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Lam SK, Celix B, Lenhard N, Cobb C, Van Genderen K, Gundacker C, Schleicher M, Colbert CY. A review of local global health education in post-graduate medical education. MEDICAL TEACHER 2024:1-20. [PMID: 39049816 DOI: 10.1080/0142159x.2024.2372086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 06/20/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Global health (GH) education is offered in post-graduate medical education (PGME) programs and local experiences are desired by trainees and educators. This scoping review aimed to map the literature on local GH education in PGME, to describe curricular components, factors facilitating successes, and challenges to implementation using a validated education intervention checklist and inclusion of seven components of local GH programming. METHODS A decolonization conceptual framework informed a 5-step scoping review. In May 2022, eight databases and MedEdPORTAL were searched using key words describing local GH education curricula. RESULTS Sixty-eight full-text articles described local GH education programs in residencies (n = 52; 76.4%) and fellowships (n = 10; 14.7%) spanning multiple specialties, predominantly in North America (90%). Successful programs included faculty mentoring, community-based partnerships, and a multidisciplinary component. Scheduling challenges, cultural and linguistic differences, and trainee workload contributed to implementation difficulties. Only four programs included all seven local GH health equity/decolonization components. CONCLUSIONS Local GH curricula vary widely in clinical experiences, didactic sessions, and inclusion of mentorship and partnerships. Local populations within the communities of these training programs could benefit from standardized inclusion of components for local global health education with careful consideration of health equity.
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Affiliation(s)
- Suet Kam Lam
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Breastfeeding Medicine, Primary Care Pediatrics, Cleveland Clinic, Cleveland, OH, USA
| | - Brianna Celix
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nora Lenhard
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Carmen Cobb
- Department of Internal Medicine & Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Kristin Van Genderen
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Mary Schleicher
- Floyd D. Loop Alumni Library, Education Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Colleen Y Colbert
- Office of Educator & Scholar Development, Education Institute, Cleveland Clinic, Cleveland, OH, USA
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Umphrey L, Beck A, Zhou S, Kagoya EK, Paasi G, Coria A, Evert J, Haque M, Rule A, Lamb MM. Access, interest and equity considerations for virtual global health activities during the COVID-19 pandemic: a cross-sectional study. Glob Health Res Policy 2024; 9:8. [PMID: 38317192 PMCID: PMC10845763 DOI: 10.1186/s41256-023-00333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Global health activities (GHAs) reduce health disparities by promoting medical education, professional development, and resource sharing between high- and low- to middle-income countries (HICs and LMICs). Virtual global health activities facilitated continuity and bidirectionality in global health during the COVID-19 pandemic. While virtual engagement holds potential for promoting equity within partnerships, research on equitable access to and interest in virtual global health activities is limited. METHODS We conducted a cross-sectional, online, mixed-methods survey from January to February 2022 examining access to virtual activities before and during the pandemic across resource settings. Eligible participants were participants or facilitators of global health activities. Closed- and open-ended questions elicited participants' access to and interest in virtual global health engagement. RESULTS We analyzed 265 surveys from respondents in 45 countries (43.0% LMIC vs. HIC 57.0%). HIC respondents tended to report greater loss of in-person access due to the pandemic at their own institutions (16 of 17 queried GHAs), while LMIC respondents tended to report greater loss of in-person activities at another institution (9 of 17 queried GHAs). Respondents from LMICs were more likely to gain virtual access through another organization for all 17 queried VGHAs. HIC respondents had significantly more access to global health funding through their own organization (p < 0.01) and more flexibility for using funds. There were significant differences and trends between respondent groups in different resource environments in terms of accessibility to and interest in different virtual global health activities, both during and after the pandemic. CONCLUSIONS Our results highlight the need to examine accessibility to virtual global health activities within partnerships between high- and low- to middle-income countries. While virtual activities may bridge existing gaps in global health education and partnerships, further study on priorities and agenda setting for such initiatives, with special attention to power dynamics and structural barriers, are necessary to ensure meaningful virtual global health engagement moving forward.
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Affiliation(s)
- Lisa Umphrey
- Department of Pediatrics, University of Colorado School of Medicine, 13123 E 16th Ave, B302, Aurora, CO, 80045, USA.
