It is not my job to sit in so-called problem-

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based learning groups watching studentsstruggle, often ineffectively, with a subject newto them and in the process wasting both theirand my time.”

“I am concerned about the amount of time Iam expected to serve on the curriculumcommittee and on the system-based workinggroups, planning the course and its delivery.In my previous post I was simply left to get onand deliver the teaching programme in mysubject, which is what I am employed to do.”

“I carry a heavy clinical, research andteaching burden. I need, therefore, to look athow my time can be used most effectively. Ihave been asked to prepare study guidesrelating to the part of the course for which Iam responsible. I do not think that thepreparation of study guides, which it is claimedwill make learning easier and more effectivefor the student, makes the best use of my time.There is no need to spoon feed students in thisway. If they attend my lectures and clinicalteaching sessions they will soon find out whatit is that they are expected to learn.”

Fortunately, not all teachers share these roleambiguities as illustrated in a further set of extracts.

“I greatly enjoyed working last term with thestudents in the PBL groups. My previousexperience as a teacher had been with a moredidactic approach and an emphasis on

lectures. I found this new method, by far, amore rewarding experience for me as ateacher. I am convinced that the studentsbenefit from the more active participation intheir own learning that inevitably occurs.”

“Thank you for giving me the opportunity tomeet with the students and go over with themtheir responses in the recent ObjectiveStructured Clinical Examination. A number ofstudents subsequently told me that they foundthis one of the most powerful learning sessionsthis year.”

“I welcome the time I have been given off myroutine teaching duties to prepare a series ofcomputer-based learning programmes in mysubject. This will allow us to replace about halfof the lectures currently scheduled withopportunities for the student to engage inindependent learning and critical thinking. Wewill be able also to make better use of theremaining lectures scheduled.”

Unless we agree what roles of a teacher we need forour institution, we cannot seriously attempt to appointappropriate teachers to the post, we cannot arrangeuseful staff development activities and we cannotdefine ‘good teaching’ and reward it by promotionor other recognition. This guide presents a model orframework in which the teacher’s expanded role ineducation today is described. It identifies twelve rolesfor the medical teacher. The implications and use ofthe model are discussed.

�� The twelve roles described in the model presentedhave been identified from three sources:

❑ from an analysis by the authors of the tasksexpected of the teacher in the design andimplementation of a curriculum in one medicalschool (Harden et al 1997)

❑ from a study of the diaries kept by 12 medicalstudents over a three month period and an analysisof their comments as they related to the role ofthe teacher

❑ from the literature relating to the roles of a teacheridentified in Medline and the TIME (Topics InMedical Education) database and from medicaleducation texts including Cox and Ewan (1988)and Newble and Cannon (1995).

The six areas of activity of the teacher can besummarised as:

1 The teacher as information provider

2 The teacher as role model

3 The teacher as facilitator

4 The teacher as assessor

5 The teacher as planner

6 The teacher as resource developer.

Using a musical metaphor, the roles of the teachermay be likened to the performance of an orchestralpiece of music. The composer is the planner whohas the inspiration and delineates the music to beplayed. The conductor interprets the composer’sscore and facilitates and guides the players toperform the music and the audience to appreciate

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the music. Resources in the form of sheet music forthe players and programmes for the audience haveto be developed to enable the musicians to producethe music and for the audience to fully appreciatethe experience. Finally the musicians transmit themusic to the audience – they are the ‘informationproviders’. This ‘performer role’ (Harris and Bell1996) may include all or just one of the orchestralensemble. Individual members of the orchestragiving solo performances may be perceived as rolemodels. Finally the conductor evaluates themusicians’ performance in private and the musiccritic and the audience assess the performance inpublic.

Each of the six roles described can be subdividedinto two roles, making a total of twelve roles asillustrated in Figure 1. Roles to the right in the figurerequire more content expertise or knowledge, androles to the left more educational expertise.

Roles to the top are associated with face-to-facecontact with students, and the roles to the bottomare associated with less student contact. Figure 2shows how the 12 roles of the teacher can be viewedin the context of the relationships that exist betweenthe student, the teacher and the curriculum.

The twelve roles identif ied were validated by aquestionnaire sent to 251 teachers at different levelsof seniority, in the medical school at the Universityof Dundee. The twelve roles were described in thequestionnaire and staff were asked to rate, on a 5point scale, the relevance to the medical school ofeach of the twelve roles identif ied where 1 =definitely no, 2 = probably no, 3 = uncertain, 4 =probably yes and 5 = definitely yes. The respondentsrecognised all twelve roles identif ied as theresponsibilities of a teacher. The mean rating for eachof the roles ranged from 3.5 to 4.2 and is shown inTable 1.

Curriculumand learningopportunities

Teacher

Information providerRole model

Student ▼

▼ ▼

▼

▼

▼▼

PlannerResource material developerAssessor

Study guidesproducer Facilitator

Figure 2The roles of the teacher in the context of the teacher/

student/curriclum framework

Figure 1The twelve roles of the teacher

Teacher’s role Mean rating Teacher’s role Mean rating

Information provider Examiner1 Lecturer in 7 Planning or participating in

classroom setting 3.6 formal examinations of students 3.9

2 Teacher in clinical or practicalclass setting 4.2 8 Curriculum evaluator 3.6

Role model Planner3 On-the-job role model 4.2 9 Curriculum planner 3.8

4 Role model in the teaching setting 3.6 10 Course organiser 3.9

Facilitator Resource developer5 Mentor, personal adviser or tutor 3.5 11 Production of study guides 3.5

6 Learning facilitator 3.8 12 Developing learning resource materialsin the form of computer programmes,videotape or print 3.6

Table 1Mean rating for each of the twelve roles

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Table 2Questionnaire used to assess the teacher’s perception of the importance of the twelve roles and their

current personal commitment and preferred personal future commitment to each role

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��In this section we explore each of the twelve rolesidentified in more detail.

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�� Traditionally students expect to be taught. Theybelieve that it is the responsibility of the teacherto pass on to them the information, knowledgeand understanding in a topic appropriate at thestage of their studies. This leads to the traditionalrole of the teacher as one of provider ofinformation in the lecture context. The teacher isseen as an expert who is knowledgeable in his orher field, and who conveys that knowledge tostudents usually by word of mouth. Intransmitting the knowledge, the teacher may alsoassist the student to interpret it using one of avariety of educational strategies by which theteacher explains the subject matter to the student(Brown and Atkins 1986).

