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Njeru J, Odero J, Chebore S, Ndung’u M, Tanui E, Wesangula E, Ndanyi R, Githii S, Gunturu R, Mwangi W, Mutonga D, Dahourou A, Thaiyah A. Development, roll-out and implementation of an antimicrobial resistance training curriculum harmonizes delivery of in-service training to healthcare workers in Kenya. Front Microbiol 2023; 14:1142622. [PMID: 37593544 PMCID: PMC10427499 DOI: 10.3389/fmicb.2023.1142622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Background Antimicrobial resistance (AMR) is an increasingly severe threat to global public health that requires action across different sectors. Selection of appropriate antimicrobials is an urgent challenge due to the emergence of drug resistance. In 2017, Kenya developed an AMR policy and National Action Plan to drive prevention and containment of AMR. A priority activity under AMR surveillance strategic objective was to develop a national AMR training curriculum for in-service healthcare workers. In this paper we discuss the development process, gains achieved through implementation across the country and lessons learned. Methods An initial stakeholders' forum was convened to brainstorm on the process for developing the curriculum and some issues deliberated upon include the design approach, development roadmap, curriculum outline and scope, delivery, and evaluation methodologies. A dedicated team of subject matter experts (SMEs), drawn from the project and government ministries, compiled the initial draft of the curriculum and later the training materials. A series of other stakeholders' meetings were convened to review these materials. The National Antimicrobial Stewardship Interagency Committee (NASIC) of the MOH in Kenya identified a team of experts from academia, research, and government to work with the SMEs in reviewing and providing valuable inputs to the curriculum. Additionally, principles of adult learning and a One Health approach for development were considered as AMR has drivers and impacts across sectors. A validation workshop was held to finalize the documents with a formal launch conducted during the World Antibiotics Awareness Week of 2020. Results A multisectoral AMR surveillance training curriculum and facilitator and trainee manuals were developed and endorsed by MOH and Ministry of Agriculture, Livestock, Fisheries and Cooperatives within one year. Over 500 healthcare workers in 19 counties were trained, with overwhelming adoption by other stakeholders in Kenya and beyond. Conclusion This curriculum was developed to standardize training for AMR detection and surveillance. The central role played by the MOH ensured expeditious development and roll-out of this curriculum. The in-service curriculum, now available on an e-learning platform, provides a ready opportunity to build capacity of healthcare professionals. Additional resources are needed to standardize and scale these efforts to reach all healthcare workers.
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Affiliation(s)
- Josiah Njeru
- USAID Infectious Disease Detection and Surveillance (IDDS) Project, Nairobi, Kenya
| | - Joshua Odero
- USAID Infectious Disease Detection and Surveillance (IDDS) Project, Nairobi, Kenya
| | - Sheilla Chebore
- USAID Infectious Disease Detection and Surveillance (IDDS) Project, Nairobi, Kenya
| | - Mungai Ndung’u
- USAID Infectious Disease Detection and Surveillance (IDDS) Project, Nairobi, Kenya
| | - Emmanuel Tanui
- National Antimicrobial Stewardship Interagency Committee (NASIC), Ministry of Health, Nairobi, Kenya
- Directorate of Patient and Health Workers Safety, Ministry of Health, Nairobi, Kenya
| | - Evelyn Wesangula
- National Antimicrobial Stewardship Interagency Committee (NASIC), Ministry of Health, Nairobi, Kenya
- Directorate of Patient and Health Workers Safety, Ministry of Health, Nairobi, Kenya
| | - Romona Ndanyi
- National Antimicrobial Stewardship Interagency Committee (NASIC), Ministry of Health, Nairobi, Kenya
- Department of Veterinary Services, Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi, Kenya
| | - Susan Githii
- National Antimicrobial Stewardship Interagency Committee (NASIC), Ministry of Health, Nairobi, Kenya
- National Public Health Laboratories, Ministry of Health, Nairobi, Kenya
| | | | | | - David Mutonga
- USAID Infectious Disease Detection and Surveillance (IDDS) Project, Nairobi, Kenya
| | - Anicet Dahourou
- USAID Infectious Disease Detection and Surveillance (IDDS) Project, Fairfax, VA, United States
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2
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Lee S, Kim E, Yoon JY. Global Health Competencies and Educational Needs for Nursing Students in South Korea. J Nurs Educ 2023; 62:75-82. [PMID: 36779893 DOI: 10.3928/01484834-20221213-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Despite the increasing demand for global health education, relatively few global health courses currently are offered in Korea. METHOD This mixed-methods study examined the need for global health competency and global health education experience for nursing students. A survey of 208 nursing students was conducted from May 2020 to August 2020, and three focus groups were conducted with 12 nursing students. RESULTS The average score of global health nursing competencies was 2.8 ± 0.7 on a scale ranging from 1 to 4. Female, higher academic achievement, fluent English, and higher global health education experience had a significant effect on global health competency. The most influential factor was more experience with global health education. Nursing students' perceptions and educational needs related to global health education were classified into four subthemes. CONCLUSION The development of global health education programs for nursing students is needed. [J Nurs Educ. 2023;62(2):75-82.].
