Abstract
BackgroundThe number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide. Despite the increasing number of GEM fellowships, there is not an agreed upon approach for assessment of GEM trainees.Main bodyIn order to study the lack of standardized assessment in GEM fellowship training, a working group was established between the International EM Fellowship Consortium (IEMFC) and the International Federation for Emergency Medicine (IFEM). A needs assessment survey of IEMFC members and a review were undertaken to identify assessment tools currently in use by GEM fellowship programs; what relevant frameworks exist; and common elements used by programs with a wide diversity of emphases. A consensus framework was developed through iterative working group discussions. Thirty-two of 40 GEM fellowships responded (80% response). There is variability in the use and format of formal assessment between programs. Thirty programs reported training GEM fellows in the last 3 years (94%). Eighteen (56%) reported only informal assessments of trainees. Twenty-seven (84%) reported regular meetings for assessment of trainees. Eleven (34%) reported use of a structured assessment of any sort for GEM fellows and, of these, only 2 (18%) used validated instruments modified from general EM residency assessment tools. Only 3 (27%) programs reported incorporation of formal written feedback from partners in other countries. Using these results along with a review of the available assessment tools in GEM the working group developed a set of principles to guide GEM fellowship assessments along with a sample assessment for use by GEM fellowship programs seeking to create their own customized assessments.ConclusionThere are currently no widely used assessment frameworks for GEM fellowship training. The working group made recommendations for developing standardized assessments aligned with competencies defined by the programs, that characterize goals and objectives of training, and document progress of trainees towards achieving those goals. Frameworks used should include perspectives of multiple stakeholders including partners in other countries where trainees conduct field work. Future work may evaluate the usability, validity and reliability of assessment frameworks in GEM fellowship training.
Highlights
The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide
The purpose of this article is to provide a review of current approaches to assessment currently in use, to consider common elements needed for GEM fellowship assessments, to present examples of how such common elements may be used to develop assessment tools for GEM fellowship programs with different areas of focus, and to present consensus-based recommendations
Using the International Federation for Emergency Medicine (IFEM) Framework for Curricular Assessment as a guide we propose an assessment framework for GEM fellowships to guide knowledge acquisition, as well as, professionalism and social accountability in field experiences [3, 4, 11, 12]
Summary
The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide. 3 (27%) programs reported incorporation of formal written feedback from partners in other countries Using these results along with a review of the available assessment tools in GEM the working group developed a set of principles to guide GEM fellowship assessments along with a sample assessment for use by GEM fellowship programs seeking to create their own customized assessments. The subspecialty developed organically over years and encompasses a wide range of medical and public health activities around the world including: development and implementation of emergency care systems in various settings from lowresource settings to even some high-resource settings that do not yet have formal emergency care; development of EM as a recognized medical specialty where it does not formally exist; health care during complex emergencies; and research to advance the science and practice of emergency care globally [2] This wide range of GEM activities encompasses diverse skills – research techniques, project management, logistics, public health training – that are not routinely included in most EM training programs. Some GEM fellowships incorporate graduate degrees in related sciences (e.g. Public Health, Epidemiology, Education) [3]
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