segunda-feira, 21 de janeiro de 2019

FAIMER programs




FAIMER fellowship programs: An international, project-centered approach to improving health through health professions education


Published online: 2 January, TAPS 2019, 4(1), 1-3
DOI: https://doi.org/10.29060/TAPS.2019-4-1/GP1072


Julie Drendall & John J. Norcini
Foundation for Advancement of International Medical Education and Research, United States



I. INTRODUCTION


The Foundation for Advancement of International Medical Education and Research (FAIMER®) is a non-profit foundation committed to improving the health of communities by enhancing the quality of health professions education. This article highlights several of FAIMER’s international efforts, with particular emphasis on the fellowship programs developed in partnership with institutions in the Asia-Pacific region.


II. PERSONAL VIEW


FAIMER’s work has historically been concentrated in lower-income regions of Asia, Africa, and Latin America, and has focused on three specific strategies: faculty development, targeted research that informs health workforce policy and practice, and development of data that advances educational quality improvement decisions. FAIMER’s fellowship programs, in particular, enable us to build partnerships with local experts aimed at creating meaningful and sustained improvements in the systems that produce health care providers. These programs provide health professions educators with opportunities to learn new methodologies in teaching and assessment, develop leadership and management skills, exchange educational expertise, and pursue advanced degrees in health professions education (Burdick, 2014). Participants apply this knowledge to improve teaching and learning at their home institutions, with the ultimate goal of improving health outcomes.

The FAIMER Institute is a two-year, part-time fellowship program for international health professions faculty who have demonstrated the potential to play key roles in improving education at their institutions and in their regions. Fellows receive training, tools, and support that enables them to become agents of change — creators of meaningful and sustainable advances in health professions education. The curriculum is organized around four overlapping themes: education methods, project management and evaluation, leadership and management, and education research. Practical application of the knowledge and skills acquired in these four areas is demonstrated through individual, locally relevant education projects, which are proposed during the application process, endorsed by the Fellows’ home institutions, and developed and implemented over the course of the two-year fellowship.

The FAIMER Institute is designed to foster professional support and collaboration with other educators as each Fellow becomes a member of a global health professions education community of practice (Burdick et al., 2010). The program consists of two brief residential sessions in the United States, each followed by a one-year distance learning session. The residential sessions are scheduled so that incoming Fellows overlap with returning Fellows, which means that over the course of the two-year fellowship, each Fellow has the opportunity to work closely with nearly 50 other health professions educators. During the distance learning sessions, Fellows participate in a series of web-based discussions with other Fellows and Institute faculty while implementing their projects at their home institutions. Fellows also interact regularly with each other via a listserv and receive individual coaching and mentoring throughout the program from international experts.

FAIMER’s Regional Institute fellowship programs are modelled after the FAIMER Institute, adapting the curriculum and content to meet the needs of specific regions. To date, FAIMER has established 11 Regional Institutes, located in India, Brazil, Sub-Saharan Africa, China, Chile, Egypt, and Indonesia. Generally hosted by local medical schools, these regional programs draw their participants from the area. This regional concentration facilitates the development of a strong local professional community for collaboration and peer support (Burdick, 2014). Like the FAIMER Institute, the Regional Institute programs include both residential and distance learning sessions, and participants are required to propose and implement education innovation projects that are supported by their home institutions.

To date, we have more than 1,500 FAIMER Fellows, representing more than 50 countries. Slightly more than half of them are from the Asia-Pacific region. The largest concentrations of FAIMER Fellows in the Asia-Pacific region are in India and China, where six of FAIMER’s existing Regional Institutes are located: four in India, developed in partnership with Seth G.S. Medical College (Mumbai), Christian Medical College (Ludhiana), PSG Institute of Medical Sciences and Research (Coimbatore), and Manipal University (Manipal); and two in China, developed in partnership with China Medical University (Shenyang) and Southern Medical University (Guangzhou). The FAIMER Regional Institute of Indonesia for Educational Development and Leadership will welcome its first class of Fellows in Yogyakarta in February 2019, and current Asia-Pacific FAIMER Fellows also hail from Malaysia, Indonesia, Nepal, Pakistan, Sri Lanka, the Philippines, Vietnam, Mongolia, and Fiji.

This international, project-centered approach and emphasis on bringing together a mix of health professions educators from different disciplines make FAIMER’s fellowship programs relatively unique. One of our newer Regional Institutes, the Manipal University-FAIMER International Institute for Leadership in Interprofessional Education, has gone even a step further by inviting participation not just from health professions educators, but from all of the professions (e.g., engineers, urban designers) that contribute to the health of communities. Participants in this program design interprofessional projects, which foster interaction and collaboration among faculty of diverse professional backgrounds.

