Global health and rehabilitation education in Canada: a qualitative analysis of experiences and perspectives of educators

BACKGROUND

Rehabilitation practice is increasingly tied to global trends. First, healthcare services are increasingly tailored to be patient-centered, requiring knowledge of sociocultural contexts and experiences of a diverse patient population. Second, non-communicable diseases and morbidity stemming from infectious diseases are creating greater needs for rehabilitation services in countries facing this double burden of disease. Third, globalization continues to shape the risk factors for disease and disability and influences the type of services accessible and the financing and management of such services. Given this context, there is a critical need to examine how global health (GH) is approached in rehabilitation curricula. How students learn about these various dynamics will impact their ability to practice in this environment and best meet the needs of the patients and populations they are caring for.

OBJECTIVES

This study explores how university-level Canadian occupational and physical therapy educators understand GH within their academic and clinical practices.

METHODS

The project followed a qualitative design. Semi-structured interviews were conducted with participants (n = 12; randomized purposive sampling was used). A deductive and inductive thematic analysis was performed to describe the participants perspectives on and practices of GH education in rehabilitation education programs.

FINDINGS

There was an overall coherence between the literature and the participant's views of the constituent elements of GH. Participants viewed GH as a framework to broaden the clinical training of students by encouraging a critical "clinical toolbox" via themes of structural competency, cultural sensitivity, and a sense of global citizenship and stewardship. However, GH was also described by participants as being implicitly present in the curriculum due to ambiguities regarding the scope of GH, seen as a key obstacle in the integration of GH education in rehabilitation programs.

INTERPRETATION

Despite the growing interest and relevance of GH, there is a noteworthy absence of GH education guidelines. There is a need to uncover the scope and underpinnings of GH and to outline rehabilitation-oriented GH competencies as per the positive value of GH attributed by the educators to the training of our healthcare workforce.IMPLICATIONS FOR REHABILITATIONGlobal health is seen by a sample of educators to provide rehabilitation students with a critical and holistic "clinical toolkit" by introducing themes of structural competency, cultural sensitivity and awareness, and global stewardship, enabling them to become good global clinicians and global citizens;The increased interest in global health throughout academic curricula presents new challenges for educators and students, specifically relating to understanding the mission and aims of this field. There is a need to clarify the notion and field of global health and how it complements clinical training within rehabilitation programs;There is a need to advance the literature on global health in rehabilitation by exploring what competencies are seen to be relevant to the field and practice of rehabilitation.