Despite the availability of other sources ofinformation, both print and electronic includingexciting interactive multimedia learning resourcematerials, the lecture remains as one of the mostwidely used instructional methods. It can be acost-effective method of providing newinformation not found in standard texts, of relatingthe information to the local curriculum and contextof medical practice and of providing the lecturers’personal overview or structure of the f ield ofknowledge for the student. In a study of teacherswho had received awards for ‘excellent teaching’,Johnston (1996) found that although the teachersdid not speak specif ically of teaching astransmitting the content of their subject,disciplinary knowledge was at the heart of theirteaching approaches. The teachers used interactiveways, including the lecture, to pass this knowledgeon to the students.

There has been, however, a general call for areduction in the number of lectures scheduled inthe curriculum, and a tendency for new medicalschools to move away from their use as a learningtool. The exclusion of the lecture from theteachers’ tool box, however, has been questionedand rightly so. A lecture in which the infectiousenthusiasm of an expert, who is also a goodcommunicator, excites or motivates the studentshas much to commend it.

The importance attached to the role of the teacheras an information provider is partly cultural.Gokcora (1997), for example, found that Chinese

students valued more than American students theprofessor’s knowledge of the subject and theirtransmission of this to the students.

�� The clinical setting, whether in the hospital or inthe community, is a powerful context for thetransmission, by the clinical teacher, ofinformation directly relevant to the practice ofmedicine. The teacher selects, organises anddelivers information. This is achieved duringteaching ward rounds, ward-based tutorials ormore informally with the student in the role ofthe clinical apprentice. In clinical teachingattachments, the most important factor related tostudent learning may be the quality of the clinicalteacher. Good clinical teachers can share with thestudent their thoughts as a ‘reflectivepractitioner’, helping to illuminate, for thestudent, the process of clinical decision making.

In a study of distinguished clinical teachers, Irby(1994) concluded that a key element in teachingis the organisation and presentation of medicalknowledge “so that learners can comprehend itand use it to satisfy their learning objectives”(p340).

The clinical teacher explains the basic skills ofhistory taking and physical examination inclinical practice-based and simulated situations.Increasing use is being made of simulators toteach clinical skills (Gordon et al, 1999). Thisrequires of the teacher additional skills not neededin more traditional clinical teaching. One area ofcontroversy in medical education is the extent towhich clinical skills learning units should havespecif ically recruited and trained staff, whoserole is to teach in the unit or whether teacherswho teach in the clinical practice-based contextshould also be expected to teach in the clinicalskills unit.

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��The importance of the teacher as a role model iswell documented. Walton (1985) concluded“Sociological research has demonstrated theextent to which an important component oflearning derives from the example given in theirown person by teachers, who signif icantlyinfluence medical students in many respects, suchas in their choice of future career, their

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professional attitudes, and the importance theyassign to different subjects” (p50). The GeneralMedical Council (1999) in the UK acknowledgesthat “the example of the teacher is the mostpowerful influence upon the standards of conductand practice of every trainee, whether medicalstudents or junior doctor” (p1).

The teacher as a clinician should model orexemplify what should be learned. Students learnby observation and imitation of the clinicalteachers they respect. Students learn not just fromwhat their teachers say but from what they do intheir clinical practice and the knowledge, skillsand attitudes they exhibit. “Being a role model”suggested McAllister et al 1997, “is widelyrecognised as critical in shaping, teaching,coaching and assisting future clinicians as it isthe most powerful teaching strategy available toclinical educators” (p53). Role modelling is oneof the most powerful means of transmittingvalues, attitudes and patterns of thoughts andbehaviour to students (Bandura 1986) and ininfluencing students’ career choice (Campos-Outcalt et al 1995).

The f irst native American physician, CharlesAlexander Eastman (1991), described theimportance of the role model in the education ofan Indian. “We watched the men of our peopleand acted like them in our play, then learned toemulate them in our lives” (p20). Ullian et al(1994) described as the ‘physician’ role, themodelling by the teacher of knowledge and skillsthrough performing medical duties. “As clinicianswe overtly teach by example, whether we chooseto or not” suggested Westberg and Jason (1993).“Any time that learners witness us doing whatthey view as their future work or way of being,we are serving as role models. The admonition inthe old aphorism “Do as I say, not as I do”, seldomworks. What we do is likely to have more impacton learners than what we tell them to do” (p155).

Indeed role modelling may have a greater impacton the student than other teaching methods. Falvoet al (1991), for example, found role modellingto be educationally more effective than lecture/discussion sessions in enhancing the students’ability to communicate with patients aboutimmunodef iciency virus. Douglas (1999)describes vividly her experience of terminal careas a trainee and the lessons learned from hertrainer. “Jimmy (her trainer) was an inspirationaldoctor and man, and I miss him terribly. Hislegacy to me, as a trainer myself now, is to remindme of the importance of teaching by example,which matters as much as, if not more than,

anything that happens in a tutorial” (p889). Theimportance of the role model was emphasised tooby Sir Donald Irvine (1999), President of theGeneral Medical Council in the UK. He suggestedthat “the model of practice provided by clinicalteachers is essential because students learn bestby good example” (p1175). Better medicalstudents who work with the best internal medicineattending physicians and residents in their internalmedicine clerkship are more likely to choose aninternal medicine residency Griffith et al (2000).

There has not been a great deal of research onwhat makes an important role model from astudent perspective. Wright (1996) found thatstudents rated low, in terms of importance in rolemodels, seniority or title and research ability. Themost important physician characteristics foundin role models identified by students (Ambrozyet al 1997) were:

❑ expresses enthusiasm for speciality

❑ demonstrates excellent clinical reasoningskills

❑ establishes close doctor-patient relationships

❑ views the patient as a whole.

The most important teacher characteristicsidentified were:

❑ expresses enthusiasm for teaching

❑ actively involves students

❑ communicates effectively with students.

Althouse et al (1999) examined how clinicalinstructors, designated by their medical studentsas influential role models, described theirteaching and their relationships with the students.“Medical students and their models did notgenerally spend large amounts of time together.Often they met only briefly after patientencounters to discuss care of a specific patient.This finding indicated that the quantity of timephysicians spent with their students was notnearly as important as the quality of the time.Regardless of the amount of time spent together,students chose models who were more than justa good instructor or clinically competent.Students chose models who demonstrated adedication to their speciality and patients, a loveof teaching, and a caring personality, whichfostered an environment of mutual respect. Therole models were genuinely interested infacilitating the growth of the students, whichmanifested in being selected by students as amodel” (p120).

