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Sanghvi RI, Songolo T. What Is the Current Status of Global Health Training for US Postgraduate Trainees in Anesthesiology? What Are Possible Visions for the Future? CURRENT ANESTHESIOLOGY REPORTS 2023; 13:99-107. [PMID: 37168833 PMCID: PMC10036958 DOI: 10.1007/s40140-023-00552-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/26/2023]
Abstract
Purpose of Review There is a great deal of interest in global health at all levels of educational attainment. Many residency programs wish to offer a global health opportunity (GHO) but lack the resources to create one de novo. This review will look at the prevalence of global health education in residency and consider the fellowships available. It will summarize the existing recommendations about a curriculum in global health and how best to prepare trainees for a GHO. Recent Findings While approximately 45% of residency programs make GHOs available to their residents, there is a lack of standardization of curriculum. Logistical and ethical challenges, funding, and the lack of international partners are all barriers to offering a GHO. Residents and fellows can benefit from a GHO as it helps achieve their ACGME core competencies, among other benefits. Summary We make the recommendation for more robust training and education with the investment of fewer resources by aligning with existing global health participation opportunities. We also recommend the use of the Consortium of Universities for Global Health (CUGH) which provided curriculum for creating a context in global health for trainees regardless of discipline.
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Affiliation(s)
- Reema I. Sanghvi
- Division of Global Health, Department of Anesthesiology, University of California San Diego, 200 W. Arbor, San Diego, CA 92103 USA
| | - Tosha Songolo
- Global Health and Policy in Anesthesia, San Diego, CA USA
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2
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Bartholomew JB, Bute JJ. Exploring Internal Medicine Interns' Educational Experiences on Opioid Addiction: A Narrative Analysis. HEALTH COMMUNICATION 2023; 38:169-176. [PMID: 34114896 DOI: 10.1080/10410236.2021.1939232] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Increased efforts to educate physicians on addiction are crucial based on widespread addiction rates and the ongoing opioid crisis. Physicians in the United States hesitate to adopt medication-assisted treatment (MAT) due to a lack of addiction education. For this study, we used a narrative framework to understand how internal medicine interns (first-year residents) recount their educational experiences on addiction during their medical school education and early residency. In using a sensemaking function, our results revealed four types of narratives: dearth, futility, priority, and impact. We found that the narratives were interrelated and indicated that interns understood addiction as a disease yet felt unprepared to treat it. We also discovered that interns did not fully appreciate the nuances of addiction. Their attempts to engage patients in substance recovery or reduction were often unsuccessful, leaving them feeling disappointed. Interns had mixed feelings when working with addiction-related issues as patients' addiction was rarely ever addressed. Interns also encountered "eye-opening" events leaving them astonished. Thus, shaping their views on the opioid crisis, and by extension, addiction. Increasing medical students' and residents' competency through practical education and training may improve physician comfort and confidence leading to the adoption of opioid addiction treatment such as MAT, potentially reducing the opioid epidemic.
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Affiliation(s)
| | - Jennifer J Bute
- Department of Communication Studies, Indiana University-Purdue University
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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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International medical electives during and after the COVID-19 pandemic - current state and future scenarios: a narrative review. Global Health 2022; 18:44. [PMID: 35459191 PMCID: PMC9026059 DOI: 10.1186/s12992-022-00838-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background International medical electives are an important and popular component of the academic curriculum in many medical schools and universities worldwide. The purpose of abroad electives is to provide medical students with an opportunity to gain a better understanding of education and healthcare in an international context. The COVID-19 pandemic, however, has substantially changed the international elective landscape. Travel restrictions, closures of international elective programs and the expansion of virtual methods for education caused a widespread disruption to abroad electives. A comprehensive analysis with regard to other consequences for abroad electives, however, has not been done before. Thus, we sought to a) summarize the current transformation of the international medical elective and b) to address potential challenges for post-pandemic international medical electives. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on international electives during the last two years of the COVID-19 pandemic. Results Students worldwide had electives postponed or canceled. Apart from evident immediate pandemic-related consequences (such as the substantial decline in global electives and impaired elective research opportunities for educators), there are other several problems that have received little attention during the last two years. These include challenges in the elective application process, poorly-understood consequences for host institutions, and growing global (ethical) disparities that are likely to increase once elective programs will gradually re-open. There is ample evidence that the post-pandemic elective landscape will be characterized by increasing elective fees, and a more competitive seat-to-applicant ratio. Ethical problems for international electives arising from an unequal global vaccine distribution will pose an additional challenge to students and elective coordinators alike. Conclusion The COVID-19 pandemic transformed the international medical elective landscape in an unprecedented way, and future generations of medical students will face a series of additional challenges when applying for global medical electives.