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3
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Storz MA. Clinical electives in China: trends, experiences, barriers. Global Health 2022; 18:96. [DOI: 10.1186/s12992-022-00889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022] Open
Abstract
AbstractIn recent decades, China has quickly transformed itself into a modern, urban, technological and economic powerhouse. China’s medical education system is internationalizing and attracting a considerable number of foreign students seeking medical degrees and other clinical experience, such as observerships, in China. Although the majority of international students in China come from low- and middle income countries, China’s rise towards the world’s largest medical education system also offers new opportunities for stronger cooperation with European countries. Both sides maintain tight economic ties, and China’s rise is also attracting more and more medial students for short-term clinical electives from the German-speaking countries. Such clinical electives are pertinent to global health education in a globalized world, and allow students to immerse in foreign healthcare systems for a short period. Notably, reasons for (and barriers to) electives in China are largely unexplored. To address this gap, we reviewed 4 popular German elective report databases and extrapolated key characteristics of electives in China undertaken by German-speaking medical student. N = 40 elective testimonies were analyzed with regard to students’ elective experience, elective barriers and organizational aspects. The vast majority of students reported an elective in Shanghai (n = 29, 72.50%). More than 70% of students applied directly to an elective program for foreign students, whereas less than 25% applied through a bilateral exchange program. Frequently cited positive aspects of electives in China included the Chinese hospitality and the regular high-quality teaching in English for international students. Notably, almost half of student reported some kind of difficulties during their elective (n = 18, 45%), including language barriers (n = 6), administrative issues (n = 5) and visa problems (n = 2). Our data suggest that international electives in China were overall well-rated by German-speaking students. The combination of structured clinical elective programs with English supervision and the opportunity to learn more about the Chinese culture apparently attracted said students in the past 2 decades.
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A Systematic Review of Global Health Assessment for Education in Healthcare Professions. Ann Glob Health 2022; 88:1. [PMID: 35083127 PMCID: PMC8740639 DOI: 10.5334/aogh.3389] [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] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusions:
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5
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James E, Evans M, Mi M. Leadership Training and Undergraduate Medical Education: a Scoping Review. MEDICAL SCIENCE EDUCATOR 2021; 31:1501-1509. [PMID: 34026307 PMCID: PMC8131083 DOI: 10.1007/s40670-021-01308-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 05/09/2023]
Abstract
The purpose of this scoping review is to fill the gap in understanding the current status of intervention-based studies regarding leadership training in undergraduate medical education. As of late, there is an increased focus on the role of physicians as leaders in their fields, and communities. In order to evaluate these studies, both the PubMed and ERIC databases were searched, and an ultimate total of 35 articles methodologies were evaluated for their general methodology, curricular content, specific teaching methods, and evaluation methodologies. There were a number of trends identified, as well as remaining gaps. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01308-9.
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Affiliation(s)
- Eric James
- Oakland University, William Beaumont School of Medicine, Rochester, MI USA
| | - Mallory Evans
- Oakland University, William Beaumont School of Medicine, Rochester, MI USA
| | - Misa Mi
- Department of Foundational Medical Studies, Oakland University, William Beaumont School of Medicine, Rochester, MI USA
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6
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Douthit NT, Norcini J, Mazuz K, Alkan M, Feuerstein MT, Clarfield AM, Dwolatzky T, Solomonov E, Waksman I, Biswas S. Assessment of Global Health Education: The Role of Multiple-Choice Questions. Front Public Health 2021; 9:640204. [PMID: 34368038 PMCID: PMC8339563 DOI: 10.3389/fpubh.2021.640204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The standardization of global health education and assessment remains a significant issue among global health educators. This paper explores the role of multiple choice questions (MCQs) in global health education: whether MCQs are appropriate in written assessment of what may be perceived to be a broad curriculum packed with fewer facts than biomedical science curricula; what form the MCQs might take; what we want to test; how to select the most appropriate question format; the challenge of quality item-writing; and, which aspects of the curriculum MCQs may be used to assess. Materials and Methods: The Medical School for International Health (MSIH) global health curriculum was blue-printed by content experts and course teachers. A 30-question, 1-h examination was produced after exhaustive item writing and revision by teachers of the course. Reliability, difficulty index and discrimination were calculated and examination results were analyzed using SPSS software. Results: Twenty-nine students sat the 1-h examination. All students passed (scores above 67% - in accordance with University criteria). Twenty-three (77%) questions were found to be easy, 4 (14%) of moderate difficulty, and 3 (9%) difficult (using examinations department difficulty index calculations). Eight questions (27%) were considered discriminatory and 20 (67%) were non-discriminatory according to examinations department calculations and criteria. The reliability score was 0.27. Discussion: Our experience shows that there may be a role for single-best-option (SBO) MCQ assessment in global health education. MCQs may be written that cover the majority of the curriculum. Aspects of the curriculum may be better addressed by non-SBO format MCQs. MCQ assessment might usefully complement other forms of assessment that assess skills, attitude and behavior. Preparation of effective MCQs is an exhaustive process, but high quality MCQs in global health may serve as an important driver of learning.