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��Teachers serve as role models not only when theyteach students while they perform their duties asdoctors, but also when they fulfill their role asteachers in the classroom, whether it is in thelecture theatre or the small discussion or tutorialgroup. The good teacher who is also a doctor candescribe in a lecture to a class of students theirapproach to the clinical problem being discussedin a way that captures the importance of thesubject and the choices available. The teacher hasa unique opportunity to share some of the magicof the subject with the students. They can kindle,in the students, a curiosity and quest for a betterunderstanding of the topic and the relevantpathophysiology by their own personal examplethat is difficult to reproduce in an instructionaltext or computer programme. One problemfacing medical education today is that manyteachers of medical students, particularly in thebasic sciences, but also in clinical departments,are not medically qualif ied. This may haveimplications for role modelling. One result is thatstudents may have more difficulty understandingthe relevance of what they are learning to theirfuture career as a doctor.

Reviewing the roles of teachers, Squires (1999)noted that “it is important to identify modellingas a distinct function and heading in order to drawattention to what is a pervasive but sometimesunconscious, and even denied process ineducation. Teachers may not see themselves asmodels, and may even regret the very idea aspretentious and paternalistic, but it is difficult forlearners not to be influenced by the livingexample set before them.”

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�� The move to a more student-centred view oflearning has required a fundamental shift in therole of the teacher. No longer is the teacher seenpredominantly as a dispenser of information orwalking tape recorder, but rather as a facilitatoror manager of the students’ learning. The moreresponsibility and freedom given to the student,the greater the shift required in the teachers’ role.Not all teachers adapt to this different role. “Manyteachers” suggested Jacques (1991), find the taskof facilitator “difficult to perform satisfactorilyand fall back with some disappointment on theirreserve position of authority, expert and primetalker”.

The introduction of problem-based learning witha consequent fundamental change in the student-teacher relationship has highlighted the changein the role of the teacher from one of informationprovider to one of facilitator. The teacher’s role isnot to inform the students but to encourage andfacilitate them to learn for themselves using theproblem as a focus for the learning (Barrows andTamblyn 1980, Davis and Harden 1999). Thischanging role of the teacher is also reflected inthe constructivist approach to learning, in whichknowledge is ‘constructed’ in the mind of thestudent and is constantly evolving (Brooks andBrooks 1993). It is the role of the teacher tofacilitate this process rather than to act simply asan information provider. Schmidt and Moust(1995) looked at the characteristics of an effectiveteacher in a problem-based curriculum. Teachersneeded the ability to communicate with studentsin an informal way in the small groups sessions,and to encourage student learning by creating anatmosphere in which open exchange of ideas wasfacilitated. Teachers were able to function mosteffectively if, in addition to those skills, they alsohad subject-based knowledge.

The increasing availability and use of learningresource materials also brings with it the needfor the teacher as a learning facilitator. No set ofcourse materials, whether in print or electronicformat, is perfect for all students. It is theresponsibility of the teacher to facilitate thestudent use of the resources by overcoming anydeficiencies in the materials and by integratingthem with the curriculum.

The facilitative relationship between students andteachers is perceived by both as a key element instudent learning and one that distinguishes goodfrom poor clinical teaching (Christie, Joyce andMoller 1985). This role – of the teacher as afacilitator in the clinical setting – has been referredto as the ‘supervisor’ role, with the teacherproviding the student with opportunities forworking in the clinical context, observing thestudent and giving feedback (Ullian et al 1994).

��The role of mentor is a further role for the teacherwhich is in vogue. Everyone has a mentor or isbeginning to want one, suggest Morton-Cooperand Palmer (2000). The role however is oftenmisunderstood or ambiguous. There remains‘considerable semantic and conceptual variabilityabout what mentoring is and does, and what amentor is and does’ (SCOPME 1998, p5).

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Megginson and Clutterbuck (1995) have definedmentoring as “off-line help by one person toanother in making signif icant transition inknowledge, work or thinking.” The mentor isusually not the member of staff who is responsiblefor the teaching or assessment of the student andis therefore “off-line” in terms of relationship withthe student. Mentorship is less about reviewingthe students’ performance in a subject or anexamination and more about a wider view ofissues relating to the student. The mentor, suggestsMegginson and Clutterbuck, has a role to helpthe learner grasp the wider signif icance ofwhatever is happening.

Mentoring can be viewed as a special relationshipthat develops between two persons with thementor always there for support but notdependency (Ronan 1997). Lingham and Gupta(1998) defined mentoring as a process by whichone person acts towards another as a trustedcounsellor or guide. It is not for educationalsupervision. It is about helping a person to learnwithin a supportive relationship. It may be a singleevent but is usually a longer relationship.

Easton and Van Laar (1995) showed that 97% ofrespondents in a survey of University lecturersreported having helped at least one student indistress during the previous year. Grayson et al(1998) found that students both expect and wanttheir lecturers to be a source of help. ProfessorJohn Radford, addressing a meeting of the BritishPsychological Society in 1996 on receipt of anaward for the teaching of psychology, suggestedthat in some respects academics resembled priestswho had a caring, pastoral role.

Three emerging models for the teacher as mentoroutlined by Morton-Cooper and Palmer (2000)are:

1 The apprenticeship model and the mentor asskilled craftsperson. This role includeslearning by observing. This is sometimesreferred to as ‘sitting by Nellie’

2 The competence-based model and the mentoras trainer. This encompasses the role of thetrainer as an instructor and coach whodemonstrates and assists the student to achievea set of competencies.

3 The reflective practitioner model and mentoras critical friend and co-enquirer. This includesthe promotion of collaboration and partnershipin the learning process.

As can be seen, there are different concepts ofwhat is a mentor. Some of the mentor rolesdescribed overlap with other roles identified inthis guide.

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��The assessment of the student’s competence isone of the most important tasks facing the teacher.“Good teachers know how they must assess theirstudents’ learning” suggested Mapstone (1996)“and they want to do it well.” Ian Lang, whenScottish Secretary and resisting pressure forparents to choose whether their children took partin national testing in primary schools, put it ratherwell: “I believe that teaching without testing islike cooking without tasting”.

Assessment has emerged as a distinct area ofactivity for the medical teacher and one that maydominate the curriculum. It offers perhaps thegreatest challenges facing medical educationtoday. “Educational achievement testing”suggested van der Vleuten (1996) “is an area ofturmoil in the health sciences” (p41). It is an areawhere the number of instruments available hasincreased dramatically but where their value maybe difficult to determine in a field at risk of beingdominated by the psychometrics.

