TRAINING MEDICAL

EDUCATION TRAINERS
Framework

A competency-based approach towards

sustainable Medical Education Capacity Building

www.ifmsa.org Medical Students Worldwide

Contributors The International Federation of Medical Students’
- Tomáš Petras (SCOME Associations (IFMSA) is a non-profit, non-
Development Assistant) governmental organization representing
- Ali Channawi (SCOME associations of medical students worldwide. IFMSA
Director) was founded in 1951 and currently maintains 141
- Martín Ignacio Guillermo National Member Organizations from 130 countries
Cortés Espinoza (IFMSA-Chile) across six continents, representing a network of 1.3
- Abdelrahman Khaled Fouad million medical students.
(IFMSA-Egypt) IFMSA envisions a world in which medical students
- Prabhat Jha (MSAI India) unite for global health and are equipped with the
- Carlos Augusto Sánchez knowledge, skills, and values to take on health
Alvarado (IFMSA-Peru) leadership roles locally and globally, so to shape a
- Yaseen Magzoub Saeed sustainable and healthy future.
Mohamadkhair (MedSIN IFMSA is recognized as a non-governmental
Sudan) organization within the United Nations’ system and
the World Health Organization and works in
collaboration with the World Medical Association.

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CONTENTS Introduction and background 4

Medical Education Facilitator -> 5

Medical Education Trainer:

Medical Education Trainer

7
Competencies
Medical Education Expert
Educator
Communicator
Professional
Leader

Agenda Preparation 14

15
Facilitation Methods

17
Follow-up
 Introduction and
background

The Training Medical Education Trainers (TMET) workshop was

first introduced back in 2014 during the pre-August Meeting in
Taiwan. Since then, 57 more TMET workshops took place
during SRTs (Sub-Regional Trainings) and pre-General
Assemblies all around the world, capacitating more than 750
SCOMEdians, on medical education related topics and the
ways to promote them.

All of these were developed and conducted by following firstly

TMET Regulations and later the Annex 1 of the SCOME
Capacity Building Regulations, which ordered a set of
mandatory topics to be delivered during the workshop, 4
medical education topics and 5 facilitation skills topics. The
analysis of the workshop content has led to a conclusion that 9
mandatory topics do not ensure that the participants develop
expected competencies of a Medical Education trainer.

On another note, the follow-up proposed in the earlier

generation of TMET workshops was hard to track and didn’t
have a clear outcome. The situation resembled a “leaking
pipeline”. More than 750 participants attended the TMET
workshop, but we have no clear idea of their follow-up after
their graduation (How many hours of medical education
sessions did they deliver? What topics did they facilitate? Are
they still active facilitators?). There was a need for
implementation of feasible, outcome-based follow-up for
TMET graduates, so they can continuously develop their
competencies and further improve their quality, as much as
there is a need for a strong foundation of the pipeline.

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 Medical Education Facilitator

Medical Education Trainer

Many times, the terms facilitator and trainer are thought to mean
the same. Even though they do share some similarities and
competencies, they have their own different meanings, as they
foster 2 different domains of content providing.

Facilitator:

The definition of facilitate is “to make easy” or “ease a process”.

Unlike a trainer, the facilitator doesn’t necessarily have to know
more than the participants, but rather has an important role in
planning, guiding and managing a session and leading the group
in a certain direction. They try to ensure that the objectives of the
session are effectively met, with full participation from the
participants.

Trainer:

A trainer is a person capable of designing and delivering

educational content, regardless of the topic itself, including
knowledge, skills and attitudes, using, but not limited to formal
and non-formal education methods. They are the experts of the
content and deliver the knowledge to the participants.

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 “A trainer brings the participants from unknown to known.
A facilitator brings the participants from known to unknown.”

The goal of the TMET workshop is toprovide a set of competencies to

participants, to be able to capacitate their peers and to be able to
design, deliver, evaluate and follow-up on non-formal education
sessions related to Medical Education.

As these goals encompass a trainer’s competencies, this framework will

focus only on the competencies of a Medical Education Trainer.

Medical Education Trainer

“A person capable of designing, delivering, evaluating

and following-up on medical education content,
including knowledge, skills, and attitudes, using non-
formal education methods.”

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 Medical Education
Trainer Competencies

1 ME Expert

Teaching and Learning

Participants are able to define the teaching methods, such as affective

development, cognitive development and psychomotor development.

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Participants are able to describe, define the utility of the teaching
methodologies, such as Dale’s cone of experience, learning/forgetting
curve and attention curve.

Participants are able to understand and reflect on the difference

between informative, formative, and transformative learning in Medical
Education.

Participants are able to recognize different frameworks describing

physicians’ competencies, such as CanMEDS or Scottish Doctor, and
understand how they can be implemented in teaching and learning
methods.

