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Figure 1. AAL Competency Model for Deans
Though often interconnected in practice, each of these competency domains reflects a particular focus. The Leadership domain includes such abilities as working with senior administration, facilitating change, managing public relations, influencing policy, possessing knowledge of health sciences education and research, and thinking strategically. The Self-Development domain covers the qualities of self-awareness, work-life balance, communication skills, decision-making style, and emotional and social intelligence. The Management domain contains expertise in negotiation, conflict and crisis management, fundraising, financial management, team building, and use of technology. The final domain acknowledges the newly appreciated area of Interprofessionalism, covering such qualities as collaborative leadership ability, knowledge of other professions and emerging models of health care, and attention to the values of interprofessional teams and collaborative education and practice.These competency domains are based substantially on AAL’s research with osteopathic medicine, dental, and veterinary deans,2-6 the work of the Interprofessional Education Collaborative Expert Panel,7 and a study to define qualities of the successful medical school dean conducted by Rich et al.8
Areas shown in bold on the model are themes that recurred in responses to AAL’s surveys of deans regarding 1) areas in which they felt least prepared; 2) areas in which knowledge is most important to succeed as a dean; and 3) areas associated with future challenges.In the veterinary deans study, for instance, respondents reported feeling best prepared in the areas of curriculum and student relations—notably, the “areas in which they had gained experience as faculty”; by contrast, they reported feeling “least prepared in the areas of fundraising, interaction with other schools and groups at the parent institution, and technology applications.” When dental deans were asked about the importance of 17 knowledge areas in fulfilling their responsibilities as dean, a large majority (91.1%) selected communication as most important, followed by conflict resolution (78.6%), finance and budget (71.4%), and leadership development (69.1%). The survey of osteopathic medicine deans asked respondents to rate a list of factors by how prepared they were to address challenges in that area when they took their position. Among the areas in which they felt least prepared were fundraising, public relations, budget/financial management, and collaborating with colleges/schools/other groups at their parent institutions. These findings are broadly consistent with those identified by Rich et al. in their study of medical school deans. Their research identified the high-priority management skills as “the ability to assess the institutional environment and judge support for initiatives”; communication skills enabling one to interact with a “wide audience of students, faculty, university and hospital administrators, and community members that include civic and state legislators as well as potential benefactors”; “skills in financial stewardship and strategic planning”; and “effective management of leadership teams.”
Considering these health professions deans’ perceived needs, it is not surprising that they support an increased level of leadership training for individuals in their position. Among the dental deans, almost 90% reported having participated in leadership and/or deanship training programs of the American Dental Education Association (ADEA), and 75% said they took part in courses and classes beyond the ADEA programs. Even with this high level of involvement, 64% reported feeling there is a need for formal training beyond what currently exists with the ADEA Council of Deans. The veterinary deans also reported a high level (86%) of participation in leadership programs, although most examples they provided were general in nature rather than directed to their specific position. Perhaps as a result, 78% of those respondents agreed that a need exists for formal leadership training for veterinary deans. Similarly, the study of osteopathic medicine deans found little participation in leadership courses designed specifically for their position, while 93% agreed that a need exists for more formal leadership training.
What we know about the needs of health professions deans, along with general principles of adult learning, also points to some recommendations for the design of such leadership programs. While lectures about professional development topics may be useful to introduce critical subjects and provide summaries and conclusions, deep learning most likely will occur through assessment of and feedback on critical individual strengths, and through small-group interactions conducted in class and via videoconferences between in-person meetings. Active learning will be fostered through the use of roundtable discussions, case studies and simulations, role-playing, peer coaching and feedback, in-class presentations by participants, and practice sessions with instructor guidance. Individual assignments to be completed prior to in-class interactions might include self-study modules, online discussion boards, reading of assigned literature, reflection exercises, and projects conducted at each dean’s home institution that apply leadership principles and practices learned in the program curriculum. Finally, establishing a relationship with a mentor (ideally, a more senior or former dean or senior administrator) and taking part in one-on-one sessions with a professional coach can help participants shape what they learn to meet their individual situations and address their needs for further growth.