- Center for Global Health, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA.
| | - Alyssa Beck
- Department of Epidemiology, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA
| | - Shuo Zhou
- Department of Communication Studies, School of Communication and System Health Lab, Hong Kong Baptist University, No. 5 Hereford Rd, Kowloon, Hong Kong
| | - Enid Kawala Kagoya
- Department of Community Health, Institute of Public Health, Busitema University, P.O Box 1460, Mbale, Uganda
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda
| | - George Paasi
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda
| | - Alexandra Coria
- Department of Pediatrics, Maimonides Children's Hospital and SUNY Downstate College of Medicine, 4802 10th Ave, Brooklyn, NY, 11219, USA
| | - Jessica Evert
- Child Family Health International, 11135 San Pablo Ave #929, El Cerrito, CA, 94530, USA
| | - Marina Haque
- Department of Anesthesiology, Wayne State University, Detroit, MI, 48202, USA
| | - Amy Rule
- Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA, 30307, USA
- Children's Healthcare of Atlanta, 2015 Uppergate Dr, Atlanta, GA, 30307, USA
| | - Molly M Lamb
- Center for Global Health, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA
- Department of Epidemiology, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA
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Leuche VT, Delgado-Zapata R, Umphrey L, Lam SK, Nunez KC, Musiime V, Rule A. Decolonizing Global Child Health Education for More Equitable and Culturally Safe Collaborations. Pediatr Ann 2023; 52:e467-e473. [PMID: 38049188 DOI: 10.3928/19382359-20231017-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Global health (GH) as an academic field is fraught with both historical and present systemic injustice, including unilateral partnerships, power asymmetry in grant funding and research agenda setting, lack of acknowledgment of low- and middle-income countries' contributions, and bias toward high-income countries' institutions. Reflecting on colonialism and White supremacy's legacy is vital for training pediatricians to actively work to create more bidirectional partnerships to improve the health of all children worldwide. In this review, we discuss the present challenges within academic GH and offer four key action steps to decolonize GH education: (1) reflecting on the history of global child health; (2) creating a new language framework; (3) reviewing cultural humility, antiracism, and decolonization curricula; and (4) discussing institutional action steps to decolonize and sustain culturally safe global child health education. [Pediatr Ann. 2023;52(12):e467-e473.].
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4
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Dhawan A, Rammelkamp Z, Kayandabila J, Surapaneni VL. Ethical Considerations of Climate Justice and International Air Travel in Short-Term Electives in Global Health. Am J Trop Med Hyg 2023; 109:506-510. [PMID: 37549896 PMCID: PMC10484251 DOI: 10.4269/ajtmh.22-0508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 05/21/2023] [Indexed: 08/09/2023] Open
Abstract
In July 2022, the American Society of Tropical Medicine and Hygiene Green Task Force advocated to acknowledge the health impacts of climate change, particularly on those in low- and middle-income countries, and called on global health organizations to act. Simultaneously, academic medical centers are resuming Short-Term Electives in Global Health (STEGH) as travel restrictions imposed during the COVID-19 pandemic ease in most countries. International flights by trainees from academic medical centers in high-income countries (HIC) on these electives encapsulate the climate injustice of who generates carbon emissions and who bears the impacts of climate change. Using "decolonization" and "decarbonization" as guiding principles, we suggest several strategies that global medical education programs in HIC could implement. First, restructure rotations to halt STEGH with minimal benefit to host institutions, optimize trainee activities while abroad, and lengthen rotation duration. Second, programs can calculate the carbon impact of their STEGH and implement concrete measures to cut emissions. Finally, we urge academic medical centers to promote climate-resilient healthcare infrastructure in host countries and advocate for climate solutions on the global stage.
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Affiliation(s)
- Adriana Dhawan
- Division of Hospital Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Zoe Rammelkamp
- Division of Hospital Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Johnstone Kayandabila
- Arusha Lutheran Medical Centre, Arusha, Tanzania
- Eastern and Southern Africa Management Institute, Arusha, Tanzania
- London School of Tropical Medicine & Hygiene, London, United Kingdom
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5
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Tchonang Leuche V, Delgado-Zapata R, Umphrey L, Lam SK, Cardiel Nunez K, Musiime V, Rule A. Decolonizing Global Child Health Education for More Equitable and Culturally Safe Collaborations. Pediatr Ann 2023; 52:e344-e350. [PMID: 37695281 DOI: 10.3928/19382359-20230720-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Global health (GH) as an academic field is fraught with both historical and present systemic injustice, including unilateral partnerships; power asymmetry in grant funding and research agenda setting; lack of acknowledgment of contributions from low- and middle-income country collaborators; and disadvantageous bias toward low- and middle-income country institutions. Reflecting on the legacies of colonialism and White supremacy is vital for training pediatricians to actively work to improve the health of all children worldwide, within bidirectional and culturally safe partnerships in which power dynamics and ethnocentrism are dismantled. In this article, we discuss the present challenges within academic GH education (GHE) and offer four key action steps to decolonize GHE: (1) reflecting on the history of global child health; (2) creating a new language framework on pertinent concepts in GHE; (3) developing cultural humility, antiracism, and decolonization curricula; and (4) intentional institutional action steps to decolonize and sustain culturally safe global child health education. [Pediatr Ann. 2023;52(9):e344-e350.].