Assessment and Evaluation

Participants are able to differentiate between assessment and

evaluation, and use different assessment methods

Participants are able to apply the Miller’s prism of clinical competencies

Participants are able to explain the Vleuten’s criteria of assessment

Educational strategies

Participants are able to explain the importance of, and apply VMOSA
and SWOT analysis in education activity planning

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Participants are able to explain the different educational strategies, their
advantages and disadvantages, such as Flexner strategy, SPICES and
PRISM

Participants are able to explain and reflect on the importance of

competency-based Medical Education

Curriculum planning and development

Participants are able to define the difference between the planned,

delivered, learned and hidden curriculum

Participants are able to apply the Kern's 6 steps approach to developing

curricula

Participants are able to point out and explain the features of the
authentic curriculum and reflect on the solutions relevant to the
problems associated with it

History of Medical Education

Participants are able to summarize the evolution process of medicine

and medical education

Participants are able to reflect on the quality assurance of medical

education throughout history

Participants are able to recognize the development and importance of

informal education in the process of medical education

Participants are able to reflect on the relationship between Medical

Education Systems and Healthcare Systems

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 2 Educator

Facilitation skills

Participants are able to understand and use different facilitation

techniques most suitable for delivering in-person and online medical
education sessions

Participants are able to identify and use different facilitation platforms

most suitable for delivering in-person and online medical education
sessions

Participants are able to recognize the difference between facilitating a

non-formal discussion related to medical education, and training
participants on specific medical education topic

Participants are able to apply most suitable ice-breakers and energizers

throughout any non-formal medical education session

Sessions planning and design

Participants are able to use the NAOMIE method for the non-formal
medical education session

Participants are able to prepare a non-formal medical education activity

with a goal, objectives (SMART) and indicators of success

Participants are able to apply different non-formal educational

strategies during session design, such as the 4MAT, Kolb's learning cycle
or Bloom’s taxonomy

Participants are able to devise strategies for measuring the impact of

their non-formal medical education sessions, such as pre-assessment,
post-assessment, evaluation and feedback

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 3 Communicator

Active Listening

Participants are able to recognize and describe components of active

listening, such as comprehend, retain and respond

Participants are able to establish differences between the various types

of listeners and construct the importance of active listening

Participants are able to apply active listening skills in team-based

setting

Communication models

Participants are able to describe and apply the various communication

models, such as linear, interactional and transactional

Participants are able to determine the dynamics of each communication

model and apply them during session facilitation

Participants are able to identify verbal communication and non-verbal

communication styles and apply them during session facilitation

Presentation and public speaking

Participants are able to define the different elements of public speaking

and apply them during session facilitation

Participants are able to identify and apply presentation formats during

delivering in-person and online medical education sessions

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 4 Professional

Feedback, briefing and debriefing

Participants are able to define and use accordingly the most suitable
feedback method in medical education.

Participants are able to perform productive briefing and debriefing

using various methods, such as 4Fs debriefing.

Continuous development

Participants are able to define the concept of continuous development

and lifelong learning.

Participants are able to use the continuous development cycle steps

effectively for their professional and personal development in medical
education.

Participants are able to determine and apply for IFMSA training

opportunities related to medical education.

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 5 Leader

Leadership

Participants are able to apply different leadership styles in team-based

setting

Participants are able to identify skills necessary for good leadership, such
as conflict management, professional development, team-building and
others

Team dynamics

Participants are able to identify and reflect on types of teams and stages
of team development

Participants are able to showcase roles and responsibilities in a team

based setting related to medical education

Participants are able to determine and apply team effectiveness models

Participants are able to define and apply team-building strategies

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 Agenda Preparation

Training Medical Education Trainers (TMET) workshop is one of the

capacity building efforts by which we can raise the next generation of
Medical Education capacitators, sharing knowledge, skills and attitudes
related to Medical Education. As such, in the following part, you will find
recommendations on how to prepare an agenda, in order to create a
transformative learning experience for your participants.

Transformative Learning Theory

Understanding that every participant will perceive the educational

material, as well as the workshop environment differently is very
important in developing the agenda, and defining the facilitation
methods, which would be the most optimal for all participants. On
another note, raising Medical Education Trainers requires efforts to
tackle change in the way they see issues with the Medical Education
status quo. As such, the Transformative Learning Theory can be applied
during non-formal education sessions in TMET.

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Why Transformative Learning and what is it?

Transformative Learning is a theory that particularly focuses on

andragogy (adult learning). It’s based on the assumption that adults can
adjust their thinking process based on new information. Defined as “an
orientation which holds that the way learners interpret and reinterpret
their sense experience is central to making meaning and hence
learning”. In simple terms, transformative learning is the idea that
learners who are getting new information are also evaluating their past
ideas and understanding, and are shifting their very worldview as they
obtain new information, through critical reflection.

How to apply Transformative Learning during TMET workshop?

