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Rent S, Valentine G, Ehret D, Kukora S. Global health training during neonatal fellowship: fellow and program director perspectives. J Perinatol 2020; 40:1253-1261. [PMID: 32152489 DOI: 10.1038/s41372-020-0639-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 02/15/2020] [Accepted: 02/25/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study explored the availability and perception of Global Health (GH) training opportunities in US-based Neonatal-Perinatal Medicine (NPM) fellowship programs. STUDY DESIGN Electronic surveys, containing discrete choice and open-ended questions, were distributed to current and recent fellows and to Program Directors (PDs). RESULTS Fifty-eight PDs and ninety-eight fellows completed the survey. Fellows reported declining GH participation from 48% in medical school to 21% in fellowship. Among the 42% of fellows reporting GH opportunities at their programs, 30% personally participated. Fewer than 30% of these programs offer structured classroom or online learning; 10% offer research opportunities. 72% of fellows stated that GH availability is moderately to extremely important, compared with 58% of PDs. PDs cited cost, scheduling, mentorship, and lack of suitable global partners as barriers to supporting fellows in GH. CONCLUSION NPM fellows place high importance on GH opportunities during fellowship, but only a minority engage in GH work.
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Affiliation(s)
| | - Gregory Valentine
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Danielle Ehret
- University of Vermont Larner College of Medicine, Burlington, VT, USA
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Chamberlain S, Gonzalez N, Dobiesz V, Edison M, Lin J, Weine S. A global health capstone: an innovative educational approach in a competency-based curriculum for medical students. BMC MEDICAL EDUCATION 2020; 20:159. [PMID: 32429897 PMCID: PMC7236959 DOI: 10.1186/s12909-020-02070-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Global health educational programs for medical and public health professionals have grown substantially in recent years. The University of Illinois Chicago College of Medicine (UICOM) began a global medicine (GMED) program for selected students in 2012 and has since graduated four classes. As part of the four-year curriculum, students complete a longitudinal global health capstone project. This paper describes the global health capstone project as an innovative educational tool within a competency-based curriculum. METHODS The authors define and describe the longitudinal global health capstone including specific requirements, student deliverables, and examples of how the global health capstone may be used as part of a larger curriculum to teach the competency domains identified by the Consortium of Universities for Global Health. The authors also reviewed the final capstone projects for 35 graduates to describe characteristics of capstone projects completed. RESULTS The global health capstone was developed as one educational tool within a broader global health curriculum for medical students. Of the 35 capstones, 26 projects involved original research (74%), and 25 involved international travel (71%). Nine projects led to a conference abstract/presentation (26%) while five led to a publication (14%). Twenty-one projects (60%) had subject matter-focused faculty mentorship. CONCLUSIONS A longitudinal global health capstone is a feasible tool to teach targeted global health competencies and can provide meaningful opportunities for research and career mentorship. Further refinement of the capstone process is needed to strengthen mentorship, and additional assessment methods are needed.
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Affiliation(s)
- Stacey Chamberlain
- University of Illinois Chicago Center for Global Health, 1940 W. Taylor St., 2nd floor, Chicago, IL, 60612, USA.
| | - Nicole Gonzalez
- University of Illinois Chicago Center for Global Health, 1940 W. Taylor St., 2nd floor, Chicago, IL, 60612, USA
| | - Valerie Dobiesz
- Brigham and Women's Hospital, Harvard Humanitarian Initiative, Harvard Medical School, Boston, MA, USA
| | - Marcia Edison
- University of Illinois Chicago Center for Global Health, 1940 W. Taylor St., 2nd floor, Chicago, IL, 60612, USA
| | - Janet Lin
- University of Illinois Chicago Center for Global Health, 1940 W. Taylor St., 2nd floor, Chicago, IL, 60612, USA
| | - Stevan Weine
- University of Illinois Chicago Center for Global Health, 1940 W. Taylor St., 2nd floor, Chicago, IL, 60612, USA
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Pitt MB, Slusher TM, Gladding SP, Moskalewicz R, Howard CR. The Minnesota Model: A Residency Global Health Track Framework. Am J Trop Med Hyg 2019; 102:11-16. [PMID: 31701860 DOI: 10.4269/ajtmh.19-0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Residency programs are increasingly responding to the growing demand for global health (GH) education by forming dedicated GH tracks. These tracks incorporate a targeted curriculum, support best practices surrounding GH electives such as predeparture preparation and post-return debriefing, and encourage meaningful engagement with international and domestic partners. The University of Minnesota's pediatric residency has had a formal GH track since 2005, and although they have shared several curricular components in the literature, they have yet to provide a comprehensive summary of their GH track. In this article, the authors provide a thorough description of their evolving GH track model, highlighting outcomes and sharing free resources, with the goal of providing a concise, replicable GH track framework for educators seeking to provide more formal GH education within residency programs.
