Effectiveness and Needs Assessment of Faculty Development Programme for Medical Education Experience from Saudi Arabia *

Objectives: Faculty members are the most important resource in any institution of higher education as medical education has been, and continues to be, a priority for medical colleges in Saudi Arabia. This study aimed to assess faculty members’ perceptions of faculty development programmes (FDPs) in supporting important goals in medical education. In addition, this study aimed to assess faculty members’ perceived needs. Methods: This crosssectional study was conducted between August 2016 and August 2017 and involved participants from six universities in Saudi Arabia’s Western Province. The survey consisted of 31 items designed to assess FDP effectiveness and 49 items designed to assess needs in FDPs. Results: A total of 210 faculty members participated in the study (response rate = 52.5%) and identified 49 needs. Faculty members perceived personal improvement in delivering medical education and the provision of greater educational involvement as the most effective considerations in an FDP. The respondents considered 13 needs to be of utmost importance; the remaining were considered important. Conclusion: This study assessed and identified faculty needs and important skills to consider when establishing an FDP. Furthermore, it provided information addressing the needs of, or gaps between, current and desired conditions in medical education in Saudi Arabia. The study also identified the most important elements (i.e. personal improvement) of faculty-perceived effectiveness for a successful FDP in medical education.

M edical education has been, and continues to be, the highest priority of medical colleges in Saudi Arabia. This prioritisation is evident in the establishment of more than 35 medical colleges nationwide. 1 Every medical college has a goal, vision, mission and core values that it tries to maintain and adhere to through a carefully articulated curriculum. 2 Physicians who graduate from these colleges must be competent, professional and able to respond to needs within the society. 3 A faculty development programme (FDP) is a planned activity that is designed to improve an individual's knowledge and skills in areas considered essential to the performance of a faculty member as a teacher, researcher or administrator in order to address needs for future development. 4 Faculty development can lay the foundation of quality enhancement in medical education. 5 Faculty members are the most important resources in any institution of higher education. Therefore, an FDP should act as a resource to meet faculty members' individual goals as teachers, scholars and leaders. 6 Faculty members at medical schools must be talented and productive teachers, effective clinicians and successful researchers. These pressures have evolved from the competition between different medical schools and institutions, contemporary curriculum development and shortcomings in research, teaching and production. 7 In addition, FDPs must prepare faculty members to deal with rapidly occurring changes in medical education, healthcare delivery systems and clinical teaching and practice. 8 Glowacki-Dudka and Brown elucidated the most beneficial effects of FDPs as selfevaluation through teaching scales, awareness of effective teaching methods and student evaluations. 9 However, the beneficial effects of FDPs were later found to be broader than what was described by Glowacki-Dudka and Brown and other benefits were established. 9 A needs assessment is defined as a systematic process of collecting and analysing information to address the gaps between current and desired conditions. 10 This study is one of three parallel projects that tackled different aspects of FDPs. Although the same inclusion and exclusion criteria were used across all three projects, separate groups of surveyors used entirely different questionnaires for each project. This study aimed to assess faculty members' perceptions of FDP effectiveness and identify the most important goals for the programme. Additionally, this study aimed to assess the perceived needs of faculty members participating in FDPs.

Methods
This cross-sectional study involved participants from six universities in Saudi Arabia's Western Province and was conducted from August 2016 to August 2017. The participants were faculty members who had worked as full-time or joint appointees, taught with or without clinical assignments and had participated in FDPs during the previous two years. Newly employed and part-time faculty members and those classified as serving in non-teaching positions were excluded. Participants were selected through a consecutive sampling technique which was based on eligibility criteria.
The total number of faculty members in the population under consideration was 400. The required sample size was estimated at a 95% confidence level with an estimated 40% response distribution and a margin of error of ± 5%. The required minimum sample size, calculated using Raosoft ® (Raosoft, Inc., Seattle, Washington, USA) was 197, and the final sample size was determined to be 210, accounting for an approximately 10% non-response rate.
The questionnaire used in this study was a predesigned self-administered tool generated by previous research. [11][12][13][14][15][16] This comprehensive questionnaire included all possible items from related publications in the literature. The items of the questionnaire were divided into two sections that addressed two different aspects of faculty development (i.e. needs and effectiveness). The researchers personally distributed the survey to maximise the number of completed items and allow participants to ask questions. Explaining the purpose of the study and its impact on enhancing FDPs encouraged the faculty members to complete the questionnaires.
The survey consisted of 31 items designed to assess the effectiveness of FDPs and 49 items designed to assess the needs that should be addressed by FDPs. The questionnaires used a five-point Likert scale with ordinally scaled options. The options for the first questionnaire were: one, not effective; two, less effective; three, somewhat effective; four, moderately effective; and five, more effective. For the second questionnaire, the options were: one, not at all important; two, not very important; three, moderately important; four, important; and five, very important. In addition, the demographic profile of the participants was collected to identify whether any demographic and work factors correlated with perceptions of FDPs.
The validity of the questionnaire's content was ensured by consulting a panel of experts in the field of FDPs for review and modifications. The panel included three local experts from King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and three international experts from three different universities in the USA. Analyses of data collected during pilot testing were conducted using Cronbach α for internal consistency, which demonstrated high reliability. The scales' and subscales' consistency were determined by factor analysis.
Statistical Package for the Social Sciences (SPSS), Version 23 (IBM Corp., Armonk, New York, USA) was used to analyse the collected data. To summarise quantitative variables, descriptive statistics such as mean, median and standard deviation were used. Frequencies and percentages were used to summarise qualitative variables.
To ensure the confidentiality of information, all questionnaires were completed and submitted anonymously. Furthermore, the cover page of each questionnaire explained confidentiality issues, including instructions on how to complete the questionnaire and provided space for participants to give informed consent to participate in the study. The Institutional Review Board of King Abdullah International Medical Research Center, Riyadh, Saudi Arabia, approved this study (IRBC/430/16).
Faculty members perceived the two most effective items to be addressed in an FDP as the improvement of personal qualities and making provisions for greater educational involvement (mean = 4.22 ± 0.88 A total of 49 needs were identified with 13 needs considered of utmost importance while the remaining were considered important [ Table 3].