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Affiliation(s)
- Nathan T Douthit
- Department of Geriatrics, Internal Medicine Residency, East Alabama Medical Center, Opelika, AL, United States.,BMJ Case Reports, London, United Kingdom
| | - John Norcini
- FAIMER, Educational Commission for Foreign Medical Graduates, Philadelphia, PA, United States.,Psychiatry Department, Upstate Medical University, Syracuse, NY, United States
| | - Keren Mazuz
- Anthropology, Hadassah Academic College, Jerusalem, Israel
| | - Michael Alkan
- Faculty for Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel.,Medical School for International Health, BGU Faculty for Health Sciences, Be'er Sheva, Israel.,Open Clinic, Physicians for Human Rights, Tel Aviv, Israel
| | - Marie-Therese Feuerstein
- Faculty for Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel.,Medical School for International Health, BGU Faculty for Health Sciences, Be'er Sheva, Israel
| | - A Mark Clarfield
- Department of Geriatrics and Centre for Global Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel.,Department of Geriatrics, McGill University, Montreal, QC, Canada
| | - Tzvi Dwolatzky
- Geriatric Unit, Rambam Health Care Campus, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Evgeny Solomonov
- General and Hepatobiliary Surgery, Ziv Medical Center, Tzfat, Israel.,The Azrieli Faculty of Medicine, Bar Ilan University, Tzfat, Israel
| | - Igor Waksman
- The Azrieli Faculty of Medicine, Bar Ilan University, Tzfat, Israel.,Department of Surgery, Galilee Medical Center, Nahariya, Israel
| | - Seema Biswas
- BMJ Case Reports, London, United Kingdom.,Department of Surgery, Galilee Medical Center, Nahariya, Israel
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Frange A, Duffy S, Al-Rousan T, Evensen A, Nelson BD. Trainee Perspectives Regarding Advanced Clinical Global Health Fellowships in North America. Am J Trop Med Hyg 2021; 104:2286-2292. [PMID: 33872209 PMCID: PMC8176480 DOI: 10.4269/ajtmh.20-1589] [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: 12/15/2020] [Accepted: 02/10/2021] [Indexed: 11/07/2022] Open
Abstract
Postgraduate clinical global health (GH) training is a rapidly evolving field. To understand and improve training opportunities, we sought the perspectives of current and former trainees related to their advanced clinical training or global health fellowships and the anticipated impact on their careers. Clinical GH fellowships across North America were identified through websites and previous studies. An e-mail was sent to program directors to invite all current and former GH fellows to complete a web-based questionnaire. We contacted 100 GH fellowship programs. Fifty-two fellows from 10 different specialties completed the survey. The median fellowship length was 23.3 months, with an annual median of 4.8 months spent in low-income and middle-income countries, which was less than their reported ideal of 6 months. The majority reported satisfaction, the anticipation of career benefits, and that they would recommend fellowship training to others. Challenges included insufficient funding, mentorship, and formal curricula. Conducting research in high-income countries was a significant negative predictor of fellowship satisfaction. Most fellows (73.1%) were not at all or only a little concerned about the absence of fellowship accreditation, with only 17.3% desiring accreditation. Survey respondents were largely satisfied with their training and valued program flexibility and educational opportunities, including advanced tropical medicine certificates or diplomas. However, to improve fellowship training, improvements are needed in mentorship, standardized curricula, institutional support, and funding. For GH fellowship training to be effective and sustainable, institutions will need to balance the needs of fellows, training programs, and the communities (low-, middle-, and high-income countries) where the fellows serve.
