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Falade AS, Hornstein PR, Slater SE, Triedman SA, Buswell LA, Fadelu TA. Survey of Hematology/Oncology Program Leaders on Equity and Global Health Opportunities for Fellows. JCO Glob Oncol 2024; 10:e2400254. [PMID: 39173079 DOI: 10.1200/go-24-00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/17/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024] Open
Abstract
PURPOSE The study assesses the current state of global oncology (GO)/hematology training opportunities in US fellowship programs. METHODS We developed a comprehensive survey of 64-Likert multiple-choice and open-ended questions. The survey was electronically distributed to fellowship program leaders at Accreditation Council for Graduate Medical Education-accredited adult hematology/oncology fellowships. Program directors received three reminders after which survey was sent to assistant program directors or division heads for programs not represented. RESULTS A total of 171 programs were eligible for the survey. We received 42 (24.6%) responses; 40 were included in the analysis, and two were excluded for declined consent and incomplete responses. The programs include large academic (81.6%) and community hospitals (10.5%). Of the respondents, 18 (48.6%) reported offering some opportunities for global health training, and half reported interest among current fellows. Most programs (29, 82.9%) had three or fewer faculty engaged in GO research. Institutional training grants were available in 15 (39.5%) programs, of which six (40%) allowed for global health research. Of the 18 programs offering global health training activities, most (15, 83.3%) report less than a quarter of their trainees currently participate in GO experiences. The most commonly perceived barriers to GO opportunities include competing priorities (85.3%) and lack of faculty mentors with GO-related experience (82.4%). Conversely, the most commonly perceived facilitators include established partnerships outside the United States (97.0%) and dedicated institutional funding (93.9%). CONCLUSION Our survey demonstrates that although there is significant interest among fellowship trainees, a minority of the fellowship programs offer GO opportunities. Providing GO opportunities would require programs to establish partnerships with institutions outside the United States and to have systematic approaches of addressing other barriers, including enhancing funding and mentorship.
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Affiliation(s)
- Ayo S Falade
- Mass General Brigham Salem Hospital, Salem, MA
- Division of Hematology/Oncology, Mayo Clinic, Rochester, MN
| | | | - Sarah E Slater
- Center for Global Cancer Medicine, Dana Faber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Scott A Triedman
- Center for Global Cancer Medicine, Dana Faber Cancer Institute, Boston, MA
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Lori A Buswell
- Center for Global Cancer Medicine, Dana Faber Cancer Institute, Boston, MA
| | - Temidayo A Fadelu
- Center for Global Cancer Medicine, Dana Faber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
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Sanghvi RI, Songolo T. What Is the Current Status of Global Health Training for US Postgraduate Trainees in Anesthesiology? What Are Possible Visions for the Future? CURRENT ANESTHESIOLOGY REPORTS 2023; 13:99-107. [PMID: 37168833 PMCID: PMC10036958 DOI: 10.1007/s40140-023-00552-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/26/2023]
Abstract
Purpose of Review There is a great deal of interest in global health at all levels of educational attainment. Many residency programs wish to offer a global health opportunity (GHO) but lack the resources to create one de novo. This review will look at the prevalence of global health education in residency and consider the fellowships available. It will summarize the existing recommendations about a curriculum in global health and how best to prepare trainees for a GHO. Recent Findings While approximately 45% of residency programs make GHOs available to their residents, there is a lack of standardization of curriculum. Logistical and ethical challenges, funding, and the lack of international partners are all barriers to offering a GHO. Residents and fellows can benefit from a GHO as it helps achieve their ACGME core competencies, among other benefits. Summary We make the recommendation for more robust training and education with the investment of fewer resources by aligning with existing global health participation opportunities. We also recommend the use of the Consortium of Universities for Global Health (CUGH) which provided curriculum for creating a context in global health for trainees regardless of discipline.
