COMPARISON OF CLINICIAN TEACHER AND SALARIED CLINICAL FACULTY PATHWAYS, PSYCHIATRY AND BEHAVIORAL SCIENCES 9/22/14

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1 COMPARISON OF CLINICIAN TEACHER AND SALARIED CLINICAL FACULTY PATHWAYS, PSYCHIATRY AND BEHAVIORAL SCIENCES 9/22/14 Clinician Teacher Primary responsibilities Clinical care Teaching and/or supervision Scholarship about psychiatric education or area of teaching Salaried Clinical Faculty Clinical care Other possible responsibilities Administration Teaching and/or supervision in the context of clinical care Administration Core Promotion criteria Type of faculty pathway Non-competition agreement required? Clinical care Quality of care Quantity (e.g. RVUs) Teaching Quality Quantity Scholarship Focus on education or area of teaching Peer-reviewed products, including curricula/ teaching materials Academic Up to 6 years Acting 3 years as Assistant Professor with 3 year reappointment before mandatory review Yes, when switching from Acting status to Assistant Professor. Includes 30-mile non-compete restriction. Clinical care Quality of care Quantity (e.g. RVUs) Recognized area of clinical expertise Clinical Annual reappointment Yes, when switching from Acting status. Includes 10- mile non-compete restriction until 12/31/17.

2 UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES CLINICIAN TEACHER PATHWAY GUIDELINES FOR APPOINTMENT, EVALUATION, AND PROMOTION Approved June 20, 2000/Revised March 31, 2008 DRAFT REVISION, March 13, 2015 INTRODUCTION The Clinician-Teacher Pathway is a University of Washington School of Medicine (UWSOM) academic track for those faculty involved in all four aspects of a traditional academic career (clinical care, teaching, research/scholarship, and administration) but whose primary commitment is to clinical care and teaching. The criteria below are used for appointment and promotion within this track in the Department of Psychiatry and Behavioral Sciences. Clinician-Teacher faculty have the titles Instructor, Assistant Professor, Associate Professor, and Professor. Appointment An individual in this pathway devotes the majority of his/her time to clinical practice and teaching at one of the University s affiliated clinical teaching sites. The individual must have a scholarly focus related to education and/or to his/her teaching activities. The individual also may have a substantive administrative role, such as the leadership of an educational program, administration of a clinical program, or chairing a major committee within the Department or School of Medicine. Leadership in regional or national programs, especially those related to psychiatric education, may also be considered administrative service. Specific criteria for initial appointment include: 1. M.D. or D.O. and clinical residency training necessary to meet the American Board of Psychiatry and Neurology certification requirements, or completion of an American Psychological Association accredited Ph.D. program and internship, or equivalent training. 2. Eligibility to receive a medical staff appointment at one of the major University of Washington affiliated teaching sites. 3. Excellent clinical competence, documented from training or practice settings. 4. Documented excellence as a teacher. 5. Potential for development of educational scholarship. At the time of appointment, the Chair and Chief of Service should define in writing for each individual clinician teacher his or her responsibilities and time allocation for patient care, teaching, administration, and scholarship.

