Current FIT Program Participants
 
Jeff Stein, MD

Assistant Professor, Clinical Child Health and Clinical Medicine
University of Missouri
Guide: TBD
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Barbette Weimer-Elder
Barbette Weimer-Elder PhD, RN

Director, Service Excellence, Physician Partnership Programs
Stanford Health Care
Guide: TBD
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Judy Passaglia
Judy Passaglia, CNS, RN, ACHPN

APP Program Manager
Center for Advanced Practice
Stanford Health Care
Guide: TBD
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Jan Veesart
Jan Veesart, MD

Department of Emergency Medicine
University of New Mexico Health Services Center
Albuquerque, New Mexico
Guide: TBD
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Lynda Tang
Lynda Tang, DO

Palliative Medicine Physician
Vancouver Clinic
Vancouver, WA
Guide: TBD
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Nuala Crotty
Nuala Crotty, MD
Physical Medicine and Rehabilitation
Spectrum Health System
Grand Rapids, MI
Guide: Jenni Levy
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Tina Foster
Tina Foster, MD, MPH, MS Associate Professor, Obstetrics and Gynecology and Community and Family Medicine
Dartmouth Hitchcock Medical Center
Lebanon, NH
Guide: Sally Fortner
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Robbie Sherman
Robbie Sherman, MD
The Polyclinic
Seattle, WA
Guide: Marla Rowe Gorosh
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Swana de Gijsel
Swana de Gijsel, MD
New York Presbyterian
Brooklyn, NY
Guide: Ellen Pearlman
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Erum Jadoon-Khamash
Erum Jadoon-Khamash, MD
Senior Associate Consultant
Mayo Clinic
Scottsdale, Arizona
Guide: David Gullen
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Raghava Nagaraj
Raghava Nagaraj, MBBS, MPH, FHM 
Wake Forest School of Medicine
Winston-Salem, NC
Guide: Auguste Fortin
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Sumita Kalra
Sumita Kalra, DO
San Mateo Medical Center
Union City, CA
Guide: Sheira Schlair
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Kathleen Kieran
Kathleen Kieran, MD, MS, FAAP, FACS
University of Seattle Children's Hospital
Seattle, WA
Guide: Stuart Sprague, PhD
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Melissa Times, MD, MS, FACS, FASCRS
MetroHealth Medical Center
Cleveland, OH
Guide: Carol Chou
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Darryl Woods
Darryl Woods, MD
Head of Diversity and Cultural Competency
Stroger Hospital of Cook County
Chicago, Illinois
Guide: Krista Hirschmann
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Laura Kirk
Laura Kirk, MSPAS, PA-C
Senior PA, Supervisor
Otolaryngology, Head and Neck Surgery
University of California at San Francisco Medical Center
San Francisco, California
Guide: Bronwyn Wilson
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Annual Reviews for FITs starting Fall 2017 or later

What is a FIT Portfolio?

Your FIT Portfolio is a master compilation of the items that document your progress in, and ultimately completion of, the FIT program.  The purpose of requiring FITs to maintain their FIT Portfolio throughout their program tenure is to provide a non-burdensome, meaningful and educational practice for FITs to track documentation of their FIT progress, which will be used by the FIT committee to make assessments regarding progress and graduation.

FIT Portfolio
 

What is the FIT Progress Tracker?

The Progress Tracker displays the required skills components of the FIT program first by the 4 core domains: Facilitation, Workshop Content & Development, Coaching, and Personal Awareness.  Each core domain is then broken down into its respective Entrustable Professional Activities (EPAs).  Finally, each EPA is then broken down into specific microskills.  The tracker allows for a qualitative assessment of each EPA, with space for faculty narrative assessment (specific and illustrative) and FIT narrative assessment.

When to update and submit your FIT Portfolio?

Submit: January (If you started the FIT program in January 2018, your FIT Portfolio would be due January 2019, and annually thereafter for each additional year you are in the program).
Update: It is suggested that you update your FIT Progress Tracker regularly. 