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Affiliation(s)
- Adam Frange
- 1Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Sean Duffy
- 2Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Tala Al-Rousan
- 3University of California San Diego Herbert Wertheim School of Public Health, La Jolla, California
| | - Ann Evensen
- 2Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Brett D Nelson
- 1Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
- 4Divisions of Global Health and Neonatology, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
- 5Harvard Medical School, Boston, Massachusetts
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8
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Kreitlow A, Steffens S, Jablonka A, Kuhlmann E. Support for global health and pandemic preparedness in medical education in Germany: Students as change agents. Int J Health Plann Manage 2021; 36:112-123. [PMID: 33704858 PMCID: PMC8207038 DOI: 10.1002/hpm.3143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/24/2021] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
The COVID‐19 pandemic has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the drivers for change. Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hanover Medical School, March/April 2020. Target groups were undergraduate medical students (n = 384) and additionally lecturers (n = 172), and finally new multiprofessional teaching courses initiated by students and developed collaboratively. The results reveal only slow pace of change on the level of the education system, while demand for global health education has increased markedly in all actor groups, but strongest in the group of students in the preclinical phase. Implementation of global health programmes illustrates how students can become change agents and enhance institutional innovation bottom‐up. However, in order to achieve wider transformative potential, these efforts must be flanked by macro‐level policy changes and integrated in future pandemic preparedness strategies.
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Affiliation(s)
- Annika Kreitlow
- Globalisation and Health Initiative, bvmd - German Medical Students' Association, Berlin, Germany.,Dean's Office, Hannover Medical School, Hannover, Germany
| | | | - Alexandra Jablonka
- Clinic for Rheumatology and Clinical Immunology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research, Hannover, Germany
| | - Ellen Kuhlmann
- Dean's Office, Hannover Medical School, Hannover, Germany.,Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
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9
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Wu A, Leask B, Choi E, Unangst L, de Wit H. Internationalization of Medical Education-a Scoping Review of the Current Status in the United States. MEDICAL SCIENCE EDUCATOR 2020; 30:1693-1705. [PMID: 32837797 PMCID: PMC7406216 DOI: 10.1007/s40670-020-01034-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This article explores the current status of internationalization of medical education in the United States. Dominant themes of articles published from 2000 to 2018 indicate that common formats are institutional partnerships, international learning at home, and student mobility programs. Critical analysis on the basis of internationalization of higher education, recommendations, and future perspective is given.
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Affiliation(s)
- Anette Wu
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeon, New York, NY USA
| | - Betty Leask
- Center for International Higher Education, Lynch School of Education, Boston College, Boston, MA USA
- School of Education, La Trobe University, Melbourne, Australia
| | - Edward Choi
- Center for International Higher Education, Lynch School of Education, Boston College, Boston, MA USA
| | - Lisa Unangst
- Center for International Higher Education, Lynch School of Education, Boston College, Boston, MA USA
| | - Hans de Wit
- Center for International Higher Education, Lynch School of Education, Boston College, Boston, MA USA
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10
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Biswas S, Douthit NT, Mazuz K, Morrison Z, Patchell D, Ochion M, Eidelman L, Golan A, Alkan M, Dwolatzky T, Norcini J, Waksman I, Solomonov E, Clarfield AM. Implementing a Practical Global Health Curriculum: The Benefits and Challenges of Patient-Based Learning in the Community. Front Public Health 2020; 8:283. [PMID: 32766194 PMCID: PMC7379171 DOI: 10.3389/fpubh.2020.00283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/29/2020] [Indexed: 12/26/2022] Open
Abstract
Background: A growing number of medical schools across the world have incorporated global health (GH) into their curricula. While several schools focus GH education on lecture-based courses, our premise is that global health education should embody a holistic approach to patient care and medical education in local communities. Medical students may learn global health by focusing on real patients, their families and communities as part of a practical curriculum. Aims and Objectives: A unique GH curriculum was devised to compare student learning outcomes on a practical vs. lecture-based course. The premise was that learning from patients would result in a greater breadth of coverage of the global health syllabus as compared to that from a lecture-based course. Methods: A teaching and learning program was developed over 3 years to provide medical students interaction with real patients in the community on a first-preclinical-year Introduction to Global Health and Medical Anthropology course. Learning outcomes on the practical vs. lecture-based course were compared using thematic analysis of the written assignments of both courses: global health case reports and literature reviews, respectively. All members of three cohorts of students undertaking the course in successive academic years were compared (Group A: literature review; Groups B and C: case reports; n = 87). Results: Case reports provided evidence of a greater breadth of learning outcomes when compared to the literature review (p < 0.001). The writing of the case report was enhanced by completion of a field journal and family health needs assessment tool (p < 0.001). Students demonstrated a closeness to their patients that added depth, understanding and motivation to assist patients in health activities and advocate for their needs. Discussion: Placements with patients in the community provided students with a rich learning environment and facilitated the formation of relationships with patients to better understand the social determinants of health and advocate for improvements in their living and working conditions and access to healthcare. Conclusions: Global health may be better learned experientially by following patients rather than from frontal lectures. Patient-based learning inspires a commitment to the individual and facilitates medical schools in meeting their obligations to the communities they serve.