As Rich et al. point out in their study of medical school deans, a universally applicable definition of successful deanship is impossible due to the distinctive qualities of each school and the individuals involved. Nevertheless, the research reported in this article suggests a set of needs and guidelines that can serve as goals and indicators of success in a leadership position two former deans defined as both “the worst of jobs” and “the best of jobs”: “a near impossible and thankless task from which any sane and reasonable person might justifiably run” and “the greatest job in the academy.”9 Deans are in a position to influence people and policy in order to move their schools, the practitioners they produce, and their disciplines forward—which is why we all should be invested in supporting their success.
1Haden NK, Chaddock M, Hoffsis GF, et al. “Knowledge, Skills, and Attitudes of Veterinary College Deans: AAVMC Survey of Deans in 2010.” Journal of Veterinary Medicine Education 37, no. 3 (2010): 210-19.
3Valachovic RW, Weaver RG, Kirby AM, Haden NK, Robertson PB. “Profile and Decreasing Term Length of Dental School Deans.” Journal of Dental Education 64, no. 6 (2000): 433-39.
4Chmar JE, Weaver RW, Ranney RR, Haden NK, Valachovic RW. “A Profile of Dental School Deans, 2002.” Journal of Dental Education 68, no. 4 (2004): 475-87.
5Haden NK, Ditmyer MM, Rodriguez T, et al. “A Profile of Dental School Deans, 2014.” Journal of Dental Education, forthcoming.
6Haden NK, Slocum P, Weinstein G. “American Association of Colleges of Osteopathic Medicine Deans’ Profile Survey: Summary and Analysis of Results.” 2011. Unpublished study.
7Interprofessional Education Collaborative Expert Panel. Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. 2011. http://www.aacn.nche.edu/education-resources/ipecreport.pdf. Accessed August 1, 2014.
8Rich EC, Magrane D, Kirch DG. “Qualities of the Medical School Dean: Insights from the Literature.” Academic Medicine 83, no. 5 (2008): 483-87.
9Wasicsko MM, Balch B. “A Tale of 2 Deans.” Chronicle of Higher Education, Nov. 24, 2014.
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• improve workplace performance,
• deal with a difficult situation at work,
• avoid feeling stuck with current responsibilities,
• develop his or her career, and
• take on more leadership responsibilities.
Coaching for faculty members can be especially productive, because the time to begin practicing leadership is when you are not consumed by a leadership role. This is when you have the best opportunity to try on new skills, take some risks, reflect on your strengths, assess your skills, and ask for feedback. When you are not burdened by broad leadership responsibilities, the stakes are not quite so high — and your mistakes will not be quite so visible. What that means is that you have a greater opportunity to learn. Coaching often can accelerate that learning.
From my perspective, coaching faculty members is not very different from coaching those who are in leadership roles. I am always open to a first conversation, without fee, to explore the coaching opportunity so that an individual can make the best possible decision about whether coaching is the best approach. In that conversation, we talk about what the faculty member hopes to get from coaching, whether I – or another coach – would be the best fit for their coaching needs, what other options there might be, and what the ground rules for a coaching engagement would be.
Coaching is most beneficial when it is focused on specific goals. With candidate coaching or coaching that is directed at specific work situations, those goals usually are relatively clear. For developmental coaching, aimed at general growth in effectiveness, it is often important to get additional feedback or input on the process. This can be done in the form of a 360-degree approach, whereby others are asked to respond to questions about the faculty member who is being coached. Either a standardized assessment tool or individual interviews, conducted by the coach, can provide this information. Then, we use this information for the creation of a professional development plan that identifies specific goals and behaviors for the focus of the coaching. These plans are greatly aided by input from others. When 360 feedback is not possible, we may rely on one or two others for input, or simply move forward after some discussion and analysis of situations and challenges. With mutual agreement, I sometimes make “homework” assignments that may involve practicing a new approach to dealing with a challenging situation, for example. Although one can gain greater understanding of strengths and capacities through coaching, practicing new behaviors is the key to goal attainment and greater success. The coach and client together monitor progress towards goals throughout the coaching engagement.