As a FIT, your primary venues for demonstrating and receiving feedback on your skills are Winter Course and ENRICH, attendance at which are required of all FITs.  Therefore, you should aim to update this document at least once after Winter Course and once after ENRICH.  This will not only allow for more real-time reflection and steady progress, but will also make it easier each year when you submit your full FIT Portfolio!

Who should sign off on your microskills and provide a narrative for your EPAs?

Any ACH faculty member may sign off on your microskills and provide a narrative for your EPAs.  This could include a faculty member in in whose Winter Course personal awareness group or ENRICH learning group you participated or assisted with, a faculty member in whose Winter Course FIT Skills session you participated, a faculty member in whose Winter Course or ENRICH workshop you participated, or your ACH Guide.  The goal is to capture a variety of faculty’s assessment of you to paint a picture of your progress and abilities.  

What are faculty responsible for?

  • Entrustment decision(s) resulting in signing off on individual EPAs.
  • Direct observation of the FIT
  • Honest feedback to the FIT
  • Please note that any one individual faculty member is not the sole determinant of the FIT's readiness to graduate from the FIT program.  The decision regarding readiness to graduate will be made by the FIT Committee on the basis of reviewing multiple pieces of data from multiple sources.
Core Competencies for FITs who started PRIOR to Fall 2017

The criteria only apply to those FITs who entered the program prior to Fall 2017.  
Those who entered the program Fall 2017 or later are subject to competency in the 4 core domains and subsequent EPAs and microskills.


The Core Competencies of the FIT Program are divided into seven primary domains which are described below.  Appendix I.2 delineates the level of attainment required for each sub-domain for advancement to the next level in the FIT Program.

 

 

Clinical Interviewing Skills
  • Structure of the interview
  • Function of the interview
  • Process of the interview
Group Work
  • Recognizes stages of group development: orientation, dissatisfaction, resolution, production
  • Recognizes individual/group behavior: participation, influence, membership, norms, roles, etc.
  • Recognizes interpersonal issues: inclusion, control, intimacy
Co-facilitation
  • Negotiates co-facilitation relationship
  • Recognizes and manages co-facilitation dilemmas: power and status, gender, similarities and differences in style, developmental concerns
  • Manages co-facilitation effectively in presence of participants
  • Elicits feedback effectively
  • Provides feedback effectively
Personal Awareness
  • Recognizes personal feelings, attitudes, behaviors
  • Recognizes how these affect others
  • Is able to communicate these awarenesses to others
  • Elicits feedback effectively
Small Group Facilitation
  • Implements session stages
  • Promotes progress toward goals: time management, transitions, focus
  • Facilitates participation
  • Deals with problematic participation
  • Creates a supportive learning environment: genuineness, unconditional positive regards, active listening
  • Promotes personal awareness
  • Enables individual responsibility for learning: starts where learner is, encourages self-identification of goals, encourages self-assessment, enables learners to view each other as resources
  • Tracks group process
  • Facilitates effective use of role-play
  • Facilitates effective simulator experiences
  • Facilitates inter-learner provision of effective feedback
  • Provides effective feedback
  • Elicits feedback effectively
Interpersonal Effectiveness
  • Demonstrates genuineness/congruity of feelings and actions
  • Demonstrates unconditional positive regard
  • Communicates accurate empathy
Self-directed Learning
  • Takes responsibility for learning
  • Elicits feedback effectively
  • Utilizes learning plan effectively

 

 

FIT 2 to FIT 3 Advancement for FITs who started PRIOR to Fall 2017

The criteria only apply to those FITs who entered the program prior to Fall 2017.  
Those who entered the program Fall 2017 or later are subject to the "Annual Assessment" guidelines further down on this page.

Procedure:

As soon as you decide you would like to advance, notify the FIT co-directors and Rachel Poarch, ACH Program Manager, of your intent to do so with your goal advancement dates.  Once you have received confirmation from the FIT co-directors and Rachel of your goal advancement date, you can begin compiling your materials.  

All materials should be sent directly to Rachel at rpoarch@achonline.org

In order to ensure the most honest and thoughtful recommendations, we ask that you waive your right to see your recommendation letters.  Therefore, please instruct your letter writers to send their recommendation letters directly to Rachel.