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Affiliation(s)
- Seema Biswas
- British Medical Journal Group, BMJ Case Reports, London, United Kingdom
| | - Nathan T Douthit
- Brookwood Baptist Health, Medical Education, Birmingham, AL, United States.,British Medical Journal Group, BMJ Case Reports, London, United Kingdom
| | - Keren Mazuz
- Hadassah Academic College, Jerusalem, Israel
| | - Zach Morrison
- Department of Surgery, Marshfield Medical Center, Marshfield, WI, United States
| | - Devin Patchell
- Department of Emergency Medicine, Mercy Health, Cincinnati, OH, United States
| | - Michael Ochion
- Department of Social Work, Municipal Health, Be'er Sheva Municipality, Be'er Sheva, Israel
| | - Leslie Eidelman
- Clalit Health Services, Gastroenterology Unit, Ambulatory Specialist Center, Ashkelon, Israel
| | - Agneta Golan
- Department of Neonatology, Soroka University Medical Center, Be'er Sheva, Israel.,Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Michael Alkan
- Department of Medicine, Ben Gurion University of the Negev, Be'er Sheva, Israel.,Medical School for International Health, BGU Faculty for Health Sciences, Be'er Sheva, Israel.,P.H.R. Open Clinic, Volunteer Physician, Tel Aviv-Yafo, Israel
| | - Tzvi Dwolatzky
- Geriatric Unit, Rambam Health Care Campus and Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - John Norcini
- Foundation for Advancement of International Medical Education and Research, Philadelphia, PA, United States.,Psychiatry Department, Upstate Medical University, Syracuse, NY, United States
| | - Igor Waksman
- Department of Surgery, Galilee Medical Center, Nahariya, Israel.,The Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Evgeny Solomonov
- The Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.,Department of General and Hepatobiliary Surgery, Ziv Medical Center, Safed, Israel
| | - A Mark Clarfield
- Department of Geriatrics, Soroka University Medical Center, Be'er Sheva, Israel.,Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.,Department of Geriatrics, McGill University, Montreal, QC, Canada
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Abstract
Background: The interest in Global Health (GH) as an academic discipline has increased in the last decade. This article reports the findings of a scoping review of studies about Global Health education in the Americas. Objective: To analyse educational programs on global health in the Americas. Method: Five electronic databases were used in a scoping review: PubMed, Scopus, Web of Knowledge, CINAHL, and Lilacs. Data collection happened in November 2017–March 2018. The following stages were rigorously observed: identification, selection, charting, and summarizing the studies that were included. To process the data, we used IRaMuTeQ software. Findings: Forty-six studies were identified and organized in categories: 1) diversity of the topics addressed in GH; 2) models of teaching; 3) emotional, cultural, and collaborative aspects in teaching GH; 4) student preparation for GH experiences; and 5) structures required for a GH course. Conclusions: The existing global health curriculum in the Americas is diffuse and limited, with a greater focus on clinical aspects. Thus, a minimum curriculum for students from different areas is needed. Results evidenced that the teaching of global health in the Americas is still incipient, although it is promising. The lack of a common curriculum for the courses in the region makes it difficult to train sensitive and capable professionals to achieve the 2030 Sustainable Development Goals.
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12
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Maweni RM, Foley RW, Lupi M, Woods A, Shirazi S, Holm V, Vig S. Improving safety for medical students and patients during medical electives—a novel simulation-based course. Ir J Med Sci 2019; 188:1033-1045. [DOI: 10.1007/s11845-018-1919-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 10/17/2018] [Indexed: 11/28/2022]
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13
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Wu A, Kielstein H, Sakurai T, Noel G, Viranta-Kovanen S, Chien CL, Bernd P. Internationalization of Medical Education-Building a Program to Prepare Future Leaders in Healthcare. MEDICAL SCIENCE EDUCATOR 2019; 29:535-547. [PMID: 34457511 PMCID: PMC8368475 DOI: 10.1007/s40670-019-00695-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In a globally interconnected world, internationalization of medical education has become increasingly important. While many programs focus on international programs for clinical students, the number of programs for preclinical medical and dental students is small. Based in the Anatomy course, the program presented here involves early international collaborations between preclinical students from six countries. Our work involves small-group video sessions and a large international student videoconference (including cultural and didactic components). The online connections progress with in-person basic sciences summer internships undertaken at the international partner institutions. This collaborative program features unique elements that facilitate cultural exchange and help develop leadership skills in healthcare early in a student's career. We present recommendations for international program implementation.
