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Alali KF, Crouse HL, Rus MC, Marton S, Haq H. Debriefing Trainees After Global Health Experiences: An Expert Consensus Delphi Study. Acad Pediatr 2024; 24:155-161. [PMID: 37524166 DOI: 10.1016/j.acap.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/15/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Global health (GH) opportunities in pediatric residencies are prevalent. Debriefing trainees after a GH experience is a tool to optimize educational processing, identify post-return stressors, and facilitate coping skills; however, there are no consensus recommendations for debriefing in this context. OBJECTIVE Our objective was to develop structure and content guidelines for standardized debriefing of residents returning from short-term clinical GH rotations abroad. METHODS Through a modified Delphi methodology, we developed a standardized consensus-based debriefing tool. Eleven pediatric GH education experts were recruited. Experts were individuals with leadership experience in GH education who demonstrated academic engagement by either primary or senior authorship of a publication or relevant presentation at a conference. The expert panel (EP) completed 4 surveys that were amended after each round based on qualitative data, which was assessed for emergent themes. In the final round, the EP rated each consensus recommendation in importance using a 4-point Likert scale. RESULTS Ten of the 11 panelists completed all study rounds. The EP achieved consensus that residents should complete post-return debriefing and rated 32 consensus recommendations in importance. Twelve recommendations were deemed "essential"; these debriefing recommendations focused on timing and preparation, reflection and feedback, trainee well-being and coping skills, ethical concerns, and the need to provide mental health support and resources for trainees with psychological distress. CONCLUSIONS According to GH experts, all residents who participate in GH experiences should participate in a post-return debrief. Thirty-two consensus recommendations regarding content, timing, structure, and actions for post-return debriefing were formulated.
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Affiliation(s)
| | - Heather L Crouse
- Department of Pediatrics, Baylor College of Medicine, Houston, Tex.
| | - Marideth C Rus
- Department of Pediatrics, Baylor College of Medicine, Houston, Tex.
| | - Stephanie Marton
- Department of Pediatrics, Baylor College of Medicine, Houston, Tex.
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, Tex.
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2
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Mercedes R, Van Buren K, Shneider BL, Crouse H. Integrating Global Health Education and Research in Pediatric Gastroenterology, Hepatology, and Nutrition Fellowship Training. J Pediatr Gastroenterol Nutr 2023; 77:579-582. [PMID: 37587558 DOI: 10.1097/mpg.0000000000003917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- Rebecca Mercedes
- From the Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
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3
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Malik GR, Jayabalan P. Reaching Underserved Domestic and International Populations through Physical Medicine & Rehabilitation Residency Training: A Survey of Residents and Program Directors. PM R 2022; 15:596-603. [PMID: 35466522 DOI: 10.1002/pmrj.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/27/2022] [Accepted: 04/12/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION In 2015, the World Health Organization (WHO) reported that over 400 million individuals worldwide lack access to medical care. Additionally, clinicians are more likely to treat underserved patients during their careers if they have exposure to these populations during their training. OBJECTIVES To analyze what forms of didactic experiences are available and which opportunities are the most valuable with domestic/international underserved populations in Physical Medicine & Rehabilitation (PM&R) residency programs in the USA. DESIGN Cross-sectional survey using REDCap software. SETTING PM&R residency programs in the USA. PARTICIPANTS 137 participants in ACGME Accredited PM&R residencies in the USA (24 program directors and 113 residents). INTERVENTIONS Not applicable MAIN OUTCOME MEASURES: Surveys collected information regarding demographic data, prior global health training experiences, current residency training experiences involving domestic/international underserved populations being offered, participants' perceived importance of training experiences with domestic/international underserved population, barriers that impede these experiences, and if availability of these opportunities affected resident recruitment. RESULTS Participants reported