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Affiliation(s)
- Reema I. Sanghvi
- Division of Global Health, Department of Anesthesiology, University of California San Diego, 200 W. Arbor, San Diego, CA 92103 USA
| | - Tosha Songolo
- Global Health and Policy in Anesthesia, San Diego, CA USA
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Hamilton ARL, Dylewski Begis M, Vo V, Fuzaylov G. The role of global health opportunities for professional development during anaesthesiology training: A primary survey study. Anaesth Intensive Care 2022; 50:325-328. [PMID: 35086363 DOI: 10.1177/0310057x211051752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Rebecca L Hamilton
- Division of Pediatric Anesthesia, Department of Anesthesia, Critical Care and Pain Medicine, 2348Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, USA.,Department of Cell and Molecular Biology, 27106Karolinska Institute, Karolinska Institute, Stockholm, Sweden
| | - Maggie Dylewski Begis
- Department of Agriculture, Nutrition and Food Systems, 3067University of New Hampshire, University of New Hampshire, Durham, USA
| | - Victoria Vo
- Department of Anesthesiology and Perioperative Medicine, 1867Tufts Medical Center, Tufts Medical Center, Tufts University School of Medicine, Boston, USA
| | - Gennadiy Fuzaylov
- Division of Pediatric Anesthesia, Department of Anesthesia, Critical Care and Pain Medicine, 2348Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Kynes JM, Kauffmann R, Walters CB, Sizemore C, Banerjee A. The Preparing Residents for International Medical Experiences (PRIME) Simulation Workshop: Equipping Surgery and Anesthesia Trainees for International Rotations. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11088. [PMID: 33598534 PMCID: PMC7880254 DOI: 10.15766/mep_2374-8265.11088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/24/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Although global health training expands clinical and sociocultural expertise for graduate medical trainees and is increasingly in demand, evidence-based courses are limited. To improve self-assessed competence for clinical scenarios encountered during international rotations, we developed and assessed a simulation-based workshop called Preparing Residents for International Medical Experiences. METHODS High-fidelity simulation activities for anesthesiology, surgery, and OB/GYN trainees involved three scenarios. The first was a mass casualty in a low-resource setting requiring distribution of human and material resources. In the second, learners managed a septic operative patient and coordinated postoperative care without an ICU bed available. The final scenario had learners evaluate a non-English-speaking patient with pre-eclampsia. We paired simulation with small-group discussion to address sociobehavioral factors, stress, and teaching skills. Participants evaluated the quality of the teaching provided. In addition, we measured anesthesiology trainees' self-assessed competence before and after the workshop. RESULTS The workshop included 23 learners over two iterations. Fifteen trainees (65%) completed the course evaluation, 93% of whom strongly agreed that the training met the stated objectives. Thirteen out of 15 (87%) anesthesiology trainees completed the competence survey. After the training, more trainees indicated confidence in providing clinical care with indirect supervision or independently. Mean self-assessed competency scores on a scale of 1-5 increased for all areas, with a mean competency increase of 0.3 (95% CI, 0.2-0.5). DISCUSSION Including simulation in a pretravel workshop can improve trainees' self-assessed competence for a variety of scenarios involving clinical care in limited-resource settings.