Examining does represent a distinct andpotentially separate role for the teacher. Thus it ispossible for someone to be an ‘expert teacher’but not an expert examiner. All institutions nowneed on their staff some teachers with a specialknowledge and understanding of assessmentissues. Such individuals act as test developers andprovide guidance on the choice of instrument,marking procedures and standard setting.Examining however, must also be regarded as anintegral part of the teacher’s role and part of theoccupation of teaching in higher education (Piper1994). Most teachers have something tocontribute to the assessment process. This maybe in the form of contributing questions to aquestion bank, of acting as examiners in an OSCEor a portfolio assessment and of serving on aboard of examiners faced with the key decisionof who should pass and who fail the examination.The assessment of students is an integral part ofteaching, suggests Whitman et al (1984), andrequires the development of rapport and genuineinterest in the student (p30).

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The assessor role of the teacher is often perceivedas different from the other roles. While asinformation provider, role model, facilitator andcurriculum planner, the aim of the teacher is toassist the student in a variety of ways to achievethe course goals, as an assessor the teacher hasthe role of passing judgement on the student. Thisis particularly true in summative assessment, butis less so with formative assessment where theboundaries between assessment and teachingbecome increasingly blurred.

The teacher’s role as an assessor is an importantone. Murray et al (1996) suggested “Given theimportance of assessment of student performancein university teaching and in students’ lives andcareers, instructors are responsible for takingadequate steps to ensure that assessment ofstudents is valid, open, fair, and congruent withcourse objectives.” Students can walk away frombad teaching, suggests Boud (1990), but they areunable to do so with regard to assessment.

�� The teacher has a responsibility not only to planand implement educational programmes and toassess the students’ learning, but also to assessthe course and curriculum delivered. Monitoringand evaluating the effectiveness of the teachingof courses and curricula is now recognised as anintegral part of the educational process. Thequality of the teaching and learning process needsto be assessed through student feedback, peerevaluation and assessment of the product of theeducational programme. Curriculum and teacherevaluation is a form of accountability whichemphasises the obligation of those employed inthe education system to be answerable to thepublic, to the profession, to those who fund theeducation and to the students themselves. In thissense evaluation is an instrument of managementand control (Nisbet 1990).

Evaluation can also be interpreted as an integralpart of the professional role of teachers,recognising teachers’ own responsibility formonitoring their own performance. Part of theexpectation of the professional role of the teacheris as assessor of their own competence as ateacher. “Standards are the most effective whenwe set them ourselves” suggests Nisbet (1986).“Professionalism requires from us the capacityto apply the highest standards to ourselves evenwhen there is no one but ourselves to judge…This is what we try to teach our students… Theylearn (or do not learn) from our example.” Course

evaluation is thus part of every teacher’sresponsibilities. Within the context of thecurriculum, however, some teachers may beexpected to assume greater responsibility foroverall assessment of the teaching and some mayhave this as a major personal responsibility.

Curriculum evaluation has been defined (Colesand Grant 1985, p405) as “a deliberate act ofenquiry which sets out with the intention ofallowing people concerned with an educationalevent to make rigorous, informed judgements anddecisions about it, so that appropriatedevelopment may be facilitated.” The assessmentof teaching and of the curriculum can beconducted at an institutional level with the teacherone of the stakeholders in the process. Just asimportant is the self-evaluation by the teacher ofhis or her teaching with the individual teachersreflecting on and analysing their own teaching.

Feedback from students and other teachers or‘critical friends’ may be brought in to provide afurther insight and to identify areas in teachingfor the teacher’s growth and development. Themost widely used technique for obtainingfeedback from students for the purpose ofevaluating the teacher is the questionnaire. Theuse of focus groups, the nominal group technique,a Delphi technique, interviews with individualstudents and a study of diaries kept by studentsmay give information which is perceived by theteacher as of more value (Tiberius et al 1987).

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�� Most medical schools and postgraduate bodieshave education committees charged with theresponsibility for planning and implementing thecurriculum within their institution. Teachersemployed by the school and members of thepostgraduate institution may be expected to makea contribution to curriculum planning. Teacherscan undertake few activities, suggests Diamond(1998), that will have greater impact on theirstudents than their active involvement in thedesign of a curriculum or course they teach.Curriculum planning is an important role for theteacher. Different approaches to curriculumplanning can be adopted (Harden 1986b) andthere are 10 issues that need to be addressed(Harden 1986a). The following should bespecified:

❑ The needs that the curriculum should meet

❑ The expected learning outcomes

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❑ The content to be included in the curriculum

❑ The organisation of the content

❑ The educational strategies

❑ The teaching methods

❑ The assessment procedure

❑ Communication about the curriculum to staffand students

❑ The educational environment

❑ Procedures for managing the curriculum.

Curriculum planning presents a signif icantchallenge for the teacher and both time andexpertise is required if the job is to be undertakenproperly.

��The best curriculum in the world will beineffective if the courses which it comprises havelittle or no relationship to the curriculum that isin place. Once the principles which underpin thecurriculum of the institution have been agreed,detailed planning is then required at the level ofthe individual course or phase of the curriculum.Traditionally much of the planning was disciplineor subject-based. More recently there has been amove to inter-disciplinary or integrated teaching(Harden 2000). Such approaches need to bereflected in course design. Course planning, likeplanning the curriculum as a whole, requiresdedicated time of individuals. The task issignif icantly more demanding in integratedprogrammes, but it is generally accepted that thisis a small price to pay for the advantages ofintegrated teaching. Lack of attention to detailmay lead to problems with the teachingprogramme.

Participation in course planning gives the teacheran opportunity to exert a significant influence onthe educational process and to design courseswhich will achieve the learning outcomesspecified by the institution. “Teachers in highereducation” suggest Toohey (1999) “retain a verysignif icant advantage over teachers in otherbranches of education: their control of thecurriculum. In much of primary, secondary,technical and vocational education, course designhas been handed over to ‘experts’, to theimpoverishment of the role of classroom teachers.Yet course design is an advantage of which manyteachers in universities seem quite unaware. Muchof the creativity and power in teaching lies in thedesign of the curriculum: the choice of texts and

ideas which become the focus of study, theplanning of experiences for students and themeans by which achievement is assessed. Thesedef ine the boundaries of the experience forstudents. Of course the way in which thecurriculum is brought to life is equally important,but the power of good teacher-student interactionsis multiplied many times by course design.”

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�� An increased need for learning resource materialsis implicit in many of the developments ineducation. With problem-based learning and otherstudent-centred approaches, students aredependent on having appropriate resourcematerial available for use either as individuals orin groups. Even in traditional curricula, studentsspend as much time with their workbooks as withtheir teachers.