Discussion
FDPs in medical colleges are currently considered more important than before. Although full-time Saudi faculty members constitute a large body in academia, most are not equipped with formal training in the field of medical education. 17 The current study reflected this finding as faculty members believed the most effective items in an FDP were improving personal qualities and providing greater educational involvement. Such  In this study, enhancing and improving teaching strategies, skills and methodologies were among the most important features in faculty-perceived effectiveness. This result is similar to findings by Haden et al., wherein the respondents showed interest in learning more about matters related to teaching. 19 Other important aspects of faculty-perceived effectiveness were improvements in personal, student or curriculum-related aspects of their jobs. Faculty development plays an important role in bringing about organisational changes and promoting innovation and excellence in teaching. It also contributes by changing the institutional culture and establishing policies that support and reward excellence in academia. Unfortunately, this finding was not reflected in this study as there was only one institution-related perceived effectiveness aspect among the top ten elements. Other important institution-related aspects, including increasing awareness about an institution's mission and vision, improving test development abilities and linking instructional activities to set objectives, were less important than other personalrelated aspects of perceived effectiveness.
Among the least important aspects of facultyperceived effectiveness in FDPs were research awareness, understanding and funding, retention in academia, establishing faculty networks and improving colleague relationships. Steinert et al. 's study found that FDPs helped with faculty development by improving competencies pertaining to teaching, administration and research. 13 Most of the faculty members in this study focused on personal aspects of perceived effectiveness, whereas institutional, research-related and other aspects of perceived effectiveness were considered to be less important. This finding is similar to previously published research, which reported a need to improve faculty members' knowledge in related areas in order to function properly as teachers, however, other findings determined that faculty needed more training in research skills. 5 An effective FDP should be established based on the five major elements published by Wilkerson and Irby and Steinert et al. 20,21 These elements include professional, instructional, leadership, organisational development and programme evaluation. These elements were also reflected in the results of the current study, with professional and instructional development being the most important.
The needs assessment is a process that includes the collection and analysis of information regarding what a target group needs to learn. 22 In a faculty development needs assessment at the Faculty of Medicine at McGill University, Canada, McLeod et al. concluded that the needs assessment process is an important way to direct faculty development activities to the particular responsibilities of the faculty members. 18 Similar national surveys assessing faculty development have been published in the USA and Europe. 23,24 As the number of medical schools in Saudi Arabia is growing rapidly and the faculty of medical schools include both locals and expatriates, a needs assessment should be the first step to establishing an FDP. While the results of this study have local importance, a survey distributed to faculty members of all Saudi medical schools might provide more specific information about their needs and help establish a basis for FDP activities on a national level.
In this study, the most important skills to be covered in FDPs were those related to improving transition points in individual faculty members' careers. An effective FDP should also include skills that medical educators should master, including presenting at conferences, giving effective feedback and teaching communication skills and evidence-based medicine. Additionally, faculty members identified the importance of FDPs addressing important tools for learning and assessment such as objective-structured clinical examinations, small group teaching and problem-based learning as well as understanding wellness, professionalism and interprofessional education. Among the least important skills to emphasise in FDPs were giving media interviews, planning sabbaticals and chairing committees.
A major limitation in the present study was the poor response rate, which might have occurred due to the difficulty in convincing busy faculty members to spend time completing the survey. The methodology of this study did not allow the researchers to collect in-depth responses that could have been achieved through a qualitative, interview-based study. Such a study might include a comparison of responses from different faculty ranks or teaching experiences. Qualitative research concerning FDPs in Saudi Arabia would constitute an extensive research project but would complement the current study's quantitative data. Such a study could be done by faculty members and masters' students interested in medical education.

Conclusion
Most faculty members at colleges of medicine in Saudi Arabia need further formal training in essential areas to improve their academic performance. This study assessed and identified important needs and skills that should be incorporated into an FDP to address these areas. In addition, this study provided information to address the gaps between current and desired conditions. Local and national medical schools are urged to assess faculty needs and create FDPs according to those needs. Several methods and strategies may be used to achieve these needs, including collaborative joint reviews between the six universities and medical education conferences that tackle FDPs. The most important items to be achieved for faculty-perceived effectiveness in FDPs in medical education were personal aspects of perceived effectiveness. Colleges and medical institutions should establish a comprehensive FDP focusing on aspects of personal effectiveness which would prepare faculty members to fulfil their academic roles and promote career development. FDPs are created to improve a faculty member's commitment to their work and their ability to achieve goals and objectives for themselves and their institution. A unified faculty development diploma should be established in Saudi universities which would address faculty members' professional needs.
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