Required Materials:

 

  • Cover letter- State your intention to advance and list the letters of recommendation that you have requested
  • Personal Reflective Statement- This is typically 1-1.5 page essay that should explain in a narrative-style fashion where you feel you are in the process, and may include any realizations you have made about yourself, what you feel you need to work on, what areas you have experienced personal growth in, etc. 
  • Letters of recommendation: In order to ensure the most honest and thoughtful recommendations, we ask that you waive your right to see your recommendation letters.  Therefore, please instruct your letter writers to send their recommendation letters directly to Rachel.
    • 2 letters of recommendation from ACH faculty- These should be sent by faculty with whom you have worked in ACH courses or in other capacities. These letters should discuss your knowledge and competence in psychosocial medicine and teaching. They should also provide an opinion about your readiness to function at the FIT3 level.
    • 2 letters of recommendation from learners- There should be from learners with whom you have worked in a teaching capacity within the last year.  These may be students and learners from any level or house-officers.
    • 1 letter from your Faculty Guide- This letter should convey evidence of your growth and progress toward your learning objectives, as well as provide specific examples of how you have demonstrated competence in the areas required to become a FIT 3.
  • Updated Learning Plan- Update your learning plan so that it contains overall goals for the year, specific objectives which will lead to those goals, learning activities that will lead to attainment of your objectives, and methods for evaluating your progress. (Click here for a sample learning plan).
  • Self-Assessment of Progress  - This is an objective self-assessment that explicitly addresses where you stand with respect to your learning goals.
  • Core Reading - List of related articles, books, etc. that you have read as a FIT 2
  • Personal Log- List and brief description of related activities you’ve been involved in (Including 2 to 4 ACH and non-ACH trainings and workshops you co-facilitated) as a FIT 2.
  • Evaluations from 2-4 ACH (ENRICH and/Winter Course) and non-ACH trainings or workshops you co-facilitated
  • ENRICH Co-facilitation Form
  • Attendance at Winter Course
  • Guide/FIT Evaluation Form

 

Graduation for FITs who started PRIOR to Fall 2017

The criteria only apply to those FITs who entered the program prior to Fall 2017.  
Those who entered the program Fall 2017 or later are subject to the "Annual Assessment" guidelines further down on this page.

Procedure:

As soon as you decide you would like to graduate, notify the FIT co-directors and Rachel Poarch, ACH Program Manager, of your intent to do so with your goal graduation date.  Once you have received confirmation from the FIT co-directors and Rachel of your goal graduation date, you can begin compiling your materials.  

All materials should be sent directly to Rachel at rpoarch@achonline.org

In order to ensure the most honest and thoughtful recommendations, we ask that you waive your right to see your recommendation letters.  Therefore, please instruct your letter writers to send their recommendation letters directly to Rachel.

Required Materials:

  • 2 letters of recommendation from ACH faculty- These should be sent by faculty with whom you have worked in ACH courses or in other capacities. These letters should discuss your knowledge and competence in psychosocial medicine and teaching.  They should also provide an opinion about your readiness to become faculty of the ACH.
  • 1 letter from your Faculty Guide- This letter should convey evidence of your growth and progress toward your learning objectives, as well as provide specific examples of how you have demonstrated competence in the areas required to become a FIT 3.
  • Personal Log- List and brief description of related activities you’ve been involved in (Including ACH and non-ACH trainings and workshops you co-facilitated) as a FIT 3
  • Evaluations from ENRICH co-facilitation
  • ENRICH Co-Facilitation form

Optional Materials:

  • (Effective 3/16/18)- Elective reflection narrative- This should summarize your personal growth through your FIT journey, as well as provide feedback to the FIT committee about the FIT program experience.
Annual Check-In Process for FITs not Applying for Advancement

This only applies to those FITs who joined the program prior to Fall 2017.

