Brock talks about her new role as associate dean of teaching and learning

Education researcher Tina Penick Brock, BSPharm, MSPH, EdD, became the UCSF School of Pharmacy associate dean of teaching and learning, effective March 11, 2011. She joined the School’s Department of Clinical Pharmacy faculty in July 2010. Her credentials include:

  • a doctorate in education from the University of North Carolina at Chapel Hill
  • a master of science in pharmaceutical sciences, and undergraduate degrees in German and pharmacy, from the University of Mississippi
  • stints as a licensed pharmacist in community, hospital, and professional association settings
  • university teaching and curriculum development
  • university student services administration, and
  • work for a nongovernmental agency, to improve access to and use of medicines globally.

She shares here with Susan Levings, UCSF School of Pharmacy associate dean of planning and communications, her thoughts on her new appointment.

Brock and Levings

Tina Brock discusses her new role with Susan Levings.

Your charge as associate dean is a tall order, Tina. How are you approaching it?

With eagerness and optimism, frankly…mixed with a bit of awe. At UCSF, we are truly standing on the shoulders of giants, and never in my wildest dreams did I consider that I would be part of that tradition.

There is a saying: “Be bold and mighty forces will come to your aid.” Well, there are definitely mighty educational forces in the School of Pharmacy and across the UCSF community, and I am so looking forward to working together with them to evolve our curricula, thoughtfully and purposefully, for a new day in health care delivery and, ultimately, to make sure our patients achieve the best possible health outcomes.

I recently lost a mentor, my father-in-law, a dermatologic surgeon who practiced medicine, farmed, and played jazz into his 90s. I like to think this amazing opportunity gives me a chance to follow his advice—put the patient first and everything else will work out. Over the past few months, I’ve thought a lot about how his advice applies to what we do in pharmacy education here and internationally.

You came to this position with great teaching credentials. Were you always a good teacher?

Ha! In my first faculty position, I was spending about 12 hours preparing for every 1 hour of lecture. I was working very hard, and I wanted to be good at it…but I wasn’t. My teaching evaluations were terrible. I was becoming demoralized, and I just knew something had to change. Most people start academic careers because they are good researchers or clinicians, but they get very little formal training in education. Thankfully, my university had a peer review program that came to my rescue. But the rescue was not exactly painless. The faculty in the program went through some basic concepts with me, videotaped my lectures, and reviewed my exams. It was hard work, but I saw I was spending far too much time trying to make sure I knew and conveyed every little fact, and not nearly enough time thinking about how I would teach complex concepts to smart, but inexperienced, future pharmacists.

From there, how did you get interested in education as a science?

I would read books about education to try to improve my skills even more, but this wasn’t enough for me. So my mentor suggested I look into the courses that were offered by our university’s School of Education. That did it—I was hooked!

Just as in any other science field, once I understood the theories behind education, I was able to use these to develop and test hypotheses. From these research results, I could predict behavior change. And how is that not fascinating? It became so clear—and so exciting to me—that the skills associated with good teaching could be learned. That meant they could also be shared.

Teaching is inherent in everything we do as pharmacists, and the skills are transferrable to so many other facets of our lives. These skills served me well, not only as a teacher, but also as a clinician and researcher.

What are the most important things we can do to make sure that our curricula prepare the best possible pharmacists and scientists?

Brock

In A New Culture of Learning by Douglas Thomas and John Seely Brown, the authors say that “embracing change means looking forward to what will come next.” What’s coming next is that learning will be increasingly collaborative and social in classroom, clinical, and community environments. But that change won’t necessarily be easy, because for most of us it will mean changing to a way of teaching that will be very different from the way we were taught. Fortunately, we’re in the health sciences, so the concept of lifelong learning is the norm for us. We now just need to become comfortable with facilitating that learning in new ways.

This new culture of learning actually partners well with a movement in healthcare called “disruptive innovation,” as described by Clayton Christensen in The Innovator’s Prescription. We want to make sure that the School of Pharmacy is pushing the envelope the way it did in 1966, when it established the first clinical pharmacy services. Christensen’s concepts apply just as well to PhD education.

Regardless of the program, one of the keys is to build stronger connections between our courses and the concepts described in them. Think of it like a mosaic—each individual piece may be nice, but it’s the way all of the pieces fit together that creates the image.

We already have the top PharmD program in the United States and exceptional PhD graduate programs. "What's to change?" some might ask.

To ensure our graduates remain at the top once they leave here, it’s our responsibility to make sure our curricula are integrated, remain fresh and meaningful, and are presented in ways that reflect how young people actually learn best, based on the latest evidence from educational research. This might mean that we need to invest some discussion time in developing a UCSF-specific approach…but I have every confidence that the most innovative scientists and clinicians in the world can be the most innovative educators.

No question, technology is transforming how we work, how we learn and educate. What do you see as the opportunities for us to leverage technology for the benefit of our students?