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Affiliation(s)
- Anette Wu
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
| | - Heike Kielstein
- Department of Anatomy and Cell Biology, Medical Faculty, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06108 Halle (Saale), Germany
| | - Takeshi Sakurai
- Department of Drug Discovery Medicine, Medical Innovation Center, Kyoto University Graduate School of Medicine, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Geoffroy Noel
- Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, Canada
| | - Suvi Viranta-Kovanen
- Department of Anatomy, School of Medicine, University of Helsinki, Helsinki, Finland
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Paulette Bernd
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
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14
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Kalbarczyk A, Nagourney E, Martin NA, Chen V, Hansoti B. Are you ready? A systematic review of pre-departure resources for global health electives. BMC MEDICAL EDUCATION 2019; 19:166. [PMID: 31118015 PMCID: PMC6532266 DOI: 10.1186/s12909-019-1586-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 04/30/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND There has been an exponential increase in the offering of short-term international field experiences in recent years in response to student demands for global health opportunities. Pre-departure preparation is an essential component to equip trainees with the adequate safety, wellness, and cultural competence needed to engage in a meaningful and mutually beneficial elective. This review seeks to quantify the plethora of pre-departure preparation training available to public health, clinical, and undergraduate trainees across the continuum of education for short-term experiences in low-and middle-income countries (LMICs). METHODS We performed a systematic review of Pubmed, Embase, Web of Science, Scopus, and Ovid Global Health in February, 2018. A three-concept search was employed and included "global or international health"; "education or preparation of personnel/students"; and "field programs or travel." The study teamed used PRISMA reporting guidelines to conduct title and full-text reviews and conduct data extraction and analysis. RESULTS The search returned 2506 unique articles. Of these, 55 met inclusion criteria and were included in the final review. Ninety one percent (91%) of articles focused on pre-departure trainings for medical students and residents. Nine thematic domains for short-term international field experiences emerged; culture, safety, and project-specific knowledge were the most frequently covered domains while mentorship, professionalism, and emotional wellness and culture shock were least common. Approximately half (53.3%) of studies specifically evaluated the pre-departure component of the international experience using a survey or evaluation form. Recommendations emerged from these evaluations including early engagement with international partners, inclusion of self-reflection exercises and site-specific content, and utilization of interactive approaches in learning. Some institutions face barriers to conducting pre-departure preparation such as lack of dedicated faculty, finances, and institutional support. CONCLUSIONS Interest in pre-departure training for international experiences is growing but few programs conduct and publish evaluations of these trainings. Pre-departure trainings should be developed in partnership with receiving institutions and faculty and incorporate critical self- reflection throughout the experience. In addition to the experience itself, institutions need to evaluate these curricula to better understand how they influence trainees' capacity to effectively engage in LMIC settings.