The role of the teacher as resource creator offersexciting possibilities. Teachers will become,suggests Ravet and Layte (1997) “activitybuilders, creators of new learning environments.”Indeed, the vision has been painted of the virtualuniversity in which lecturers are replaced byinstructional designers. The new technologieshave greatly expanded the formats of learningmaterials to which the student may have accessand make it much easier for the student to takemore responsibility for their own education. Asdevelopers of resource materials, teachers mustkeep abreast with changes in technology. Aninvestment in the further development ofcomputer based learning material is needed. Theuse of computers in education is expanding andsome schools make the purchase of computersby students compulsory. Computer-basedlearning however is often limited by the lack ofgood material for use by students (Platt andBairnsfather 1999).

Institute wide use of resource materials to supportlearning using traditional paper media or newtechnologies, however, will occur only if at leastsome teachers possess the array of skills necessaryto select, adapt or produce materials for usewithin the institution. The raising awareness andthe training of staff in the role of resourcedeveloper is necessary for the appropriatedevelopment within an institution of technologysupported learning (Longstaffe et al 1996; Ryanet al 1996).

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The twelve roles model for the teacher provides anunderstanding of the different views of the functionsfulf illed by the teacher and a framework for thefurther consideration of these. The explicitidentif ication of the twelve roles and theirarrangement in the circle offers a useful model orframework for teachers, for curriculum planners andfor administrators in an institution to think and makedecisions related to teaching. The description of the12 roles is not intended as a guideline on how toteach or the methods and educational strategiesavailable. The circle represents the overall functionsto be filled by a teacher and the segments within thecircle represent the key elements that go to make upthe overall picture. The position of the differentsegments or roles relative to each other is significantand each quadrant of the circle has a differentemphasis. On the north/south axis is the relationshipwith students – either face-to-face or at a distance.On the east/west axis is the area of competence ofthe teacher – in education or in medicine.

Quinn (1996) has used a similar approach to presenta model for the functions of a manager. He describedthis as a ‘competing values framework’ with the

�� The trend from the teacher as an informationprovider to the teacher as a manager of students’learning has been discussed. While learning isfacilitated by face-to-face contact with students,the amount of time available for this is restrictedand can provide only to a limited extent thenecessary guidance for students. Study guidessuitably prepared in electronic or print form canbe seen as the students’ personal tutor available24 hours a day and designed to assist the studentswith their learning. Study guides tell the studentwhat they should learn � the expected learningoutcomes for the course, how they might acquirethe competences necessary � the learningopportunities available, and whether they havelearned it � the students assessing their owncompetence (Laidlaw and Harden 1990). Studyguides can be used in both undergraduate andpostgraduate education (Mitchell et al 1998).

The role of teachers as a producer of learningresource materials was highlighted in the previoussection. It can be argued however that it is notcost-effective for the teacher to reinvent the wheel

and produce instructional material and handoutson topics that are already covered in books orother resource materials.

What may be more valuable is for the teacher toidentify the best resources available, direct thestudents to these and guide the students’ use ofthem in study guides prepared by the teacher.

Study guides can facilitate learning in three ways(Harden et al 1999).

❑ assisting in the management of studentlearning

❑ providing a focus for student activities relatingto the learning

❑ providing information on the subject or topicof study.

A ‘study guide triangle’ model can be used torepresent these different functions, with onefunction at each point of the triangle. Guides canbe placed at different points in the trianglereflecting the relative emphasis on these threefunctions.

management functions within the quadrants of theframework carrying a conflicting message. In thesame way the different teaching roles appears at firstsight to conflict with each other. We see the teacheras a provider of information but also as a facilitatorof learning, encouraging the student to takeresponsibility for acquiring his or her owninformation. The teacher is a facilitator, helping thestudent to learn, but also is an assessor whose role isto pass judgement on the student. Within theframework these opposing views of a teacher’s rolecan mutually exist. Neighbouring roles in the circlemay compliment each other, eg the facilitator androle model. As set out in Figure 1 (p6) the dimensionsin the circle are not necessarily orthogonal. The fourquadrants into which the dimensions divide the map,however, are of equal importance and so they canbe considered orthogonally.

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There is a need for a better understanding of thenature and practice of academic work includingteaching (Blaxter et al 1998) and for theinterconnectedness of different academic roles. Joyceet al (1997) describes the problem. “Thinking about

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the roles that make up teaching can make you dizzy.Just for starters, these roles include helping studentsgrow in understanding, knowledge, self-awareness,moral development and the ability to relate to others.Simultaneously we are mangers of learning,curriculum designers, facilitators, counsellors,evaluators and, reluctantly, disciplinarians. To thebest of our ability, we modulate across rolesaccordingly to individual and group needs as weselect and create learning experiences for all ourstudents” (p11).

While each of the twelve roles has been describedseparately, in reality they are often interconnectedand closely related one to another. Indeed a teachermay take on simultaneously several roles. Anexample is the lecture situation where teachers maysee as their main function the provision ofinformation. They may choose, however, to adopt amore interactive approach, providing the studentswith some information but at the same timeencouraging them during the lecture to engage withthe subject and come up with their own solutions toproblems posed. During the lecture the teachercannot escape from being a potential role model,with how he approaches the subject and the attitudeshe reveals influencing the student. Similarly in theproblem-based tutorial group the teacher’s mainresponsibility is as facilitator but he may at timesalso serve as an information provider. This mayexplain why students who were facilitated by subjectmatter experts achieved somewhat better results thanthose facilitated by teachers who did not have thisbackground (Schmidt and Moust 1995).

Teachers may be engaged simultaneously in acombination of teaching tasks. White and Ewan(1991) have referred to the multiple teaching rolesoften needed within a single clinical teachingexperience and Irby (1994) described how clinicalteachers need to assess learners’ knowledge andprovide information as well as facilitate learning. Asthe teaching situations arise, a good teacher willmove instinctively between different roles. The goodclinical teacher for example needs to fulfil a rangeof roles (McAllister et al 1997).

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It needs to be emphasised that a good teacher neednot be competent in all twelve roles and that it wouldbe unusual to find, and unreasonable to expect oneindividual to have all the required competencies.Human resource planning should involve matchingteachers with the roles for which they have thegreatest aptitude.

Teachers will have an interrelated set of teaching roleswhich combined represent their teachingresponsibilities and their “role portfolio”. While allthe roles of a teacher need to be covered in thecontext of an institution, it is unlikely that one teacherwill assume all of the roles. A few teachers mayassume only one role and indeed may have beenappointed with this specif ic responsibility. Themajority of teachers however will assume a numberof roles.

Medical practice and approaches to medicaleducation are changing and there is a continuingneed to re-examine the role of the teacher in theeducational process. Different roles require differentskills and abilities in the teacher. All teachers maybe expected however to fill roles such as informationprovider, while other roles, such as resourcedeveloper or assessor, may require more specialisedskills.

