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Ventres WB, Stone LA, Bryant WW, Pacheco MF, Figueroa E, Chu FN, Prasad S, Blane DN, Razon N, Mishori R, Ferrer RL, Kneese GS. Storylines of family medicine X: standing up for diversity, equity and inclusion. Fam Med Community Health 2024; 12:e002828. [PMID: 38609082 PMCID: PMC11029210 DOI: 10.1136/fmch-2024-002828] [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] [Indexed: 04/14/2024] Open
Abstract
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'X: standing up for diversity, equity and inclusion', authors address the following themes: 'The power of diversity-why inclusivity is essential to equity in healthcare', 'Medical education for whom?', 'Growing a diverse and inclusive workforce', 'Therapeutic judo-an inclusive approach to patient care', 'Global family medicine-seeing the world "upside down"', 'The inverse care law', 'Social determinants of health as a lens for care', 'Why family physicians should care about human rights' and 'Toward health equity-the opportunome'. May the essays that follow inspire readers to promote change.
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Affiliation(s)
- William B Ventres
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Leslie A Stone
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Wayne W Bryant
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Mario F Pacheco
- Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Edgar Figueroa
- Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Francis N Chu
- San Jose Family Medicine Residency, Kaiser Permanente, San Jose, California, USA
| | - Shailendra Prasad
- Family Medicine and Community Health, University of Minnesota Medical School-Twin Cities Campus, Minneapolis, Minnesota, USA
| | - David N Blane
- School of Health and Wellbeing, University of Glasgow, Glasgow, Glasgow, UK
| | - Na'amah Razon
- Family and Community Medicine, University of California, Davis, Sacramento, California, USA
| | - Ranit Mishori
- Family Medicine, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Robert L Ferrer
- Family and Community Medicine, UT Health San Antonio Long School of Medicine, San Antonio, Texas, USA
| | - Garrett S Kneese
- UC San Diego Family Medicine Residency Program, San Diego, California, USA
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Millar C, Chahda L, Carey LB, Ly A, McLaren PO, Drakopoulos E, Bhopti A. Global Citizenship: Cultural, Religious and Spiritual-An Exploratory Scoping Review. JOURNAL OF RELIGION AND HEALTH 2024; 63:63-88. [PMID: 38091204 DOI: 10.1007/s10943-023-01968-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 02/13/2024]
Abstract
This paper seeks to provide an exploration of the interplay between global citizenship, culture, religion and spirituality. Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) scoping literature review framework was utilised to qualify the research question, develop inclusion and exclusion criteria, select relevant studies, chart data and collate information. From the available peer-reviewed literature, a total of 44 articles were initially identified using the selection criteria, 19 of which were subsequently analysed. Eight main themes were identified within the literature; (1) development of global citizenship identity, (2) prosocial values and perspectives, (3) cultural competence and influence, (4) religion and religious teachings, (5) immersion experiences, (6) normative influence, (7) political compass and (8) spirituality. The literature suggests a clear link between global citizenship and spirituality. There were, however, some inconsistencies in the relationship between formalised religion and global citizenship across the studies, with evidence of religion both contributing to and detracting from prosocial values related to global citizenship. Additionally, cultural experiences, including immersion experiences, volunteering and study aboard were all positively linked to prosocial values related to global citizenship. Global citizenship provides individuals with an opportunity to develop intercultural skills, respect, sensitivity, empathy and concern for all of humanity. It is recommended that future global citizenship research should ensure adequate definitions of religion and spirituality, with caution to not generalise the two terms into one concept. Additional research into the relationship between spiritualty and global citizenship could provide a strong basis to increase understanding of the contributing factors to global citizenship identity.