Most coaches will be open to assessments beyond those I describe above. There are a variety of techniques that can help an individual both develop greater awareness of existing strengths and challenges, and develop new strategies for maximizing their performance using those strengths. Obviously, commitment and honest effort are important to achieving one’s goals through coaching. Faculty members tend to get the most from coaching when they are able to commit to regular sessions. Twice monthly is a common choice for many of those whom I coach, but most of us are flexible on the issue of scheduling. Faculty members who have done some leadership training often are ready for coaching and can make rapid progress on their goals. The great advantage of coaching over other forms of leadership training, however, is that it begins where the client is, and is expertly tailored to the individual faculty member’s needs and development goals. Those who are considering this option definitely should give coaching a closer look.
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A comprehensive meta-analysis was conducted to assess the findings of 22 published reports of PD efforts from 1989 through 2010.3 While the majority of these reports focused on improving teaching efficacy of faculty members, several reports demonstrated efforts to assist faculty with scholarship, academic effectiveness, and leadership needs. Topics included research training, curriculum development, career management, and leadership skills. While these interventions do show a more holistic approach to PD, the study more notably revealed that most PD efforts are commonly assessed through traditional quantitative measures from a single source (i.e., a single unvalidated survey of program participants). While effective, this practice is limited in scope as it does not account for variances in faculty members applying what they were taught, nor does it measure downstream effects the programming may have on students, patient care, or career development.
To help with the efficacy and applicability of PD programs, facilitators and program administrators should evaluate for whom programming is designed, how it is delivered, and how it will be assessed. Too often PD interventions focus on the individual faculty member and fail to account for the realities of the institution and the context in which taught material is to be applied.4 For example, is it better to work with a team of faculty who may be involved in a new curricular innovation rather than the faculty en masse? Should certain departments or schools be involved in integrated training? What is the proper andragogy for a particular session?
For these reasons, an effective PD program should begin with a comprehensive needs assessment of the entire faculty.5 This allows programs to measure congruency between the current efforts of the institution and its stated goals and mission. It also allows for identification of any themes that are common to the entire faculty or specific to a particular group.
Once the focus of PD is identified, it is imperative to create an assessment from several sources, both qualitatively and quantitatively. As Leslie et al. reported, the majority of assessments are quantitative studies of program participants. While these studies provide a subjective evaluation of the facilitators and of participant satisfaction, they do not provide a measure of the effectiveness of the content. By incorporating mixed-method approaches to evaluation (faculty and students interviews, direct observation of learned skills, progress reports, CV evaluation, etc.) from several data sources (students, peers, etc.), programs can garner a better assessment of the impact of the program. These types of studies can provide better evidence of the value and applicability of PD activities.6,7
Additionally, facilitators of PD programs should define the intended learning outcomes (ILOs) and the competencies the programming seeks to imbue. Outcomes-based education is driven by the educational goals and evaluations of these anticipated learning outcomes.8 As with curriculum development, both ILOs and competencies should be clear, concise, and most importantly, easy to assess. Most faculty members are accustomed to utilizing ILOs in their own courses, and it may help to clarify expectations in a given PD session. Additionally, core competencies for faculty members have been proposed for a number of disciplines and may help provide more focus for participants.9-11
As O’Sullivan concludes, PD programs should have two goals: (1) to provide participants with optimal approaches and best practice skills, and (2) to support participant interactions within the context of the teaching environment.4 Professional development of faculty needs be a continual, evolving process. While there are a number of barriers that may limit the scope or implementation of these efforts, even small-scale programs can be effective if developed and assessed appropriately.
1Holmboe, Eric S., Denham S. Ward, Richard K. Reznick, Peter J. Katsufrakis, Karen M. Leslie, Vimla L. Patel, Donna D. Ray, and Elizabeth A. Nelson. 2011. “Faculty Development in Assessment: The Missing Link in Competency-Based Medical Education:” Academic Medicine 86 (4): 460–67. doi:10.1097/ACM.0b013e31820cb2a7.
2Adams, Pamela. 2009. “The Role of Scholarship of Teaching in Faculty Development: Exploring an Inquiry-Based Model.” International Journal for the Scholarship of Teaching and Learning 3 (1). http://digitalcommons.georgiasouthern.edu/ij-sotl/vol3/iss1/6.
3Leslie, Karen, Lindsay Baker, Eileen Egan-Lee, Martina Esdaile, and Scott Reeves. 2013. “Advancing Faculty Development in Medical Education: A Systematic Review.” Academic Medicine 88 (7): 1038–45. doi:10.1097/ACM.0b013e318294fd29.