The functions of the teacher are complex and therole will vary depending on:

❑ The aim of a course. Is the aim to developindependent learning skills or to provide thetrainee with specif ic competencies, such ascardiac auscultation?

❑ The stage of the student. The importance of thedifferent roles for the undergraduate teacher maydiffer from the roles expected of the postgraduateteacher.

❑ The curriculum within which the teacher operates.The roles of the teacher will differ in a problem-based learning curriculum compared with thosein a more traditional curriculum.

❑ The culture. Some cultures favour more informalroles of teachers and others more didactic roles.

The roles most appropriate for an individual teachermay change as his or her career develops. The rolestaken on by a teacher may vary with the seniority ofthe teacher and may change as the teacher gains moreexperience. Kugel (1993) has suggested that teachingactivities evolve with time and experience, with ashift taking place from an emphasis on self, to anunderstanding of subject matter and later from anemphasis on teaching to an emphasis on learning.

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Identification of the required and available teachingroles in an institution makes it possible, within theconstraints of the curriculum, to match a teacher withthe roles to which he/she is best suited. Some teachersprefer and are better at fulfilling certain roles, while

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other teachers may be interested in and have expertisein other directions. It may help with the assignationof teaching roles in a faculty if staff have the optionto indicate their own preferred roles. They may beasked to compare their current roles with theirpreferred roles using a questionnaire as in Table 2(p7). The teaching responsibilities can then beallocated within an institution taking account, wherepossible, the preferences of staff. Some staff mayhave an interest in curriculum planning and servingon curriculum committees, while others prefer to haveface-to-face contact with students, for example inthe clinical teaching contexts. The former can beappointed to curriculum planning groups and thelatter can be given clinical teaching responsibilities.

An analysis of the roles expected of teachers for theimplementation of the curriculum and a comparisonof these required roles with the role expertiseavailable within the teachers in an institution,demonstrates the strengths and weaknesses in termsof the ability of a school to deliver its teachingprogramme. Where there are no major discrepanciesbetween the available and the required roles, it maybe sufficient to highlight where the discrepanciesexist. Recognising the deficiencies and the need toaccommodate the full range of roles, discussing thematter openly and placing it on the agenda atexecutive and staff meetings may be all that isrequired. Where there are more serious discrepanciesbetween required and available roles there arenumber of options.

❑ Ignore the deficiencies. This is usually a recipefor disaster with frustration developing on the partof both staff and students. An adverse effect onthe quality of teaching is almost inevitable.

❑ Change the curriculum to accommodate theavailable teaching roles. If for example, a schoolis populated by good lecturers who lack expertisein group facilitation, one can design thecurriculum to place an emphasis on lectures ratherthan on problem-based learning where there is aneed for tutor facilitated small group work. Thecompromises that such an approach entails mayor may not be acceptable and an institution hasto make this judgement.

❑ Retrain staff within the institution to fulfil therequired roles. This is possible but requires acommitment from the staff and administration andan energetic and focussed staff developmentprogramme.

❑ Recruit staff with the appropriate expertise to fillthe roles. This is easier in a new school, but mayalso be implemented in an established schoolwhen staff leave or when new appointments are

created. Staff recruitment may be particularlynecessary in the case of more specialised rolessuch as assessment or learning resource materialdevelopment.

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The need for staff development programmes and thetraining of medical teachers in education has beenrecognised. The areas to be covered in suchprogrammes and the particular teacher skills to beaddressed are often a matter of debate. Aconsideration of the “twelve roles” can inform thedebate and ensure that the programme helps to equipthe teachers with the compencies necessary for themto fulf il the roles expected of them. A staffdevelopment programme can be tailored to meet theneeds of the individual teacher and this may succeedwhere “one size fits all education” may fail (Tyree1996). There should be an agreement with theindividual teacher whether the aim of a staffdevelopment activity is to make the teacher better atwhat he/she already is doing or to help him/her toacquire new skills and fulfil new roles which werepreviously not within his/her remit.

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Consideration of the roles of the teacher should bepart of the culture of good teaching practice. Tyree(1996) conceptualised our current understanding ofthe importance of the commitment of teachers toteaching and the multi dimensional nature of thephenomenon. There needs to be a commitment bothto the subject which is being taught and to theteaching role expected of the teacher. Attention isoften paid to the former with the latter being relativelyneglected. The different roles of the teacher need tobe recognised and accepted by staff. Use of theframework presented in this guide makes thedifferent roles explicit and encourages a carefulconsideration of the different roles rather than blindlypursuing one or two and undervaluing the others.

Explicit recognition of a teacher’s commitment to aspecific role can reinforce the teacher’s commitmentto teaching and serves also as an indication of thevalue attached by the institution to teaching. Thiscan be reflected in tools used to measure organisationcommitment to teaching (Mowday et al 1979). It islikely that an acknowledgement of the value attachedby the institution to the teacher’s specific roles willencourage teachers to give their best performanceand to put more effort into their teaching.

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The uses of the teachers’ role framework model canbe summarised as follows:

❑ To make explicit an institutions commitment toteaching and to the different roles expected of ateacher. An open discussion about the values ofthe different roles identified in the model mayhelp to prevent a gravitational pull within aninstitution to the information provider section ofthe circle.

❑ To assist with identification of the teaching skillsrequired within an institution. It is important thatwithin a medical school or training institution,all of the roles are represented among the staff inthe school. What is needed is a balanced team ofstaff responsible for delivering all aspects of theteaching programme.

❑ To identify staff recruitment needs and tocontribute to the job specifications and contractswith staff. This should include a ‘roles profile’for each member of staff.

❑ To identify the needs for staff developmentprogrammes and to relate these to therequirements of individual teachers. The twelveroles have different optimal training strategies.

❑ To evaluate staff. Recognition of the different rolesis important with regard to teacher evaluation. Ateacher rated by students and peers as poor inone role, eg giving formal lectures, may performwell with small groups of students or alternativelyas a developer of resource materials. Studentsmay express different levels of satisfaction in thesame teacher, even within the same course,according to the model of teaching beingassessed (Husbands 1996).

❑ To inform an analysis of teaching activities. Suchan analysis may be required for the allocation ofresources within the institution or for otherpurposes. In the past there has been a tendency

to measure teaching in terms of student contacthours. This does not reflect the range of rolesexpected of the teacher. The involvement of staffacross widely varying teaching roles, includingtime spent on curriculum planning and productionof resource materials, can be incorporated intomeasures of teacher activity (Bardes and Hayes1995).

