Creating Educational Opportunities for Medical Educators

The Institute

The FAIMER Institute is a two-year, part-time fellowship program designed to teach education methods and leadership skills, and to promote the development of professional relationships among participants. By fostering interaction among international medical educators and supporting regional centers of activity in the field of medical education, the Institute strives for co-creation of experiences and resources that serve the needs of the international medical education community.

During the first year, Fellows attend two residential sessions in Philadelphia, one year apart. They develop knowledge and skills in a wide range of educational concepts, such as problem-based learning, adult learning theory, lecturing, and use of computers in education. They also participate in sessions on clinical skills teaching and assessment, faculty development, student assessment, use of educational materials, and audio-visual techniques.

In the interval between the two residential sessions, Fellows implement their curriculum innovation projects, which they have refined during the Institute's first session. The projects serve as vehicles for learning and practice of planning and leadership skills, as well as use of enhanced educational knowledge and skills. The Fellows also participate in web-based discussions between residential sessions.

In the second year, Fellows mentor a member of the entering class and actively participate in web-based discussions among members of the two classes. Throughout the program, Fellows learn methods of effective organizational leadership, personal leadership style assessment, program evaluation, project management, conflict management, strategic planning, and various e-leadership skills using web-based tools.

Curriculum Innovation Project

A major goal of the program is completion of a curriculum innovation project, proposed by Fellows in their initial application to the Institute, and implemented at their medical schools during the intersession period. Analysis of the projects completed by former Institute Fellows shows that the curriculum innovations typically involve one or more of the following areas: problem-based learning, student assessment, information technology, community-based medical education, program evaluation, faculty development, medical student certification, comprehensive curriculum revision and integration, and distance learning.

Global Professional Network Building

Building regional networks of medical educators is another major goal of the Institute. Each Fellow is part of the Institute for a two-year period, and interacts closely with up to 35 other Fellows. Network building is fostered by a period of overlap in the residential sessions for first- and second-year participants, providing opportunities for interaction between Fellows who are beginning their curriculum innovation projects and those who have just completed their projects. The Collaborative Projects on-line discussion provides a forum for group work on research and projects among both Institute alumni and current Fellows. Finally, the development of professional networks is advanced by FAIMER's geographical foci, which accelerate the development of resources locally. The results are mentoring and collaborative relationships that contribute to regional and, ultimately, global networks of experts in medical education.

The designation of one curricular day as International Medical Education Day provides a specific opportunity for focused interaction among new and returning Fellows. For 2004, this event was particularly successful. Discussants focused on developing research questions related to physician migration and, through the active engagement of all involved, made four feasible proposals. One proposal, a cross-sectional study of medical school graduates from 14 medical schools in eight countries in sub-Saharan Africa, has already begun, under the leadership of two Institute Fellows. The topics covered during this one-day event provide additional information about the needs and interests of international faculty that can be incorporated into the Institute curriculum.

Results of the Institute's formal evaluation plan confirm that Fellows experience an increase and change in their professional networks. Prior to the Institute, the classes of 2001 and 2002 had professional networks that were small in number, dense (most members of their networks knew each other), and nearby geographically. After the Institute, the Fellows' professional networks had become larger, less dense, and more diverse geographically. The pattern exhibited by Fellows before their Institute experience is well suited to teamwork and the implementation of local projects. Their post-fellowship networks provide a much broader perspective and access to more information and resources. This type of network is more useful in the implementation of complex projects and/or projects that require innovation.

Measuring Impact

Ongoing evaluation of the Institute is essential to measuring and improving the efficacy of the program. Although it is still early in the life of the program, a formal evaluation plan is in place and is providing valuable feedback on the impact of the fellowship experience. The evaluation plan includes data collection and analysis by FAIMER staff and, to ensure an independent perspective, external investigators. The external review is conducted by Stewart Mennin, Ph.D., Summers Kalishman, Ph.D., and MaryAnn Eklund, R.N., Ph.D., of the University of New Mexico Office of Program Evaluation, Education, and Research.

The evaluation employs surveys and interviews of Institute Fellows, beginning with the first class of 2001. The evaluation team interviews Fellows at the end of their second session, and will continue interviewing all Fellows periodically for a number of years to assess the full impact of the Institute.

Both quantitative and qualitative data are analyzed in evaluating the FAIMER Institute. Quantitative data from survey and professional network analysis show significant increases in knowledge, skills, and network effectiveness. Qualitative data from exit and follow-up interviews, also extremely positive, offer rich insights into the significant impact that the FAIMER Institute has had on the Fellows' professional lives. An additional measure of the Institute's impact is the high level of professional accomplishment achieved by Fellows after the fellowship experience. Refer to Exhibit C for recent accomplishments by members of the 2003 class. Ongoing evaluation of the program has enabled many improvements to the Institute's curriculum, including those relating to faculty involvement, on-line discussions, poster presentation of Fellows' curriculum innovation projects, and new workshop topics.

Global Faculty Advisors

The Institute's faculty include both permanent members and visiting members, selected on an annual basis, who represent a variety of disciplines. The Institute has moved closer to its goal of having an international faculty through the addition of Global Faculty Advisors to the program. The Institute's Global Faculty Advisors work to expand and improve the mentoring curriculum and provide individualized help with curriculum innovation projects. Each Global Faculty Advisor leads a group of second-year mentors and first-year mentees throughout the year. The 2004 Global Faculty Advisors, who are former Fellows from the Institute 2001 and 2002 classes, are listed in Exhibit E.

Regional Institutes

To maximize impact, FAIMER concentrates its resources in specific geographical areas. South Asia is FAIMER's primary geographic focus, with sub-Saharan Africa and South America as additional areas of concentration. Within the context of the Institute, these regional foci guide the selection of Institute Fellows and the allocation of FAIMER resources. In broader context, they will facilitate the development of regional Institutes, centers of activity where ongoing exchange among medical educators supports improvement in local medical education systems. The first regional Institutes are planned to begin in India in 2006. See South Asia Regional Institutes to Begin in 2006.