Goals:

  1. Learn about each FIT’s accomplishments in the past year and progress towards learning goals
  2. Review FIT-Guide relationship
  3. Identify any individual or systems barriers to progress in the upcoming year
  4. Receive feedback about the FIT program
  5. Identify ways in which the FIT program can best support each person, including specific learning opportunities at the upcoming courses

Process:

  • If an FIT is not applying for advancement during a given calendar year, they will be asked to submit:
  • Annual review process will be completed following the Winter Course each year, with the materials from the FITs due by the co-directors’ deadline
  • Within 6 weeks of receipt of materials, a conference call will be scheduled with the FIT, his/her guide, and a FIT co-director or committee member
  • The FIT co-director or committee member will report back to committee on each FIT’s progress
  • If any areas of concern are raised by the FIT, the guide, the committee member, or the committee as a whole, a follow-up phone call with one of the FIT co-directors may be scheduled.

Process for FITs currently on Leave of Absence (LOA):

The current LOA policy states that the FIT on leave should keep the FIT committee apprised of her activities and plans vis-à-vis the FIT program.  This policy now specifies that there should be yearly contact from the FIT on LOA with the FIT committee.  The annual check-in process for FITs on LOA will be as follows:

  • FITs on LOA will be expected to submit a letter to the FIT committee at least annually (due on September 15) describing their activities during the past year (or since the last update) and their future plans regarding the FIT program (such as when they hope to end their leave or if they still will remain on leave for the foreseeable future).
  • Within 1 month of receipt of this letter, an FIT co-director will schedule a call with the FIT on leave in order to foster an ongoing connection between the FIT program and the FIT, even while on LOA.
FIT Participation at Winter Course

The Winter Course, typically held in February at a retreat-like venue, is designed for current faculty, FITs, and RCFs to deepen their skills and knowledge of relationship-centered care. It also serves as an opportunity for personal and professional renewal.  The course activities include learning (Personal Awareness/PA) groups, standalone workshops, FIT skills sessions, and large group exercises led by seasoned facilitators. Each FIT will be paired with either their own guide or a surrogate guide (if one's own guide is not attending the Course), who will check-in regularly and ensure the FIT's goals are being met.

1. Learning Groups - Each FIT/guide pair will have the opportunity to indicate their preference for a learning group modality prior to arriving at the Course.  These learning groups, modalities of which often include Rogerian, Matrix, Family of Origin, and Diversity, are facilitated by outside facilitators allowing FITs and faculty time and space to work on their individual learning goals for the course.

2. Workshops - Several workshops on various topics are offered at Winter Course.  Each FIT will have the opportunity to select which workshop he or she would like to attend.  These selections are usually made on-site at the Course.  FITs of all levels are encouraged to participate in workshop planning leading up to the Winter Course if they so desire.  Solicitation of interest in workshop planning for Winter Course usually occurs in the fall prior to the Course.  In some situations, a workshop being developed for ENRICH will be presented in an early form at Winter Course to allow for additional tweaking of content and presentation.

3. FIT Skills Course - Started in 2014, the FIT Skills Course is an added component of Winter Course aimed to provide FITs with a standard set of skills in relationship-centered communication and facilitation.

Life in the ACH after the FIT Program

Internal Opportunities
After one graduates from the FIT program and becomes a faculty member of the ACH, other internal education opportunities include: co-facilitating with FITs at ENRICH or Winter Course, becoming a Guide for a FIT, or joining the FIT committee as a faculty representative (if openings are available).

External Opportunities
Additionally, there are a growing number of external education opportunities for ACH faculty to lead custom, on-site workshops on behalf of the Academy.  To be considered for selection, you must have successfully completed the RCF program or Faculty Development Track. 

 

FIT Co-Directors & Committee

The purpose of this committee is to supervise the quality of the Faculty-in-Training Program relative to policy, admissions, advancements, graduation, and guides. The committee convenes monthly and consists of the 2 FIT co-directors, 4-5 faculty and usually 2-3 FITs (our goal is to keep the FIT representation on the committee proportional to the number of FITS in the program at any given time).  

FIT representatives

  • Purpose:  Their role is to advocate for FIT needs on the FIT Committee.
  • Responsibilities: To assist with administrative projects and to coordinate FIT-FIT Committee communications. FITs may vote, with the exception of applications, advancements, and graduations.  FIT input in developing training needs assessment, policies, materials and procedures is welcome. This is a wonderful venue for becoming more active in Academy work, having some input into the FIT experience, and learning about effective leadership.
  • Selection: FIT reps are selected from among interested FITs by their fellow FITs when an opening becomes available.
  • Term (effective 3/16/18): 1 year with a maximum of 2 consecutive terms as a FIT representative.  