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6
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Kayingo G, Gordes KL, Fleming S, Cawley JF. Thinking Outside the Box: Advancing Clinical Education in an Era of Preceptor Shortage. J Physician Assist Educ 2023; 34:135-141. [PMID: 37126204 DOI: 10.1097/jpa.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
ABSTRACT The expansion of health professions educational programs has led to an acute shortage of available clinical training sites. Rapid growth in the number of medical schools, physician assistant (PA) programs, and advanced nurse practitioner (APRN) programs, all of which share a need for similar types of clinical training experiences, has increased competition for clinical training sites and placed new challenges on educational institutions. Solutions are urgently needed to increase the quantity and quality of supervised clinical practice experiences as well as to ensure diversity among preceptors and geographical clinical sites. This article identifies key barriers to securing sufficient clinical training sites, notes emerging trends, and presents potential innovations through stakeholder collaboration for enhancing clinical training across health professions.
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Affiliation(s)
- Gerald Kayingo
- Gerald Kayingo, PhD, MBA, PA-C, is assistant dean, executive director, and professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Karen L. Gordes, PhD, PT, DSc, is chief learning officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Shani Fleming, MPH, PA-C, is chief equity, diversity and inclusion officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- James F. Cawley, MPH, PA-C, is a scholar in residence and visiting professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
| | - Karen L Gordes
- Gerald Kayingo, PhD, MBA, PA-C, is assistant dean, executive director, and professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Karen L. Gordes, PhD, PT, DSc, is chief learning officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Shani Fleming, MPH, PA-C, is chief equity, diversity and inclusion officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- James F. Cawley, MPH, PA-C, is a scholar in residence and visiting professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
| | - Shani Fleming
- Gerald Kayingo, PhD, MBA, PA-C, is assistant dean, executive director, and professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Karen L. Gordes, PhD, PT, DSc, is chief learning officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Shani Fleming, MPH, PA-C, is chief equity, diversity and inclusion officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- James F. Cawley, MPH, PA-C, is a scholar in residence and visiting professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
| | - James F Cawley
- Gerald Kayingo, PhD, MBA, PA-C, is assistant dean, executive director, and professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Karen L. Gordes, PhD, PT, DSc, is chief learning officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- Shani Fleming, MPH, PA-C, is chief equity, diversity and inclusion officer and associate professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
- James F. Cawley, MPH, PA-C, is a scholar in residence and visiting professor for the Physician Assistant Leadership and Learning Academy, Graduate School, University of Maryland Baltimore, Baltimore, Maryland
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Urva M, Cortez A, Katyal T, Shearer DW, Morshed S, Miclau T, MacKechnie MC, Sabharwal S. Orthopaedic trauma observerships in North America for international surgeons: the visitors' perspective. OTA Int 2023; 6:e229. [PMID: 36760658 PMCID: PMC9904194 DOI: 10.1097/oi9.0000000000000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 10/30/2022] [Indexed: 06/18/2023]
Abstract
International observerships are one of many efforts aimed at addressing disparities in orthopaedic trauma care globally. However, their impact on visiting surgeons and their home countries, as well as the challenges faced by participating surgeons, are not well-documented. Methods A survey was distributed to overseas surgeons who participated in an orthopaedic trauma observership from 2009 to 2020. Surgeons were identified through North American institutions previously recognized by the authors as having hosted international observerships. Information gathered included participant demographics, details of and perceived impact of the observership, and barriers faced before, during, and after the program. Responses from 148 international surgeons (ISs) from 49 countries were analyzed. Results Sixty percent of observerships were at academic programs, 57% lasted 1-3 months, and 60% were self-funded. Participants identified cost and housing as primary barriers. After completing their observership, lack of funding, equipment and support staff, and excessive workload prevented participants from implementing changes at their clinical practice. Most observers believed that they gained relevant clinical (89%) and surgical knowledge (67%) and developed a professional network of North American hosts (63%). The most common suggested changes to the observership were greater hands-on experience in the operating room and structured goal setting relevant to the visiting surgeon. Conclusions Visiting surgeons find North American orthopaedic trauma observerships helpful in improving their surgical and clinical skills. However, financial constraints and resource limitations at their clinical practice and limited operative experience during the observership present barriers to maximizing this clinical experience. To enhance the relevance of clinical observerships for ISs and impact global orthopaedic trauma care, the unique needs and challenges facing ISs must be addressed. Level of Evidence IV-Cross-Sectional Study.
