Success stories: exploring the long-term impact of a global faculty development program for health professions educators

Success stories: exploring the long-term impact of a global faculty development program for health professions educators | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Success stories: exploring the long-term impact of a global faculty development program for health professions educators Shiyao Yuan, Asma Rahim, Suvetha Kannappan, Amol Dongre, Animesh Jain, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3944180/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Sep, 2024 Read the published version in BMC Medical Education → Version 1 posted 14 You are reading this latest preprint version Abstract Background Faculty development programs (FDPs) in health professions education (HPE) are instrumental in supporting, promoting, and improving HPE curricula and activities that target individual- and system-level capacity strengthening. FAIMER, a division of Intealth, has been offering FDPs for global health professions educators in HPE and leadership for over two decades through the International FAIMER Institute in USA and FAIMER Regional Institutes located globally. This paper examines the long-term impact of FAIMER's global FDPs by eliciting stories of success from program participants (Fellows). Methods The study utilizes a modified Success Case Method approach. Study participants recruited were 14 FAIMER Fellows nominated as exemplars of success cases by program directors and faculty members from seven global sites, using extreme case sampling technique. Of the 14 Fellows, two were from Africa, nine from Asia and three from Latin America. In-depth interviews were conducted with each Fellow to understand their self-perceived success and factors from both their local context and FAIMER’s FDPs that have contributed to their success. Theoretical thematic analysis method was used to analyze the data. Results The top three emergent areas of success perceived by Fellows were career advancement & recognition, professional development, and advancement of HPE. Fellows identified both institution-level factors and personal attributes as contributing to their success. They also reported that FAIMER’s FDPs have substantially contributed to their success by expanding professional networks, fostering academic achievement, and enhancing interpersonal development and leadership skills. Conclusions The findings show the long-term impact of FAIMER’s FDPs in advancing the field of HPE which is reflected by the multiple pathways for Fellows to succeed. The Fellow stories highlight the continuing value of FAIMER’s global FDP for HPE educators worldwide in professional development and leadership. The study also proposes recommendations for enhancing faculty development activities in HPE for long-term impact. Global Faculty Development Programs Health Professions Education Long-term Impact Success Case Method Qualitative Methodology BACKGROUND Faculty development is an important method of strengthening educational resources and is vital in reforming professional health education to help meet individual and population health needs ( 1 ). Faculty development programs (FDPs) are primarily viewed as a capacity strengthening intervention to improve educators’ expertise in teaching, research, scholarship, leadership and management ( 2 – 5 ). In addition to fostering educational leadership ( 6 , 7 ), FDPs facilitate meaningful interpersonal collaboration ( 8 ). Despite their ubiquitous adoption, the long-term impact of FDPs and their effectiveness in sustaining global needs has not been thoroughly studied. Though there has been increasing reports of studies on effectiveness of FDPs for health professions educators in the past five years ( 9 – 15 ), most measure shorter term program effectiveness through a pre-post program comparison. Only few studies have examined the long-term influence of FDPs ( 16 – 20 ), and most of these FDPs are local programs within an institution. With the rise of FDPs globally ( 21 ), examining the long-term impact of global FDPs is an important and desirable area. Since 2001, FAIMER, a division of Intealth, has offered global FDPs in health professions education (HPE) through its International FAIMER Institute (IFI) in the USA and FAIMER Regional Institutes (FRIs) in Brazil, Chile, China, Egypt, India, Indonesia, South Africa and Uganda ( 22 ). Participants who complete the two-year program are known as FAIMER Fellows. The IFI and FRIs offer the program through the curricular components that include education methods, leadership and management, project management and evaluation, and education research and scholarship. Fellows’ education innovation projects are the focal point for the application of learning that integrate throughout the four curricula components. Intentional building and sustaining a global community of practice (CoP) provides supportive learning environment, and encourages networking and collaboration among Fellows ( 12 , 22 ). The IFI and FRIs have resulted in almost 2000 Fellows from more than 55 countries to form a vibrant global network of health professions educators. Many Fellows choose to become FAIMER faculty after they complete their fellowship, a benefit of capacity strengthening. This study focused on FAIMER global FDPs, a large initiative in HPE faculty development to understand the long-term impact of FDPs. Qualitative assessment offers a more flexible approach to understanding the long-term effectiveness of FDPs and provides insights into how and why program outcomes may have been achieved. Case studies have been recommended for studying the impact of FDPs in HPE to better measure the impact and understand the process of change ( 12 ). This study adopted the Success Case Method by eliciting stories of success from the program participants to (i) understand the impact and gain insights into how and why program impact may have been achieved; and (ii) propose recommendations for enhancing faculty development activities in HPE for long-term impact. METHODS Study Aims The aim of this paper is to examine the long-term impact of FAIMER’s global FDPs through an in-depth investigation of a selected cohort of Fellows who have been identified as successful health professions educators/leaders by FAIMER program directors and faculty members. Specifically, we aim to investigate 1) Fellows’ perception of success, 2) contextual factors that have contributed to their success, and 3)Program-related factors that have contributed to their success. Study design We adopted modified Success Case Method (SCM) with a case study design for this qualitative evaluation study. Traditionally, SCM analyzes the most and least successful groups to investigate how well an organizational initiative (e.g., a training program) is working along with the causal link from program activities to impact ( 23 ). SCM achieves efficiencies by focusing the bulk of inquiries on relatively few subjects. The underlying notion is outliers, i.e., those subjects who either have been exceptionally successful in applying their learning in their work or have been the least successful, may have some patterns of skills, abilities, and behaviors that we learn best from. However, one of the major limitations of SCM is the difficulty of identifying non-success cases ( 24 ). Therefore, we applied a modification of Brinkerhoff’s SCM study approach ( 25 ) by only examining the most successful cases. Ethical approval for this study was obtained from Institutional Ethics Committee, Kasturba Medical College, Mangalore (IEC KMC MLR 07–19/287). Setting and study population Fellows eligible to participate in this case study were those who had completed a FAIMER FDP before 2017 and from a FAIMER site that had implemented the FDP for at least 5 years. The rationale for these criteria was to allow time (a) for program stability and sustainability and, (b) for Fellows to grow professionally and produce tangible impact in HPE after completing a FAIMER FDP. Based on these inclusion criteria, seven FAIMER sites were included in this study: IFI, FRIs in India (n = 3), China, Brazil, and Sub-Saharan Africa. This study was implemented from 2019 to 2021. Sampling, recruitment, and data collection Samples were selected using the extreme case sampling technique ( 26 ) where the most successful FAIMER Fellows, the “positive deviants” ( 27 ), were recruited for the study. Eligible FAIMER Fellows were nominated independently by directors, co-directors, and core faculty (at least five) at each site using a nomination screener that was developed by the study investigators (see Additional file 1 ). The screener was developed to ensure a fair, standardized, common metric to select successful Fellows at all sites. Based on their knowledge of Fellows, nominators used the screener to rate nominees’ success on these themes that represent the FAIMER FDP’s goals and outcomes for the program (a) leadership and change management; (b) role as a health professions educator; (c) research and scholarship productivity, and (d) contribution to faculty development programs. Each site nominated and ranked between 4 to 20 Fellows and the two Fellows who scored the highest from each site were recruited to participate in the study, with a total of 14. All 14 Fellows consented to participate in the study. Measures An interview guide developed for the semi-structured interviews measures 1) the ways Fellows perceive their career has been a success; 2) the contextual factors that contributed to their success; and 3) ways FAIMER experience contributed to their success. The interview guide can be accessed in Additional file 2 . Data collection Data was collected via semi-structured interviews with each Fellow, either online using Zoom or via phone calls. Of the 14 interviews, nine were conducted in English by a trained research assistant based in India, the study implementation site. Three interviews were conducted in Mandarin and two in Portuguese by two trained and experienced local native language-speaking interviewers. Each interview lasted between 40 to 60 minutes. After obtaining permission, interviews were audio-recorded and then transcribed to ensure the views of the Fellows were captured verbatim. The interviews conducted in Mandarin and Portuguese were translated into English before analyses. The transcription was completed within a week of the interview to prevent data distancing from what has been said, understood and documented by the interviewers. For quality assurance, each transcription was shared with and approved by the Fellows interviewee for participant validation. This member checking process was to ensure credibility and trustworthiness of the data. Data analysis Theoretical thematic analysis was used following the six phases framework described by Braun and Clarke ( 28 ). All investigators read through the transcripts, keeping in mind the evaluation questions. To ensure trustworthiness in coding process, we used a standard approach to reduce bias where two investigators (A.D. and A.R.) led the analysis process, and other investigators of the team reviewed the first draft of coding output. Any discrepancies in coding were resolved by discussions. Efforts were made to select