3 The policy and expectation of UW Medicine and the Department of Psychiatry and Behavioral Sciences is that all faculty members conduct themselves with professionalism, dignity, and respect in their interactions with patients, trainees, members of the public, and each other, as outlined in the UW Medicine Policy on Professional Conduct. Professionalism includes demonstration of excellence, integrity, respect, compassion, accountability, and a commitment to altruism in all work interactions and responsibilities. Continuing Appointment and Promotion Clinician-Teacher faculty are evaluated for continuing appointment and promotion on the basis of: 1) clinical competence and clinical service; 2) teaching; 3) administration; 4) scholarly activity; and 5) professionalism. Criteria for promotion to each faculty rank are given in Appendix A, and definitions and methods of evaluation are provided below. Recognizing that each Clinician-Teacher faculty member has a unique professional activity profile and assigned responsibilities in teaching, clinical care, scholarship, and administration, the relative importance of each of these as criteria for promotion should be aligned with the relative time commitment to each activity established by the faculty member, Service Chief and Chair. 1. Clinical Competence and Clinical Service For promotion within the clinician-teacher pathway, the faculty member must be an excellent clinician. Evaluation of clinical competence should use regular peer evaluations and focus on two main areas: (1) fund of knowledge, problem-solving skills, management of complex patients, overall clinical skills, mastery in implementation of evidence-based treatments; and (2) humanistic qualities, responsibility, compassion, integrity, professional behavior and attitudes, interpersonal skills, and effectiveness in working in multidisciplinary settings. Peer evaluations should be performed by other faculty and trainees who work with the individual and are able to assess the faculty member s clinical abilities. Peer evaluators should be chosen by the faculty member, Service Chief and Chair. No more than half of the evaluations should be performed by trainees. These evaluations should be performed in an ongoing way throughout the faculty member s career, to allow early and ongoing feedback and to identify areas for growth. At the time of initial appointment, each clinician-teacher should be informed of the expectations for her/his clinical practice and productivity. Examples include number and types of patients seen, clinical activity as measures in work RVUs (wrvus), revenues, months of inpatient attending, half days of clinical outpatient practice, and types of service provided. Specific guidelines and expectations should be individualized for and clearly communicated to each clinician-teacher by the Chair or his/her designee (e. g. the Chief of Service). 2. Teaching Faculty members in the Clinician-Teacher pathway are expected to be excellent teachers. Evaluation of teaching includes assessment of direct clinical, didactic teaching, curriculum development activities, and evaluations of mentorship activities.

4 Direct teaching includes lectures, seminars, small group sessions, clinical supervision, preceptorships, mentoring, Grand Rounds and continuing medical education teaching of students, residents, fellows, practicing physicians, and other health care providers within the broader local and national community. The quality of direct teaching should be documented by standardized trainee evaluations, peer evaluations, evaluations from Grand Rounds and continuing education programs, and (as appropriate) letters evaluating teaching and mentoring effectiveness. Special recognition of teaching excellence, including local and national teaching awards and invitations to teach in the form of lectures, workshops, or other teaching programs at the local, regional, or national level, is also important in the evaluation of the quality and impact of the faculty member s teaching. Curriculum development activities include the creation of courses, lecture series, training programs, rotations, clerkships, syllabi, web-based programs, videotapes/dvds, clinical case vignettes, clinical simulations, and other innovative educational materials. The quality of these materials should be assessed by learner ratings, impact on learner practice and performance, use in other settings within or beyond UWSOM, recognition as an innovative and/or excellent curricular development on a regional or national level, and/or evaluation by internal or external experts. When a clinician-teacher faculty member is appointed, the Chair, Service Chief, and Vice Chair for Education should specify the expectations regarding the type and quantity of her/his teaching activities. Examples include number of hours of clinical supervision per week, number and level of trainees supervised, amount and type of didactic teaching, involvement in continuing education activities. Specific guidelines should be individualized for and clearly communicated to each clinician-teacher. 3. Administration Effective administration, development, and evaluation of teaching and clinical programs is crucial to the Department's success and we strongly support the involvement of clinician teachers in key administrative positions in the Department. However, administration is not required of faculty members in this track. For those clinicianteachers for whom program development and administrative work is expected, these activities should be evaluated at the time of promotion, as are their teaching, clinical care, and scholarship activities. Evaluation should begin with a narrative from the clinician-educator which describes the program administered or developed and its goals, the exact role of the individual in the program (e. g. clinic director, course director, training director), the relation of the program to the department's mission, the users of the program or the population it serves, indicators of the program's ability to meet its goals (for a clinic this might include an increase in the number of patients served, improvements in outcomes, on-time performance or no-show rates; for a teaching program this might include achievements of students, residents or fellows leaving the program), the estimated number of hours/week spent in administration of the program or program development and evaluation.