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Affiliation(s)
- Anna Kalbarczyk
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Emily Nagourney
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Nina A. Martin
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Victoria Chen
- Johns Hopkins Center for Global Health, Baltimore, USA
| | - Bhakti Hansoti
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins School of Medicine, Baltimore, USA
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Watson DA, Cooling N, Woolley IJ. Healthy, safe and effective international medical student electives: a systematic review and recommendations for program coordinators. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:4. [PMID: 30988957 PMCID: PMC6448218 DOI: 10.1186/s40794-019-0081-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/26/2019] [Indexed: 12/14/2022]
Abstract
Background Thousands of medical students undertake international medical electives each year. These students face potentially substantial health and safety risks as well as educational and ethical challenges and therefore should undertake their electives within well-structured and coordinated programs. Methods We conducted a qualitative systematic review based on a pre-determined protocol. Relevant publications and guidelines relating to international medical electives were identified through a review of the literature using on-line search engines, principally PubMed. We then conducted a systematic qualitative synthesis to extract relevant publications. Finally, the literature was organized according to themes, with the aim of developing a structured set of Recommendations for Implementation for program coordinators. Results A wide range of important issues were identified which were categorized into seven themes upon which recommendations were made principally for the benefit of program coordinators: Responsibilities; General policies; Travel advisories; Occupational risk assessment; Funding & finances, Pre-departure training programs; and Post-return debriefing and screening. Conclusions Recommendations for program coordinators on the health and safety of medical students while on international medical electives have been sourced from existing guidelines and relevant publications. There was considerable consensus from the literature and as such these synthesised recommendations could form the basis for internationally accepted standards for elective placement program coordinators. Electronic supplementary material The online version of this article (10.1186/s40794-019-0081-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D Ashley Watson
- 1Australian National University Medical School - Canberra Hospital Campus, Garran, ACT Australia
| | - Nicholas Cooling
- 2School of Medicine, University of Tasmania, Tasmania, Australia
| | - Ian J Woolley
- 3Monash Infectious Diseases, Monash Health and Monash University, Clayton, Victoria Australia
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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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Fotheringham EM, Craig P, Tor E. International medical electives in selected African countries: a phenomenological study on host experience. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2018; 9:137-144. [PMID: 29805120 PMCID: PMC6129154 DOI: 10.5116/ijme.5aed.682f] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 05/05/2018] [Indexed: 05/21/2023]
Abstract
OBJECTIVES To explore the host experience on international medical electives at a selection of hospitals in low- and middle-income countries in Africa. Outcomes of the study may inform and improve the preparation of global health curriculum, pre-elective training and debriefing for international medical electives. METHODS A descriptive phenomenological study was undertaken, involving semi-structured interviews with ten elective hosts at seven study sites in three African countries. Purposive convenience sampling augmented by snowballing was utilised to recruit study participants. The data were thematically analysed and interpreted with reflexivity to generate an accurate aggregate of the experience of participants in hosting international medical electives. RESULTS Six main themes emerged from the thematic analysis of interview data: international medical student contribution to host hospitals, host professional and personal fulfiment, barriers to student learning experience, international medical student preparedness, hope for reciprocity and barriers to cultural immersion and patient care. CONCLUSIONS Study participants described the experience of hosting international medical elective students as overwhelmingly positive. However, they highlighted issues such as barriers to students' learning experience and the lack of reciprocity between host and sending institutions as areas which could be addressed to optimize the experience for both hosts and international medical students. An understanding of the host experience provides stakeholders with a clearer idea of what is important in preparation, organisation and evaluation of the elective experience. This study provides the impetus for further research to examine the effectiveness of introducing appropriate pre-departure training and post-elective debriefing to students embarking on international medical electives.
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Affiliation(s)
| | - Pippa Craig
- School of Medicine, University of Notre Dame, Australia
| | - Elina Tor
- School of Medicine, University of Notre Dame, Australia
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Mehta A, Xu T, Murray M, Casey KM. Medical Student Perceptions of Global Surgery at an Academic Institution: Identifying Gaps in Global Health Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1749-1756. [PMID: 28767491 DOI: 10.1097/acm.0000000000001832] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Robust global health demands access to safe, affordable, timely surgical care for all. The long-term success of global surgery requires medical students to understand and engage with this emerging field. The authors characterized medical students' perceptions of surgical care relative to other fields within global health. METHOD An optional, anonymous survey was given to all Johns Hopkins medical students from February to March 2016 to assess perceptions of surgical care and its role in global health. RESULTS Of 480 students, 365 (76%) completed the survey, with 150 (41%) reporting global health interests. One-third (34%) of responding students felt that surgical care is one of two fields with the greatest potential global health impact in the future, second to infectious disease (49%). A minority (28%) correctly identified that trauma results in more deaths worldwide than obstetric complications or HIV/AIDS, tuberculosis, and malaria combined. Relative to other examined fields, students perceived surgical care as the least preventive and cost-effective, and few students (3%) considered adequate surgical care the best indicator of a robust health care system. Students believed that practicing in a surgical field was least amenable to pursuing a global health career, citing several barriers. CONCLUSIONS Medical students have several perceptions of global surgery that contradict current evidence and literature, which may have implications for their career choices. Opportunities to improve students' global health knowledge and awareness of global surgery career paths include updating curricula, fostering meaningful international academic opportunities, and creating centers of global surgery and global health consortia.