❑ To facilitate change. Resistance to change notinfrequently characterises the adoption of a newapproach in medical education. Hannafin andSavenye (1993) have suggested that when “thetraditional role of the teacher – that of lecturer,imparter of knowledge and controller of activities– was being assailed” teachers may feeldispensable and as a result choose to resist achange (p26). Less resistance from teachers tochange may be experienced if the roles of theteacher are made more explicit and it isrecognised that traditional teachers’ rolescontinue to have an important part to play inaddition to any new roles.

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This paper has considered the teaching roles of theteacher. The teaching roles framework describedreflects the complexities of teaching in universitiesand medical schools and provides a tool to broadenthinking about teaching. Other roles for the teacherincluding clinical, administrative, and researchcannot be ignored. These place additional demandsand pressures on the lecturer.

Implicit in the widely proposed changes in medicaleducation is the need to accept new norms of whatis expected of the teacher. If these changes are to bewidely adopted, then new roles for the teacher, asdescribed in this paper, have to be accepted, valuedand recognised in academic audit. The teaching rolecircle as described in this guide may facilitate this.

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�� Althouse LA, Stritter FT and Steiner BD (1999).Attitudes and approaches of influential role modelsin clinical education, Advances in Health SciencesEducation 4: 111-122.

Ambrozy DM, Irby DM, Bowen JL, Burack JH,Carline JD and Stritter FT (1997). Role models’perceptions of themselves and their influence onstudents’ speciality choices. Academic Medicine72(12): 1119-1121.

Bandura A (1986). Social foundations of thoughtand action. Englewood Cliffs, NJ: Prentice Hall, Inc.

Bardes CL and Hayes JG (1995). Are the teachersteaching? Measuring the education activities ofclinical faculty. Academic Medicine 70(2): 111-114.

Barrows HS and Tamblyn EM (1980). Problem-based learning. An approach to medical education.New York, Springer Publications.

Bashir TH (1998). Dangerous liaison: Academics’attitude towards open learning in higher education,Open Learning 43-45.

Biggs J (1999). What the student does: teaching forenhanced learning. Higher Education Research &Development 18: 1.

Blaxter L, Hughes C and Tight M (1998). Writingon academic careers. Studies in Higher Education23(3): 281-295.

Boud D (1990). Assessment and the Promotion ofAcademic Values. Studies in Higher Education15(1): 101-111.

Boyson R (1996). Let’s bring back teacher. ReadersDigest 148: 43-48.

Brew A and Boud D (1998). Preparing for newacademic role: An holistic approach to development.International Journal of Academic Development1(2): 17-25.

Brookfield S (1990). The skilful teacher p2. SanFrancisco, Jossey-Bass.

Brooks JG and Brooks MG (1993). In search ofunderstanding: The case for constructivistclassrooms. Alexandra VA, Association forSupervision and Curriculum Development.

Brown GA and Atkins MJ (1986). Explaining inProfessional Contexts. Research Papers in Education1(1): 60-86.

Campos-Outcalt D, Senf J, Watkins AJ, Bastacky S(1995). The effects of medical school curricula,faculty role models and biomedical research support

on choice of generalist physician careers: a reviewand quality assessment of the literature. AcademicMedicine 70(7): 611-619.

Christie BA, Joyce PC, Moller PL (1985). Fieldworkexperience, Part 1: Impact on practice preference,American Journal of Occupational Therapy 10:671-674.

Coles CR and Grant JG (1995). Curriculumevaluation in medical and health-care education,ASME Medical Research Booklet No. 1. MedicalEducation 19: 405.

Cox KR and Ewan CE (1988). The Medical Teacher.London, Churchill Livingstone.

Davis MH and Harden RM (1999). AMEE MedicalEducation Guide 15: Problem-based learning: apractical guide. Medical Teacher 21(2): 130-140.

Dearing R (1997). Report: Higher Education in theLearning Society. Hayes, Middlesex, NationalCommittee of Inquiry into Higher Education.

Diamond RM (1998). Designing and AssessingCourses and Curricula: a practical guide. SanFrancisco, Jossey-Bass (revised edition).

Douglas A (1999). A lesson learnt, An inspirationalteacher. British Medical Journal 319: 889

Dozier T (1998). Philadelphia Inquirer, July 12th,pA24.

Eastman CA (1991). The ways of learning. NativeAmerican Wisdom, ch3, p20 (Eds Nerburn andMengelkoch). San Rafael, USA: New World Library.

Easton S and Van Laar D (1995). Experiences ofLecturers Helping Distressed Students in HigherEducation. British Journal of Guidance andCounselling 23(2): 173-178.

Falvo DR, Smaga S, Brenner JS and Tippy PK (1991).Lecture versus role modelling: A comparison ofeducational programs to enhance resident’s abilityto communicate with patients about HIV. Teachingand Learning in Medicine 3(4): 227-231.

General Medical Council (1993). Tomorrow’sDoctors. Recommendations on UndergraduateMedical Education. London, General MedicalCouncil.

General Medical Council (1999). The doctor asteacher. London, General Medical Council.

Gokcora D (1997). Teaching assistants from thePeople’s Republic of China and US undergraduates:Perceptions of teaching and teachers, InternationalJournal of Academic Development 1(2): 34-42.

��

��

Gordon MS, Issenberg SB, Mayer JW and Felner JM(1999). Developments in the use of simulators andmultimedia computer systems in medical education.Medical Teacher 21(1): 32-36.

Grayson A, Clarke DD and Miller H (1998). Help-seeking among students: are lecturers seen as apotential source of help? Studies in HigherEducation 23(2): 143-154.

Griffith CH, Georgesen JC and Wilson JF (2000).Speciality choices of students who actually havechoices: the influence of excellent clinical teachers,Academic Medicine 75(3): 278-282.

Hannafin RD and Savenye WC (1993). Technologyin the classroom: The teachers new role andresistance to it. Educational Technology June:26-31.

Harden RM (1986a). Ten questions to ask whenplanning a course or curriculum. ASME MedicalEducation Booklet no 20. Medical Education 20:356-365.

Harden RM (1986b). Approaches to curriculumplanning. ASME Medical Education Booklet No 21.Medical Education 20: 458-466.

Harden RM (2000). The integration ladder: a toolfor curriculum planning and evaluation. MedicalEducation 34: (in press)

Harden RM and Davis MH (1995). The corecurriculum with options or special study modules.AMEE Medical Education Guide no 5. MedicalTeacher 17: 125-148.

Harden RM, Sowden S and Dunn WR (1984). Someeducation strategies in curriculum development: theSPICES model. ASME Medical Education bookletno 18. Medical Education 18: 284-297.