5 Each clinician-teacher should also provide a description of other activities involving service to the Department and/or University. This should include committee membership, the purpose and accomplishments of the committees listed and the level of involvement and/or leadership of the individual within the committee. For those clinician-teachers with significant administrative responsibilities, evaluation of administration should include input from the individual's immediate supervisor, those he/she supervises, and (where possible) users of the service/program administered. Input from supervisees and users of the service should include an assessment of the clinicianteacher's availability, ability to communicate ideas and information, ability to provide feedback, degree of respect for workers, ability to stimulate interest and/or enthusiasm for the program, encouragement of independent and/or creative thinking, development and effective communication of a vision for the program, and an overall assessment of his/her performance as an administrator. 4. Scholarship The Department views scholarship as an essential activity for clinician-teachers, and has the goal of developing clinician-teacher faculty who approach clinical work and teaching in a scholarly manner, demonstrating critical thinking abilities, and teaching reflective and evidence-based practice, rather than having solely an apprenticeship model of training. Scholarship may include the generation of new knowledge (the scholarship of discovery), the synthesis and review of existing knowledge (the scholarship of integration), or the development of novel educational methods and materials (the scholarship of teaching). Each clinician-teacher faculty member is expected to have a coherent scholarly focus, centered on the scholarship of teaching and/or related to the subject matter of her/his teaching activities (e.g. a particular psychiatric disorder, area of psychiatry or mental health, or specific patient population). The Scholarship of Discovery refers to the generation of new knowledge through research, which is then disseminated through data-based, peer-reviewed publications in scientific journals. Clinician-teachers can work as principal investigators or collaborators on research studies, contributing to the generation of the research idea, recruiting patients, conducting chart reviews, treating patients as part of a treatment study, participating in data collection and analysis, and/or writing up the results for publication. The Scholarship of Integration refers to the synthesis and integration of existing information on a particular question. This includes writing systematic reviews of the literature, including meta-analyses or Cochrane Collaboration reviews, book chapters, or review articles published in peer-reviewed journals; writing or editing books; or serving as the editor or on the editorial board of a journal. The Scholarship of Teaching refers to the development of new educational methods and materials, and to the generation of new knowledge regarding education and teaching. Contributions in this area could include peer-reviewed publications of studies or reviews regarding educational methods, or the development of new curricula, materials for in-

6 house use such as resident handbooks and evidence based clinical guidelines, educational software, audiovisual materials, web-based educational programs, or new methods to evaluate the success of educational programs and the progress of trainees. For promotion, clinician-teachers are expected to demonstrate ongoing scholarly achievement, as evidenced by independently reviewed scholarly products. If a scholarly product is a data-based research paper or peer-reviewed review article, these presumably have already undergone external review as a prerequisite for publication. Other scholarly products might include curricula, websites, videotapes/dvds, books, or other teaching materials. Products that have been nationally disseminated can be sent to external experts in the area for review, while materials or curricula used locally within the department or UWSOM should be reviewed by departmental faculty, including senior clinician-teacher faculty members. The individual clinician teacher s mentor, Chief of Service, the Vice Chair for Education, and/or the Chair should provide him/her with guidance regarding seeking appropriate independent review of scholarly products. The Teaching Portfolio Every clinician-teacher faculty member should develop a teaching portfolio to submit at the time of consideration for promotion. The portfolio documents the individual faculty member s teaching philosophy and the nature and evaluation documents for his/her teaching, mentoring, educational administration and leadership, scholarship, regional/national/international recognition, honors and awards, and long-term goals. Professionalism A faculty member meets expectations for professionalism by consistently demonstrating: Respect for colleagues, trainees, patients, staff, and others Commitment to honesty and transparency, encouraging trust in all interactions Commitment to working as a team member who is accountable to others, fair, confronts unprofessional behavior, and works constructively to support established operational goals Understanding of own limitations and willingness to accept feedback and make needed corrections Sensitivity and respect for diversity, including others culture, age, gender, and disabilities Patient confidentiality, timely completion of notes and evaluations, accurate completion of professional billing Commitment to improving quality of care and to promoting a culture of safety, including encouraging others to express concerns Management of conflicts of interest For faculty engaged in research: appropriate protection of human subjects and intellectual integrity, and adherence to university research regulations Excellent citizenship, including administrative contributions, participation in departmental meetings and activities, and in general supporting the clinical and academic mission of the Department and School of Medicine

7 Appendix A CLINICIAN-TEACHER PATHWAY PROMOTION CRITERIA Department of Psychiatry & Behavioral Sciences University of Washington ASSISTANT PROFESSOR Documented evidence of: excellent clinical competence and productivity, excellence as a teacher scholarly achievement excellent professionalism ASSOCIATE PROFESSOR Documented evidence of: clinical excellence and productivity high ranking as a teacher a thoughtfully articulated teaching philosophy ongoing scholarly achievement with a coherent focus excellence in administration (if part of the faculty member s assigned responsibilities) excellent professionalism regional recognition as a clinician, teacher, or medical educator. PROFESSOR Documented evidence of: clinical excellence and productivity high ranking as a teacher a thoughtfully articulated teaching philosophy ongoing substantial, mature scholarship as reflected by a coherent body of high quality scholarly work outstanding administrative leadership (if part of the faculty member s assigned responsibilities) excellent professionalism national or international recognition as a clinician, teacher, or medical educator.