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Affiliation(s)
- CaraJane Millar
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia
| | - Laura Chahda
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia.
| | - Lindsay B Carey
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia
| | - Alexander Ly
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia
| | - Phoebe O McLaren
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia
| | - Eutichia Drakopoulos
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia
| | - Anoo Bhopti
- Speech Pathology, Schoolf of Allied Health, College of Science Health and Engineering, Victoria University, 1 Ballarat Road, Footscray, Australia
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Wilson BK. When numbers eclipse narratives: a cultural-political critique of the 'ethical' impacts of short-term experiences in global health in Dominican Republic bateyes. MEDICAL HUMANITIES 2022; 48:190-199. [PMID: 34845098 DOI: 10.1136/medhum-2021-012252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
With the rising demand for short-term experiences in global health (STEGH) is an ever-increasing volume of literature that focuses attention on ethics and ethical concerns, such as the effects of STEGH on host populations. Such concerns have driven the development of ethical principles and guidelines, with discussions and debates largely centred around normative questions of positive/negative and benefit/harm for us/them. Using a critical medical humanities lens, this paper blurs these dichotomous framings and offers a more complex understanding of the effects and effectiveness of STEGH on hosts. I explore STEGH that send volunteers from North American universities to the Dominican Republic to participate in service-learning activities aimed at improving the lives of impoverished Haitian migrants living in bateyes I address the following questions: What perspectives about the impacts of interventions on host communities manifest through STEGH? What tensions emerge through interactions among diverse stakeholders related to those perspectives, and with what effects? Drawing together critical theory and ethnography, I examined the perspectives of three stakeholder groups: student and faculty volunteers, host organisation staff, and hosts in batey communities. Data collected from observations and interviews were counterposed; I analysed interactions and interplay between stakeholders. My findings revealed conflicts around an emergent theme: counting efforts, or volunteers' proclivity for numerical evidence of impactful STEGH for hosts. With attention on power relations, I argue that a preoccupation with quantifiable evidence eclipsed and erased the lived realities of hosts, thereby blocking a fully ethical engagement. These sociopolitical effects, often overlooked in conventional ethics assessments, are no less harmful and may reinforce rather than reduce inequalities that the global health movement seeks to eliminate. My study offers a compelling case for how the critical medical humanities lend critical insights in the name of improving global health.
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Affiliation(s)
- Brenda K Wilson
- Global Health Program, University of California San Diego, La Jolla, California, USA
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Lessons learned from academic medical centers’ response to the COVID-19 pandemic in partnership with the Navajo Nation. PLoS One 2022; 17:e0265945. [PMID: 35381019 PMCID: PMC8982841 DOI: 10.1371/journal.pone.0265945] [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] [Received: 06/10/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Structural forces that drive health inequalities are magnified in crises. This was especially true during the COVID-19 pandemic, and minority communities were particularly affected. The University of California San Francisco and Health, Equity, Action, Leadership Initiative jointly sent volunteer teams of nurses and doctors to work in the Navajo Nation during the COVID-19 pandemic. This presented an opportunity to explore how academic medical centers (AMCs) could effectively partner with vulnerable communities to provide support during healthcare crises. Therefore, the aims of this study were to describe volunteers’ perspectives of academic-community partnerships by exploring their personal, professional and societal insights and lessons learned based on their time in the Navajo Nation during COVID-19. Methods We recruited key informants using purposeful sampling of physicians and nurses who volunteered to go to the Navajo Nation during the spring 2020 COVID-19 surge, as well as hospital administrators and leaders involved in organizing the COVID-19 efforts. We used in-depth qualitative interviews to explore key informants’ experiences pre-departure, during their stay, and after their return, as well as perspectives of the partnership between an AMC and the Navajo Nation. We used thematic analysis to systematically identify, analyze and report patterns (themes) within the data. Results In total, 37 clinicians and hospital administrators were interviewed including 14 physicians, 16 nurses, and 7 health system leaders. Overall, we found 4 main themes each with several subthemes that defined the partnership between the AMC and the Navajo Nation. Mission and values incorporated civic duty, community engagement, leadership commitment and employee dedication. Solidarity, trust and humility encompassed pre-existing trust, workforce sustainability, humility and erasure of ‘savior narratives.’ Coordination included logistical coordination, flexibility, selectivity of who and what traveled to the response and coordination around media response. Workforce preparation and support encompassed understanding of historical context and providing healthcare in limited settings, dangers of inadequate preparation and the need for emotional support. Conclusion This study provides guidelines which AMCs might use to develop and improve partnerships they have or would like to develop with vulnerable communities. These guidelines may even be broadly applied to partnerships outside of a pandemic response. Importantly, such partnerships need to be built with trust and with an eye towards sustainability and long-term relationships as opposed to ‘medical missions’.