that their PM&R programs did not offer global health simulations (91.2%), educational tracks (75.2%), international electives (71.5%), or rotations with domestic underserved populations (48.9%). Residents viewed exposure to simulation labs (3.25/5), educational tracks (3.42/5), and electives (4.02/5) more importantly than attending physicians who viewed lectures (3.92/5), journal clubs (3.58), and domestic underserved population rotations (4.42/5) more favorably. Both residents and attending physicians endorse financial support and mentorship as barriers to these opportunities. Participants from all regions outside the Midwest reported that these educational opportunities would affect residency recruitment (56% vs 31%). CONCLUSIONS This is the first study assessing the current state of global health training opportunities for PM&R residents as well as the perceived value of such experiences. Many PM&R medical trainees desire exposure to global health medicine curriculum, and many would alter their residency selection based on its availability. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- G Ross Malik
- McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Shirley Ryan Ability Lab (Formerly the Rehabilitation Institute of Chicago), Chicago, IL, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Prakash Jayabalan
- Shirley Ryan Ability Lab (Formerly the Rehabilitation Institute of Chicago), Chicago, IL, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Urban MJ, Jagasia AA, Batra PS, LoSavio P. Design and Implementation of a Global Health and Underserved Care Track in an Otolaryngology Residency. OTO Open 2022; 6:2473974X221078857. [PMID: 35224412 PMCID: PMC8874174 DOI: 10.1177/2473974x221078857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
Despite widespread resident interest in global health and underserved care, few otolaryngology residency programs offer a formal global health experience. This article is the first to characterize a formal otolaryngology global health and underserved care track with a focus on how this curriculum integrates with and supplements resident education. Components of the track include longitudinal limited-resource field experiences in domestic and abroad settings, a related quality improvement project, and completion of a formalized global health educational curriculum. In addition to delivering humanitarian aid, residents in this track obtain a unique educational experience in all 6 core competencies of the Accreditation Council for Graduate Medical Education. Early barriers to implementation included identifying mentorship, securing funding, and managing busy resident schedules. In this work, we detail track components, schedule by track year, keys to implementation, and potential educational pitfalls.
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Affiliation(s)
- Matthew J Urban
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Ashok A Jagasia
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Pete S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Phillip LoSavio
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
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5
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Rent S, North K, Diego E, Bose C. Global Health Education and Best Practices for Neonatal-Perinatal Medicine Trainees. Neoreviews 2021; 22:e795-e804. [PMID: 34850151 DOI: 10.1542/neo.22-12-e795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neonatal-perinatal medicine (NPM) trainees are expressing an increased interest in global health. NPM fellowship programs are tasked with ensuring that interested fellows receive appropriate training and mentorship to participate in the global health arena. Global health engagement during fellowship varies based on a trainee's experience level, career goals, and academic interests. Some trainees may seek active learning opportunities through clinical rotations abroad whereas others may desire engagement through research or quality improvement partnerships. To accommodate these varying interests, NPM fellows and training programs may choose to explore institutional partnerships, opportunities through national organizations with global collaborators, or domestic opportunities with high-risk populations. During any global health project, the NPM trainee needs robust mentorship from professionals at both their home institution and their partner international site. Trainees intending to use their global health project to fulfill the American Board of Pediatrics (ABP) scholarly activity requirement must also pay particular attention to selecting a project that is feasible during fellowship and also meets ABP criteria for board eligibility. Above all, NPM fellows and training programs should strive to ensure equitable, sustainable, and mutually beneficial collaborations.
