Freely Accessible Medical Education (FAME) for Africa

African Journal of Emergency Medicine 8 (2018) 41–42 Contents lists available at ScienceDirect African Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/afjem EDITORIAL Freely Accessible Medical Education (FAME) for Africa The 4th African Conference on Emergency Medicine (AfCEM) will be held this year, 2018, in Kigali, Rwanda, 7 through 9 November. Previous conferences in Ghana (2012), Ethiopia (2014) and Egypt (2016), have shown that Africa can host world-class conferences, and the upcoming conference in Rwanda will continue to build on those successes. The AfCEM draws speakers and delegates from all over Africa and further afield, sharing experiences and opinion to help further the development of emergency care in Africa. This year the theme is Breaking Barriers in Emergency Medicine Education. Emergency medicine education in Africa is the key to increasing the number of well-trained emergency care providers across the continent. Additionally, education is a vital component of developing systems and fostering research to address health needs. New systems in emergency medicine will not flourish unless people learn how to use them, and new research cannot be implemented without communicating the findings. Medicine has always depended on education, dating from Hippocrates’s oath which reinforced the need for practitioners to teach their art to the next generation – and insisted that this education should be free [1]. But the way education is delivered changes over time. Sir William Osler said in 1892: ‘In the methods of teaching medicine the old order changeth, giving place to new’ [2], and his wisdom holds true over a century later. The challenge that now lies before the contemporary emergency medicine community is to provide appropriate education that is freely available to all of today’s learners. With the highest emergency care mortality burden globally, the provision of accessible education is more crucial in Africa than anywhere else [3]. Textbooks are expensive to produce, distribute and purchase; they are also rapidly superseded by the latest developments in healthcare. Journals are more current but no single journal is comprehensive for emergency medicine practice, and the volume of publications prohibits any one person from being able to keep on top of all of them. Although more up to date in delivery, conferences are expensive to attend. Since its inception in 2012, the educational community has witnessed the rise of FOAM, or Free Open Access Medical education [4–7]. FOAM harnesses the prevalence and ease of social media, from outlets such as Twitter®, Facebook®, and a multitude of web based educational platforms, to provide peer-sourced educational content to augment traditional educational mechanisms [8,9]. In large because of the success of FOAM, emergency care practitioners now have a greater opportunity than ever before to provide high-quality and up-to-date information, bridging the gap between research, education and practice. T However, despite its name, FOAM is not always free or accessible, especially when accessing audio and video media. For many in Africa, the lack of reliable internet connection or bandwidth, and the cost of data, limits adequate access to the important educational resources offered freely through the global FOAM community. Furthermore, the vast majority of FOAM is targeted at high-resource settings, so even if practitioners in Africa can access the learning, they rarely have access to the technology required to translate their learning into practice. Due to these barriers, AfCEM 2018 is putting forward a novel iteration of FOAM; that of FAME, or Freely Accessible Medical Education. The focus is on what is needed in Africa and other resourceconstrained settings, to deliver high-quality and up to date education in emergency care. FAME embodies a modification of Penchansky and Thomas’s dimensions of accessibility in health services [10]. Accessibility in emergency medicine education comprises availability, appropriateness, and affordability. FAME is aimed at low- and-middle income countries (LMICs), providing available and affordable educational tools to teach appropriate emergency care. FAME therefore includes traditional educational methods, as well as internet-based resources and social media. FAME seeks to make all educational tools more accessible for LMIC. So FAME will utilise lowbandwidth tools like Facebook Lite® and emphasize more accessible media