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Hill E, Gurbutt D, Makuloluwa T, Gordon M, Georgiou R, Roddam H, Seneviratne S, Byrom A, Pollard K, Abhayasinghe K, Chance-Larsen K. Collaborative healthcare education programmes for continuing professional education in low and middle-income countries: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 65. MEDICAL TEACHER 2021; 43:1228-1241. [PMID: 34499841 DOI: 10.1080/0142159x.2021.1962832] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Large discrepancies exist between standards of healthcare provision in high-income (HICs) and low and middle-income countries (LMICs). The root cause is often financial, resulting in poor infrastructure and under-resourced education and healthcare systems. Continuing professional education (CPE) programmes improve staff knowledge, skills, retention, and practice, but remain costly and rare in low-resource settings. One potential solution involves healthcare education collaborations between institutions in HICs and LMICs to provide culturally appropriate CPE in LMICs. To be effective, educational partnerships must address the challenges arising from differences in cultural norms, language, available technology and organisational structures within collaborating countries. METHODS Seven databases and other sources were systematically searched on 7 July 2020 for relevant studies. Citations, abstracts, and studies were screened and consensus was reached on which to include within the review. 54 studies were assessed regarding the type of educational programme involved, the nature of HIC/LMIC collaboration and quality of the study design. RESULTS Studies varied greatly regarding the types and numbers of healthcare professionals involved, pedagogical and delivery methods, and the ways in which collaboration was undertaken. Barriers and enablers of collaboration were identified and discussed. The key findings were: 1. The methodological quality of reporting in the studies was generally poor. 2. The way in which HIC/LMIC healthcare education collaboration is undertaken varies according to many factors, including what is to be delivered, the learner group, the context, and the resources available. 3. Western bias was a major barrier. 4. The key to developing successful collaborations was the quality, nature, and duration of the relationships between those involved. CONCLUSION This review provides insights into factors that underpin successful HIC/LMIC healthcare CPE collaborations and outlines inequities and quality issues in reporting.
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Affiliation(s)
- Elaine Hill
- School of Sport and Health Sciences, UCLan, Preston, UK
| | - Dawne Gurbutt
- Centre for Collaborative Learning, UCLan, Preston, UK
| | - Thamasi Makuloluwa
- Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | | | | | - Hazel Roddam
- School of Sport and Health Sciences, UCLan, Preston, UK
| | - Sujatha Seneviratne
- Department of Nursing and Midwifery, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Anna Byrom
- School of Community Health and Midwifery, UCLan, Preston, UK
| | - Kerry Pollard
- School of Community Health and Midwifery, UCLan, Preston, UK
| | - Kalpani Abhayasinghe
- Department of Nursing and Midwifery, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
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Kühner S, Ekblad S, Larsson J, Löfgren J. Global surgery for medical students - is it meaningful? A mixed-method study. PLoS One 2021; 16:e0257297. [PMID: 34618809 PMCID: PMC8496788 DOI: 10.1371/journal.pone.0257297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 08/30/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction There has been an increase in global health courses at medical universities in high-income countries. Their effect on students, however, is poorly understood. In 2016 an elective global surgery course was introduced for medical students at Karolinska Institutet in Sweden. The course includes a theoretical module in Sweden and a two-week clinical rotation in Uganda. The present study aimed to assess the format and determine its effect on students’ knowledge of global surgery and approach towards patients of non-Swedish origin. Method A mixed-methods design was used. Semi-structured case-based interviews were conducted individually with 18 students and analysed using qualitative content analysis. Examination scores and the course evaluation were analysed with Kruskal Wallis one-way analysis of variance, Pearson’s Chi-square and a Wilcoxon signed-rank test as appropriate. Results The course was appreciated and students reported gained insights and interest in global surgery. Students’ ability to reason about global surgery issues was improved after the course. Students considered complicating aspects in the meeting with patients of non-Swedish origin. Students with abroad clinical experience felt less compelled to act on preconceptions. Discussion The global surgery course at Karolinska Institutet is appreciated and students gained valuable knowledge. The case-based interviews acted as a catalyst for reflection and showed that students felt insecure as they lacked knowledge about globally common surgical conditions and struggled with generalized preconceptions of patients of non-Swedish origin. To further support students to integrate theoretical knowledge and professional development, we suggest the introduction of problem-based learning. Conclusion The ability of the course to inspire students’ commitment to global surgery is promising as this engagement is the key to reaching the goal of equitable health globally. Offering such courses is a step towards inspiring and recruiting the future clinicians and researchers needed for expanding the field of global surgery.