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Affiliation(s)
- Sharla Rent
- Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, NC
| | - Krysten North
- Division of Neonatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Ellen Diego
- Division of Neonatology Department of Pediatrics, Medical University of South Carolina, Charleston, SC
| | - Carl Bose
- Division of Neonatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
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Good RJ, O'Hara KL, Ziniel SI, Orsborn J, Cheetham A, Rosenberg A. Point-of-Care Ultrasound Training in Pediatric Residency: A National Needs Assessment. Hosp Pediatr 2021; 11:1246-1252. [PMID: 34625490 DOI: 10.1542/hpeds.2021-006060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES As point-of-care ultrasound (POCUS) evolves into a standard tool for the care of children, pediatric residency programs need to develop POCUS training programs. Few POCUS training resources exist for pediatric residents, and little is known about POCUS training in pediatric residencies. We aim to describe pediatric residency leadership perspectives regarding the value of POCUS and to elucidate the current state of POCUS training in pediatric residency programs. METHODS A group of pediatric educators and POCUS experts developed a novel survey followed by cognitive interviews to establish response-process validity. The survey was administered electronically to pediatric residency associate program directors between December 2019 and April 2020. Program characteristics, including region, setting, and size, were used to perform poststratification for analyses. We performed comparative analyses using program and respondent characteristics. RESULTS We achieved a 30% (58 of 196) survey response rate. Although only a minority of respondents (26%) used POCUS in clinical practice, a majority (56%) indicated that all pediatric residents should be trained in POCUS. A majority of respondents also considered 8 of 10 POCUS applications important for pediatric residents. Only 37% of programs reported any POCUS training for residents, primarily informal bedside education. Most respondents (94%) cited a lack of qualified instructors as a barrier to POCUS training. CONCLUSIONS Most pediatric residency programs do not provide residents with POCUS training despite its perceived value and importance. Numerous POCUS applications are considered important for pediatric residents to learn. Future curricular and faculty development efforts should address the lack of qualified POCUS instructors.
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Affiliation(s)
- Ryan J Good
- Department of Pediatrics, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Kimberly L O'Hara
- Department of Pediatrics, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Sonja I Ziniel
- Department of Pediatrics, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Jonathan Orsborn
- Department of Pediatrics, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Alexandra Cheetham
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Adam Rosenberg
- Department of Pediatrics, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
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7
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Kaeppler C, Holmberg P, Tam RP, Porada K, Stryker SD, Conway K, Schubert C. The impact of global health opportunities on residency selection. BMC MEDICAL EDUCATION 2021; 21:384. [PMID: 34266446 PMCID: PMC8280583 DOI: 10.1186/s12909-021-02795-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/11/2021] [Indexed: 06/11/2023]
Abstract
BACKGROUND An increasing number of medical trainees across specialties desire and expect Global Health (GH) experiences during training. It is useful for residency programs to know the impact that offering GH opportunities has on resident recruitment. The study objectives were to explore the importance of GH opportunities in residency selection among fourth-year medical students, examine the relationship between interest in GH and career plans, and describe students' perspectives on prior GH experiences. METHODS The authors administered an electronic survey to all fourth-year medical students attending 12 different US institutions in February 2020. Data from the ten schools who were able to comply with the survey distribution methodology and with response rates above 25% were analyzed using descriptive statistics and Pearson's correlation. RESULTS A total of 707 fourth-year medical students from the included schools completed the survey out of 1554 possible students (46% response rate). One third of respondents ranked the presence of GH experiences in residency as moderately or very important and 26% felt that the presence of a formal GH curriculum was at least moderately important, with variation noted among specialties. After training, 65% of students envision practicing internationally in some capacity. A desire to care for underserved patients in their careers was significantly correlated with an interest in GH experiences during residency. CONCLUSIONS The opportunity to be involved in GH experiences during training can be an important factor for many medical students when considering residency choice, and the availability of these opportunities may be a valuable recruitment tool. Students valuing GH opportunities during residency are more interested in working with underserved populations in their future careers.