Harden RM, Davis MH and Crosby JR (1997). Thenew Dundee medical curriculum: a whole that isgreater than the sum of the parts. Medical Education31: 264-271.

Harden RM, Laidlaw JM and Hesketh EA (1999).AMEE Medical Education Guide No 16: Studyguides – their use and preparation. Medical Teacher21(3): 248-265.

Harris D and Bell C (1996). Evaluating andassessing for learning Section 4: 129-135, London,Kogan Page.

Husbands CT (1996). Variations in students’evaluations of teachers’ lecturing and small-groupteaching: a study at the London School of Economicsand Political Science. Studies in Higher Education:21(2): 187-206.

Irby DM (1994). What clinical teachers in medicineneed to know. Academic Medicine 69(5): 333-342.

Irvine D (1999). The performance of doctors: thenew professionalism. The Lancet 353: 1174-1176.

Jacques D (1991). Learning in Groups 1. London,Kogan Page.

Johnston S (1996). What can we learn about teachingfrom our best university teachers? Teaching inHigher Education 1(2): 213-225.

Joyce B, Calhoun E and Hopkins D (1997). Modelsof learning – tools for teaching, pll. Buckingham,Open University Press.

Kugel P (1993). How professors develop as teachers,Studies in Higher Education 18(3): 315-328.

Laidlaw J M and Harden R M (1990). What is... astudy guide? Medical Teacher 12(1): 7-12.

Lingham S and Gupta R (1998). Mentoring foroverseas doctors. British Medical Journal Classified2-3.

Longstaffe JA, Williams PJ, Whittlestone KD,Hammond PM and Edwards J (1996). Establishinga support service for educational technology withina university. Association for Learning TechnologyJournal (ALT-J) 4: 85-92.

Mapstone E (1996). The art of teaching. NewAcademic 5: 2.

McAllister L, Lincoln M, McLeod S and Maloney D(1997). Facilitating learning in clinical settings, p53.Cheltenham, Stanley Thornes (Publishers) Ltd.

Megginson D and Clutterbuck D (1995). Mentoringin Action. A Practical Guide for Managers. London,Kogan Page.

Mitchell HE, Harden RM and Laidlaw JM (1998).Towards effective on-the-job learning: thedevelopment of a paediatric training guide. MedicalTeacher 20(2): 91-98.

Morton-Cooper A and Palmer A (2000). Mentoring,preceptorship and clinical supervision – a guide toprofessional roles in clinical practice. SecondEdition. Oxford, Blackwell Science.

Mowday RT, Steers MM and Porter LW (1979). Themeasurement of organizational commitment.Journal of Vocational Behavior 14: 224-247.

Murray H, Gillese E, Lennon M, Mercer P andRobinson M (1996). Ethical principles in universityteaching. Ontario, Society for Teaching and Learningin Higher Education.

��

��

Newble D and Cannon R (1995). A handbook forteachings in universities and colleges. London,Kogan Page.

Nisbet J (1986). Staff and Standards. In Moodie GC, Standards and Criteria in Higher Education, pp90-106. Society for Research into Higher Education andNFER-Nelson.

Nisbet J (1990). Rapporteur’s Report on theevaluation of education programmes: methods, usesand benefits. Scottish Council for Research inEducation (EDS). Amsterdam, Seets and Zeitlinger.

Piper DW (1994). Are professors professional? TheOrganisation of University Examinations. HigherEducation Policy, Series 25. London, JessicaKingsley.

Platt MW and Bairnsfather L (1999). Compulsorycomputer purchase in a traditional medical schoolcurriculum. Teaching and Learning in Medicine11(4): 202-206.

Quinn RE, Faerman SR, Thompson MP and McGrathMR (1996). Becoming a master manager: acompetency framework, pp9-24. New York, JohnWiley & Sons. Second Edition.

Ravet S and Layte M (1997). Technology-basedtraining – A comprehensive guide to choosing,implementing, managing and developing newtechnologies in training. London, Kogan Page.

Ronan NJ (1997). Mentoring the distance learner.Open Learning 12(3): 62-67.

Rowntree D (1990). Teaching through self-instruction: How to develop open learningmaterials. London, Kogan Page.

Ryan M, Wells J, Freeman A and Hallam G (1996).Resource-based learning strategies: implications forstudents and institutions. Association for LearningTechnology Journal (ALT-J) 4(1): 93-98.

Scherpbier AJJA, van der Vleuten CPM, Rethans JJand van der Steeg AFW (1997). Advances in MedicalEducation. London, Kluwer Academic Publishers.

Schmidt HG and Moust JHC (1995). What makes atutor effective? A structural-equations modelingapproach to learning in problem-based curricula.Academic Medicine 70: 708-714.

Shuell, TJ (1986). Cognitive conceptions of learning.Review of Education Research 56: 411-436.

Squires G (1999). Teaching as a professionaldiscipline. London, Falmer Press.

Standing Committee on Postgraduate MedicalEducation (1998). An enquiry into mentoring:Supporting doctors and dentists at work. London,SCOPME.

Tiberius RG, Sackin HD and Cappe L (1987). Acomparison of two methods for evaluating teaching.Studies in Higher Education 12(3): 287-297.

Toohey S (1999). Designing courses for highereducation. The Society for Research into HigherEducation & Open University Press.

Tyree Jr AK (1996). Conceptualizing and measuringcommitment to high school teaching. The Journalof Educational Research 89(5): 295-304.

Ullian JA, Bland CJ and Simpson DE (1994). Analternative approach to defining the role of theclinical teacher. Academic Medicine 69(10): 832-838.

van der Vleuten CPM (1996). The assessment ofprofessional competence: developments, researchand practical implications. Advances in HealthScience Education 1: 41-67.

Walton H (1985). Overview of themes in medicaleducation, in Education for the Professions, pp49-51, Ed S. Goodlad. The Society for Research intoHigher Education & NFER-Nelson.

Walton HJ (1993). Proceedings of the World Summiton Medical Education. Medical Education28(supplement 1): 140-149.

Westberg J and Jason H (1993). Collaborativeclinical education: The foundation of effective healthcare. New York, Springer Publications.

White R and Ewan C (1991). Clinical teaching innursing. London, Chapman and Hall.

Whitman NA and Schwenk TL (1984). Preceptorsas teachers: A guide to clinical teaching. p30; 1 (SaltLake City, University of Utah, School of Medicine).

Wright S (1996). Examining what residents look forin their role models. Academic Medicine 71:290-292.

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cmedbd.comcmedbd.com/cmed-admin/upload/ppts//Twelev_Roles_of_a_Lecturer.pdf · Brew and Boud (1998) have highlighted the more complex demands now being placed on university teachers