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Affiliation(s)
- J. Matthew Kynes
- Assistant Professor, Department of Anesthesiology, Vanderbilt University Medical Center
| | - Rondi Kauffmann
- Assistant Professor, Department of Surgery, Vanderbilt University Medical Center
| | - Camila B. Walters
- Assistant Professor, Department of Anesthesiology, Vanderbilt University Medical Center
| | - Christopher Sizemore
- Assistant Professor, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center
| | - Arna Banerjee
- Associate Professor, Department of Anesthesiology, Vanderbilt University Medical Center
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Elmore SNC, Royce TJ, Oladeru OT, Freese CM, Wakefield DV, Vapiwala N, Zietman AL. Global Health Perspectives Among Radiation Oncology Residency Program Directors: A Knowledge, Attitudes, and Practices Survey. Int J Radiat Oncol Biol Phys 2020; 107:419-425. [PMID: 32126266 DOI: 10.1016/j.ijrobp.2020.02.467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Interest in global health has risen among medical students applying to and residents training in radiation oncology, often outpacing available educational offerings. The Association of Residents in Radiation Oncology Global Health Subcommittee sought to determine the perceptions of program directors (PDs) in radiation oncology and their current or planned global health curricular opportunities. METHODS AND MATERIALS A standardized, Knowledge-Attitudes-Practices survey composed of 32 binary items was sent to PDs for all Accreditation Council for Graduate Medical Education-accredited radiation oncology programs. RESULTS The program response rate was 60% (55 of 91). Responding programs were distributed evenly geographically and included a range of training program sizes. Most PDs (77%) knew that most nations did not meet standard minimum benchmarks for radiation therapy access. Although 89% would support residents in pursuing global health rotations, only 22% would support departmental funding of such rotations. Furthermore, 94% believed that global health was a field worthy of an academic career, but only 39% believed that it had appropriate rigor. Only 8% of programs had dedicated global health rotations. CONCLUSIONS Radiation oncology PDs largely expressed favorable views of global health as a pursuit and affirmed a high degree of resident and medical student interest. However, faculty commitment and program offerings currently lag behind the interest level. In particular, a substantial number of PDs do not perceive global health to be a rigorous academic endeavor. Future progress in academic global health in radiation oncology will require strategies to systematically support pathways for the development of experience and scholarship both within and beyond residency.
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Affiliation(s)
- Shekinah N C Elmore
- Harvard Radiation Oncology Program, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Trevor J Royce
- Harvard Radiation Oncology Program, Boston, Massachusetts; Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Oluwadamilola T Oladeru
- Harvard Radiation Oncology Program, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Chris M Freese
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio
| | - Daniel V Wakefield
- University of Tennessee Health Science Center, Memphis, Tennessee; Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anthony L Zietman
- Harvard Radiation Oncology Program, Boston, Massachusetts; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
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Why every anesthesia trainee should receive global health equity education. Can J Anaesth 2020; 67:924-935. [DOI: 10.1007/s12630-020-01715-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/31/2022] Open
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Dohlman L, DiMeglio M, Laudanski K. The Impact of an International Elective on Anesthesiology Residents as Assessed by a Longitudinal Study. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519873940. [PMID: 31565671 PMCID: PMC6755626 DOI: 10.1177/2382120519873940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 08/13/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Participation of anesthesiology residents in international electives may lead to the acquisition of skills as described in the Accreditation Council for Graduate Medical Education (ACGME) competencies. There is great interest in participating in such electives, but it is not clear there are educational or professional benefits. The purpose of this study was to evaluate the educational benefits of participating in overseas electives among anesthesiology residents. METHODS A longitudinal study design was used between 2010 and 2015 to survey all anesthesiology residents selected to participate in the nationally competitive Society for Education in Anesthesia-Health Volunteers Overseas (SEA-HVO) Traveling Fellowship Program in which third-year residents receive scholarships and ABA credit for 1-month teaching electives in a low-resource country. Pre-elective and post-elective surveys were sent via de-identified e-mails during the third year of residency. We investigated residents' expectations, plans, and comfort level with teaching techniques prior to the elective and after and asked about perceived benefits. RESULTS The response rate was 68.8% of the 45 residents who received the survey. Participants were motivated by professional and humanitarian goals. Residents reported improved comfort with teaching techniques, especially lecturing and giving feedback. Participants acquired better skills in assessing the learning needs of students. There was a slight but nonsignificant increased comfort dealing with cultural and language barriers. The major self-perceived unique benefit of international electives was improvement in intercultural communication. The systems' changes reported by residents as the most important to improve were those that affected patient safety. CONCLUSION Global health electives have a small positive effect on teaching, cultural proficiency, and systems assessment skills. Residents improve in their ability to identify educational needs and to give feedback. Patient safety during anesthetic care is appreciated as the most important systems' need.
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Affiliation(s)
- Lena Dohlman
- Department of Anesthesia, Critical Care
and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston,
MA, USA
| | - Matthew DiMeglio
- Philadelphia College of Osteopathic
Medicine, Philadelphia, PA, USA
| | - Krzysztof Laudanski
- Department of Anesthesiology and
Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA,
USA
- Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, PA, USA
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