8 UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES SALARIED CLINICAL FACULTY PATHWAY APPOINTMENT AND PROMOTION GUIDELINES DRAFT 3/13/15 INTRODUCTION The Salaried Clinical Faculty (SCF) pathway is for faculty members who have a paid appointment in the department and have as their primary responsibility provision of direct clinical service. Faculty members in this pathway are expected to be excellent clinicians with a defined area of clinical expertise, and to further the Department s clinical mission. They may be expected to teach medical students, psychiatry residents, psychology residents, and/or fellows in the context of their clinical work. Faculty members in this pathway advance the Department s clinical mission by providing: high quality, high productivity clinical care in a defined area of interest, in a specific clinical setting, or working with a specific patient population as applicable, clinical supervision and teaching in the context of, and related to, the faculty member s clinical focus area, setting, or patient population SCF pathway faculty may also enhance the quality, efficiency, and management of clinical services, for example through quality improvement projects or through development and/or administration of clinical programs. Faculty in this pathway will have the title Clinical Instructor, Clinical Assistant Professor, Clinical Associate Professor, or Clinical Professor. APPOINTMENT Initial appointment in the SCF Pathway is generally at the level of Clinical Instructor. Key criteria for appointment are: M.D., D.O., or Ph.D. degree (or equivalent) and clinical training needed to meet relevant licensing, Board certification, and specialty or subspecialty requirements Demonstrated excellence in clinical work, documented from residency, fellowship, other equivalent training, or clinical practice settings Interest and promise for high quality and high productivity clinical work in a defined area of interest, in a specific clinical setting, or working with a specific patient population relevant to the Department s clinical mission As applicable, interest and promise in clinical supervision and teaching

9 At the time of appointment, the specific scope of responsibilities will be established by mutual agreement between the faculty member, Service Chief and Chair. These responsibilities will be reviewed annually and updated as needed. The following will be specified at the time of appointment: Clinical FTE Expectations regarding the nature and volume of clinical work Financial incentives for high clinical productivity Expectations regarding the nature and amount of clinical supervision and/or teaching Any additional responsibilities, such as program development and administration, quality improvement projects The policy and expectation of UW Medicine and the Department of Psychiatry and Behavioral Sciences is that all faculty members conduct themselves with professionalism, dignity, and respect in their interactions with patients, trainees, members of the public, and each other, as outlined in the UW Medicine Policy on Professional Conduct. Professionalism includes demonstration of excellence, integrity, respect, compassion, accountability, and a commitment to altruism in all work interactions and responsibilities. PROMOTION Promotion is based on the quality of the faculty member s documented contributions to the clinical mission of the Department. Time in rank alone is not sufficient for promotion. Clinical Assistant Professor This rank requires that the individual has evidence of training or clinical practice experience beyond that required for initial appointment to the rank of Clinical Instructor. In general, Board certification (or its equivalent) is required for psychiatrists, and licensure for psychologists, at this rank or higher. Promotion to Clinical Assistant Professor requires excellent clinical competence and productivity, identification of a defined focus area of clinical expertise, and, where applicable, excellence in clinical supervision and teaching. Candidates must also demonstrate excellence in professionalism. Clinical Associate Professor Promotion to Clinical Associate Professor requires local or regional recognition as a clinical expert, sustained excellence in clinical competence, clinical productivity, and professionalism and, where applicable, excellence in clinical supervision and teaching related to the faculty member s area of clinical expertise. If administration is a substantive part of the faculty member s responsibilities, significant accomplishments in clinical program development and/or leadership will be expected for promotion to this rank. Board certification (or equivalent) is required for psychiatrists and licensure for psychologists.