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Affiliation(s)
- Caitlin Kaeppler
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
- Children's Wisconsin Corporate Center, 999 N 92nd St, Suite 560, Wauwatosa, WI, 53226, USA.
| | - Peter Holmberg
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - Reena P Tam
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kelsey Porada
- Clinical Research Coordinator, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Shanna D Stryker
- Department of Family/Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kate Conway
- Department of Family Medicine, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Charles Schubert
- Departments of Family/Community Medicine and Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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8
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Salm M, Ali M, Minihane M, Conrad P. Defining global health: findings from a systematic review and thematic analysis of the literature. BMJ Glob Health 2021; 6:bmjgh-2021-005292. [PMID: 34083243 PMCID: PMC8183196 DOI: 10.1136/bmjgh-2021-005292] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/04/2021] [Accepted: 05/04/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Debate around a common definition of global health has seen extensive scholarly interest within the last two decades; however, consensus around a precise definition remains elusive. The objective of this study was to systematically review definitions of global health in the literature and offer grounded theoretical insights into what might be seen as relevant for establishing a common definition of global health. METHOD A systematic review was conducted with qualitative synthesis of findings using peer-reviewed literature from key databases. Publications were identified by the keywords of 'global health' and 'define' or 'definition' or 'defining'. Coding methods were used for qualitative analysis to identify recurring themes in definitions of global health published between 2009 and 2019. RESULTS The search resulted in 1363 publications, of which 78 were included. Qualitative analysis of the data generated four theoretical categories and associated subthemes delineating key aspects of global health. These included: (1) global health is a multiplex approach to worldwide health improvement taught and pursued at research institutions; (2) global health is an ethically oriented initiative that is guided by justice principles; (3) global health is a mode of governance that yields influence through problem identification, political decision-making, as well as the allocation and exchange of resources across borders and (4) global health is a vague yet versatile concept with multiple meanings, historical antecedents and an emergent future. CONCLUSION Extant definitions of global health can be categorised thematically to designate areas of importance for stakeholders and to organise future debates on its definition. Future contributions to this debate may consider shifting from questioning the abstract 'what' of global health towards more pragmatic and reflexive questions about 'who' defines global health and towards what ends.
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Affiliation(s)
- Melissa Salm
- Anthropology, University of California Davis, Davis, California, USA
| | - Mahima Ali
- University of California Davis, Davis, California, USA
| | | | - Patricia Conrad
- VM:PMI, University of California Davis, Davis, California, USA
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9
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Balmer DF, Teunissen PW, Devlin MJ, Richards BF. Stability and Change in the Journeys of Medical Trainees: A 9-Year, Longitudinal Qualitative Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:906-912. [PMID: 32852322 DOI: 10.1097/acm.0000000000003708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE It takes many years for trainees to become physicians-so long that their individual journeys through medical school and residency are seldom systematically studied and thus not well understood. Lack of understanding hinders effective support of future physicians' development across traditional time-bound phases of medical education. The authors initiated a longitudinal qualitative study, tracing a cohort of 6 trainees through the same medical school and 6 different residencies. They asked, how do stability and change characterize the lived experience of trainees through time? METHOD From 2010 to 2019, the authors conducted in-depth interviews every 6 to 12 months with 6 trainees, using reflective prompts about formative events and prior interviews. Data were inductively coded and analyzed in an iterative fashion. By scrutinizing data via time-ordered displays of codes, the authors identified 3 patterns of stability and change, particularly related to constructing careers in medicine. The study originated at a private medical school in New York, New York. RESULTS Patterns in the balance between stability and change were shaped by trainees' career interests. Trainees motivated by stable clinical interests perceived their journey as a "series of stepping-stones." Trainees motivated by evolving clinical interests described disruptive change or "upsets"; however, they were still accommodated by medical education. In contrast, trainees motivated by stable nonclinical (i.e., social science) interests perceived their journey as a "struggle" in residency because of the clinically heavy nature of that phase of training. CONCLUSIONS Based on this descriptive, 9-year study of a small number of trainees, medical education seems to accommodate trainees whose journeys are motivated by clinical interests, even if those clinical interests change through time. Medical education could consider alternatives to time-bound frames of reference and focus on the right time for trainees to integrate clinical and social sciences in medical training.