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Affiliation(s)
- Sofia Kühner
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Solvig Ekblad
- Department of Learning, Informatics, Management and Ethics, Cultural Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jan Larsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Jenny Löfgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Ventres W. Toward a New Ethic in Global Health Practice: Perspectives from Central America. South Med J 2020; 113:374-377. [PMID: 32747964 DOI: 10.14423/smj.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- William Ventres
- From the Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock
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Stallwood L, Adu PA, Tairyan K, Astle B, Yassi A. Applying equity-centered principles in an interprofessional global health course: a mixed methods study. BMC MEDICAL EDUCATION 2020; 20:224. [PMID: 32664903 PMCID: PMC7362565 DOI: 10.1186/s12909-020-02141-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/06/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Medical students, practitioners and other health professionals are commonly unprepared to address the many complex issues that emerge while conducting research in the Global South. As a response to identified deficiencies in global health education, a hybrid online/face-to-face multi-institutional credit course was developed based on the equity-centered principles advanced by the Canadian Coalition for Global Health Research (CCGHR), namely Authentic partnering, Inclusion, Shared benefits, Commitment to the future, Responsiveness to causes of inequities, and Humility. This study aimed to analyze the extent to which the course was effective in fortifying attitudes consistent with the CCGHR principles; identify successes and challenges; and assess how a course such as this can fill an identified gap. METHODS This interprofessional course was offered to 25 graduate and postgraduate students in various health professions and public health. Faculty were drawn from medicine, public health, nursing and social sciences from four universities in Western Canada. A pre-post retrospective survey, key informant interviews and participant observation were used to gather data for this study. RESULTS Findings showed that student attitudes regarding global health research and practice significantly evolved towards views consistent with the principles articulated. The multiple instructors and hybrid course format created both opportunities and challenges; the interprofessional nature of the cohort was considered a strong asset, as was the fact that many students came from the Global South. Some students suggested that the course could be further strengthened by concretely partnering with institutions in the Global South rather than offered solely to learners registered in universities in the Global North. CONCLUSIONS While weaknesses were identified, results support the conclusion that a course focused on the CCGHR principles could be useful in preparing the next generation of global health researchers and practitioners to mitigate historical limitations in this field. Longitudinal follow-up is warranted to provide more definitive conclusions.
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Affiliation(s)
- Lisa Stallwood
- Faculty of Health Science, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Prince A Adu
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Kate Tairyan
- Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Barbara Astle
- School of Nursing, Trinity Western University, 7600 Glover Rd, Langley, BC, V2Y 1Y1, Canada
| | - Annalee Yassi
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada.