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Affiliation(s)
- Mayur Urva
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
| | - Abigail Cortez
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
| | - Toshali Katyal
- UCSF Benioff's Children's Hospital Oakland,
Department of Pediatric Orthopaedics, Oakland, CA
| | - David W. Shearer
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
| | - Saam Morshed
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
| | - Theodore Miclau
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
| | - Madeline C. MacKechnie
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
| | - Sanjeev Sabharwal
- Institute for Global Orthopaedics and Traumatology,
Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, CA; and
- UCSF Benioff's Children's Hospital Oakland,
Department of Pediatric Orthopaedics, Oakland, CA
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Umphrey L, Lenhard N, Lam SK, Hayward NE, Hecht S, Agrawal P, Chambliss A, Evert J, Haq H, Lauden SM, Paasi G, Schleicher M, McHenry MS. Virtual global health in graduate medical education: a systematic review. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:230-248. [PMID: 36057978 PMCID: PMC9911141 DOI: 10.5116/ijme.62eb.94fa] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To synthesize recent virtual global health education activities for graduate medical trainees, document gaps in the literature, suggest future study, and inform best practice recommendations for global health educators. METHODS We systematically reviewed articles published on virtual global health education activities from 2012-2021 by searching MEDLINE, EMBASE, Cochrane Library, ERIC, Scopus, Web of Science, and ProQuest Dissertations & Theses A&I. We performed bibliography review and search of conference and organization websites. We included articles about primarily virtual activities targeting for health professional trainees. We collected and qualitatively analyzed descriptive data about activity type, evaluation, audience, and drivers or barriers. Heterogeneity of included articles did not lend to formal quality evaluation. RESULTS Forty articles describing 69 virtual activities met inclusion criteria. 55% of countries hosting activities were high-income countries. Most activities targeted students (57%), with the majority (53%) targeting trainees in both low- to middle- and high-income settings. Common activity drivers were course content, organization, peer interactions, and online flexibility. Common challenges included student engagement, technology, the internet, time zones, and scheduling. Articles reported unanticipated benefits of activities, including wide reach; real-world impact; improved partnerships; and identification of global health practice gaps. CONCLUSIONS This is the first review to synthesize virtual global health education activities for graduate medical trainees. Our review identified important drivers and challenges to these activities, the need for future study on activity preferences, and considerations for learners and educators in low- to middle-income countries. These findings may guide global health educators in their planning and implementation of virtual activities.
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Affiliation(s)
- Lisa Umphrey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nora Lenhard
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Suet Kam Lam
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Shaina Hecht
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Priya Agrawal
- Mid-Atlantic Permanente Medical Group, Washington, DC, USA
| | - Amy Chambliss
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jessica Evert
- Child Family Health International, El Cerrito, California, USA
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Texas, USA
| | - Stephanie M. Lauden
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - George Paasi
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Mary Schleicher
- Cleveland Clinic Floyd D. Loop Alumni Library, Cleveland, OH, USA
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9
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Zivanov CN, Joseph J, Pereira DE, MacLeod JBA, Kauffmann RM. Qualitative Analysis of the Host-Perceived Impact of Unidirectional Global Surgery Training in Kijabe, Kenya: Benefits, Challenges, and a Desire for Bidirectional Exchange. World J Surg 2022; 46:2570-2584. [PMID: 35976431 PMCID: PMC9383670 DOI: 10.1007/s00268-022-06692-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2022] [Indexed: 11/25/2022]
Abstract
Background As globalization of surgical training increases, growing evidence demonstrates a positive impact of global surgery experiences on trainees from high-income countries (HIC). However, few studies have assessed the impact of these largely unidirectional experiences from the perspectives of host surgical personnel from low- and middle-income countries (LMIC). This study aimed to assess the impact of unidirectional visitor involvement from the perspectives of host surgical personnel in Kijabe, Kenya. Methods Voluntary semi-structured interviews were conducted with 43 host surgical personnel at a tertiary referral hospital in Kijabe, Kenya. Qualitative analysis was used to identify salient and recurring themes related to host experiences with visiting surgical personnel. Perceived benefits and challenges of HIC involvement and host interest in bidirectional exchange were assessed. Results Benefits of visitor involvement included positive learning experiences (95.3%), capacity building (83.7%), exposure to diverse practices and perspectives (74.4%), improved work ethic (51.2%), shared workload (44.2%), access to resources (41.9%), visitor contributions to patient care (41.9%), and mentorship opportunities (37.2%). Challenges included short stays (86.0%), visitor adaptation and integration (83.7%), cultural differences (67.4%), visitors with problematic behaviors (53.5%), learner saturation (34.9%), language barriers (32.6%), and perceived power imbalances between HIC and LMIC personnel (27.9%). Nearly half of host participants expressed concerns about the lack of balanced exchange between HIC and LMIC programs (48.8%). Almost all (96.9%) host trainees expressed interest in a bidirectional exchange program. Conclusion As the field of global surgery continues to evolve, further assessment and representation of host perspectives is necessary to identify and address challenges and promote equitable, mutually beneficial partnerships between surgical programs in HIC and LMIC.