Faculty:

  • Purpose: To provide faculty input in developing training needs assessment, policies, materials and procedures.
  • Responsiblities: Review and vote on program applications, advancements, and graduations; assist with administrative projects and contribute to the growth and development of the FIT program. 
  • Selection: Faculty are selected by the FIT committee via an open call when an opening becomes available.
  • Term (effective 3/16/18): None- an annual check-in is conducted to allow for continuation or roll off.

FIT Co-Directors

  • Purpose: Faculty of the ACH selected by the Education Committee to provide leadership to the FIT Program.  In their role, they provide supervisory mentorship and guidance to the FITs in the form of individual meetings with each FIT at both the Winter Course and ENRICH and additional email or phone communication as needed. They also co-chair the FIT Committee.  
  • Selection: FIT co-directors are selected by the VP, Internal Education from an open call.
  • Term: Overlapping 3-year terms.

Co-Directors:
Julie Crosson, MD, Boston Medical Center, Dorchester House (2016, 2017, 2018)
Carol Chou, MD, University of Pennsylvania (2017, 2018, 2019)

Committee Members:
Renee Bergstrom, EdD (FIT rep)
Steven Borowsky, MD, MPH, Park Nicollet Clinic

Pamela Duke, MD, Drexel University College of Medicine
Erum Jadoon, MD, Mayo Clinic Scottsdale (FIT rep)
Lynnea Mills, MD, UCSF (FIT rep)
Marla Rowe Gorosh, MD, Henry Ford Health System

FIT Participation at ENRICH

Before the course:

 

  • FITs are required to participate in the planning and execution of workshops for ENRICH, with the FIT’s specific roles and responsibilities determined by the FIT’s own learning goals and directed by the faculty leaders for the workshop.  A call for workshop teams is sent out to all FITs, who can select which track they'd like to assist with.  They are then responsible for attending the team's planning calls and contributing to the workshop's development.
  • FITs should review the Co-facilitation Guidelines to help prepare for co-facilitating a learning group.
  • Once FITs have been paired up with a faculty co-facilitator (who may or may not be their Guide), they should complete the Co-facilitation Inventory form and review it together.

At the course:

 

 

  • Co-facilitate a learning group with their assigned ACH faculty member.
  • Attend the pre-course, post-course debrief, and daily faculty meetings.
  • Participate in the daily learning group debriefings with their assigned ACH faculty member
  • Participate in the delivery of their selected workshop track.

After the course:

 

 

 

Support of Fellow FITs
Your time in the Faculty-in-Training Program should be one of significant learning and skill development, as well as one of exciting personal growth. It has the potential to become one of the most valuable educational experiences you undertake. 

Upon acceptance into the program, you will be added to the FIT list serv, which is the primary form of communication among FITs and the co-directors outside of in-person events.  This provides you with a way to pose questions and share information with your fellow FITs.

FITs also meet formally during the Winter Course and ENRICH.  You will find that other FITs are sources for your learning, by virtue of expertise they bring, as well as feedback they may provide you about your learning goals.
Leaves of Absence/Withdrawal

Occasionally, trainees discover that other demands or a change in professional interests require that they suspend or stop training. Forms to be utilized in the event of a formalized leave of absence or withdrawal from the program can be found in Appendix VI and Appendix VII and should be submitted to the FIT Committee for review and approval.

Grievance Procedure

It is expected that faculty Guides and FITs will occasionally become dissatisfied with the other's performance as a result of it being a close relationship with important mutual expectations. It is also expected that problems can and will usually be resolved by early and direct communication between the FIT and faculty Guide using skills we collectively hold as important. Problems will also be addressed through discussions between the FIT, the Guide and the FIT committee. The FIT committee and co-directors will monitor the progress of FIT-Guide pairs annually to insure that standards of excellence are met. Occasionally, one or both parties will wish for mediation from a third party.

Appendix VIII explains how FITs, Guides/faculty, or both can request mediation.

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