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Kim J, Lee H, Kim IS, Lee TW, Kim GS, Cho E, Lee KH. Interprofessional global health competencies of South Korean health professional students: educational needs and strategies. BMC MEDICAL EDUCATION 2019; 19:429. [PMID: 31752844 PMCID: PMC6868740 DOI: 10.1186/s12909-019-1826-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/27/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND There is growing recognition of the importance of educating health professional students to enhance their competence in collaborating with individuals from other health professions in the area of global health. This study aimed to identify the performance levels in interprofessional global health competencies (IGHC) of health professional students, their educational needs, and the strategies for successfully developing IGHC. METHODS This study used a mixed methods design involving an online survey followed by focus group interviews. A sample of 325 fourth-year undergraduate students from 14 health-related majors completed a self-report online survey (38.8% response rate). The performance of IGHC was measured on a five-point Likert scale using the IGHC items developed by the Consortium of Universities for Global Health. Additionally, 12 senior students and five professors in global health-related majors participated in focus group interviews. The students' educational needs and priorities were analysed using the Borich needs assessment and the Locus for Focus model. RESULTS The participants' IGHC mean score was 3.11 (SD = 0.55) and differed by previous global health activity experiences (t = - 2.10, p = .037). Nine competencies in six domains using the Locus for Focus model were identified as a priority for global health education. Suggested strategies to enhance IGHC included establishing IGHC education in formal curricula, developing value-based content and outcomes, and engaging students in learning activities. CONCLUSIONS It is necessary to design an interprofessional pre-departure course to achieve the priority IGHC and to organise learning activities where there is cooperation in problem solving while applying the expertise of each major within resource-limited settings. This study supports future health professional education that should foster enhanced roles and scopes of practice as changing agents to assure the achievement of sustainable development goals.
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Affiliation(s)
- Junghee Kim
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - In Sook Kim
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Tae Wha Lee
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Gwang Suk Kim
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
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McCullough M, Msafiri N, Richardson WJ, Harman M, DesJardins JD, Dean D. Diversifying Bioengineering Design Education with an International Partnership. J Biomech Eng 2019; 141:1065453. [PMID: 31596921 DOI: 10.1115/1.4045112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Indexed: 11/08/2022]
Abstract
The field of engineering is increasingly appreciating the value of diversity for innovative design solutions. Successful engineering depends on our ability to explore constrained parameter spaces for finding the best solutions, and more diverse minds and experiences enable us to explore the entire potential solution space more thoroughly, more quickly, and more creatively. With a goal to expand the diversity of experiences and mindsets in our undergraduate bioengineering curricula, Arusha Technical College (ATC) in Arusha, Tanzania and Clemson University (CU) in Clemson, South Carolina, U.S., have partnered together over the past 5 years to provide intercontinental educational opportunities for undergraduate students, graduate assistants, and faculty. In 2018, CU and ATC collaborated on an international design course targeting undergraduate students in biomedical engineering focused on global health solutions for resource poor communities. Undergraduate students from ATC and CU collaborated on design projects through formal videoconferenced group meetings, email, and various social media platforms. The year ended with a joint design symposium in Arusha where the students presented on their work in a public poster forum. This successful ATC-CU Global Health Design Collaboration pilot year provides a solid model upon which to build. Students reported overall positive experiences and plans to continue in their curriculum to graduation, as well as some ATC and CU students changing their career direction to include global health initiatives.
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Affiliation(s)
- Melissa McCullough
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - Nicodemus Msafiri
- Electrical and Biomedical Engineering Department, Arusha Technical College, Nairobi Road, P. O. Box 296, Arusha, Tanzania
| | - William J Richardson
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - Melinda Harman
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - John D DesJardins
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - Delphine Dean
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
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Through the Lens of Postcolonial Theory: Establishing Global North-South Partnerships. Nurs Educ Perspect 2019; 40:270-277. [PMID: 31436689 DOI: 10.1097/01.nep.0000000000000556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM This study used postcolonial theory as a critical lens to examine the factors that supported or hindered equitable partnership formation within an innovative international service-learning (ISL) program in nursing education. BACKGROUND As ISL programs proliferate, ethical concerns have arisen as minimal attention has been given to both the host and visiting partners' experience and perceptions and how these impact partnership development and outcomes. METHOD A hybrid intrinsic, instrumental, single embedded case study design, including observations, interviews (n = 70), and document analysis, was used to analyze in depth varied partnerships within a US-Kenyan ISL program. RESULTS Central themes of dispelling assumptions, making connections, revealing privilege, and sharing power emerged and formed a theoretical model, Establishing and Strengthening Partnerships. CONCLUSION Attention needs to be given to preconceived assumptions, imbalances in privilege, and issues surrounding power and decision-making for equitable, impactful, partnership development. Leadership philosophy, style, and approach make a difference.
