1. Strengthening Family Medicine Faculty Development in Sub-Saharan Africa: A Qualitative Needs Assessment Paul Larson MD, MS, DTMH Maria Colon-Gonzalez, MD Roberta Lamptey, FWACP, PG Cert

2. 2 Activity Disclaimer ACTIVITY DISCLAIMER It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. Paul Larson, Maria Colon-Gonzalez & Roberta Lamptey have indicated they have no relevant financial relationships to disclose.

3. A Strong Team STFM Groups: Global Health & Faculty Development Patrick Chege MBChB, MMed-FM. Moi University Faculty of Medicine, Kenya Bruce Dahlman, MD, FAAFP, MSHPE. Institute of Family Medicine, Kenya Christine Gibson MD CCFP, DTM&H, MMedEd. University of Calgary Stephanie Onguka MD, MAAFP. Kabarak University, Kenya Roberta Lamptey, FWACP, PG Cert. Korle Bu Teaching Hospital. Ghana Cayley, B: University of Wisconsin Nguyen, M: Baylor College of Medicine Johnson, B: Contra Costa - UCSF Colon-Gonzalez, M: Univ Texas Evensen, A: University of Wisconsin Hasnain, M: University of Illinois Doubeni, A: University of Pennsylvania Brocato, J: University of Minnesota Pfeifle, A: University of Kentucky Hogan, L: University of Pittsburgh El Rayess, F: Brown University Filip, A: Brown University Mishori, R: Georgetown University

4. Objectives Describe the need for Family Medicine faculty development in sub-Saharan Africa Consider select qualitative data results Compare faculty development needs to your context Suggest strategies to meet the identified needs

5. Need locally trained & competent Family Medicine doctors Faculty inadequately prepared to teach and lead development Pioneer faculty need training

6. Interview Directors & Faculty Inform curricula to address needs Project Outline

7. Method Purposeful sampling Current faculty instructors In-Depth interviews Qualitative descriptive analysis

8. Instrument Characteristics of informant, program and current faculty Current approaches to faculty development Desired competencies of faculty Areas of current deficiency

9. Results Current Status & Future Needs “Family Medicine, I can say, is a fetus”

10. Current Status Limited Availability Limited Access Limited (Institutional) Support Assumption of Competence Motivation to Teach

11. Limited Availability “So most of us that are here now haven’t had any specific teacher training. We’ve only learnt what we know on the job” “a structured formal training as a member of faculty has not taken place. So we are all trying to sort of do the best we can” “If you’re a teacher you should be able to teach well. But some of us have never been taught, so we just do the best we can”

12. Limited Access “The trainers on the ground are few…it’s pretty difficult to run an effective training program…you have to do real long hours to be able to help the residents [be] comfortable” “One, the number of faculty members. Two, remuneration and allowances. Three, the time factor. Number four, the people who are doing the training itself are not available. And then, the last one is, sometimes non-compliance and apathy from the college itself.”

13. Limited (Institutional) Support “ You may not get a full sponsorship as other departments…but you can make the sacrifice that you’re determined to. And hopefully that as time goes on, as they recognize the contributions of family medicine to medical education, they will recognize the need to have academic departments.” “Structures are in place, it’s a comprehensive training center with all the departments that we need to harness for training. However, the trainers on the ground are few”

14. Assumption of Competence “ Because the faculty expects us to teach and if there was no curriculum to train me as a teacher. I think it's a very good concept that we must begin to train the doctors as teachers and not assume that, because the person is a doctor and therefore knows how to teach... Because teaching itself is a profession and it has a professional skill and development. ”

15. Motivation to Teach “The person must be driven by interest in what he is doing. His work should not be a burden; work is something to be enjoyed. So, the person should enjoy what he is doing, he should be driven by a larger picture.” “Very simple…recruit the right people…regular improvement of skills and knowledge of the people who are teaching…remuneration and incentives…and happy to teach…improving those who are going to take over”

16. Future Needs Mentorship & Role-modeling Formal & Informal Training Opportunities Networking, Partnerships & Collaboration

17. Mentorship & Role-modeling “I believe in kinds of clinical teaching that is a lot more of mentorship than teaching. An apprenticeship, passing on the skills and knowledge onto the mentee. And so, it’s hands on training, learning at the feet of your mentor both in theory, in practicals and in character above all. And so when you are able to see yourself reflecting in your resident, in your mentee, then I think you are doing the job.”

18. Formal & Informal Training Opportunities “Those skills that teachers must have are taught in teachers’ training institutions, which are not there for now. So we must actually bring in that kind of situation…instead of exposing only to clinical services, there should be teaching skills.” “When I started taking students feedback, I learned a tremendous lot. So I had to change a lot of the way I do a lot of things.”

19. Networking & Collaboration “ WONCA is committed to making the health of people all over the world better. Through the training and capapcity building of its members…make these findings available to all…so that people outside Africa will know about what we are going through and the challenges we are facing. And maybe consider how they could also contribute to be of help.”

20. Questions & Suggestions How do the needs described compare to your context? What faculty development strategies would you suggest to meet these needs? “Teachers are not born, they are made” Contact: larsonpr@upmc.edularsonpr@upmc.edu

21. Please evaluate this session “We must teach people how to teach”

22. Ethical Review University of Pittsburgh IRB oversight not required Moi University Institutional Research and Ethics Committee (IREC/2014/167) University of Ghana Ethical and Protocol Review Committee (MS-Et/M.5-P4.10) World Organization of Family Doctors (WONCA) Africa Region President (3/2014) No financial rewards provided to informants The Data is confidential & anonymous

23. Data Collection Trained interviewers Standard informational script regarding purpose, method and anonymity of study Standardized interview field guide 10 to 40 minute in-person interviews East Africa Completed Sept-Dec 2014 & June 2015 –Attendance at 2 nd East Africa Family Medicine Initiative Conference, November 2014, Nairobi, Kenya West Africa Completed in May 2015 –Attendance at WONCA Africa Region, May 2015