such as text and images. It will support the growth of Brave African Discussions in EM (BadEM) [9] and other similar resources from across Africa. It will include new models of classroom learning and low-fidelity simulation. It will support and promote Africa-specific, open-access journals like the African Journal of Emergency Medicine. It will include the distribution of the African Handbook of Acute and Emergency Care throughout the continent [11]. It will include free courses, like the Primary Trauma Care course, that are written specifically for the LMIC context [12]. Although much of this material can and should be provided without a fee, it needs to be recognised that there will always be costs, such as data charges or travel expenses. Efforts must be made to minimise these costs, making them affordable even if not actually free. Conferences and courses cannot be run without expenditure, and many of those in LMIC who develop or provide educational materials cannot afford to do so without receiving fair remuneration. FAME will therefore encourage global partners to provide institutional subscriptions to otherwise expensive resources. It will promote sponsorship such as the Supadel programme [13] for delegates to attend international conferences. It will encourage governments and Peer review under responsibility of African Federation for Emergency Medicine. https://doi.org/10.1016/j.afjem.2018.05.003 Received 5 April 2018; Accepted 1 May 2018 Available online 16 May 2018 2211-419X/ 2018 African Federation for Emergency Medicine. Publishing services provided by Elsevier. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/). African Journal of Emergency Medicine 8 (2018) 41–42 EDITORIAL donors to provide funding to support sustainable, local development of new resources with fair payment of educators. It will also develop partnerships between African emergency care programs and societies, and others across the world, to facilitate long-term, global interchange of teaching and training. It’s time for FAME, for African emergency medicine. Freely Accessible Medical Education. Come to the AfCEM conference in Kigali in November 2018 to be a part of this developing frontier in medical education and the flourishing world of EM in Africa. [Accessed 20.03.2018]. [9] BadEM: Brave African Discussions in Emergency Medicine website. Available from URL: https://badem.co.za/ [Accessed 20.03.2018]. [10] Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care 1981;19:127–40. [11] Wallis LA, Reynolds TA, editors. AFEM Handbook of Acute and Emergency Care. Cape Town: Oxford University Press; 2013. [12] Primary Trauma Care Foundation website. Available from URL: https://www. primarytraumacare.org/ [Accessed 20.03.2018]. [13] Bruijns SR. Editorial. Afr J Emerg Med 2015;5:97–8. Scientific Committee, AfCEM 2018 Giles N. Cattermole Emergency Department, Princess Royal University Hospital, King’s College Hospital NHS Trust, London, UK E-mail address: [email protected] Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at https://doi.org/10.1016/j.afjem.2018.05.003. Scientific Committee, AfCEM 2018 Appolinaire Manirafasha Emergency Department, Centre Hospitalier Universitaire de Kigali, University of Rwanda, Rwanda References [1] Lloyd GER, editor. Hippocratic writings. London: Penguin; 1978. [2] Osler W. Aequanimitas. London: HK Lewis; 1939. [3] Obermeyer Z, Abujaber S, Makar M, et al. Emergency care in 59 low- and middleincome countries: a systematic review. Bull World Health Organ 2015;93:577–586G. [4] Nickson C. FOAM. Lifeinthefastlane.com. Available from URL: http:// lifeinthefastlane.com/foam/ [Accessed 20.03.2018]. [5] Nickson CP, Cadogan MD. Free Open Access Medical education (FOAM) for the emergency physician. Emerg Med Australas 2014;26:76–83. [6] Thurtle N, Banks C, Cox M, Pain T, Furyk J. Free Open Access Medical Education resource knowledge and utilisation amongst Emergency Medicine trainees: a survey in four countries. Afr J Emerg Med 2016;6:12–7. [7] Kleynhans AC, Oosthuizen AH, Van Hoving DJ. Emergency medicine educational resource use in Cape Town: modern or traditional? Postgrad Med J 2017;93:250–5. [8] Life in the Fast Lane website. Available from URL: https://lifeinthefastlane.com Scientific Committee, AfCEM 2018 Adam R. Aluisio Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, RI, USA Chair of the Local Organising Committee, AfCEM 2018 Gabin Mbanjumucyo Emergency Department, Centre Hospitalier Universitaire de Kigali, University of Rwanda, Rwanda 42