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Roble J, Block L, Flannagan M, Obscherning E, Brown LD. Addressing Ethical Quandaries in Undergraduate Student-Led Global Health Trips: Design, Implementation, and Challenges of Guidelines by Students for Students. Health Hum Rights 2019; 21:149-156. [PMID: 31239623 PMCID: PMC6586975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jacob Roble
- Recent graduate of the University of Wisconsin-Madison College of Letters and Sciences, Madison, USA
| | - Laura Block
- Current student at the University of Wisconsin-Madison School of Nursing, Madison, USA
| | - Mason Flannagan
- Undergraduate student at the University of Wisconsin-Madison College of Letters and Sciences, Madison, USA
| | - Eric Obscherning
- Graduate of the University of Wisconsin-Madison College of Letters and Sciences, Madison, USA
| | - Lori Diprete Brown
- Associate director of the Global Health Institute and a distinguished faculty associate in civil society and community studies in the School of Human Ecology at the University of Wisconsin-Madison, USA
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Alsharif NZ, Brennan L, Abrons JP, Chahine EB. An Introduction to Cultural Sensitivity and Global Pharmacy Engagement. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2019; 83:7221. [PMID: 31223166 PMCID: PMC6581352 DOI: 10.5688/ajpe7221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 10/11/2018] [Indexed: 05/09/2023]
Abstract
Global engagement between schools and colleges of pharmacy in the United States and many regions of the world is increasing. For an enriching and fruitful interaction, sensitivity toward the cultural, ethical, educational, religious, historical, political, regulatory, and practice issues is critical. Lack of sensitivity may negatively impact engagement among students, professionals and other people from different regions of the world. In this special issue, eight papers will introduce general information about five regions of the world that have established and increased global engagements with institutions in the United States: Africa, the Arab world, Asia, the Caribbean, and Latin America. In addition, the special issue will include a paper with key information related to global engagement within the United States. For each paper, the specifics provided about the selected countries include: demographics, culture, climate, pharmacy education, and health care systems, as well as common stereotypes and misconceptions held by and about the people of the country. Further, recommendations for pharmacists and other health care professionals on culturally sensitive engagement will be emphasized. Finally, recommendations for culturally sensitive engagement when US schools are hosting students and faculty members from those regions will be summarized. The papers are based on literature reviews of databases from 2000 to 2018 and internet searches with specific keywords or terms, such as cultural sensitivity, global, pharmacy, stereotypes, and ethics. Additional keywords are identified in individual papers on specific regions. Authors for each paper consist of practitioners with experience in travelling to and hosting students and professionals from the regions; practitioners with local work experience, and professionals from each region. The special issue is intended to serve as a resource for US schools and colleges of pharmacy currently engaged in or considering future outreach opportunities in these regions, and for those seeking opportunities in the United States. The special issue will provide key information to facilitate culturally sensitive engagement in existing or future relationships.