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Wells T, Parameshwar P, Marais H, Hoffman R, Arora G. Using Prompted Reflective Writing to Demonstrate Learning of Physician Competencies during Global Clinical Rotations. Am J Trop Med Hyg 2022; 106:tpmd210485. [PMID: 35292590 PMCID: PMC9128709 DOI: 10.4269/ajtmh.21-0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/05/2022] [Indexed: 11/11/2022] Open
Abstract
Global health education programs have grown in number and rigor with the development of learning objectives, competency frameworks, and assessment tools. This study aimed to assess whether prompted reflective writing could demonstrate medical student learning of physician competencies during global clinical rotations. From 2014 to 2018, 135 medical students who participated in global health clinical rotations responded to four reflective writing prompts. We conducted qualitative content analysis of 487 individual responses using grounded theory and an iterative process to identify themes associated with the eight American Association of Medical College physician competency domains. In response to prompted reflective writing assignments, students demonstrated learning related to all eight competencies. They reflected on systems-based practice while also sharing their growth in knowledge and skills related to personal and professional development, knowledge for practice, interprofessional collaboration, and patient care. In demonstrating practice-based learning and improvement, students additionally reflected on how the experiences during their global clinical rotations might influence their future careers as physicians. Our findings suggest that prompted reflective writing during global clinical rotations allows medical students to demonstrate learning in the competency domains expected of all physician trainees and to reflect on the application of this learning to current and future patient care. In reading students' writings, we found that prompted reflective writing during global clinical rotations offers an opportunity for students to illustrate the knowledge and skills they have acquired as physicians in training.
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Affiliation(s)
- Traci Wells
- David Geffen School of Medicine, University of California, Los Angeles, California
| | | | - Hendrik Marais
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Risa Hoffman
- David Geffen School of Medicine, University of California, Los Angeles, California
| | - Gitanjli Arora
- Keck School of Medicine, University of Southern California, Los Angeles, California
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Rule ARL, Warrick S, Rule DW, Butteris SM, Webber SA, Smith L, Schubert C. Using Reflective Writing to Explore Resident Resilience during Global Health Electives. Am J Trop Med Hyg 2022; 106:923-929. [PMID: 35008047 PMCID: PMC8922490 DOI: 10.4269/ajtmh.21-0682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/24/2021] [Indexed: 11/07/2022] Open
Abstract
Pediatric residents participating in global health electives (GHEs) report an improved knowledge of medicine and health disparities. However, GHEs may pose challenges that include cost, personal safety, or individual mental health issues. The objective of this study was to describe the use of guided reflections to understand resident resilience during GHEs. Forty-five residents enrolled in two pediatric training programs were asked to respond in writing to weekly prompts during a GHE and to complete a post-trip essay. Analysis of the reflections and essays, including an inductive thematic analysis, was completed. Two coders performed a second analysis to support classification of themes within the Flinders Student Resilience (FSR) framework. Four themes emerged from the initial analysis: 1) benefits, 2) stresses and challenges, 3) career development, and 4) high-value care. Analysis using the FSR framework revealed the following themes: acknowledgment of personal limitations, importance of relationships in coping throughout the GHE, and discernment of career focus. Reflective writing provided insight into how residents mitigate GHE challenges and develop resilience. Despite statements of initial distress, residents focused on their personal benefits and growth during the GHE. The FSR framework revealed the residents' robust self-awareness of limitations and that strong relationships on the ground and at home were associated with perceived benefits and growth. Programs should consider helping residents to identify healthy coping practices that can promote personal resilience during GHEs as part of pre-departure preparation and debriefing, as well as providing for supportive communities during the GHE.