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Affiliation(s)
- Ambar Mehta
- A. Mehta is a fourth-year medical student, Johns Hopkins School of Medicine, Baltimore, Maryland. T. Xu is a recent graduate, Johns Hopkins School of Medicine, Baltimore, Maryland. M. Murray is a fourth-year medical student, Johns Hopkins School of Medicine, Baltimore, Maryland. K.M. Casey is president-elect, Alliance for Surgery and Anesthesia Presence, Newport, Rhode Island
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Carman AS, John CC. The Benjamin H. Kean Travel Fellowship in Tropical Medicine: Assessment of Impact at 15 Years. Am J Trop Med Hyg 2017; 97:958-963. [PMID: 28722593 PMCID: PMC5590605 DOI: 10.4269/ajtmh.17-0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The Benjamin H. Kean Fellowship in Tropical Medicine is an American Society of Tropical Medicine and Hygiene initiative that provides medical students with funding for international clinical or research experiences lasting at least 1 month. Of the 175 Kean fellows from 1998 to 2013, 140 had current available e-mails, and 70 of the 140 (50%) responded to a survey about their fellowship experience. Alumni indicated that the Kean Fellowship had a high impact on their career plans with regard to preparation for (N = 65, 94.2%) and inspiration to pursue (N = 59, 88.1%) a career in tropical medicine and global health. Continued involvement in tropical medicine and global health was common: 52 alumni (74.3%) were currently working in tropical medicine or global health, 49 (71.0%) had done so in the interim between the Kean fellowship and their current position; and 17 of 19 Kean fellows (89.4%) who had completed all medical training and were now in professional practice continued to work in tropical medicine and global health. Alumni had been highly productive academically, publishing a total of 831 PubMed-indexed manuscripts, almost all on tropical medicine or global health topics, in the period between their fellowship year and 2013. Alumni reported strengths of the fellowship including funding, networking, and flexibility, and suggested that more networking and career mentoring would enhance the program. The Benjamin H. Kean fellowship program has been highly successful at inspiring and fostering ongoing work by trainees in tropical medicine and global health.
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Affiliation(s)
- Aubri S Carman
- Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana.,The University of Arizona College of Medicine, Tucson, Arizona
| | - Chandy C John
- Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana
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Hayward LM, Li L. Sustaining and improving an international service-learning partnership: Evaluation of an evidence-based service delivery model. Physiother Theory Pract 2017; 33:475-489. [DOI: 10.1080/09593985.2017.1318425] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lorna M Hayward
- Physical Therapy Department, Northeastern University, Boston, MA, USA
| | - Li Li
- Department of Physical Therapy, Pain Relief Physical Therapy, Boston, MA, USA
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Ousman K, Polomano RC, Seloilwe E, Odero T, Tarimo E, Mashalla YJ, Voss JG, O’Malley G, Chapman SA, Gachuno O, Manabe Y, Nakanjako D, Sewankambo N, Urassa D, Wasserheit JN, Wiebe DJ, Green W, Farquhar C. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium. J Assoc Nurses AIDS Care 2016; 27:331-43. [PMID: 27086192 PMCID: PMC4834555 DOI: 10.1016/j.jana.2016.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/29/2016] [Indexed: 02/03/2023]
Abstract
HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses.
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Affiliation(s)
- Kevin Ousman
- Principal Partner, African Health Resource Group, Baltimore, Maryland, USA
| | - Rosemary C. Polomano
- Professor of Pain Practice, University of Pennsylvania School of Nursing, and Professor of Anesthesiology and Critical Care (Secondary), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Esther Seloilwe
- Associate Professor, School of Nursing University of Botswana, Gaborone, Botswana
| | - Theresa Odero
- Senior Lecturer, School of Nursing Sciences, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Edith Tarimo
- Senior Lecturer, Department of Nursing Management, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Yohana J. Mashalla
- Dean, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Joachim G. Voss
- Professor and Director, Sarah Cole Hirsh Center for Evidence Based Practice, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
| | - Gabrielle O’Malley
- Assistant Professor, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA
| | - Susan A. Chapman
- Associate Professor, Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, California, USA
| | - Onesmus Gachuno
- Senior Lecturer, Department of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Yukari Manabe
- Associate Professor, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Damalie Nakanjako
- Associate Professor, Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nelson Sewankambo
- Principal, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David Urassa
- Associate Dean, Department of Community Health, College of Health Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Judith N. Wasserheit
- Chair, Department of Global Health, and Professor of Global Health & Medicine, University of Washington, Seattle, Washington, USA
| | - Douglas J. Wiebe
- Associate Professor, Departments of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Wendy Green
- Assistant Professor, Counseling, Administration, Supervision & Adult Learning, Cleveland State University, Cleveland, Ohio, USA
| | - Carey Farquhar
- Director and Professor, Departments of Medicine, Epidemiology, and Global Health, School of Medicine, University of Washington, Seattle, Washington, USA
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