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Affiliation(s)
- Naser Z. Alsharif
- School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
| | - Lisa Brennan
- School of Pharmacy, Wingate University, Wingate, North Carolina
| | | | - Elias B. Chahine
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, Florida
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Trotter S, Dunnivan-Mitchell S. Simulation Enhances Soft Skills Among Inter-Professionals Participating in an International Service-Learning Experience to a Resource-Limited Country. MEDEDPUBLISH 2019; 8:24. [PMID: 38089386 PMCID: PMC10712614 DOI: 10.15694/mep.2019.000024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Introduction:Soft skills are the hallmark of a master healthcare provider. One of the most effective ways to teach soft skills to healthcare providers is through service-learning. Evidence suggests that adding simulation as part of a service-learning team's pre-departure training (PDT) will better prepare them to resolve ethical and cultural dilemmas often encountered in resource-limited countries, plus facilitate soft skills. We hypothesized that simulation could improve soft skills of physical and occupational therapy students and clinicians providing rehabilitation services on a one-week service-learning experience in Guatemala. Methods:A convenience sample of 21 physical and occupational therapy students and clinicians who participated in four 1-hour PDTs were included in this qualitative study using grounded-theory methods. Training consisted of didactic, reflective and simulation components designed to introduce self-awareness, team-building, cultural knowledge, and to support trip preparations. Four debriefings were recorded using open-ended questions with a thematic approach around the concepts of preparedness and cultural adaptability, which represented the dependent variables. The independent variable was a 20-minute simulation emphasizing cultural and socio-emotional challenges of the host community. Results:Six themes emerged: confidence, empathy, communication, mentorship, self-knowledge, and cultural competency. The themes described were core elements of empowering the participants towards advocacy and process improvement. As a result of the simulation experience, participants in this study were better able to respond to distressing situations encountered on site, and they expressed the service-learning experience, supported by the PDT simulation, stirred significant maturation. Discussion and Conclusion:Simulation is useful for developing self-regulatory skills, especially in response to culturally novel, emotionally-charged situations. Simulation for enriching international service-learning experiences is recommended as best practice to prepare healthcare providers in facing ethical and cultural demands of resource-limited countries.
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Ventres W, Boelen C, Haq C. Time for action: key considerations for implementing social accountability in the education of health professionals. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:853-862. [PMID: 28900801 DOI: 10.1007/s10459-017-9792-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
Within health professional education around the world, there exists a growing awareness of the professional duty to be socially responsible, being attentive to the needs of all members of communities, regions, and nations, especially those who disproportionately suffer from the adverse influence of social determinants. However, much work still remains to progress beyond such good intentions. Moving from contemplation to action means embracing social accountability as a key guiding principle for change. Social accountability means that health institutions attend to improving the performance of individual practitioners and health systems by directing educational and practice interventions to promote the health of all the public and assessing the systemic effects of these interventions. In this Reflection, the authors (1) review the reasons why health professional schools and their governing bodies should codify, in both curricular and accreditation standards, norms of excellence in social accountability, (2) present four considerations crucial to successfully implementing this codification, and (3) discuss the challenges such changes might entail. The authors conclude by noting that in adopting socially accountable criteria, schools will need to expand their philosophical scope to recognize social accountability as a vitally important part of their institutional professional identity.
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Affiliation(s)
- William Ventres
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for the Medical Sciences, 4301 W. Markham Street, #530, Little Rock, AR, 72205-7199, USA.
- Institute for Studies in History, Anthropology and Archeology, University of El Salvador, San Salvador, El Salvador.
