119 Preparing medical teachers for small-group active learning INTRODUCTION Faculty Development Initiatives (FDIs) in medical education typically emphasize the importance of active learning, since student engagement in various active learning methods has been shown to play a crucial role in medical student development (1–6). Reviews of FDIs generally support their effectiveness in enhancing medical teachers’ proficiency in active learning strategies (7–9). However, medical teachers often face barriers in consistently applying the knowledge and skills they have acquired about active learning in their teaching practice. These barriers include: a) student factors, such as lack of preparation or reluctance to engage, b) teacher factors, such as limited preparation time or concerns about content coverage, c) pedagogical issues, such as inadequate classroom design or large class sizes, and d) institutional restrictions, such as insufficient support or recognition for teachers who use active learning (10–13). These barriers can decrease teachers’ motivation to develop their competencies in facilitating active learning and limit the required changes that they need to make to their teaching practices to implement active learning properly. This may lead to inadequate implementation of active learning, which has been shown to limit medical student development, as students tend to disengage from learning in such situations (14–16). The process by which participants apply lessons from FDIs in their own teaching practice is called ‘transfer’. Transfer has been defined as ‘the effective (generalization) and continuing (maintenance) application in the job environment of the skills, knowledge and conceptions gained in a staff development context’ (17). Successful transfer contributes to medical faculty wellbeing and development, improved behaviors, organizational change, student learning, and even patient outcomes (7–9). Transfer, however, is a complex process influenced by numerous interacting variables. This often leads to participants failing to apply their newly acquired knowledge and skills in their teaching practice (17,18). In addition, FDIs are typically limited in time and scope due to constraints such as high job demands, lack of organizational support, and financial restrictions, making it difficult to incorporate strategies that enhance transfer (7,8,19). Another contributing factor to the transfer problem is that FDIs are often conducted away from the workplace. This creates a gap between the learning and application settings, which makes it less likely for FDI participants to remember and use what they have learned (9,17,18,20). Thus, it is important to design FDI in such a way that the transfer of knowledge and skills from FDI to teaching practice is stimulated. Two potential solutions to overcome these limitations in FDI design and to reduce the gap between learning and application settings are Self-Directed Learning (SDL) and combining off-the-job and on-the-job learning (7,9,17–19). SDL has been defined by major proponent Malcolm Knowles as “a process in which individuals take the initiative, with or without the help of others, in diagnosing their learning needs, formulating learning goals, identifying human and material resources 6
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