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We realize that in any learner-centered evaluation process there may be tension between the learner’s self-assessment and the expectations of the certifying body, which has not only the learner’s interests at heart, but also those of the constituents to whom it is responsible (AACH course participants). It should be clear that the seven basic competencies (Appendix III) are of fundamental importance and required of all FITs. However, the specifics of how to achieve basic competence – your prioritization, your use of learning resources, etc.– can be negotiated among you, your guide, and the FTPC. In addition to achieving basic competence in all areas, we anticipate that you will develop your own unique profile of advanced competence. You may be entirely satisfied with basic competence in some areas; in others you may want to go far beyond these minimum standards. We expect every FIT to meet our basic standards. Beyond these, however, you are free to pursue your growth as little or as much as you like. In this way, we feel that we will maintain a process which is facilitative for trainees, while assuring high standards for our constituents. We will attempt to preserve your prerogatives, and will also certify that you have developed acceptable levels of knowledge and skills appropriate to each level of training. Throughout training we will request that you critically assess your progress and growth by soliciting feedback from those with whom you work and through critical self-reflection. You should regularly be gathering formal assessments from your guide (Appendix V), and from participants, faculty and co-facilitators (Appendix IV.1, Appendix IV.2) with whom you work during training experiences. We will also expect you to provide periodic assessments from supervisors and students with whom you work in your home institution. These on-going assessments are reviewed with your faculty guide. They will be used formatively when making decisions about goal accomplishment and future learning activities, and summatively when decisions are made concerning advancement to the next phase of training. Periodically you may be asked to submit video- or audiotapes of patient care or teaching sessions to your Guide. Advancement: At those times when you and your faculty guide feel that you are ready to take more responsibility for facilitation, or to be certified to facilitate independently, another type of evaluation will occur. At these times, you will submit to the FDC a reflective personal statement, a written self-assessment of your learning and goals for the next level of training, and documentation of evidence gathered regularly through your training (see Appendix II, Appendix IV.1, Appendix IV.2, Appendix V, and Appendix VI). Your request for advancement should include evidence of personal reflection regarding your personal and professional growth as a facilitator and should address your achievements and future learning goals linking knowledge, skills and personal awareness. Your faculty guide will be asked to provide information to the committee and to make a recommendation regarding your status. After reviewing all available information, the FDC will make a decision regarding advancement or certification. Certification: Responsibility for final certification lies with the FDC. By certifying you as a graduate of our training program, we are stating to you and others that you have achieved at least basic competence in the seven areas (Appendix III) that we have defined for facilitative (learner-centered) teaching and patient care. Our certification process is a rigorous one. It emphasizes commitment to our core values and attainment of the broad knowledge base, high quality skills, and attitudes necessary for the complex and varied tasks of teaching psychosocial medicine. Our applicant pool is of uniformly high quality. Therefore, we anticipate that most of those who are accepted will be certified. However, it is important to state that acceptance does not guarantee certification. Duration of Training: The amount of time spent at each level of training is variable, according to individual learning needs and personal and professional circumstances. Therefore, it may take anywhere from three to six years to complete the training. 
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