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Affiliation(s)
- Dorene F Balmer
- D.F. Balmer is associate professor of pediatrics, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0001-6805-4062
| | - Pim W Teunissen
- P.W. Teunissen is professor of workplace learning in healthcare, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, and gynecologist, Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Michael J Devlin
- M.J. Devlin is professor of clinical psychiatry, Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Boyd F Richards
- B.F. Richards is professor of pediatrics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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10
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Lauden SM, Wilson PM, Faust MM, Webber S, Schwartz A, Mahan JD, Batra M, Schubert CJ. Global Health Experiences, Well-Being, and Burnout: Findings From a National Longitudinal Study. Acad Pediatr 2020; 20:1192-1197. [PMID: 32437879 DOI: 10.1016/j.acap.2020.05.006] [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: 01/20/2020] [Revised: 04/25/2020] [Accepted: 05/07/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Describe the demographics of pediatric and internal medicine/pediatric residents participating in global health (GH) experiences and examine relationships between GH involvement and self-perceived burnout, resilience, mindfulness, empathy, and spirituality. METHODS The Pediatric Resident Burnout and Resilience Study Consortium developed a national longitudinal study through collaboration with the Association of Pediatric Program Directors' Longitudinal Educational Assessment Research Network. Electronic surveys were administered to pediatric trainees annually (2016-2018). GH and well-being data were extracted. Descriptive statistics were calculated. RESULTS Of 9653 eligible pediatric and medicine/pediatric residents from 55 institutions, 6150 responded to the survey in 1 or more years, with average completion rate of 63.7% over a 3-year period. Controlling for repeat survey-takers, 12.7% (536/4213) of residents reported involvement in a GH-specific pathway, curricula, or track. GH participants were significantly more likely to be unmarried (P < .001), childless (P = .003), and medicine/pediatric trainees (P < .001). Controlling for repeated measures and demographic factors, GH participants demonstrated higher levels of empathic concern (P < .001) and higher spirituality scores in 2 of 3 domains (P < .01/<.05). GH involvement was not associated with lower reports of burnout or improved resilience/mindfulness. CONCLUSION Although GH involvement is associated with increased levels of empathy and spirituality, it was not protective against burnout in this study. This highlights the need to study and promote the well-being of all residents, and perhaps especially those experiencing the challenges of working in low-resource settings. Future efforts should determine the impact of predeparture training, programmatic support, and post-trip debriefing on resident well-being.
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Affiliation(s)
- Stephanie M Lauden
- Department of Pediatrics, The Ohio State University (SM Lauden, MM Faust, and JD Mahan), Columbus, Ohio.
| | - Paria M Wilson
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati (PM Wilson and CJ Schubert), Cincinnati, Ohio
| | - Maureen M Faust
- Department of Pediatrics, The Ohio State University (SM Lauden, MM Faust, and JD Mahan), Columbus, Ohio
| | - Sarah Webber
- Department of Pediatrics, University of Wisconsin-Madison (S Webber)
| | | | - John D Mahan
- Department of Pediatrics, The Ohio State University (SM Lauden, MM Faust, and JD Mahan), Columbus, Ohio
| | - Maneesh Batra
- Seattle Children's Hospital (M Batra), Seattle, Wash
| | - Charles J Schubert
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati (PM Wilson and CJ Schubert), Cincinnati, Ohio
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11
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Sisk B, Green A, Chan K, Yun K. Caring for Children in Immigrant Families: Are United States Pediatricians Prepared? Acad Pediatr 2020; 20:391-398. [PMID: 31790799 DOI: 10.1016/j.acap.2019.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A growing number of children in the United States are from immigrant families. We conducted a national survey to examine pediatricians' self-rated preparedness to care for children in immigrant families. METHODS A 2017 survey of American Academy of Pediatrics members assessed respondent characteristics, formal training in and experience with global, public, or immigrant health, and preparedness to care for children in immigrant families. Descriptive statistics and a multivariable logistic regression model examined associations between characteristics, formal training, experience, and preparedness. RESULTS The survey response rate was 47% (n = 758/1628). One third of respondents (33.6%) reported being unprepared to care for children in immigrant families. In bivariate analyses, respondents who had graduated from medical school outside of the United States, had previous education on immigrant health care, or had recent international global health experience were most likely to report feeling prepared to care for children in immigrant families. Multivariable regression model results indicated that prior education on immigrant health (adjusted odds ratio [AOR] 4.07; 95% confidence interval [CI] 2.68, 6.32), graduation from medical school outside the United States (AOR 2.35; 95% CI 1.22, 4.67), and proficiency in a language other than English (AOR 1.78; 95% CI 1.14, 2.80) were independently associated with preparedness. CONCLUSIONS One in 3 US pediatricians report being unprepared to care for children in immigrant families. Wider implementation of graduate and continuing medical education on immigrant child health is needed to ensure that practicing pediatricians have the appropriate skills and knowledge to care for this patient population.