10 Clinical Professor Promotion to Clinical Professor requires distinguished and substantial professional activity in patient care, national or international recognition as an expert in a well-defined area of clinical care relevant to the Department s clinical mission, and sustained and outstanding clinical competence, clinical productivity, professionalism, and, where applicable, clinical supervision and teaching. Faculty members promoted to Clinical Professor in this pathway are expected to be outstanding clinical role models and leaders. While scholarship is not required or expected for promotion in this pathway, promotion to Clinical Professor requires a regional reputation as evidenced by referrals for expert clinical consultation, regional lectures and presentations, significant administrative contributions, contributions to national or international professional societies, clinical guideline development or implementation, and/or significant leadership roles within the Department or School of Medicine. Emeritus Emeritus status is reserved for faculty members who have retired from clinical activities and whose clinical and teaching record has been highly meritorious, including sustained and substantial contributions to the missions of the Department. In general, Emeritus appointments require at least ten years of prior service and achievement of the rank of Clinical Associate Professor or Clinical Professor. EVALUATION CRITERIA Professionalism Professionalism is assessed annually by the Chief of Service and Chair as part of the annual review process. A faculty member meets expectations for professionalism by consistently demonstrating: Respect for colleagues, trainees, patients, staff, and others Commitment to honesty and transparency, encouraging trust in all interactions Commitment to working as a team member who is accountable to others, fair, confronts unprofessional behavior, and works constructively to support established operational goals Understanding of own limitations and willingness to accept feedback and make needed corrections Sensitivity and respect for diversity, including others culture, age, gender, and disabilities Patient confidentiality, timely completion of notes and evaluations, accurate completion of professional billing Commitment to improving quality of care and to promoting a culture of safety, including encouraging others to express concerns Management of conflicts of interest For faculty engaged in research: appropriate protection of human subjects and intellectual integrity, and adherence to university research regulations Excellent citizenship, including administrative contributions, participation in departmental meetings and activities, and in general supporting the clinical and academic mission of the Department and School of Medicine

11 Clinical Competence, Productivity, and Area of Expertise SCF Pathway faculty members are expected to provide high quality clinical care, meet expectations for clinical productivity, and develop a coherent area of clinical expertise important to the Department s clinical mission. This area of clinical expertise may be the diagnosis and/or treatment of particular conditions, development and provision of a type of treatment, clinical work in a particular clinical setting, or clinical care of a specific patient population. Clinical competence, productivity, and area of expertise will be assessed by the faculty member s Chief of Service and by the Chair as part of the annual review process. Measures assessed include the following: Peer evaluations of clinical competence Patient satisfaction ratings and comments Recommendations, ratings, or comments from referring health care providers Specific clinical training and/or certification Meeting expectations for productivity (e.g. hours of clinical care provided, RVUs) Referrals for expert consultations and/or treatment Invitations to present lectures, workshops, or trainings as a clinical expert Recognition or awards for clinical excellence Teaching Faculty members in this pathway may be expected to provide clinical supervision and teaching to trainees in the context of their clinical work. Clinical supervision and teaching will be assessed by the Chief of Service and Chair as part of the annual review process, based on the following: Clerkship teaching evaluations from medical students Clinical supervision evaluations from residents and fellows Evaluations of any didactic teaching Awards or other recognition for high quality supervision and teaching Meeting expectations for quantity and nature of supervision and teaching Administration Administration may be included in the specific responsibilities for an individual SCF Pathway faculty member. In this case, performance in administration will be assessed by the Chief of Service and Chair as part of the annual review process, based on: Design and/or implementation of clinical program(s) Management and leadership of clinical program(s) Success of clinical program(s) in meeting program goals Local, regional, or national recognition of clinical program (e.g. awards, certification)

12 Local, Regional, and/or National Recognition Scholarship is not required or expected for appointment or promotion in this faculty pathway. However, in considering faculty members for promotion, scholarship or other factors can be taken into account, especially as they contribute to a local, regional, or national reputation as an expert clinician, role model, and teacher. Such factors can include: Service in local, regional, or national professional societies Contribution of medical expertise to non-academic organizations or groups (e.g., community, regional and/or national non-profits) Membership in and/or chairmanship of departmental, school, and hospital clinical committees and/or task forces at a level that is significant to the function of the committee and/or task force Effective translation of new clinical knowledge into departmental teaching and clinical programs Publications, especially in the faculty member s area of clinical expertise (e.g. case reports, participation in clinical research, scholarly reviews of the literature, book chapters) Quality of curriculum or other teaching materials developed Quality and impact of other professional activities relevant to one s area of clinical expertise such as the development and / or implementation of clinical treatment guidelines or quality improvement programs / projects.

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