descriptive codes as close as possible to the speech patterns and ideas expressed by the participants. The codes were collated first into subthemes and then into themes. This process was also led by A.D. and A.R. and reviewed by other investigators. The two foreign-language interviewers also helped validate data analysis and interpretation. We used ATLAS.ti software package (Full Version – WIN 7.5) to analyze the interview data. RESULTS The qualitative results are summarized in three sections: 1. Fellow’s self-perceived success; 2. contextual factors contributing to success, and 3. FAIMER’s contribution to their success. The top two or three common, emergent themes from each section are reported in this paper. Fellows’ characteristics Table 1 lists the characteristics of study participants. Eight (57%) of the 14 Fellows were female. two (14%) were from Africa (South Africa), nine (64%) from Asia (China and India) and three (21%) from Latin America (Brazil). Out of the 14 Fellows, 10 (71%) primarily work in teaching, and 4 (29%) in clinical fields. Five (36%) Fellows held leadership positions at their institutions. Except for three Fellows, all others were faculty in one or more FAIMER FDP(s). Table 1 Characteristics of study participants (Fellows) (N = 14) Characteristics Women (N = 8) Men (N = 6) Overall (N = 14) Region Africa 1 1 2 Asia 6 3 9 Latin America 1 2 3 Academic Rank (current) Professor/Associate Professor 3 2 5 Other (e.g. lecturer) 4 5 9 Predominantly working in Clinical setting 2 2 4 Teaching 6 4 10 Administrative Role (current) Vice Chancellor Dean/Director/President 4 1 5 Head of department 1 0 1 No administrative role 3 5 8 Faculty at a FAIMER Institute 7 4 11 1. Fellows’ self-perceived success The data on Fellow’s self-perceived success resulted in emergence of three major themes, namely career advancement and recognition, professional development, and advancement of HPE. These themes and subthemes are summarized in Table 2 , followed by illustrative quotes. Table 2 Themes and subthemes on Fellows’ self-perceived success (N = 14) Themes and subthemes Number of codes* A. Career advancement & recognition • Career growth • leadership and management • Global and national recognition • Mentoring others 13 B. Professional development • Formal education/training in HPE • Scholarship portfolio 13 C. Advancement of health profession education • Course/assessment system development • Curriculum, teaching and/or policy reform 9 * More than one code could be assigned to each respondent’s interview. A. Career advancement & recognition Most Fellows perceived success as a reflection of their career advancement and recognition. Career growth, particularly promotion at their workplace, assuming leadership roles and having more administrative responsibilities were considered important pathways to success. “Considering my knowledge and expertise in the previous institution, I was appointed as head of examination in the new university which I developed from scratch.” (Fellow #8) “I have been able to progress from just being a lecturer at university, to becoming the Deputy Vice Chancellor for research and innovation ... my career as an academic, and in the higher education sector has been successful. (Fellow #14) Fellows also perceived their success reflected by being recognized by national bodies for innovation and evaluation reforms in medical education, particularly in resource-constrained settings. Other perceived success as exemplified in professional advancement, include attaining global recognition as faculty, resource persons and experts in HPE, and through collaborations with international agencies including FAIMER. In addition, recognition as student and faculty mentors at the regional level was considered as an achievement by two Fellows. “They called me ‘father of medical education’ due to my involvement in HPE activities all around the region and considering my role in qualifying large number of scholars.” (Fellow #1) “The students consider me as a mentor as I helped them learn better, had good relations with them and made them more interested in education.” (Fellow #3) “I gained opportunities for career advancement being invited as a faculty in regional Institutes and as facilitator, external assessor for HPE courses outside my country… a greater recognition of my expertise.” (Fellow #8) B. Professional development Professional development, reported by Fellows, included acquiring higher degrees, educational scholarships, individual and collaborative publications. “I had an opportunity to complete master’s in health Professions Education abroad, sponsored by FAIMER.” (Fellow #4) “FAIMER gives us the platform to meet medical educators from different medical schools, form a community, exchange, and grow.” (Fellow #6) Some Fellows also reported a growing scholarship portfolio. Since 2009, I have published some Chinese papers, and then I have also started to publish in English… I was the only one who had SCI [Science Citation Indexed Journal] paper published in medical education. (Fellow #2) “I am the author of four books in medical education, available worldwide. Particularly the book on community-based education is disseminated worldwide.” (Fellow #10) C. Advancement of health professions education Fellows reported contributing to HPE in manifold ways such as developing courses and assessment systems, establishing advanced HPE courses, implementing faculty development programs, and enhancing the visibility of medical education at regional, national, and international level. Other examples of contributing to HPE were module development at the national level under expert mentorship and curriculum and/or policy reform. Some Fellows noted that their success and sense of accomplishment increased because of their involvement in national and international collaborations for curricular reforms. “I was successful in introducing medical education at regional, national and international levels reaching out to scholars.” (Fellow #5) “I introduced a whole region to medical education- very geographically wide like the Eastern Mediterranean region… I have 3 distance learning programs that reach out to scholars, national, regional and international wide.” (Fellow #10) “I think, is very helpful to me is doing is a large program for faculty development, and this is a comprehensive, integrated program.” (Fellow #11) “We implemented the (TBL) methodology in this class and we created and instrument for the students to evaluate the teaching and learning process. The results of this evaluation generated a paper…. So, we started getting out from our school, from our university and we disseminated this methodology to other institutions.” (Fellow #13) 2. Contextual factors contributing to success Two major themes (See Table 3 ), institutional-level factors, and personal attributes have contributed to Fellow’s success. Table 3 Themes and subthemes related to contextual factors contributing to Fellows’ success (N = 14) Themes and subthemes Number of codes* A. Institutional-level factors • Robust medical educations units/Support from institutions • Guide/resources/opportunities provided by mentors • Institutional stature and influence • Grants and fundraising availability • Supportive work culture 17 B. Personal attributes • Passion to medical education/Dedication to work • Willing to make changes • Being generous and tolerant 6 * More than one code could be assigned to each respondent’s interview. A. Institutional-level factors Fellows stated that working in institutions with strong medical education units was a key catalyst for success. Institutions offered strong support to the Fellows in executing innovative ideas and put emphasis on medical education while giving prime importance to patient care. “A Robust medical education existed in my institution at the time of joining [FAIMER Fellowship program], which called for recruiting faculty members who can give inputs to program.” (Fellow #7) “The institutional support was amazing! All started at my academic unit, with the director from my school motivating me to participate at FAIMER…, the institutional support came from the university president who bought the idea of a faculty development program to every school. His support is too valuable because it became a management policy.” (Fellow #13) Fellows were grateful to have mentors guiding them in multiple ways, opening opportunities for research and scholarship, training and providing constructive feedback. Success was also attributed to having mentors who displayed admirable leadership traits. “My mentor involved me as a facilitator in training sessions, in an open atmosphere with lot of interactions and feedback.” (Fellow #6) Success was significantly influenced by institutional prominence and influence. The credibility of the institution and working in highly influential medical schools and universities was cited as helpful by the Fellows. One Fellow indicated that increased visibility in the field of HPE was noticed by the ministry of higher education resulting in being funded for upgrading medical education. “Being in a highly influential medical university/platform influences the result.” (Fellow #2). “Leading position of the Institute in the whole country provides a higher starting point.” (Fellow #4). B. Personal attributes Working for institutions that have the power to act and the ability to seize opportunities were cited by a few Fellows as contributors to success. Passion for medical education, willing to make changes, dedication to work, being generous and tolerant, self-confidence and perseverance were other personal attributes listed. “… being generous and tolerant is also very important. That is, you should not haggle over everything with others. You should learn to be tolerant and help others.” (Fellow #2) “I think that was the major thing behind my success - passion to medical education. This is one thing. The other thing is that I was honest with myself and with everything, with everyone around me, honesty.” (Fellow #10) “I have always been a person who is not satisfied with the current situation. I always want to change…I always hope to improve.” (Fellow #11) “I think I had an important role with the dedication I put into implementing the changes: I created working groups and learned to share tasks, since I would not be able to do all by myself.” (Fellow #12) 3. FAIMER’s contributions to their success Three themes emerged from analyzing the descriptions of Fellows about FAIMER’s contributions to success - expanding professional network, fostering academic achievement, and enhancing interpersonal development and leadership skills (see Table 4 ). Table 4 Themes and subthemes related to FAIMER’s contribution to success (N = 14) Themes and subthemes Number of codes A. Expand professional network • Platform for networking • Broaden/widen communication • Increase opportunity to connect 13 B. Foster academic achievement • Publications • Advanced degree and qualification • Recognition of expertise 10 C. Enhance interpersonal development and leadership skills • Ability to self-reflect • Understand self and others • Leadership skills 9 * More than one code could be assigned to each respondent’s interview. A. Expand professional network Fellows reported that FAIMER FDPs facilitated the expansion of their professional network and as well as an international platform for communication and connectivity. “FAIMER provided me an international platform which helped me in networking.” (Fellow #3) “FAIMER´s inclusion of all health professionals and development of our abilities are two things that comes to my mind…Plurality and interdisciplinarity. And collaboration! Collaboration is the most fantastic thing from FAIMER. The collaboration network is unbelievable!” (Fellow #13) B. Foster academic achievement FAIMER’s contributions to fostering academic achievement was defined by increase in educational research studies and publications, sponsorship for advanced degree and education, and receiving recognition as an expert and resource person in HPE because of FAIMER qualification. “I would like to thank FAIMER, exposure to XXX University as it changed the way I study and the way I teach. That masters made difference on how I do things.” (Fellow #1) “FAIMER stimulated and inspired me to do educational research.” (Fellow #3) “I am now in a position to transform our curriculum with my FAIMER qualification.” (Fellow #5) C. Enhance interpersonal development and leadership skills Fellows highlighted interpersonal development, such as the ability to self-reflect, and understand people. “FAIMER taught me to reflect on my strengths and weakness which helped me personally.” (Fellow #1) “To understand your people around you, it gave me a better insight on understanding people with whom you are working.” (Fellow #6) Leadership skills enhancement was another FAIMER’s contribution to their success. “In addition, through FAIMER, I learned some specific skills. For example, the one that has a great impact on me is leadership.” (Fellow #11) “FAIMER program and all the learning process coming from it contributed a lot for the leadership role I took over in the process of restructuring the curriculum.” (Fellow #12) DISCUSSION In the current study, we used the SCM approach to examine the impact of FAIMER’s global FDPs by eliciting success stories from Fellows. The top reported successes were career advancement & recognition, professional development, and advancement of HPE. These findings indicate that advancing the field of HPE can be achieved through multiple pathways. Findings in the current study validated those in the 15-year impact study we conducted in 2017, in which 15 leaders of Fellows’ institution were interviewed on how these Fellows have been successful in improving HPE ( 29 ). These findings also imply the ripple effect of program impact from individual-level growth to driving system-level change. Regarding the contextual factors to Fellows’ success, both personal attributes and institutional-level factors were reported to play essential roles. The findings were closely aligned with the career-success model for physician-scientists by Rubio and colleagues ( 30 ), which showed that both personal factors and organizational factors contribute to career success. Working in institutions with strong medical education units and institutional support are pivotal for educators to foster innovative ideas and dedicate time and effort to advancing medical education. The lack of institutional support is known to be a barrier to faculty development ( 31 ). Therefore, it is critically important that programs and individuals leverage institutional support and align with institutional needs, as faculty development can facilitate organizational change and development, such as institutional policies, leadership and management promotions in HPE, and moving organizations forward ( 21 , 32 , 33 ). This study has validated the long-term impact of FAIMER on Fellows by fostering mutual partnership and collaboration with local institutions in developing its FRIs around the world ( 22 ). In addition, as a focal point for the application of learning during the FDP, Fellows develop and implement an education innovation project that is endorsed by their institutions. FAIMER also leverages institutional support by soliciting a letter of support from the Institution leadership for the Fellows participation in the FAIMER program. Fellows acknowledged FAIMER’s contributions to their success through expanding professional networks. This factor is supported by literature showing that FDPs are essential in developing communities of practice and that educators benefit professionally through belonging to such communities ( 12 , 21 , 34 ). In another study, Baker et al. (2010) highlighted the collaborative network structure in facilitating the participation of members who are geographically distributed. One of the principles of FAIMER FDPs is to build and sustain an online CoP for global health professions educators to foster networking, exchanging ideas and collaborations ( 22 , 35 ). During their inception, each FAIMER FDP had their own local online CoP through listservs. Fortuitously, the COVID-19 pandemic offered opportunities for education innovation ( 36 ). FAIMER transitioned from individual CoPs into a new online community “FAIMER Connect” designed to facilitate, accelerate, support and sustain the connections that form among all FAIMER Fellows globally ( 37 ). In addition, since 2021, by partnering with the FRIs FAIMER has organizes a 2-day virtual annual conference “FAIMER Global Forum.” FAIMER Fellows and alumni now have a platform to network and discuss topics related to HPE and workforce development. Other key contributors to success, according to FAIMER Fellows, is promoting their academic achievement and enhancement of leadership skills and interpersonal development. This is supported by literature on FDPs that HPE Faculty are expected to assume multiple roles in HPE ( 38 ). FAIMER FDP curriculum and approach prepare Fellows for multiple roles. In addition to enhancing the role of faculty members as teachers and educators, FDPs also broadened their scope in research ( 18 , 39 ) and leadership development ( 40 – 42 ). As is reported by other studies, research skills are crucial for academic advancement and promotion for clinical educators ( 43 – 45 ). FAIMER FDPs promote HPE educators to be both education scholars and leaders by providing professional development curricula in HPE and leadership ( 46 ). Health professions educators with leadership expertise are critical to leading educational programs ( 47 , 48 ). The current study supported the literature in its findings that the curriculum components contribute to Fellows’ success in the field of HPE. Strengths and Limitations We used a modification of Brinkerhoff’s ( 23 ) success case method (SCM) study design ( 25 ) which helped us identify positive deviant samples fitting into the success case definition. Selection of Fellows by extreme (or deviant) case sampling method was well aligned with the nature of research design and study aims. To reduce selection bias, we solicited independent nominations using a standardized screener for identifying, recruiting, and enrolling Fellows from FRI directors, co-directors, and multiple faculty members from each site. We also obtained endorsement from FRI directors and/or co-directors for the finalists. Another strength of the study is the analytical approach. The use of theoretical thematic analysis helped investigators to remain focused on the evaluation questions and allow new themes to emerge. The study had a limitation of using self-reported data, which may be biased by respondents’ appreciation of sponsorship and hesitance in criticizing a potential source of funding or career opportunity, and the desire to provide socially desirable responses to a study conducted by FAIMER. To minimize this bias, all interviews and data collection were conducted by three external interviewers who were not study investigators. The unprecedented COVID-19 pandemic delayed the study processes, as it created more challenges to coordinate and manage the study with team members who were geographically scattered and whose work responsibilities shifted during the pandemic. Implications for faculty development programs in health professions education The findings of this study advanced our understanding of the long-term impact of FAIMER global FDPs and enabled us to propose recommendations for enhancing faculty development activities that could result in long-term impact. We have summarized these recommendations in Table 5 . Table 5 Recommendations for enhancing faculty development activities for long-term impact Recommendations Description Examples of activity Provide professional opportunities for career advancement and support • Foster partnership and collaboration with institutions • Provide opportunities for engagement, networking, and collaboration • Establish and sustain a community of practice for participants • Provide opportunities for mentoring by international faculty • Alumni conference for engagement • Sustain a robust alumni network • Provide international platform for networking and connectivity • Solicit institutional support such as a letter of support for faculty participation in FDP Promote educational research and scholarship outputs • Integrate educational research and scholarship as key curricular components • Create opportunities for collaborative studies • Global collaborative research projects and publications by program participants and alumni facilitated by program organizers • Provide resources on advancing research (e.g. webinars by content experts) Enhance academic accomplishments • Recognition as expert and resource person in HPE • Sponsorship for advanced degree in education • Invite back some alumni to be program advisors and faculty • Support continuing professional development of program participants Strengthen leadership and interpersonal skill development • Develop ability for self-reflection and team work • Enhance competencies in change management and negotiations • Create intentional teaching -learning sessions on self-reflection and effective teamwork during the program • Teach project management, and other leadership and managerial skills in the curriculum CONCLUSION In conclusion, findings from this study reveal the impact of FAIMER FDPs through the lens of Fellows’ success in advancing the field of HPE. These findings reassure the continuing values of FAIMER global FDPs to strengthen capacity for educators in health professions education and leadership skills. The findings of this study provide insights and recommendations for the development and enhancement of global FDPs in HPE. Abbreviations Brazil FRI – Brazil FAIMER Regional Institute CoP – Community of Practice CMCL FRI – CMCL FAIMER Regional Institute CMU FRI – China Medical University FAIMER Regional Institute FDP – Faculty Development Program GSMC FRI – GSMC FAIMER Regional Institute HPE – health professions education PSG FRI – PSG FAIMER Regional Institute SAFRI – Sub-Saharan Africa FAIMER Regional Institute SCM – Success Case Method Declarations Ethics approval and consent to participate This study was approved by the Institutional Ethics Committee of Kasturba Medical College, Mangalore, India (IEC KMC MLR 07-19/287). Written informed consent was obtained from the participants. Availability of data and materials The datasets used and analyzed during the current study are available from the corresponding author on request. Competing interests The authors declare that they have no competing interests. Funding This study has been funded by FAIMER, a division of Intealth, USA. Authors' contributions S.Y. and S.M. developed the concept. All authors were involved in the design and implementation of the study. A.D. and A.R. led data analysis. All authors were involved in result interpretation and writing up the manuscript. Acknowledgements We would like to acknowledge directors, co-directors, associate directors, and faculty of the participating FAIMER Regional Institutes for their help with nominating the Fellows. We would also like to acknowledge Dr Shravya Alva, Dr Sisi Li and Dr Silvia Setubal for conducting the interviews in Mandarin Chinese and Portuguese, transcribing, translating, and helping validate data analysis and result interpretation. 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The long-term impact of an interprofessional humanistic faculty development programme: A qualitative investigation. J Eval Clin Pract. 2020;26(3). Steinert Y. Faculty development: From rubies to oak. Med Teach. 2020;42(4). Vyas R, Morahan PS, Yuan S, Amaral E, Burch V, Campos HH, et al. FAIMER Global Faculty Development: A Sustainable Partnership Model to Advance Health Professions Education. Acad Med [Internet]. 2023 Oct 5;98(10):1131–8. Available from: https://journals.lww.com/10.1097/ACM.0000000000005264 Brinkerhoff RO. The Success Case Method: A Strategic Evaluation Approach to Increasing the Value and Effect of Training. Adv Dev Hum Resour. 2005;7(1). McGuinness L. Lessons from a trial of the Success Case Method [Internet]. 2017 [cited 2023 Oct 26]. Available from: https://www.betterevaluation.org/blog/lessons-trial-success-case-method#:~:text=The Success Case Method approach,contextual forces that influence impact. Piggot-Irvine E, Marshall S, Aitken H. The three R’s of the success case model - Recruitment, response, rigour. In 2009 [cited 2023 Oct 26]. Available from: https://www.aes.asn.au/images/images-old/stories/files/conferences/2009/Papers/Piggott-Irvine, Marshall & Aitken.pdf Patton MQ. Qualitative research and evaluation methods: Theory and practice; Fourth Edition. SAGE Publications, Inc. 2015. Positive deviance | Better Evaluation [Internet]. [cited 2023 Dec 2]. Available from: https://www.betterevaluation.org/methods-approaches/approaches/positive-deviance Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2). Hasnain M, Mallow Wendell L, Yuan S. FAIMER Institutes 15-year impact study [Internet]. 2017 [cited 2023 Oct 23]. Available from: https://www.faimer.org/15-year-study-report-2-1-2017.pdf Rubio DM, Primack BA, Switzer GE, Bryce CL, Seltzer DL, Kapoor WN. A comprehensive career-success model for physician-scientists. Acad Med. 2011;86(12). McLean M, Cilliers F, Van Wyk J. Faculty development: Yesterday, today and tomorrow. Med Teach. 2008;30(6). Steinert Y. Faculty development in the health professions: A Focus on Research and Practice. Faculty Development in the Health Professions: A Focus on Research and Practice. 2014. Eitel F, Kanz KG, Tesche A. Training and certification of teachers and trainers: The professionalization of medical education. Med Teach. 2000;22(5). Haas M, Triemstra J, Tam M, Neuendorf K, Reckelhoff K, Gottlieb-Smith R, et al. A decade of faculty development for health professions educators: lessons learned from the Macy Faculty Scholars Program. BMC Med Educ. 2023;23(1). Yuan S, Mukherjee S, Vyas R, Burdick W. Using a theory of change for evaluation: has the FAIMER international faculty development program improved the field of health professions education? MedEdPublish. 2019;8. Frenk J, Chen LC, Chandran L, Groff EOH, King R, Meleis A, et al. Challenges and opportunities for educating health professionals after the COVID-19 pandemic. Vol. 400, The Lancet. 2022. FAIMER Connect [Internet]. [cited 2023 Oct 27]. Available from: https://connect.faimer.org/ Alamoudi AA, El-Deek BS, Park YS, Al Shawwa LA, Tekian A. Evaluating the long-term impact of faculty development programs on MCQ item analysis. Med Teach. 2017;39. Hodges B. Faculty development for research capacity building. In: Faculty Development in the Health Professions: A Focus on Research and Practice. 2014. Swanwick T, McKimm J. Faculty development for leadership and management. In: Faculty Development in the Health Professions: A Focus on Research and Practice. 2014. Hill F, Stephens C. Building leadership capacity in medical education: Developing the potential of course coordinators. Med Teach. 2005;27(2). Abdulghani HM, Shaik SA, Khamis N, Al-Drees AA, Irshad M, Khalil MS, et al. Research methodology workshops evaluation using the Kirkpatrick’s model: Translating theory into practice. Med Teach. 2014;36(SUPPL.1). Alexandraki I, Mooradian AD. Academic advancement of clinician educators: Why is it so difficult? Vol. 65, International Journal of Clinical Practice. 2011. Atasoylu AA, Wright SM, Beasley BW, Cofrancesco J, Macpherson DS, Partridge T, et al. Promotion criteria for clinician-educators. J Gen Intern Med. 2003;18(9). Beasley BW, Wright SM, Cofrancesco J, Babbott SF, Thomas PA, Bass EB. Promotion criteria for clinician-educators in the United States and Canada: A survey of promotion committee chairpersons. JAMA. 1997;278(9). International FAIMER Institute [Internet]. [cited 2023 Oct 31]. Available from: https://www.faimer.org/international-faimer-institute/ Ladhani Z, Shah H, Wells R, Friedman S, Bezuidenhout J, van Heerden B, et al. Global Leadership Model for Health Professions Education – A Case Study of the FAIMER program. J Leadersh Educ. 2015;14(4). Tekian A, Boker AMA, Norcini J. What does it take to become an effective medical educator? Vol. 36, Medical Teacher. 2014. Additional Declarations No competing interests reported. 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Yuan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvUlEQVRIiWNgGAWjYNCCCjkGNhK1nDEmVQtjmzEJquVn5Bh+LpxnIM8ndvjYB4aKe3YNhLQY3Mgxlp65zcCwTToteQbDmeJkwlokcgykebf9YWyTzjEGujAhmRiHGf/mnWNg3yad/5k4LQw3csykeRsMEoG2MIO02BHUYXDmWZk1zzGDZKBfjBkSziQkEHZYe/Lm2zw1BrbzZyc/ZvhQkWBP2GECyMYC2YkNBLXwH0DlE2HLKBgFo2AUjDQAAEo3NR+NVTtrAAAAAElFTkSuQmCC","orcid":"","institution":"FAIMER, A divison of Intealth","correspondingAuthor":true,"prefix":"","firstName":"Shiyao","middleName":"","lastName":"Yuan","suffix":""},{"id":274839511,"identity":"64577cd8-581c-49af-9576-6ac7d521e350","order_by":1,"name":"Asma Rahim","email":"","orcid":"","institution":"Government Medical College","correspondingAuthor":false,"prefix":"","firstName":"Asma","middleName":"","lastName":"Rahim","suffix":""},{"id":274839512,"identity":"e946fac6-379d-49ef-abb9-85fb9b0ecfd4","order_by":2,"name":"Suvetha Kannappan","email":"","orcid":"","institution":"PSG 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21:01:46","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3944180/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3944180/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-024-05823-2","type":"published","date":"2024-09-30T15:58:02+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":66096973,"identity":"3d2c36e1-fba1-4bcb-b2fc-c2db6bc36224","added_by":"auto","created_at":"2024-10-07 16:12:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":784631,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3944180/v1/79160571-8f1d-443f-a161-84113a489136.pdf"},{"id":51662831,"identity":"808cabd7-5cb7-43ab-9d3e-5c1ab5de09f8","added_by":"auto","created_at":"2024-02-26 20:13:13","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":33410,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile1NominationScreener.docx","url":"https://assets-eu.researchsquare.com/files/rs-3944180/v1/7613d6cc664f0d75484f96f9.docx"},{"id":51662830,"identity":"6b09abdb-6a12-44fd-8296-f7c83b16b3b6","added_by":"auto","created_at":"2024-02-26 20:13:13","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":77269,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile2InterviewguideFellows.docx","url":"https://assets-eu.researchsquare.com/files/rs-3944180/v1/63c19a12f021b10dfbe084f4.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Success stories: exploring the long-term impact of a global faculty development program for health professions educators","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eFaculty development is an important method of strengthening educational resources and is vital in reforming professional health education to help meet individual and population health needs (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Faculty development programs (FDPs) are primarily viewed as a capacity strengthening intervention to improve educators\u0026rsquo; expertise in teaching, research, scholarship, leadership and management (\u003cspan additionalcitationids=\"CR3 CR4\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In addition to fostering educational leadership (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), FDPs facilitate meaningful interpersonal collaboration (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Despite their ubiquitous adoption, the long-term impact of FDPs and their effectiveness in sustaining global needs has not been thoroughly studied. Though there has been increasing reports of studies on effectiveness of FDPs for health professions educators in the past five years (\u003cspan additionalcitationids=\"CR10 CR11 CR12 CR13 CR14\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), most measure shorter term program effectiveness through a pre-post program comparison. Only few studies have examined the long-term influence of FDPs (\u003cspan additionalcitationids=\"CR17 CR18 CR19\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), and most of these FDPs are local programs within an institution. With the rise of FDPs globally (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), examining the long-term impact of global FDPs is an important and desirable area.\u003c/p\u003e \u003cp\u003eSince 2001, FAIMER, a division of Intealth, has offered global FDPs in health professions education (HPE) through its International FAIMER Institute (IFI) in the USA and FAIMER Regional Institutes (FRIs) in Brazil, Chile, China, Egypt, India, Indonesia, South Africa and Uganda (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Participants who complete the two-year program are known as FAIMER Fellows. The IFI and FRIs offer the program through the curricular components that include education methods, leadership and management, project management and evaluation, and education research and scholarship. Fellows\u0026rsquo; education innovation projects are the focal point for the application of learning that integrate throughout the four curricula components. Intentional building and sustaining a global community of practice (CoP) provides supportive learning environment, and encourages networking and collaboration among Fellows (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The IFI and FRIs have resulted in almost 2000 Fellows from more than 55 countries to form a vibrant global network of health professions educators. Many Fellows choose to become FAIMER faculty after they complete their fellowship, a benefit of capacity strengthening. This study focused on FAIMER global FDPs, a large initiative in HPE faculty development to understand the long-term impact of FDPs.\u003c/p\u003e \u003cp\u003eQualitative assessment offers a more flexible approach to understanding the long-term effectiveness of FDPs and provides insights into how and why program outcomes may have been achieved. Case studies have been recommended for studying the impact of FDPs in HPE to better measure the impact and understand the process of change (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). This study adopted the Success Case Method by eliciting stories of success from the program participants to (i) understand the impact and gain insights into how and why program impact may have been achieved; and (ii) propose recommendations for enhancing faculty development activities in HPE for long-term impact.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Aims\u003c/h2\u003e \u003cp\u003eThe aim of this paper is to examine the long-term impact of FAIMER\u0026rsquo;s global FDPs through an in-depth investigation of a selected cohort of Fellows who have been identified as successful health professions educators/leaders by FAIMER program directors and faculty members. Specifically, we aim to investigate 1) Fellows\u0026rsquo; perception of success, 2) contextual factors that have contributed to their success, and 3)Program-related factors that have contributed to their success.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eWe adopted modified Success Case Method (SCM) with a case study design for this qualitative evaluation study. Traditionally, SCM analyzes the most and least successful groups to investigate how well an organizational initiative (e.g., a training program) is working along with the causal link from program activities to impact (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). SCM achieves efficiencies by focusing the bulk of inquiries on relatively few subjects. The underlying notion is outliers, i.e., those subjects who either have been exceptionally successful in applying their learning in their work or have been the least successful, may have some patterns of skills, abilities, and behaviors that we learn best from. However, one of the major limitations of SCM is the difficulty of identifying non-success cases (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Therefore, we applied a modification of Brinkerhoff\u0026rsquo;s SCM study approach (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) by only examining the most successful cases. Ethical approval for this study was obtained from Institutional Ethics Committee, Kasturba Medical College, Mangalore (IEC KMC MLR 07\u0026ndash;19/287).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSetting and study population\u003c/h2\u003e \u003cp\u003eFellows eligible to participate in this case study were those who had completed a FAIMER FDP before 2017 and from a FAIMER site that had implemented the FDP for at least 5 years. The rationale for these criteria was to allow time (a) for program stability and sustainability and, (b) for Fellows to grow professionally and produce tangible impact in HPE after completing a FAIMER FDP. Based on these inclusion criteria, seven FAIMER sites were included in this study: IFI, FRIs in India (n\u0026thinsp;=\u0026thinsp;3), China, Brazil, and Sub-Saharan Africa. This study was implemented from 2019 to 2021.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSampling, recruitment, and data collection\u003c/h2\u003e \u003cp\u003eSamples were selected using the extreme case sampling technique (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) where the most successful FAIMER Fellows, the \u0026ldquo;positive deviants\u0026rdquo; (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), were recruited for the study. Eligible FAIMER Fellows were nominated independently by directors, co-directors, and core faculty (at least five) at each site using a nomination screener that was developed by the study investigators (see \u003cb\u003eAdditional file 1\u003c/b\u003e). The screener was developed to ensure a fair, standardized, common metric to select successful Fellows at all sites. Based on their knowledge of Fellows, nominators used the screener to rate nominees\u0026rsquo; success on these themes that represent the FAIMER FDP\u0026rsquo;s goals and outcomes for the program (a) leadership and change management; (b) role as a health professions educator; (c) research and scholarship productivity, and (d) contribution to faculty development programs. Each site nominated and ranked between 4 to 20 Fellows and the two Fellows who scored the highest from each site were recruited to participate in the study, with a total of 14. All 14 Fellows consented to participate in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003eAn interview guide developed for the semi-structured interviews measures 1) the ways Fellows perceive their career has been a success; 2) the contextual factors that contributed to their success; and 3) ways FAIMER experience contributed to their success. The interview guide can be accessed in \u003cb\u003eAdditional file 2\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eData was collected via semi-structured interviews with each Fellow, either online using Zoom or via phone calls. Of the 14 interviews, nine were conducted in English by a trained research assistant based in India, the study implementation site. Three interviews were conducted in Mandarin and two in Portuguese by two trained and experienced local native language-speaking interviewers. Each interview lasted between 40 to 60 minutes. After obtaining permission, interviews were audio-recorded and then transcribed to ensure the views of the Fellows were captured verbatim. The interviews conducted in Mandarin and Portuguese were translated into English before analyses. The transcription was completed within a week of the interview to prevent data distancing from what has been said, understood and documented by the interviewers. For quality assurance, each transcription was shared with and approved by the Fellows interviewee for participant validation. This member checking process was to ensure credibility and trustworthiness of the data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eTheoretical thematic analysis was used following the six phases framework described by Braun and Clarke (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). All investigators read through the transcripts, keeping in mind the evaluation questions. To ensure trustworthiness in coding process, we used a standard approach to reduce bias where two investigators (A.D. and A.R.) led the analysis process, and other investigators of the team reviewed the first draft of coding output. Any discrepancies in coding were resolved by discussions. Efforts were made to select descriptive codes as close as possible to the speech patterns and ideas expressed by the participants. The codes were collated first into subthemes and then into themes. This process was also led by A.D. and A.R. and reviewed by other investigators. The two foreign-language interviewers also helped validate data analysis and interpretation. We used ATLAS.ti software package (Full Version \u0026ndash; WIN 7.5) to analyze the interview data.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe qualitative results are summarized in three sections: 1. Fellow\u0026rsquo;s self-perceived success; 2. contextual factors contributing to success, and 3. FAIMER\u0026rsquo;s contribution to their success. The top two or three common, emergent themes from each section are reported in this paper.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eFellows\u0026rsquo; characteristics\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e lists the characteristics of study participants. Eight (57%) of the 14 Fellows were female. two (14%) were from Africa (South Africa), nine (64%) from Asia (China and India) and three (21%) from Latin America (Brazil). Out of the 14 Fellows, 10 (71%) primarily work in teaching, and 4 (29%) in clinical fields. Five (36%) Fellows held leadership positions at their institutions. Except for three Fellows, all others were faculty in one or more FAIMER FDP(s).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of study participants (Fellows) (N\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen (N\u0026thinsp;=\u0026thinsp;8)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMen (N\u0026thinsp;=\u0026thinsp;6)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOverall (N\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eRegion\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfrica\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLatin America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAcademic Rank (current)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessor/Associate Professor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther (e.g. lecturer)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePredominantly working in\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical setting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdministrative Role (current)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVice Chancellor Dean/Director/President\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHead of department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo administrative role\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFaculty at a FAIMER Institute\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e1. Fellows\u0026rsquo; self-perceived success\u003c/h2\u003e \u003cp\u003eThe data on Fellow\u0026rsquo;s self-perceived success resulted in emergence of three major themes, namely career advancement and recognition, professional development, and advancement of HPE. These themes and subthemes are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, followed by illustrative quotes.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThemes and subthemes on Fellows\u0026rsquo; self-perceived success (N\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThemes and subthemes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of codes*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eA. Career advancement \u0026amp; recognition\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Career growth\u003c/p\u003e \u003cp\u003e\u0026bull; leadership and management\u003c/p\u003e \u003cp\u003e\u0026bull; Global and national recognition\u003c/p\u003e \u003cp\u003e\u0026bull; Mentoring others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eB. Professional development\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Formal education/training in HPE\u003c/p\u003e \u003cp\u003e\u0026bull; Scholarship portfolio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eC. Advancement of health profession education\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Course/assessment system development\u003c/p\u003e \u003cp\u003e\u0026bull; Curriculum, teaching and/or policy reform\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e* More than one code could be assigned to each respondent\u0026rsquo;s interview.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eA. Career advancement \u0026amp; recognition\u003c/h2\u003e \u003cp\u003eMost Fellows perceived success as a reflection of their career advancement and recognition. Career growth, particularly promotion at their workplace, assuming leadership roles and having more administrative responsibilities were considered important pathways to success.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Considering my knowledge and expertise in the previous institution, I was appointed as head of examination in the new university which I developed from scratch.\u0026rdquo; (Fellow #8)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I have been able to progress from just being a lecturer at university, to becoming the Deputy Vice Chancellor for research and innovation ... my career as an academic, and in the higher education sector has been successful. (Fellow #14)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eFellows also perceived their success reflected by being recognized by national bodies for innovation and evaluation reforms in medical education, particularly in resource-constrained settings. Other perceived success as exemplified in professional advancement, include attaining global recognition as faculty, resource persons and experts in HPE, and through collaborations with international agencies including FAIMER. In addition, recognition as student and faculty mentors at the regional level was considered as an achievement by two Fellows.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;They called me \u0026lsquo;father of medical education\u0026rsquo; due to my involvement in HPE activities all around the region and considering my role in qualifying large number of scholars.\u0026rdquo; (Fellow #1)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;The students consider me as a mentor as I helped them learn better, had good relations with them and made them more interested in education.\u0026rdquo; (Fellow #3)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I gained opportunities for career advancement being invited as a faculty in regional Institutes and as facilitator, external assessor for HPE courses outside my country\u0026hellip; a greater recognition of my expertise.\u0026rdquo; (Fellow #8)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eB. Professional development\u003c/h2\u003e \u003cp\u003eProfessional development, reported by Fellows, included acquiring higher degrees, educational scholarships, individual and collaborative publications.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I had an opportunity to complete master\u0026rsquo;s in health Professions Education abroad, sponsored by FAIMER.\u0026rdquo; (Fellow #4)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;FAIMER gives us the platform to meet medical educators from different medical schools, form a community, exchange, and grow.\u0026rdquo; (Fellow #6)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSome Fellows also reported a growing scholarship portfolio.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eSince 2009, I have published some Chinese papers, and then I have also started to publish in English\u0026hellip; I was the only one who had SCI [Science Citation Indexed Journal] paper published in medical education. (Fellow #2)\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I am the author of four books in medical education, available worldwide. Particularly the book on community-based education is disseminated worldwide.\u0026rdquo; (Fellow #10)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eC. Advancement of health professions education\u003c/h2\u003e \u003cp\u003e Fellows reported contributing to HPE in manifold ways such as developing courses and assessment systems, establishing advanced HPE courses, implementing faculty development programs, and enhancing the visibility of medical education at regional, national, and international level. Other examples of contributing to HPE were module development at the national level under expert mentorship and curriculum and/or policy reform. Some Fellows noted that their success and sense of accomplishment increased because of their involvement in national and international collaborations for curricular reforms.\u003c/p\u003e \u003cp\u003e\u003cem\u003e \u0026ldquo;I was successful in introducing medical education at regional, national and international levels reaching out to scholars.\u0026rdquo; (Fellow #5)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I introduced a whole region to medical education- very geographically wide like the Eastern Mediterranean region\u0026hellip; I have 3 distance learning programs that reach out to scholars, national, regional and international wide.\u0026rdquo; (Fellow #10)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I think, is very helpful to me is doing is a large program for faculty development, and this is a comprehensive, integrated program.\u0026rdquo; (Fellow #11)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;We implemented the (TBL) methodology in this class and we created and instrument for the students to evaluate the teaching and learning process. The results of this evaluation generated a paper\u0026hellip;. So, we started getting out from our school, from our university and we disseminated this methodology to other institutions.\u0026rdquo; (Fellow #13)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e2. Contextual factors contributing to success\u003c/h2\u003e \u003cp\u003eTwo major themes (See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e), institutional-level factors, and personal attributes have contributed to Fellow\u0026rsquo;s success.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThemes and subthemes related to contextual factors contributing to Fellows\u0026rsquo; success (N\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThemes and subthemes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of codes*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eA. Institutional-level factors\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Robust medical educations units/Support from institutions\u003c/p\u003e \u003cp\u003e\u0026bull; Guide/resources/opportunities provided by mentors\u003c/p\u003e \u003cp\u003e\u0026bull; Institutional stature and influence\u003c/p\u003e \u003cp\u003e\u0026bull; Grants and fundraising availability\u003c/p\u003e \u003cp\u003e\u0026bull; Supportive work culture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eB. Personal attributes\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Passion to medical education/Dedication to work\u003c/p\u003e \u003cp\u003e\u0026bull; Willing to make changes\u003c/p\u003e \u003cp\u003e\u0026bull; Being generous and tolerant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e* More than one code could be assigned to each respondent\u0026rsquo;s interview.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eA. Institutional-level factors\u003c/h2\u003e \u003cp\u003eFellows stated that working in institutions with strong medical education units was a key catalyst for success. Institutions offered strong support to the Fellows in executing innovative ideas and put emphasis on medical education while giving prime importance to patient care.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;A Robust medical education existed in my institution at the time of joining [FAIMER Fellowship program], which called for recruiting faculty members who can give inputs to program.\u0026rdquo; (Fellow #7)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;The institutional support was amazing! All started at my academic unit, with the director from my school motivating me to participate at FAIMER\u0026hellip;, the institutional support came from the university president who bought the idea of a faculty development program to every school. His support is too valuable because it became a management policy.\u0026rdquo; (Fellow #13)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eFellows were grateful to have mentors guiding them in multiple ways, opening opportunities for research and scholarship, training and providing constructive feedback. Success was also attributed to having mentors who displayed admirable leadership traits.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;My mentor involved me as a facilitator in training sessions, in an open atmosphere with lot of interactions and feedback.\u0026rdquo; (Fellow #6)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSuccess was significantly influenced by institutional prominence and influence. The credibility of the institution and working in highly influential medical schools and universities was cited as helpful by the Fellows. One Fellow indicated that increased visibility in the field of HPE was noticed by the ministry of higher education resulting in being funded for upgrading medical education.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Being in a highly influential medical university/platform influences the result.\u0026rdquo; (Fellow #2).\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Leading position of the Institute in the whole country provides a higher starting point.\u0026rdquo; (Fellow #4).\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eB. Personal attributes\u003c/h2\u003e \u003cp\u003eWorking for institutions that have the power to act and the ability to seize opportunities were cited by a few Fellows as contributors to success. Passion for medical education, willing to make changes, dedication to work, being generous and tolerant, self-confidence and perseverance were other personal attributes listed.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;\u0026hellip; being generous and tolerant is also very important. That is, you should not haggle over everything with others. You should learn to be tolerant and help others.\u0026rdquo; (Fellow #2)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I think that was the major thing behind my success - passion to medical education. This is one thing. The other thing is that I was honest with myself and with everything, with everyone around me, honesty.\u0026rdquo; (Fellow #10)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I have always been a person who is not satisfied with the current situation. I always want to change\u0026hellip;I always hope to improve.\u0026rdquo; (Fellow #11)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I think I had an important role with the dedication I put into implementing the changes: I created working groups and learned to share tasks, since I would not be able to do all by myself.\u0026rdquo; (Fellow #12)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e3. FAIMER\u0026rsquo;s contributions to their success\u003c/h2\u003e \u003cp\u003eThree themes emerged from analyzing the descriptions of Fellows about FAIMER\u0026rsquo;s contributions to success - expanding professional network, fostering academic achievement, and enhancing interpersonal development and leadership skills (see Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThemes and subthemes related to FAIMER\u0026rsquo;s contribution to success (N\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThemes and subthemes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of codes\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eA. Expand professional network\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Platform for networking\u003c/p\u003e \u003cp\u003e\u0026bull; Broaden/widen communication\u003c/p\u003e \u003cp\u003e\u0026bull; Increase opportunity to connect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eB. Foster academic achievement\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Publications\u003c/p\u003e \u003cp\u003e\u0026bull; Advanced degree and qualification\u003c/p\u003e \u003cp\u003e\u0026bull; Recognition of expertise\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eC. Enhance interpersonal development and leadership skills\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026bull; Ability to self-reflect\u003c/p\u003e \u003cp\u003e\u0026bull; Understand self and others\u003c/p\u003e \u003cp\u003e\u0026bull; Leadership skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e* More than one code could be assigned to each respondent\u0026rsquo;s interview.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eA. Expand professional network\u003c/h2\u003e \u003cp\u003eFellows reported that FAIMER FDPs facilitated the expansion of their professional network and as well as an international platform for communication and connectivity.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;FAIMER provided me an international platform which helped me in networking.\u0026rdquo; (Fellow #3)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;FAIMER\u0026acute;s inclusion of all health professionals and development of our abilities are two things that comes to my mind\u0026hellip;Plurality and interdisciplinarity. And collaboration! Collaboration is the most fantastic thing from FAIMER. The collaboration network is unbelievable!\u0026rdquo; (Fellow #13)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eB. Foster academic achievement\u003c/h2\u003e \u003cp\u003eFAIMER\u0026rsquo;s contributions to fostering academic achievement was defined by increase in educational research studies and publications, sponsorship for advanced degree and education, and receiving recognition as an expert and resource person in HPE because of FAIMER qualification.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I would like to thank FAIMER, exposure to XXX University as it changed the way I study and the way I teach. That masters made difference on how I do things.\u0026rdquo; (Fellow #1)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;FAIMER stimulated and inspired me to do educational research.\u0026rdquo; (Fellow #3)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I am now in a position to transform our curriculum with my FAIMER qualification.\u0026rdquo; (Fellow #5)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eC. Enhance interpersonal development and leadership skills\u003c/h2\u003e \u003cp\u003eFellows highlighted interpersonal development, such as the ability to self-reflect, and understand people.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;FAIMER taught me to reflect on my strengths and weakness which helped me personally.\u0026rdquo; (Fellow #1)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;To understand your people around you, it gave me a better insight on understanding people with whom you are working.\u0026rdquo; (Fellow #6)\u003c/em\u003e \u003c/p\u003e \u003cp\u003eLeadership skills enhancement was another FAIMER\u0026rsquo;s contribution to their success.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;In addition, through FAIMER, I learned some specific skills. For example, the one that has a great impact on me is leadership.\u0026rdquo; (Fellow #11)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;FAIMER program and all the learning process coming from it contributed a lot for the leadership role I took over in the process of restructuring the curriculum.\u0026rdquo; (Fellow #12)\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn the current study, we used the SCM approach to examine the impact of FAIMER\u0026rsquo;s global FDPs by eliciting success stories from Fellows. The top reported successes were career advancement \u0026amp; recognition, professional development, and advancement of HPE. These findings indicate that advancing the field of HPE can be achieved through multiple pathways. Findings in the current study validated those in the 15-year impact study we conducted in 2017, in which 15 leaders of Fellows\u0026rsquo; institution were interviewed on how these Fellows have been successful in improving HPE (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). These findings also imply the ripple effect of program impact from individual-level growth to driving system-level change.\u003c/p\u003e \u003cp\u003eRegarding the contextual factors to Fellows\u0026rsquo; success, both personal attributes and institutional-level factors were reported to play essential roles. The findings were closely aligned with the career-success model for physician-scientists by Rubio and colleagues (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), which showed that both personal factors and organizational factors contribute to career success. Working in institutions with strong medical education units and institutional support are pivotal for educators to foster innovative ideas and dedicate time and effort to advancing medical education. The lack of institutional support is known to be a barrier to faculty development (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Therefore, it is critically important that programs and individuals leverage institutional support and align with institutional needs, as faculty development can facilitate organizational change and development, such as institutional policies, leadership and management promotions in HPE, and moving organizations forward (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study has validated the long-term impact of FAIMER on Fellows by fostering mutual partnership and collaboration with local institutions in developing its FRIs around the world (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In addition, as a focal point for the application of learning during the FDP, Fellows develop and implement an education innovation project that is endorsed by their institutions. FAIMER also leverages institutional support by soliciting a letter of support from the Institution leadership for the Fellows participation in the FAIMER program.\u003c/p\u003e \u003cp\u003eFellows acknowledged FAIMER\u0026rsquo;s contributions to their success through expanding professional networks. This factor is supported by literature showing that FDPs are essential in developing communities of practice and that educators benefit professionally through belonging to such communities (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). In another study, Baker et al. (2010) highlighted the collaborative network structure in facilitating the participation of members who are geographically distributed. One of the principles of FAIMER FDPs is to build and sustain an online CoP for global health professions educators to foster networking, exchanging ideas and collaborations (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). During their inception, each FAIMER FDP had their own local online CoP through listservs. Fortuitously, the COVID-19 pandemic offered opportunities for education innovation (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). FAIMER transitioned from individual CoPs into a new online community \u0026ldquo;FAIMER Connect\u0026rdquo; designed to facilitate, accelerate, support and sustain the connections that form among all FAIMER Fellows globally (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). In addition, since 2021, by partnering with the FRIs FAIMER has organizes a 2-day virtual annual conference \u0026ldquo;FAIMER Global Forum.\u0026rdquo; FAIMER Fellows and alumni now have a platform to network and discuss topics related to HPE and workforce development.\u003c/p\u003e \u003cp\u003eOther key contributors to success, according to FAIMER Fellows, is promoting their academic achievement and enhancement of leadership skills and interpersonal development. This is supported by literature on FDPs that HPE Faculty are expected to assume multiple roles in HPE (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). FAIMER FDP curriculum and approach prepare Fellows for multiple roles. In addition to enhancing the role of faculty members as teachers and educators, FDPs also broadened their scope in research (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e) and leadership development (\u003cspan additionalcitationids=\"CR41\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). As is reported by other studies, research skills are crucial for academic advancement and promotion for clinical educators (\u003cspan additionalcitationids=\"CR44\" citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). FAIMER FDPs promote HPE educators to be both education scholars and leaders by providing professional development curricula in HPE and leadership (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). Health professions educators with leadership expertise are critical to leading educational programs (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). The current study supported the literature in its findings that the curriculum components contribute to Fellows\u0026rsquo; success in the field of HPE.\u003c/p\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eWe used a modification of Brinkerhoff\u0026rsquo;s (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) success case method (SCM) study design (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) which helped us identify positive deviant samples fitting into the success case definition. Selection of Fellows by extreme (or deviant) case sampling method was well aligned with the nature of research design and study aims. To reduce selection bias, we solicited independent nominations using a standardized screener for identifying, recruiting, and enrolling Fellows from FRI directors, co-directors, and multiple faculty members from each site. We also obtained endorsement from FRI directors and/or co-directors for the finalists. Another strength of the study is the analytical approach. The use of theoretical thematic analysis helped investigators to remain focused on the evaluation questions and allow new themes to emerge.\u003c/p\u003e \u003cp\u003eThe study had a limitation of using self-reported data, which may be biased by respondents\u0026rsquo; appreciation of sponsorship and hesitance in criticizing a potential source of funding or career opportunity, and the desire to provide socially desirable responses to a study conducted by FAIMER. To minimize this bias, all interviews and data collection were conducted by three external interviewers who were not study investigators. The unprecedented COVID-19 pandemic delayed the study processes, as it created more challenges to coordinate and manage the study with team members who were geographically scattered and whose work responsibilities shifted during the pandemic.\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eImplications for faculty development programs in health professions education\u003c/h2\u003e \u003cp\u003eThe findings of this study advanced our understanding of the long-term impact of FAIMER global FDPs and enabled us to propose recommendations for enhancing faculty development activities that could result in long-term impact. We have summarized these recommendations in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRecommendations for enhancing faculty development activities for long-term impact\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecommendations\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDescription\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExamples of activity\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProvide professional opportunities for career advancement and support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Foster partnership and collaboration with institutions\u003c/p\u003e \u003cp\u003e\u0026bull; Provide opportunities for engagement, networking, and collaboration\u003c/p\u003e \u003cp\u003e\u0026bull; Establish and sustain a community of practice for participants\u003c/p\u003e \u003cp\u003e\u0026bull; Provide opportunities for mentoring by international faculty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Alumni conference for engagement\u003c/p\u003e \u003cp\u003e\u0026bull; Sustain a robust alumni network\u003c/p\u003e \u003cp\u003e\u0026bull; Provide international platform for networking and connectivity\u003c/p\u003e \u003cp\u003e\u0026bull; Solicit institutional support such as a letter of support for faculty participation in FDP\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePromote educational research and scholarship outputs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Integrate educational research and scholarship as key curricular components\u003c/p\u003e \u003cp\u003e\u0026bull; Create opportunities for collaborative studies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Global collaborative research projects and publications by program participants and alumni facilitated by program organizers\u003c/p\u003e \u003cp\u003e\u0026bull; Provide resources on advancing research (e.g. webinars by content experts)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnhance academic accomplishments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Recognition as expert and resource person in HPE\u003c/p\u003e \u003cp\u003e\u0026bull; Sponsorship for advanced degree in education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Invite back some alumni to be program advisors and faculty\u003c/p\u003e \u003cp\u003e\u0026bull; Support continuing professional development of program participants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrengthen leadership and interpersonal skill development\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Develop ability for self-reflection and team work\u003c/p\u003e \u003cp\u003e\u0026bull; Enhance competencies in change management and negotiations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Create intentional teaching -learning sessions on self-reflection and effective teamwork during the program\u003c/p\u003e \u003cp\u003e\u0026bull; Teach project management, and other leadership and managerial skills in the curriculum\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn conclusion, findings from this study reveal the impact of FAIMER FDPs through the lens of Fellows\u0026rsquo; success in advancing the field of HPE. These findings reassure the continuing values of FAIMER global FDPs to strengthen capacity for educators in health professions education and leadership skills. The findings of this study provide insights and recommendations for the development and enhancement of global FDPs in HPE.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBrazil FRI \u0026ndash; Brazil FAIMER Regional Institute\u003c/p\u003e\n\u003cp\u003eCoP \u0026ndash; Community of Practice\u003c/p\u003e\n\u003cp\u003eCMCL FRI \u0026ndash; CMCL FAIMER Regional Institute\u003c/p\u003e\n\u003cp\u003eCMU FRI \u0026ndash; China Medical University FAIMER Regional Institute\u003c/p\u003e\n\u003cp\u003eFDP \u0026ndash; Faculty Development Program\u003c/p\u003e\n\u003cp\u003eGSMC FRI \u0026ndash; GSMC FAIMER Regional Institute\u003c/p\u003e\n\u003cp\u003eHPE \u0026ndash; health professions education\u003c/p\u003e\n\u003cp\u003ePSG FRI \u0026ndash; PSG FAIMER Regional Institute\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSAFRI \u0026ndash; Sub-Saharan Africa FAIMER Regional Institute\u003c/p\u003e\n\u003cp\u003eSCM \u0026ndash; Success Case Method\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Ethics Committee of Kasturba Medical College, Mangalore, India (IEC KMC MLR 07-19/287). Written informed consent was obtained from the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has been funded by FAIMER, a division of Intealth, USA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS.Y. and S.M. developed the concept. All authors were involved in the design and implementation of the study. A.D. and A.R. led data analysis. All authors were involved in result interpretation and writing up the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to acknowledge directors, co-directors, associate directors, and faculty of the participating FAIMER Regional Institutes for their help with nominating the Fellows. We would also like to acknowledge Dr Shravya Alva, Dr Sisi Li and Dr Silvia Setubal for conducting the interviews in Mandarin Chinese and Portuguese, transcribing, translating, and helping validate data analysis and result interpretation.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFrenk J, Chen L, qar Bhutta ZA, Cohen J, Crisp N, Evans T, et al. The Lancet Commissions Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. www.thelancet.com [Internet]. 2010;376:1923\u0026ndash;58. 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JAMA. 1997;278(9). \u003c/li\u003e\n\u003cli\u003eInternational FAIMER Institute [Internet]. [cited 2023 Oct 31]. Available from: https://www.faimer.org/international-faimer-institute/\u003c/li\u003e\n\u003cli\u003eLadhani Z, Shah H, Wells R, Friedman S, Bezuidenhout J, van Heerden B, et al. Global Leadership Model for Health Professions Education \u0026ndash; A Case Study of the FAIMER program. J Leadersh Educ. 2015;14(4). \u003c/li\u003e\n\u003cli\u003eTekian A, Boker AMA, Norcini J. What does it take to become an effective medical educator? Vol. 36, Medical Teacher. 2014. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Global Faculty Development Programs, Health Professions Education, Long-term Impact, Success Case Method, Qualitative Methodology","lastPublishedDoi":"10.21203/rs.3.rs-3944180/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3944180/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eFaculty development programs (FDPs) in health professions education (HPE) are instrumental in supporting, promoting, and improving HPE curricula and activities that target individual- and system-level capacity strengthening. FAIMER, a division of Intealth, has been offering FDPs for global health professions educators in HPE and leadership for over two decades through the International FAIMER Institute in USA and FAIMER Regional Institutes located globally. This paper examines the long-term impact of FAIMER's global FDPs by eliciting stories of success from program participants (Fellows).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe study utilizes a modified Success Case Method approach. Study participants recruited were 14 FAIMER Fellows nominated as exemplars of success cases by program directors and faculty members from seven global sites, using extreme case sampling technique. Of the 14 Fellows, two were from Africa, nine from Asia and three from Latin America. In-depth interviews were conducted with each Fellow to understand their self-perceived success and factors from both their local context and FAIMER\u0026rsquo;s FDPs that have contributed to their success. Theoretical thematic analysis method was used to analyze the data.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe top three emergent areas of success perceived by Fellows were career advancement \u0026amp; recognition, professional development, and advancement of HPE. Fellows identified both institution-level factors and personal attributes as contributing to their success. They also reported that FAIMER\u0026rsquo;s FDPs have substantially contributed to their success by expanding professional networks, fostering academic achievement, and enhancing interpersonal development and leadership skills.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe findings show the long-term impact of FAIMER\u0026rsquo;s FDPs in advancing the field of HPE which is reflected by the multiple pathways for Fellows to succeed. The Fellow stories highlight the continuing value of FAIMER\u0026rsquo;s global FDP for HPE educators worldwide in professional development and leadership. The study also proposes recommendations for enhancing faculty development activities in HPE for long-term impact.\u003c/p\u003e","manuscriptTitle":"Success stories: exploring the long-term impact of a global faculty development program for health professions educators","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-26 20:13:08","doi":"10.21203/rs.3.rs-3944180/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-04-16T09:06:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-12T14:16:30+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-10T21:41:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"62f322ea-ebcc-4695-afcf-59291b2e921a","date":"2024-03-31T15:30:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50641413-0ccf-40b4-930b-6c97c8052dac","date":"2024-03-29T14:29:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-28T04:37:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9f1074f1-2c86-4367-94c9-d122d86ae43b","date":"2024-03-27T18:39:51+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-11T15:09:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"64722b44-d7c9-40f2-8c8b-a4e846b3b8ae","date":"2024-02-25T14:57:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-02-25T08:50:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-02-24T06:48:14+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-02-23T05:41:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-02-23T05:36:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2024-02-09T20:56:09+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a80b1607-eb1c-41f1-a937-e06c883023ef","owner":[],"postedDate":"February 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-10-07T16:04:12+00:00","versionOfRecord":{"articleIdentity":"rs-3944180","link":"https://doi.org/10.1186/s12909-024-05823-2","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2024-09-30 15:58:02","publishedOnDateReadable":"September 30th, 2024"},"versionCreatedAt":"2024-02-26 20:13:08","video":"","vorDoi":"10.1186/s12909-024-05823-2","vorDoiUrl":"https://doi.org/10.1186/s12909-024-05823-2","workflowStages":[]},"version":"v1","identity":"rs-3944180","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3944180","identity":"rs-3944180","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}