This is truly where we have a real opportunity to forge new ground in health professions education. With much of the tech and gaming industry “local” to us, we should absolutely be partnering with technology groups to serve as their laboratories.

Can you imagine harnessing the power of gesture-based, multiple-player gaming technologies, like an Xbox360, to teach our students the skills needed to prepare parenteral therapies? You wouldn’t need a clean room or even an IV hood, but students could use the same technologies that kindergartners are using—but to complete much more complex tasks at a lower resource level, overall.

And because we have such talented PharmD and PhD students, we should be harnessing their abilities to use these technologies to create their own learning tools. I know that Elazar Harel, our Vice Chancellor for Information Technology, is keen to foster these types of discussions among UCSF faculty members. The new Teaching and Learning Center at UCSF really opens the door for more innovation in this area, so there are definitely exciting times ahead.

The need to teach and learn together as pharmacy, nursing, dentistry, and medical students had been discussed for years. It's now beginning to happen at UCSF, and you are very much involved. How so? Why is this so important now?

Brock

Again, this is another area in which UCSF is well positioned to excel. We’re on a dedicated health sciences campus that has an academic medical center and educational programs in pharmacy, nursing, dentistry, physical therapy, medicine, and the sciences. Plus we have a very strong library program supporting us. It’s a rare and precious combination.

In reference to the professional schools in particular, research shows that there are fewer errors and patients have better outcomes when clinicians work together, sharing the responsibility for overall outcomes.

But how can clinicians learn to work together in the clinical setting if they’ve only passed each other in the hallways during their training? We haven’t optimized this strategy as yet, but the creation of the new UCSF Center for Innovation in Interprofessional Health Education is poised to change that. One of the great things about our PhD programs is that they’re already so integrated.

Some of the most powerful learning experiences I’ve witnessed since arriving in California are the interprofessional exercises that have been going on in UCSF’s Kanbar Simulation Center where students from each of our professional programs work together to solve problems for and communicate with standardized patients, who are actually actors trained to portray a specific situation. Although this project is still in its infancy, it will be great to see the medium- and long-term results of this initiative and use that to create even more opportunities for true interprofessional learning.

There was a very interesting article in The New York Times recently [More Physicians Say No to Endless Workdays] that basically said some physicians no longer find it interesting to deal with community-based chronic care for patients with diseases like diabetes and hyperlipidemia, preferring instead diagnostic and acute treatment positions in hospitals. We can be disturbed by this…or we can recognize this opportunity for what it is and look for better ways to ensure patients’ needs are met by a team of health professionals working together within the patient-centered medical home. The more our students learn together, the more comfortable they will be sharing the responsibility for patient care.

You have had quite a bit of experience in international education. What application, if any, does it have for your new role?

The School of Pharmacy has a long history of global involvement, and with the fairly new UCSF Global Health Sciences master’s program, the potential for this type of work is expanding.

I am a member of the advisory group for the WHO-UNESCO-FIP Global Pharmacy Education Taskforce, and this organization promotes what’s known as a needs-based approach to education (See attached graphic.). In this way, educational systems are locally determined but globally connected. We can use this methodology to create and continually monitor whether the curriculum at UCSF is truly matched with the health needs of our population.

Coming from an underserved area of the U.S. makes me especially in tune with how we might partner to address some of the needs of the developing world. But I also think we have a lot to learn from our global neighbors, so it’s important to keep the dialogue open.

In countries where the human resource situation is dire, the health professions haven’t had the luxury of dividing into “silos” because they need every available person working at full capacity—there’s no room for the territorialism that has stymied collaboration in more developed countries. It’s a good lesson.

We do a lot of wonderful science at UCSF—basic, translational, clinical, health policy—but are not known as a nexus for educational research. What are your thoughts on the science of teaching and learning and its place at UCSF?

Brock

You’re absolutely right. Do a search of the scientific literature and our faculty members are published in the best journals and are presenting at the highest-profile conferences. Do a search of the educational literature, and UCSF falls short of its potential.

We have developed innovative curricular programming in the School of Pharmacy, such as the Rx for Change in tobacco cessation and our cultural competence work, but we could be doing so much more in the area of educational research. As we change our curricula we need to be measuring resultant outcomes to find out the “so what,” i.e., what’s nice to do as compared to what’s necessary. I see research potential everywhere I look.

UCSF has demonstrated excellence in theory-grounded, hypothesis-based science; we just need to consider how we can bring those same techniques into the learning environment. And we are fortunate to have colleagues across the UCSF schools with whom we can partner on this. If we create a shared vision to be the best at pharmacy education research—indeed, health sciences education research—then we will be.


About the School: The UCSF School of Pharmacy aims to solve the most pressing health care problems and strives to ensure that each patient receives the safest, most effective treatments. Our discoveries seed the development of novel therapies, and our researchers consistently lead the nation in NIH funding. The School’s doctor of pharmacy (PharmD) degree program, with its unique emphasis on scientific thinking, prepares students to be critical thinkers and leaders in their field.