| | - Charles Boelen
- Independent International Consultant, Sciez, France
- Program of Human Resources for Health, World Health Organization, Geneva, Switzerland
| | - Cynthia Haq
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Adams LV, Sosin AN. Beyond Visas and Vaccines: Preparing Students for Domestic and Global Health Engagement. Ann Glob Health 2018; 82:1056-1063. [PMID: 28314493 DOI: 10.1016/j.aogh.2016.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
At campuses across the United States, scores of students are embarking on global health experiences in low- and middle-income countries. The desire to improve the health of poor communities while preparing for future health careers is often the main driver. The spotlight on domestic health issues also has fueled a resurgence of interest in underserved communities in the United States. Regardless of the destination, rigorous preparation is needed to ensure that the students' presence benefits the communities they aim to serve. Development of mutually beneficial programs with host communities coupled with thoughtful preparation of students is essential to the future of these university programs but, more importantly, to achieve the goal of shared learning and capacity building across borders. US program leaders may not fully consider the potential risks that can occur to their programs from involving poorly prepared students, or these risks may appear largely theoretical. However, many experienced practitioners and their international collaborators can relate examples of damaged partnerships, adverse consequences on community structures, dangers to patient safety, and harmed professional reputations and credibility. Domestic health experiences do not require a visa or vaccines but bring students in contact with many of the same ethical, professional, and cross-cultural challenges as overseas endeavors. Fortunately, best practices for preparing students to confront these challenges have emerged from years of experience in domestic and global contexts alike. It all begins with establishing institutional partnerships built on principles of reciprocity and respect. Through careful program design, universities can align missions, goals, and expectations to best serve all invested parties: local partners, students, faculty, staff, and the communities where they will be working. A second critical component is appropriate student selection. Matching student skills with partner needs can optimize benefits for both the host organization and student. Finally, universities can prepare students to navigate in cross-cultural settings in a professional and ethical manner through careful training. Just as negative experiences can have lasting negative consequences, the best ones can lead to strengthened partnerships; durable benefits for local and global communities; and optimal learning for students, their supervisors, and hosts.
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Affiliation(s)
- Lisa V Adams
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH; John Sloan Dickey Center for International Understanding, Dartmouth College, Hanover, NH.
| | - Anne N Sosin
- John Sloan Dickey Center for International Understanding, Dartmouth College, Hanover, NH
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Ventres WB. Intentional Exploration on International Service Learning Trips: Three
Questions for Global Health. Ann Glob Health 2017; 83:584-587. [DOI: 10.1016/j.aogh.2017.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 09/19/2017] [Indexed: 01/10/2023] Open
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Ventres WB. The Joys of Global Medicine and the Lesson of Relationship. Am J Med 2016; 129:771-2. [PMID: 27012855 DOI: 10.1016/j.amjmed.2016.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 10/22/2022]
Affiliation(s)
- William B Ventres
- Institute for Studies in History, Anthropology and Archeology, University of El Salvador, San Salvador; Department of Family Medicine, Oregon Health and Science University, Portland.
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Flinkenflögel M, Ogunbanjo G, Cubaka VK, De Maeseneer J. Rwandan family medicine residents expanding their training into South Africa: the use of South-South medical electives in enhancing learning experiences. BMC MEDICAL EDUCATION 2015; 15:124. [PMID: 26231997 PMCID: PMC4522112 DOI: 10.1186/s12909-015-0405-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 07/06/2015] [Indexed: 06/01/2023]
Abstract
BACKGROUND International medical electives are well-accepted in medical education, with the flow of students generally being North-South. In this article we explore the learning outcomes of Rwandan family medicine residents who completed their final year elective in South Africa. We compare the learning outcomes of this South-South elective to those of North-South electives from the literature. METHODS In-depth interviews were conducted with Rwandan postgraduate family medicine residents who completed a 4-week elective in South Africa during their final year of training. The interviews were thematically analysed in an inductive way. RESULTS The residents reported important learning outcomes in four overarching domains namely: medical, organisational, educational, and personal. CONCLUSIONS The learning outcomes of the residents in this South-South elective had substantial similarities to findings in literature on learning outcomes of students from the North undertaking electives in the Southern hemisphere. Electives are a useful learning tool, both for Northern students, and students from universities in the South. A reciprocity-framework is needed to increase mutual benefits for Southern universities when students from the North come for electives. We suggest further research on the possibility of supporting South-South electives by Northern colleagues.
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Affiliation(s)
- Maaike Flinkenflögel
- Discipline Primary Health Care, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
- Partners in Health, Rwinkwavu, Rwanda.
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium.
| | - Gboyega Ogunbanjo
- Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, South Africa (previously known as University of Limpopo - Medunsa Campus, South Africa), Limpopo, South Africa.
| | - Vincent Kalumire Cubaka
- Discipline Primary Health Care, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
- Center for Global Health, Department of Public Health, Aarhus, Denmark.
| | - Jan De Maeseneer
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium.
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