Perceptions and reflections of early graduates of the first emergency medicine residency program in Ethiopia: A qualitative study

Nazanin Meshkat; Elayna Fremes; Joanna Burke-Bajaj; Sofia Kebede; Cheryl Hunchak

doi:10.1016/j.afjem.2021.09.004

Perceptions and reflections of early graduates of the first emergency medicine residency program in Ethiopia: A qualitative study

Afr J Emerg Med. 2022 Mar;12(1):7-11. doi: 10.1016/j.afjem.2021.09.004. Epub 2021 Dec 28.

Authors

Nazanin Meshkat^{1

2

3}, Elayna Fremes³, Joanna Burke-Bajaj⁴, Sofia Kebede^{5

6

3}, Cheryl Hunchak^{7

8

3}

Affiliations

¹ Division of Emergency Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² Department of Emergency Medicine, University Health Network, Toronto, ON, Canada.
³ Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM), Toronto, ON, Canada.
⁴ London School of Hygiene & Tropical Medicine, London, United Kingdom.
⁵ Department of Emergency Medicine, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
⁶ Addis Ababa University, Addis Ababa, Ethiopia.
⁷ Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada.
⁸ Department of Emergency Medicine, Mount Sinai Hospital, Toronto, Canada.

Abstract

Introduction: A bi-institutional partnership between physicians at Addis Ababa University, Ethiopia and the University of Toronto, Canada led the development and implementation of a novel emergency medicine (EM) postgraduate training program at Addis Ababa University (AAU). Subsequently, the first three cohorts of trainees were invited to participate in the evaluation of the curricular components devised and delivered by Toronto EM physicians as part of the Toronto Addis Ababa Academic Collaboration in EM (TAAAC-EM). We sought to characterise the strengths and weaknesses of the curriculum to improve it for future trainee cohorts.

Methods: This curriculum assessment used semi-structured, in-depth individual interviews to evaluate components of the TAAAC-EM program curriculum. Interviews were conducted with a purposive sampling of graduates from the first three cohorts of the TAAAC-EM program.

Results: Twelve participants were interviewed. The following themes were identified; The TAAAC-EM program built a novel EM culture at AAU and shifted teaching from didactic to learner-centered strategies where teachers serve as role models; The curriculum content of the EM resident program, including didactic and practical sessions, was well received by the graduates interviewed; Challenges identified included lack of continuity in training, and difficulties transitioning to practice in a locally nascent field; Participants evaluated the TAAAC-EM program model as very positive overall, and supported replicating the model by expanding within Ethiopia and beyond.

Conclusions: The challenges identified in the program, including lack of continuity of clinical teaching and meeting the local educational resource needs of new graduates, helped inform program adaptations and improvements. TAAAC-EM, currently in its eleventh year, is now focused on transitioning full teaching responsibilities to local faculty and continuing to support a positive EM teaching culture. We believe that this thriving partnership can serve as a model for future north-south and south-south collaborations in postgraduate medical education.

Keywords: Capacity building; Emergency medicine curriculum; Global health; Graduate medical education; International health; Medical curriculum evaluation.