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Affiliation(s)
- Catherine N Zivanov
- Eskind Family Biomedical Library and Learning Center, Vanderbilt University School of Medicine, 2209 Garland Avenue, Nashville, TN, 37240, USA
| | - James Joseph
- Department of Surgery, Africa Inland Church Kijabe Hospital, Kijabe, Kenya
| | - Daniel E Pereira
- Eskind Family Biomedical Library and Learning Center, Vanderbilt University School of Medicine, 2209 Garland Avenue, Nashville, TN, 37240, USA
| | - Jana B A MacLeod
- Department of Surgery, Africa Inland Church Kijabe Hospital, Kijabe, Kenya.,Department of Surgery and Orthopedics, Kenyatta University School of Medicine, Nairobi, Kenya
| | - Rondi M Kauffmann
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, 597 Preston Research Building, 2220 Pierce Ave, Nashville, TN, 37232, USA.
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10
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Umphrey L, Paasi G, Windsor W, Abongo G, Evert J, Haq H, Keating EM, Lam SK, McHenry MS, Ndila C, Nwobu C, Rule A, Tam RP, Olson D, Olupot-Olupot P. Perceived roles, benefits and barriers of virtual global health partnership initiatives: a cross-sectional exploratory study. Glob Health Res Policy 2022; 7:11. [PMID: 35478077 PMCID: PMC9046069 DOI: 10.1186/s41256-022-00244-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background Virtual global health partnership initiatives (VGHPIs) evolved rapidly during the COVID-19 pandemic to ensure partnership continuity. However the current landscape for VGHPI use and preference is unknown. This study aimed to increase understanding of GH partners’ perspectives on VGHPIs.
Methods From 15 October to 30 November 2020, An online, international survey was conducted using snowball sampling to document pandemic-related changes in partnership activities, preferences for VGHPIs, and perceived acceptability and barriers. The survey underwent iterative development within a diverse author group, representing academic and clinical institutions, and the non-profit sector. Participants from their professional global health networks were invited, including focal points for global health partnerships while excluding trainees and respondents from the European Economic Area. Analysis stratified responses by country income classification and partnership type. Authors used descriptive statistics to characterize responses, defining statistical significance as α = 0.05. Results A total of 128 respondents described 219 partnerships. 152/219 (69%) partnerships were transnational, 157/219 (72%) were of > 5 years duration, and 127/219 (60%) included bidirectional site visits. High-income country (HIC) partners sent significantly more learners to low- to middle-income country (LMIC) partner sites (p < 0.01). Participants commented on pandemic-related disruptions affecting 217/219 (99%) partnerships; 195/217 (90%) were disruption to activities; 122/217 (56%) to communication; 73/217 (34%) to access to professional support; and 72/217 (33%) to funding. Respondents indicated that VGHPIs would be important to 206/219 (94%) of their partnerships moving forward. There were overall differences in resource availability, technological capacity, and VGHPI preferences between LMIC and HIC respondents, with a statistically significant difference in VGHPI acceptability (p < 0.001). There was no significant difference between groups regarding VGHPIs’ perceived barriers. Conclusions The pandemic disrupted essential partnership elements, compounding differences between LMIC and HIC partners in their resources and preferences for partnership activities. VGHPIs have the potential to bridge new and existing gaps and maximize gains, bi-directionality, and equity in partnerships during and after COVID-19.
Supplementary Information The online version contains supplementary material available at 10.1186/s41256-022-00244-4.
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Affiliation(s)
- Lisa Umphrey
- Department of Pediatrics, University of Colorado School of Medicine, 13123 E 16th Ave, B302, Aurora, CO, 80045, USA. .,Center for Global Health, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA.