4O’Sullivan, Patricia S., and David M. Irby. 2011. “Reframing Research on Faculty Development.” Academic Medicine: Journal of the Association of American Medical Colleges 86 (4): 421–28. doi:10.1097/ACM.0b013e31820dc058.
5Bland, Carole J., Elizabeth Seaquist, James T. Pacala, Bruce Center, and Deborah Finstad. 2002. “One School’s Strategy to Assess and Improve the Vitality of Its Faculty.” Academic Medicine: Journal of the Association of American Medical Colleges 77 (5): 368–76.
6Behar-Horenstein, Linda S., Gail Schneider Childs, and Randy A. Graff. 2010. “Observation and Assessment of Faculty Development Learning Outcomes.” Journal of Dental Education 74 (11): 1245–54.
7Morzinski, Jeffrey A., and Deborah E. Simpson. 2003. “Outcomes of a Comprehensive Faculty Development Program for Local, Full-Time Faculty.” Family Medicine 35 (6): 434–39.
8Shumway, J. M., and R. M. Harden. 2003. “AMEE Guide No. 25: The Assessment of Learning Outcomes for the Competent and Reflective Physician.” Medical Teacher 25 (6): 569–84. doi:10.1080/0142159032000151907.
9Hand, Jed S. 2006. “Identification of Competencies for Effective Dental Faculty.” Journal of Dental Education 70 (9): 937–47.
10Harris, Dona L., Katherine C. Krause, David C. Parish, and Mike U. Smith. 2007. “Academic Competencies for Medical Faculty.” Family Medicine 39 (5): 343–50.
11Rosenbaum, Marcy. 2012. “Competencies for Medical Teachers.” SGIM Forum 25 (9): 1–2.
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Motivational interviewing, or MI, refers to a counseling approach first introduced in the early 1980s by clinical professionals to help in the treatment of behavioral problems, such as alcoholism.1-4 This goal-oriented, client-centered counseling technique has been found to be effective in helping to facilitate behavioral changes in patients. Students who learn MI also can apply it to their own behaviors, resulting in better academic outcomes.5-6 Learning this technique helps students explore and resolve their ambivalence about a specific behavior. When examining motivational learning components of classroom academic performance, one of the best predictors of achievement was students with high levels of self-efficacy.7 Another study found that MI produced significant positive changes in academic performance and self-reported positive academic behavior.7 A study of first-year medical students examined the effectiveness of motivational interviewing training on improving medical students’ knowledge of and confidence in their ability to counsel patients regarding health behavior change.8 In this study, students reported improved confidence in their understanding of MI after participation in the course. Another study found that training students in MI had a positive influence on the students’ communication skills, leading to improved counseling techniques and better ability to counsel patients on health behavior changes.10 Additionally, research on promoting academic achievement though the use of MI has found that one single session can have a beneficial effect on academic behaviors.11
Without the benefits of learning MI skills, many students struggle due to unproductive behaviors. Consider this metaphor: a man walks down a street and falls into a hole in the sidewalk. He gets up and dusts himself off, only to do the same thing the next day. Even after being cautioned by others, he continues walking down that same street day after day, always falling into the hole. Eventually he will suffer an injury if he doesn’t change his behavior.
Though this example may seem extreme, it is not unlike students who continue to engage in behaviors detrimental to their academic success. Even after they are counseled by advisors and faculty to take a different direction, they continue to miss classes, utilize counterproductive study habits, and employ poor self-management skills. Then one day they are surprised to find themselves on continued academic probation or returning from a prior academic dismissal to experience the same outcome. However, with MI, faculty can help students overcome their own ambivalence to change by teaching them how to work with their patients to initiate new behaviors and cultivate lasting change within those they serve.