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Affiliation(s)
- Blake Sisk
- Department of Research, American Academy of Pediatrics (B Sisk), Itasca, Ill.
| | - Andrea Green
- Department of Pediatrics, University of Vermont Children's Hospital, Larner College of Medicine at the University of Vermont (A Green), Burlington, Vt
| | - Kevin Chan
- Institute of Better Health and Children's and Women's Health, Trillium Health Partners (K Chan), Mississauga, ON, Canada; Department of Pediatrics, University of Toronto (K Chan), Toronto, ON, Canada
| | - Katherine Yun
- Department of Pediatrics, Children's Hospital of Philadelphia (K Yun), Philadelphia, Pa; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine (K Yun), Philadelphia, Pa
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12
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St Clair NE, Abdul-Mumin A, Banker SL, Condurache T, Crouse H, Haq H, Helphinstine J, Kazembe PN, Marton S, McQuilkin P, Pitt MB, Rus M, Russ CM, Schubert C, Schutze GE, Steenhoff AP, Uwemedimo O, Watts J, Butteris SM. Global Guide: A Comprehensive Global Health Education Resource for Pediatric Program Directors. Pediatrics 2020; 145:peds.2019-2138. [PMID: 31900316 DOI: 10.1542/peds.2019-2138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Nicole E St Clair
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin;
| | - Alhassan Abdul-Mumin
- Department of Pediatrics and Child Health, School of Medicine and Health Sciences, University for Development Studies and Tamale Teaching Hospital, Tamale, Ghana
| | - Sumeet L Banker
- Irving Medical Center, Columbia University, New York, New York
| | - Tania Condurache
- Department of Pediatrics, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Heather Crouse
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jill Helphinstine
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana
| | | | - Stephanie Marton
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Patricia McQuilkin
- Memorial Medical Center, University of Massachusetts, Worcester, Massachusetts
| | - Michael B Pitt
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Marideth Rus
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Chuck Schubert
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - Gordon E Schutze
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Omolara Uwemedimo
- Cohen Children's Medical Center of New York, New York, New York; and
| | | | - Sabrina M Butteris
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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13
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Pitt MB, Slusher TM, Gladding SP, Moskalewicz R, Howard CR. The Minnesota Model: A Residency Global Health Track Framework. Am J Trop Med Hyg 2019; 102:11-16. [PMID: 31701860 DOI: 10.4269/ajtmh.19-0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Residency programs are increasingly responding to the growing demand for global health (GH) education by forming dedicated GH tracks. These tracks incorporate a targeted curriculum, support best practices surrounding GH electives such as predeparture preparation and post-return debriefing, and encourage meaningful engagement with international and domestic partners. The University of Minnesota's pediatric residency has had a formal GH track since 2005, and although they have shared several curricular components in the literature, they have yet to provide a comprehensive summary of their GH track. In this article, the authors provide a thorough description of their evolving GH track model, highlighting outcomes and sharing free resources, with the goal of providing a concise, replicable GH track framework for educators seeking to provide more formal GH education within residency programs.
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Affiliation(s)
- Michael B Pitt
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Tina M Slusher
- Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota.,Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Sophia P Gladding
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Risha Moskalewicz
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Cynthia R Howard
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
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