As simple as the definition of transformative learning sounds, creating a

Transformative Learning Experience from the trainer's side is rather
more complicated, as there is a specific environment that has to be
created at the beginning of the workshop, after being outlined in the
workshop agenda and proposal. There are two main approaches to
tackle transformative learning in the TMET workshop:

➔ Instrumental learning - relies on task-oriented problem solving

➔ Communicative learning - relies on communication of feelings, needs
and emotions.

Both of these approaches utilize rational processes and incorporate

imagination as a part of a creative process. They are not separate from
each other, but rather condition each other, as the participants need to
be able to focus on different types of their understanding and view new
perspectives that are both logical and emotional in order to challenge
their previous understanding of the competencies tackled during the
workshop.

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 Facilitation methods

Facilitating Transformative Learning is a challenge. In the following text,

we are highlighting only recommendations for facilitation methods,
which might help the Workshop Coordinator and the Medical Education
Trainers of the TMET workshop to create an environment supporting the
compliance of participants to attain the Transformative Learning
outcomes, and as such attain the Medical Education Trainer
competencies:

Problem-based learning - The purpose of this methodology is to put

participants into real cases related to the problems addressed
through the sessions, in a way they apply and frame it into real
contexts and situations.

Reflection cycles - Participants are able to give structure to learning

from experiences relived throughout the workshop day, as well as
past experiences. This can be done in small groups, at the end of each
day.

Brainstorming - Allowing the participants to share their experiences

and reflect on the past in order to better understand the present and
define solutions for the future.

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Small Working Groups - The purpose of this methodology is to create
an environment for common ownership of the discussions and
solutions, as well as to engage participants into sharing and
reflecting.

Feedback, Briefing and debriefing - Transformative Learning is based

on changing perception on the same information through reflection.
Feedback, briefing and debriefing introduce the participants into
continuous development of their critical thinking.

Storry-telling and discussions - Communicative learning is one of the

domains of Transformative Learning. These facilitation methods allow
participants to imagine situations and reflect on them, as well as to
create a debate in order to find a common understanding of the
status quo.

Role-playing - Allowing participants to experience real life situations

and thus create an environment to apply skills acquired throughout
the workshop.

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 Follow-up

Milestones
As acquiring the necessary amount of Medical Education Trainer
competencies is a gradual process requiring experience in facilitation of
medical education related topics and continuous learning, the different
dimensions have been divided into 4 milestones, achieved by gradual
experience in facilitation:

Medical Education Trainer Candidate

Someone who has attended a TMET Workshop

Medical Education Junior Trainer

Someone who got accepted to the IFMSA Trainers Pool
as a trainer (after graduating TMET)

Medical Education Trainer

Someone who has facilitated at least 30 hours of Medical
Education competency topics

Medical Education Advanced Trainer

Someone who has facilitated at least 50 hours of Medical
Education competency topics

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 Advanced Competency Development Course for Medical Education
Trainers (ACDC)

Becoming an experienced Medical Education trainer doesn’t only require

a lot of practice, but also continuous development of the necessary
competencies. TMET Workshop is designed to train the participants on
the aspects of “training the topics right” and “training the right topics”.
However, in the proposed Learning Objectives, there is a gap, created by
the need to provide Medical Education Trainers a platform to further
attain personal and professional development in Medical Education
Capacity Building, and thus elaborating on the aspect of “the right
person training”. The Advanced Competency Development Course for
Medical Education Trainers is a final piece of the Medical Education
Trainer Learning Outcomes Pyramid:

Medical Education Trainer

Learning Outcomes Pyramid

ACDC

"The right
person training" TMET

"Training the
right topics"

"Training the
topics right"

The goal of this Advanced Online Course is to provide a platform

for Medical Education Trainers, to attain the ownership of the
professionality in Medical Education Capacity Building

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A semi-synchronous capacity building initiative, prepared by the SCOME
International Team, held both asynchronously in a form of pre- and post-
assignments, with a synchronous discussions in online sessions, is
designed to remove dust and rust, to sharpen the sword of raising
Medical Education knowledge, skills and attitudes, to create
environment of sharing experiences and to establish a standard in life-
long learning in Medical Education Capacity Building.

The Advanced Competency Development Course for Medical Education

Trainers will be opened on a regular basis for all milestones of Medical
Education Trainers and facilitated through the IFMSA Online Training
Platform.

Your trainer education doesn’t end with the TMET!

Medical Education Trainers Community

Sharing is caring! The same applies to capacity building. Since medical

education is a very specific topic, facilitating which takes a lot of practice
and experience to master, a platform to unite all Medical Education
Trainers was created.

The goal of Medical Education Trainers Community is to unite all Medical

Education Trainers to share ideas and exchange experiences related to
Medical Education Capacity Building of any kind

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Have you just attended the TMET Workshop? Would you like to get in
touch with Medical Education Trainers from all around the world? Would
you like help and tips on how to hold your first session? Then don’t
hesitate to reach out!

IFMSA Medical Education Trainers Worldwide Whatsapp Group

IFMSA Medical Education Trainers Facebook Group

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