| | - George Paasi
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda
| | - William Windsor
- Center for Global Health, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA
| | - Grace Abongo
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda
| | - Jessica Evert
- Child Family Health International, 11135 San Pablo Ave #929, El Cerrito, CA, 94530, USA
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Elizabeth M Keating
- Division of Pediatric Emergency Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT, 84132, USA
| | - Suet Kam Lam
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University School of Medicine, EC-10 Cleveland Clinic, 9501 Euclid Ave, Cleveland, OH, 44195, USA
| | - Megan S McHenry
- Department of Pediatrics, Indiana University School of Medicine, 340 W 10th St, Indianapolis, IN, 46202, USA
| | - Carolyne Ndila
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda
| | - Charles Nwobu
- Child Family Health International, 11135 San Pablo Ave #929, El Cerrito, CA, 94530, USA.,Child Family Health International, Accra, Ghana
| | - Amy Rule
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Reena P Tam
- Department of Pediatrics, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT, 84132, USA
| | - Daniel Olson
- Department of Pediatrics, University of Colorado School of Medicine, 13123 E 16th Ave, B302, Aurora, CO, 80045, USA.,Center for Global Health, Colorado School of Public Health, 13199 E Montview Blvd, Ste 310, A090, Aurora, CO, 80045, USA
| | - Peter Olupot-Olupot
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda.,Busitema University, P.O. Box 1460, Mbale, Uganda
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11
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Developing Ethical and Sustainable Global Health Educational Exchanges for Clinical Trainees: Implementation and Lessons Learned from the 30-Year Academic Model Providing Access to Healthcare (AMPATH) Partnership. Ann Glob Health 2020; 86:137. [PMID: 33178558 PMCID: PMC7597575 DOI: 10.5334/aogh.2782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: There is strong interest among healthcare trainees and academic institutions in global health rotations. There are a number of guidelines detailing the ethical principles for equitable and ethical global health rotations and bilateral exchanges, but it is often challenging to know to implement those principles and develop longstanding partnerships. Objectives: The Academic Model Providing Access to Healthcare (AMPATH) is a 30-year continuous partnership between a consortium of 12 universities in North America and Moi University in Kenya. The AMPATH bilateral educational exchange has had 1,871 North American and over 400 Kenyan clinical trainees participate to date. The article describes the bilateral exchange of trainees including curriculum, housing, and costs and discusses how each is an application of the principles of ethical global engagement. Findings: The article takes the experiences of the AMPATH partnership and offers practical strategies for implementing similar partnerships based on previously published ethical principles. Conclusions: AMPATH provides a model for developing an institutional partnership for a bilateral educational exchange grounded in cultural humility, bidirectional relationships, and longitudinal, sustainable engagement.
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12
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De Visser A, Hatfield J, Ellaway R, Buchner D, Seni J, Arubaku W, Najjuma JN, Hollaar G. Global health electives: Ethical engagement in building global health capacity. MEDICAL TEACHER 2020; 42:628-635. [PMID: 32083958 DOI: 10.1080/0142159x.2020.1724920] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Purpose: Little is known about the impact medical trainees undertaking global health electives (GHEs) have on host institutions and their communities in low-and middle-income countries. The goal of this study was to explore the relationship dynamics associated with GHEs as perceived by host stakeholders at three sites in sub-Saharan Africa.Method: This case-based interpretive phenomenological study examined stakeholder perspectives in Mwanza, Tanzania, and Mbarara and Rugazi, Uganda, where the University of Calgary, Alberta, Canada has long-standing institutional collaborations. Between September and November 2017, 33 host stakeholders participated in semi-structured interviews and 28 host stakeholders participated in focus group discussions. Participant experiences were analyzed using interpretive phenomenological techniques.Results: The findings revealed that, although GHEs are well-established and a common experience for host stakeholders, their perceptions about who visiting medical trainees (VMTs) are remains indistinct. Participants acknowledged that there are a variety of benefits to GHEs, but overall VMTs appear to benefit the most from this unique learning opportunity. Host stakeholders described significant challenges and burdens of GHEs and recommended ways in which GHEs could be improved.Conclusions: GHEs need to be designed to better embrace ethical engagement and reciprocity with host stakeholders to ensure equity in benefits and responsibilities.