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Affiliation(s)
- Michael B Pitt
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Tina M Slusher
- Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota.,Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Sophia P Gladding
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Risha Moskalewicz
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Cynthia R Howard
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
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Lauden SM. Learning Abroad: Residents' Narratives of Clinical Experiences From a Global Health Elective. J Grad Med Educ 2019; 11:91-99. [PMID: 31428264 PMCID: PMC6697285 DOI: 10.4300/jgme-d-18-00701] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND While resident participation in global health (GH) rotations has grown, little is known about trainee perceptions of the personal value of these international clinical experiences and their importance to the objectives of GH training. OBJECTIVE We sought to better understand the clinical scenarios experienced during international rotations that residents perceived as most meaningful and the frequency of these experiences across scenarios and participating residents. METHODS Using the conceptual framework of Schön's reflection on action, we asked University of Minnesota GH track pediatric and internal medicine-pediatric residents to describe 10 clinical scenarios they found interesting or impactful during their 2016-2017 GH elective. We conducted a qualitative analysis of the deidentified resident narratives and mapped themes to the Accreditation Council for Graduate Medical Education (ACGME) competencies. RESULTS All eligible residents (n = 13) participated, yielding 129 unique clinical scenarios from 7 countries. We identified 5 thematic groups: (1) addressing challenges in making diagnoses in resource-limited settings; (2) dealing with patient outcomes different from those expected in the United States; (3) encountering and managing diseases in a different clinical context; (4) encountering and managing diseases in a different cultural context; and (5) reflecting on learning and self-growth. Of the 129 unique clinical scenarios, 30% (n = 39) had not been previously experienced by participants. Across the 5 themes, all ACGME core competencies were addressed. CONCLUSIONS Residents identified meaningful scenarios of their GH experiences that are relevant to the educational and clinical objectives of GH training.
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Haq H, Barnes A, Batra M, Condurache T, Pitt MB, Robison JA, Schubert C, St Clair N, Uwemedimo O, Watts J, Russ CM. Defining Global Health Tracks for Pediatric Residencies. Pediatrics 2019; 144:peds.2018-3860. [PMID: 31213520 DOI: 10.1542/peds.2018-3860] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Global health (GH) offerings by pediatric residency programs have increased significantly, with 1 in 4 programs indicating they offer a GH track. Despite growth of these programs, there is currently no widely accepted definition for what comprises a GH track in residency. METHODS A panel of 12 pediatric GH education experts was assembled to use the Delphi method to work toward a consensus definition of a GH track and determine essential educational offerings, institutional supports, and outcomes to evaluate. The panelists completed 3 rounds of iterative surveys that were amended after each round on the basis of qualitative results. RESULTS Each survey round had 100% panelist response. An accepted definition of a GH track was achieved during the second round of surveys. Consensus was achieved that at minimum, GH track educational offerings should include a longitudinal global child health curriculum, a GH rotation with international or domestic underserved experiences, predeparture preparation, preceptorship during GH electives, postreturn debrief, and scholarly output. Institutional supports should include resident salary support; malpractice, evacuation, and health insurance during GH electives; and a dedicated GH track director with protected time and financial and administrative support for program development and establishing partnerships. Key outcomes for evaluation of a GH track were agreed on. CONCLUSIONS Consensus on the definition of a GH track, along with institutional supports and educational offerings, is instrumental in ensuring consistency in quality GH education among pediatric trainees. Consensus on outcomes for evaluation will help to create quality resident and program assessment tools.
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Affiliation(s)
- Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas;
| | - Adelaide Barnes
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Maneesh Batra
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Tania Condurache
- Department of Pediatrics, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Michael B Pitt
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jeff A Robison
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Chuck Schubert
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Nicole St Clair
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | | | - Jennifer Watts
- Children's Mercy Kansas City, Kansas City, Missouri; and
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Watts J, Russ C, St Clair NE, Uwemedimo OT. Landscape Analysis of Global Health Tracks in United States Pediatric Residencies: Moving Toward Standards. Acad Pediatr 2018; 18:705-713. [PMID: 29604460 DOI: 10.1016/j.acap.2018.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/08/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The number of pediatric Global Health (GH) tracks has more than doubled in less than 10 years. The goal of this study was to describe the characteristics of the pediatric GH tracks to identify commonalities and differences in track structure, funding, and education. In addition, we also identified demographic, institutional, and residency-related factors that were significantly associated with educational offerings and logistical challenges. METHODS A cross-sectional survey was electronically administered to pediatric residency programs with GH tracks. Statistical analyses included frequencies to describe GH track characteristics. Fisher's exact tests were used to identify bivariate associations between track structure and funding with educational offerings and logistical challenges. RESULTS Leaders of 32 pediatric GH tracks (67%) completed the survey. The majority of GH tracks were completed within the 3 years of residency (94%) and identified a GH track director (100%); however, tracks varied in size, enrollment methods, domestic and international partnerships, funding, and evaluations. Dedicated faculty time and GH track budget amounts were associated with more robust infrastructure pertaining to resident international electives, including funding and mentorship. Many tracks did not meet American Academy of Pediatrics recommended standards for clinical international rotations. CONCLUSIONS Despite the presence of multiple similarities among pediatric GH tracks, there are large variations in track structure, education, and funding. The results from this study support the proposal of a formal definition and minimum standards for a GH track, which may provide a framework for quality, consistency, and comparison of GH tracks.
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Affiliation(s)
- Jennifer Watts
- Department of Emergency Medicine, Children's Mercy Hospital, Children's Mercy Kansas City, Kansas City, Mo.
| | - Christiana Russ
- Department of Hospital Medicine, Boston Children's Hospital, Boston, Mass
| | - Nicole E St Clair
- Department of Hospital Medicine, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
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