MI can be divided into five major principles that can be summarized as the acronym DEARS: Develop Discrepancy, Express Empathy, Amplify Ambivalence, Roll with Resistance, and Suppose Self-efficacy.1-4, 11-12
Develop Discrepancy: This principle occurs at the point in time when students or patients realize that something isn’t right, but feel they need proof that there is a problem. A great deal of energy is spent simply trying to acknowledge there is a problem, right rather than trying to fix it. This tension often becomes very emotional, as people have a tendency to resist the change. To help them work through this, faculty can teach students to have an honest discussion with their patients about the consequences of NOT changing. It is important to help focus on the gap between where they are and where they need to be. What will it take to get there? As faculty, you can aid in the decision making process. Using a decision matrix is helpful in this step. Having patients answer the following questions will help them understand the gap(s) and will help students apply these questions to their own behaviors:
Express Empathy: One important element of MI is the ability of the facilitator to view the students’ or patients’ problems or concerns through their eyes. This is critical: when people feel you understand them, they are more likely to open up to you. This type of listening is what breaks down the walls of resistance between faculty and students, and between students and their patients, without any judgment and/or blame. Below are some examples of empathic responses:
Amplify Ambivalence: This principle involves realizing and verbalizing the mindset of the student or patient. Ambivalence to change is normal for most people, so it is important to help them realize that they need to move from their stagnant position to an open, reflective place, which will allow positive movement to occur. Have them examine what the behavior has caused and ask why they continue to perform that behavior knowing it hurts them and others. Then, look at what life might be like if they were able to make a decision to change and move forward.
Roll with Resistance: This is often a way for people to avoid confrontation and change behavior. It is important to get the student or patient to recognize the words and actions that indicate resistance. These often include arguing, interrupting, denying, and ignoring. By looking for these words or actions, encourage the individual to work through them by finding words of ability and reason for change in the midst of those forms of resistance. Using “change talk” at this point is helpful. Change talk refers to the mention and discussion of their desire, ability, reason, and need to change behavior and commitment. If they are open to talking about change, they are more likely to actually change. This is a great way to help an individual discover that he or she is wanting and willing to change.
Suppose Self-efficacy: Self-efficacy is the patients’ or students’ belief that they can achieve their goal. To do this, they need the self-confidence to actually make the change. Therefore one of the major goals of MI is to help increase the confidence (and thus self-efficacy) of students or their patients. The more they believe they are capable, the more likely it is they will achieve their goal. Helping them improve their self-confidence and subsequently their self-efficacy will help patients and students feel secure in the decisions they make.
We all go through times in our lives where we have difficulty changing behaviors, be it losing 10 pounds, beginning an exercise program, eating more fruits and vegetables, or making sure to take our medication as directed. Remember how difficult a change was for you. While we all have good intentions, there must always be room for flexibility based on individual differences.
MI has many applications for faculty. It can be particularly helpful for students who are having academic or personal problems, as well as helping students communicate better with their patients. The principles are simple, but they take practice. However, once you feel comfortable and have mastered the skills, you can adapt and use them any time you encounter someone who is undecided about change.
Good luck and good interviewing.
1Miller WR, Rose G. Toward a Theory of Motivational Interviewing. The American Psychologist. 2009, 64(6): 527-37.
2Miller WR. Conversation with William R. Miller. Addiction (Abingdon, England) 2009, 104(6): 883-93.
3Motivational Interviewing: What is it? Retrieved May 18, 2015 from http://motivationalinterview.org/clinical/overview.html.
4Miller W. Motivational Interviewing: Facilitating Change Across Boundaries. Mayo Clin Proc, 2004, 79(3):327-31.
5Sheldon L, Using Motivational Interviewing to Help your Students. The NEA Higher Education Journal, 2010, pp 153-159
6Pintrich PR, de Groot EV. Motivational and self-regulated learning components of classroom academic performance. Journal of Educational Psychology, 1990 82(1), 33-40.
7Bala S, Johansson V. The effect of motivational interviewing training on student’s counseling skills and confidence: A systematic literature review. Master’s Thesis in Odontology with Specialization in Oral Health, Malmo University. Retrieved May 19, 2015 from https://dspace.mah.se/bitstream/handle/2043/13380/TheeffectofMotivationalInterviewing.pdf?sequence=2
8Poirier MK, Clark MM, Cerhan JH, Pruthi S, Geda YE, Dale LC. Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change. 2004, 79(3):327-331.
9Terry J, Smith B, Strait AG, McQuillin S. Motivational Interviewing to improve middle school student academic performance: A replication study. Journal of Communication Psychology, 2013, 41(7): 902-09.
10A randomized trial of motivational interviewing to improve middle school student’s academic performance. Journal of Community Psychology, 2012, 40(8):1032-39.