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Affiliation(s)
- Adriena De Visser
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jennifer Hatfield
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Rachel Ellaway
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Denise Buchner
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Wilfred Arubaku
- Department of Dental Surgery, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Josephine Nambi Najjuma
- Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Gwendolyn Hollaar
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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13
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Myers RE, Ponitz K, Ramundo M. Pediatric Chief Resident Exchange Program-A Novel Method to Share Educational Ideas Across Training Programs. Acad Pediatr 2020; 20:301-305. [PMID: 31536822 PMCID: PMC8437398 DOI: 10.1016/j.acap.2019.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pediatric residency programs offer many conferences and activities to meet the educational needs of their residents. We developed and assessed the Pediatric Chief Resident Exchange Program where pediatric chief residents visited another institution for a day with the goal of sharing educational and curricular innovations between residency programs in an experiential manner. APPROACH/INNOVATION Pediatric chief residents participated in various activities during the exchange including educational conferences and discussions with residency program leadership at the host institutions. Surveys were administered to all participating chiefs to determine if any changes to educational conferences or curriculum were made or planned to be made at their home program based upon what they observed at the other institution and to have chiefs reflect on what they gained from the experience. RESULTS Twenty-eight chief residents from 9 programs participated in the exchange program over 3 academic years (2015-2018). All respondents felt the exchange experience was worthwhile. The majority (67%) of programs planned to implement a change at their institution based on participation in the exchange with over half actually making a change by the end of the academic year. Participating chiefs gained a sense of camaraderie, appreciated that other programs experienced similar struggles, and developed further insight into the chief resident role. DISCUSSION The Pediatric Chief Resident Exchange Program is a novel method of sharing educational practices between institutions that can lead to curricular changes at participating programs. It can also be an opportunity for chief resident professional development.
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14
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Patel S, Diouf K, Schantz-Dunn J, Nour NM. Impact of funded global health electives on career development of residents in a U.S. obstetrics and gynecology program: a cross-sectional survey. BMC MEDICAL EDUCATION 2019; 19:103. [PMID: 30971242 PMCID: PMC6458737 DOI: 10.1186/s12909-019-1536-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/28/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aims of this study were to identify factors influencing participation in global health electives during residency and to understand the career impact of global health electives on alumni of an Obstetrics and Gynecology (OB/GYN) residency program. METHODS This was a cross-sectional, web-based survey of alumni of a residency program in the United States. RESULTS The response rate was 49%. Out of 73 respondents, 29 (39.7%) had completed a global health elective. Availability of funds and flexibility of elective time were the main enabling factors for participating in global health electives. Most participants of global health electives in residency reported a positive impact on their competence in domestic and global women's health and on their career choices. Completing a global health elective in residency was associated with career work in global health and/or local health disparities (OR 4.62 (95% CI: 1.20-17.87)). CONCLUSION Global health electives are important in the career development of residents. To foster OB/GYNs that continue global health and health disparities work, OB/GYN programs should give trainees the opportunity to participate in funded global health electives.
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Affiliation(s)
- Suha Patel
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Khady Diouf
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
- Harvard Medical School, Boston, Massachusetts, 02115, USA.
| | - Julianna Schantz-Dunn
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Nawal M Nour
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, 02115, USA
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15
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Hudspeth JC, Rabin TL, Dreifuss BA, Schaaf M, Lipnick MS, Russ CM, Autry A(M, Pitt MB, Rowthorn V. Reconfiguring a One-Way Street: A Position Paper on Why and How to Improve Equity in Global Physician Training. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:482-489. [PMID: 30398990 PMCID: PMC6445611 DOI: 10.1097/acm.0000000000002511] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Large numbers of U.S. physicians and medical trainees engage in hands-on clinical global health experiences abroad, where they gain skills working across cultures with limited resources. Increasingly, these experiences are becoming bidirectional, with providers from low- and middle-income countries traveling to experience health care in the United States, yet the same hands-on experiences afforded stateside physicians are rarely available for foreign medical graduates or postgraduate trainees when they arrive. These physicians are typically limited to observership experiences where they cannot interact with patients in most U.S. institutions. In this article, the authors discuss this inequity in global medical education, highlighting the shortcomings of the observership training model and the legal and regulatory barriers prohibiting foreign physicians from engaging in short-term clinical training experiences. They provide concrete recommendations on regulatory modifications that would allow meaningful short-term clinical training experiences for foreign medical graduates, including the creation of a new visa category, the designation of a specific temporary licensure category by state medical boards, and guidance for U.S. host institutions supporting such experiences. By proposing this framework, the authors hope to improve equity in global health partnerships via improved access to meaningful and productive educational experiences, particularly for foreign medical graduates with commitment to using their new knowledge and training upon return to their home countries.