Central to FAIMER’s fellowship model, the Fellows’ education innovation projects serve as excellent learning experiences, but are also intended to address specific educational needs at participants’ home institutions. Projects with the potential to improve the health of the applicant’s community, country, or region, and which have full institutional support, are given higher priority in the fellowship selection process. For example, a project designed by FAIMER Institute Fellow Rukhsana Ayub Aslam utilized high school and medical students to supplement the care provided by public health workers through service learning projects in four different communities of Pakistan. Its primary focus was to raise awareness about the causes, effects, and prevention of iron deficiency anaemia, a common condition among women of reproductive age in Pakistan. The initial project was supported by local institutions and NGOs but within a few years, it had attracted international partners including Flinders University in Australia and Global Health through Education, Training and Service (GHETS), a U.S.-based NGO, which enabled it to add point-of-care testing and treatment components that have yielded measurable positive health outcomes (Aslam, 2015).

Individual project topics vary widely, but some of the most common areas of focus are teaching methods, curriculum change, program evaluation, alignment with health system/context, and student assessment (FAIMER Brief Reports, n.d.). In the Asia-Pacific region, specifically, the most common areas of concentration have been teaching methods, curriculum change, assessment, clinical skills, and faculty development; other popular areas of focus include problem-based learning, computer-based learning, student affairs, and community-based education.

We routinely evaluate our work and have found that through their projects, Fellows have successfully introduced new educational approaches, faculty development initiatives, curriculum reform, and the creation and/or strengthening of medical education units and departments at their home institutions. Fellows report improvements in the quality of teaching and collaboration at their schools, as well as an increased interest in research and scholarship pertaining to health professions education (FAIMER Brief Reports, n.d.). Many of the projects that have been incorporated successfully at an institutional level are then expanded and replicated at other institutions in Fellows’ countries and regions—creating a ripple or multiplier effect. A significant number of these projects are also having a direct effect on health, through faculty and student-led patient education initiatives, health surveillance projects, and community-based interventions aimed at increasing access to care (Burdick, Amaral, Campos, & Norcini, 2011).

Aside from the projects, we have evidence of the personal and professional growth of our Fellows over the course of their fellowships and beyond. Our data suggest that the leadership training Fellows receive improves their confidence, which contributes to professional advancement and enables them to have increased impact and influence on health education practice and policy, institutionally, regionally, and internationally (FAIMER Brief Reports, n.d.). Many are appointed to key leadership roles at their institutions, and some go on to become members of specialized groups and committees, serve on regulatory bodies, and are appointed to national commissions and councils.

A number of our Fellows expressed the need for additional training with academic recognition, as have other educators around the world. Consequently, we created the FAIMER Distance Learning program in partnership with Keele University and the Centre for Medical Education in Context (CenMEDIC). It aims to empower health professions educators with the knowledge and skills to take educational standards and practice to a higher level— to develop their own practice, improve health professions education at their institutions and in their communities, and ultimately help bring about real and lasting advances in local health care. Participants are able to earn a Certificate, Diploma, or Master’s Degree in Health Professions Education with a focus on accreditation and assessment. The Certificate and Diploma programs are conducted entirely online, and the Master’s Degree is a blended learning program that includes a brief residential session and a dissertation. Our inaugural Masters class graduated in 2016, and it included six educators from the Asia-Pacific region.

The improvement of health professions education may not be the most obvious or immediate means of improving global health outcomes, but evidence from FAIMER’s 18 years indicates that it has a definite impact. We are privileged to be able to do this work, and we are extremely proud of the accomplishments of our Fellows.


Note on Contributors

Julie Drendall, MSS, MLSP, is the Administrative Manager for Communications of the Foundation for Advancement of International Medical Education and Research (FAIMER).

John J. Norcini, PhD, is the President and CEO of the Foundation for Advancement of International Medical Education and Research (FAIMER).
 
Funding
No funding is involved in this paper.

Declaration of Interest
Both authors report no competing interests.

References
Aslam, R. A. (2015, September). Service learning to develop students’ social responsibility and improve women’s health. Project presented at the Annual Conference of The Network: Towards Unity for Health, Gauteng Province, South Africa.
Burdick, W. P. (2014). Global faculty development: Lessons learned from the Foundation for Advancement of International Medical Education and Research (FAIMER) initiatives. Academic Medicine, 89(8), 1097-1099.
Burdick, W. P., Amaral, E., Campos, H., Norcini, J. (2011). A model for linkage between health professions education and health: FAIMER international faculty development initiatives. Medical Teacher, 33(8), 632-637.
Burdick, W. P., Diserens, D., Friedman, S. R., Morahan, P. S., Kalishman, S., Eklund, M. A., … Norcini, J. J. (2010). Measuring the effects of an international health professions faculty development fellowship: The FAIMER Institute. Medical Teacher, 32(5), 414-421.
FAIMER Brief Reports. Retrieved from http://www.faimer.org/education/program-evaluation.html.



*John Norcini
Email: jnorcini@faimer.org
Mailing address: 3624 Market Street,
3rd Floor, Philadelphia,
PA 19104-2685 USA





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