11Fuller C, Taylor P. A Toolkit of Motivational Skills. West Sussex, England; John Wiley, 2009.
12White LL, Gazewood, MounseyAL. Teaching students behavior change skills: description and assessment of a new Motivational interviewing curriculum. Academic Psychiatry. 2011 Jan-Feb;35(1):51-3. doi: 10.1176/appi.ap.35.1.51.
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Most would agree that the quality of people in an academic community is a prime determinant of how well that community will function. Close attention must be paid to the selection against defined criteria of those who might join that community, whether they are students, staff, or faculty. There must be continual support for the professional development of each member in the community, both through individual mentoring and through other forms of learning, for the entire time they remain a member. Those development activities will be most effective when they are underpinned by continual evaluation of both individual performance and performance of the group, and are linked to transparent systems of reward.
Equally important is the development and maintenance over time of a unit, group, or institutional plan. The plan should be both clear and broadly understood. It should be structured in such a way as to find balance between continual evolution as circumstances change, and reasonable consistency over time. It should also find balance between the strength of strategic intent on one hand—a compelling answer to the question, “What is the academic unit or community striving to become?”—and the strength of tactical action on the other, including clear statements of how to get there, and defining how success will be measured.
There are many ways to develop and to maintain institutional plans. Many participants can contribute, and most should: students, staff and faculty, both as individuals and through group representation; academic leaders; governing boards; patients served, in clinical disciplines; graduates, employers of graduates, and donors; and the broader community, through its elected representatives or other leaders. Plans can be developed “top down,” “bottom up,” or a combination of the two. They can be derived largely from initial work by focus groups or workshops, or they can be drafted by a select few then modified through structured consultation. They can be supported by written documents, by oral presentation and discussion, and by visual display.
Once a choice among these options is made, a planning process then must be determined and acted upon. It is reasonable to state that each academic unit should structure its own, unique planning process. The process decided on should be influenced by culture, history, nature and circumstance. It should be inclusive, in balance with the need to reach definition within a reasonable time, and by the need to take action. For most academic communities, planning should be continual, on an annual cycle. The planning process, like the plans that it develops, should be able to evolve over time.
Good governance structures, and good processes of accreditation, review, benchmarking and ranking each will work together to facilitate close examination of the existence and operation of planning processes, just as they will to the quality of individuals within the academic unit, the measured outcomes of its work, and the plans themselves.
Although broader constituencies should be engaged in the creation of academic plans, it is the academic unit and its leader that should bear the primary responsibilities for designing its planning process. One of the key roles of an academic leader is to stimulate continual reflection among the academic community about how that community’s planning processes can best be structured. It is much better to be proactive in this regard than reactive. If an academic group is able, through its leader, to present a clear statement of how its planning process operates to the institutional governing and management structures, those structures are less likely to interfere or impose, and more likely to provide support. Active engagement among the whole academic group in designing the planning process also is highly likely to enhance mutual understanding and team cohesion.
If the quality of people in the academic group is high, the working relationship between the group and its leader sound, and the leader has appropriate guidance, knowledge and skills, then planning can be expected to have many constructive outcomes. Whatever the given political or financial circumstances, a strong, broadly understood and accepted plan provides the best basis for decisions on resource use, and the best argument in support of resource allocation or acquisition.
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The National Association of Professional Women (NAPW) honored AAL Vice President Dr. Marcia Ditmyer as a 2015-2016 inductee into the NAPW VIP Professional Woman of the Year Circle. She was recognized with this prestigious distinction for leadership in academics. With more than 700,000 members and over 200 operating Local Chapters, NAPW is the nation’s leading networking organization exclusively for professional women.
AAL Senior Consultant Dr. W. Rory Hume was a keynote speaker at the Fifth QS Middle East and North African Professional Leaders in Education Conference and Exhibition in Doha, Qatar, May 5-7, 2015, presenting the topic “Rankings Relative to Mission.” See also: The Peninsula Online and Gulf Times.
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Noteworthy Teaching and Learning Articles
Students in free online courses study less than traditional students
As reported in the Chronicle of Higher Education on June 16, 2015, a comparison of surveys by Class Central and the Cooperative Institutional Research Program showed that only about half as many students who take free online courses (e.g., MOOCs) study as much as students taking traditional campus classes: