Background: The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing\nworldwide. Despite the increasing number of GEM fellowships, there is not an agreed upon approach for\nassessment of GEM trainees.\nMain body: In order to study the lack of standardized assessment in GEM fellowship training, a working group was\nestablished between the International EM Fellowship Consortium (IEMFC) and the International Federation for\nEmergency Medicine (IFEM). A needs assessment survey of IEMFC members and a review were undertaken to\nidentify assessment tools currently in use by GEM fellowship programs; what relevant frameworks exist; and\ncommon elements used by programs with a wide diversity of emphases. A consensus framework was developed\nthrough iterative working group discussions. Thirty-two of 40 GEM fellowships responded (80% response). There is\nvariability in the use and format of formal assessment between programs. Thirty programs reported training GEM\nfellows in the last 3 years (94%). Eighteen (56%) reported only informal assessments of trainees. Twenty-seven (84%)\nreported regular meetings for assessment of trainees. Eleven (34%) reported use of a structured assessment of any\nsort for GEM fellows and, of these, only 2 (18%) used validated instruments modified from general EM residency\nassessment tools. Only 3 (27%) programs reported incorporation of formal written feedback from partners in other\ncountries. Using these results along with a review of the available assessment tools in GEM the working group\ndeveloped a set of principles to guide GEM fellowship assessments along with a sample assessment for use by GEM\nfellowship programs seeking to create their own customized assessments.\nConclusion: There are currently no widely used assessment frameworks for GEM fellowship training. The working\ngroup made recommendations for developing standardized assessments aligned with competencies defined by the\nprograms, that characterize goals and objectives of training, and document progress of trainees towards achieving\nthose goals. Frameworks used should include perspectives of multiple stakeholders including partners in other\ncountries where trainees conduct field work. Future work may evaluate the usability, validity and reliability of\nassessment frameworks in GEM fellowship training.
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