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Affiliation(s)
- James C. Hudspeth
- J.C. Hudspeth is assistant professor and director, Residency Global Health, Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Tracy L. Rabin
- T.L. Rabin is assistant professor of internal medicine and associate program director, Global and Community Health, Yale Primary Care Internal Medicine Residency Program, and associate director, Office of Global Health, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Bradley A. Dreifuss
- B.A. Dreifuss is assistant professor of emergency medicine and public health and director, Rural, Border, and Global Programs in Emergency Medicine, Colleges of Medicine and Public Health, University of Arizona, Tucson, Arizona
| | - Mylo Schaaf
- M. Schaaf is professor and associate director, Global Health Pathway, School of Medicine, and director, Global Outreach, University of California, San Francisco, San Francisco, California
| | - Michael S. Lipnick
- M.S. Lipnick is assistant professor and program director, Anesthesia Global Health Fellowships, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California
| | - Christiana M. Russ
- C.M. Russ is assistant professor, Department of Pediatrics, Harvard University, and associate director, Global Health Program, Boston Children’s Hospital, Boston, Massachusetts
| | - Amy (Meg) Autry
- A. Autry is professor and director, Graduate Medical Education, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Michael B. Pitt
- M.B. Pitt is associate professor and director, Global Health Education, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Virginia Rowthorn
- V. Rowthorn is executive director, University of Maryland–Baltimore Center for Global Education Initiatives, Baltimore, Maryland
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16
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Reciprocity? International Preceptors' Perceptions of Global Health Elective Learners at African Sites. Ann Glob Health 2019; 85. [PMID: 30896132 PMCID: PMC6634447 DOI: 10.5334/aogh.2342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Short-term global health electives (STGHEs) have become increasingly common, with evidence showing educational and clinical benefits for short-term learners (STLs). Despite increased recognition that STGHEs should be mutually beneficial for host sites and STLs, evidence demonstrating the impact on international host preceptors is lacking. Objectives: To understand international host preceptors’ perceptions regarding benefits and burdens of hosting STLs. Methods: Focus group discussions with a convenience sample of 10 of 18 eligible preceptors were conducted at pediatric STGHE sites in Malawi and Lesotho. Qualitative content analysis was performed to identify themes using a deductive-inductive approach. Findings: Common themes regarding benefits to preceptors included increased knowledge and resources for learning from STLs, broadened differential diagnoses, and the satisfaction of teaching. Regarding burdens, preceptors perceived that supervising STLs decreases efficiency. Preceptors identified the burden of having to intervene in instances that could lead to patient harm. Some preceptors perceived that STLs under-valued preceptors’ clinical decision-making in resource-limited contexts. Conclusions: Our findings emphasize the need for institutions to identify mutuality of benefits between STLs and host sites when developing STGHEs. Host preceptors identified robust pre-departure training for STLs, lengthened duration of STGHEs, and formal preceptor orientation as ways to enhance mutuality of benefits.
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18
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Arora G, Russ C, Batra M, Butteris SM, Watts J, Pitt MB. Bidirectional Exchange in Global Health: Moving Toward True Global Health Partnership. Am J Trop Med Hyg 2017; 97:6-9. [PMID: 28719333 PMCID: PMC5508910 DOI: 10.4269/ajtmh.16-0982] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/26/2017] [Indexed: 11/07/2022] Open
Abstract
Although there has been rapid growth in global health educational experiences over the last two decades, the flow of learners remains overwhelmingly one directional; providers from high-resourced settings travel to limited-resourced environments to participate in clinical care, education, and/or research. Increasingly, there has been a call to promote parity in partnerships, including the development of bidirectional exchanges, where trainees from each institution travel to the partner's setting to learn from and teach each other. As global health educators and steering committee members of the Association of Pediatric Program Directors Global Health Pediatric Education Group, we endorse the belief that we must move away from merely sending learners to international partner sites and instead become true global health partners offering equitable educational experiences. In this article, we summarize the benefits, review common challenges, and highlight solutions to hosting and providing meaningful global health experiences for learners from limited-resourced partner institutions to academic health centers in the United States.
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Affiliation(s)
- Gitanjli Arora
- Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Christiana Russ
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Maneesh Batra
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Sabrina M. Butteris
- Department of Pediatrics, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin
| | - Jennifer Watts
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri
| | - Michael B. Pitt
- Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota
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19
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Arora G, Ripp J, Evert J, Rabin T, Tupesis JP, Hudspeth J. Taking it Global: Structuring Global Health Education in Residency Training. J Gen Intern Med 2017; 32:559-562. [PMID: 27530530 PMCID: PMC5400750 DOI: 10.1007/s11606-016-3843-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/12/2016] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, offering safe and mentored international rotations, and creating GH experiences that are of service to resource-limiting settings. Academic GH partnerships allow for the opportunity to collaborate on education and research and improve health care and health systems, but must ensure mutual benefit to U.S. and international partners. This article provides guidance for incorporating GH education into U.S. residency programs in an ethically sound and sustainable manner, and gives examples and solutions for common challenges encountered when developing GH education programs.
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Affiliation(s)
- Gitanjli Arora
- Department of Palliative Medicine, Kaiser Permanente Los Angeles, Los Angeles, CA, USA.
| | - Jonathan Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica Evert
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Tracy Rabin
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Janis P Tupesis
- Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Global Health Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - James Hudspeth
- Department of Internal Medicine, Boston University, Boston, MA, USA
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