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Affiliation(s)
- Amy R. L. Rule
- Division of Hospital Medicine, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;,Address correspondence to Amy R. L. Rule, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave. MLC, Cincinnati, OH 45229. E-mail:
| | - Stephen Warrick
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - David W. Rule
- Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sabrina M. Butteris
- Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin
| | - Sarah A. Webber
- Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin
| | - Lynne Smith
- College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, Ohio
| | - Chuck Schubert
- Division of Emergency Medicine, Cincinnati, Children’s Hospital Medical Center, University of Cincinnati College of Medicine, and Department of Family and Community Medicine, Cincinnati, Ohio
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Wang X, Qin H, Zhu Y, Wang Z, Ye B, Zhu X, Liang Y. Association of off-the-job training with work performance and work-family conflict among physicians: a cross-sectional study in China. BMJ Open 2022; 12:e053280. [PMID: 35017246 PMCID: PMC8753420 DOI: 10.1136/bmjopen-2021-053280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To determine whether experiences of off-the-job training in domestic (DT) and overseas study (OS) settings are associated with work performance and work-family conflict in physicians. DESIGN, SETTING AND PARTICIPANTS We conducted a national cross-sectional survey in 77 public hospitals across seven provinces in China between July 2014 and April 2015. Participants were 3182 physicians. EXPOSURE Participants were categorised into four groups: none, DT only, OS only and DT and OS. PRIMARY OUTCOME MEASURES Work performance was assessed by work engagement, career attrition and patient-centred care. Work-family conflict was assessed by affecting care for family, feeling guilty towards family and receiving complaints from family. RESULTS A total of 25.89% participants had experienced DT only, 8.71% OS only and 8.47% DT and OS. After adjustment for potential confounders, participants who had experiences of DT and OS compared with those with no training were more likely to report positive work performance (pride in work: OR=2.11, 95% CI: 1.43 to 3.10; enjoyment of work: OR=1.67, 95% CI: 1.11 to 2.51; turnover intention: OR=0.54, 95% CI: 0.38 to 0.77; early retirement: OR=0.63, 95% CI: 0.45 to 0.89; and exhaustion: OR=0.66, 95% CI: 0.45 to 0.98) and less work-family conflicts (feeling guilty towards family: OR=0.51, 95% CI: 0.35 to 0.74; and complaints from family: OR=0.66, 95% CI: 0.47 to 0.91). We found no obvious association between DT/OS experience with patient-centred care. CONCLUSIONS Physicians with DT and OS experiences are more likely to have better work performance and less work-family conflict than those without such experience. Physicians face increasing pressure to pursue continuing education and experience associated distress. Therefore, hospitals and government policy-makers should promote DT and OS.
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Affiliation(s)
- Xiaoyu Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hua Qin
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yimei Zhu
- Department of Media and Communication, University of Leicester, Leicester, UK
| | - Zixin Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Beizhu Ye
- Department of Social Medicine and Health Management, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xi Zhu
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Yuan Liang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Coria AL, Rabin TL, Rule ARL, Haq H, Hudspeth JC, Ratner L, Walker-Descartes I. Global Health Crisis, Global Health Response: How Global Health Experiences Prepared North American Physicians for the COVID-19 Pandemic. J Gen Intern Med 2022; 37:217-221. [PMID: 34561829 PMCID: PMC8475882 DOI: 10.1007/s11606-021-07120-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic plunged hospital systems into resource-deprived conditions unprecedented since the 1918 flu pandemic. It brought forward concerns around ethical management of scarcity, racism and distributive justice, cross-disciplinary collaboration, provider wellness, and other difficult themes. We, a group of medical educators and global health educators and clinicians, use the education literature to argue that experience gained through global health activities has greatly contributed to the effectiveness of the COVID-19 pandemic response in North American institutions. Support for global health educational activities is a valuable component of medical training, as they build skills and perspectives that are critical to responding to a pandemic or other health system cataclysm. We frame our argument as consideration of three questions that required rapid, effective responses in our home institutions during the pandemic: How can our health system function with new limitations on essential resources? How do we work at high intensity and volume, on a new disease, within new and evolving systems, while still providing high-quality, patient-centered care? And, how do we help personnel manage an unprecedented level of morbidity and mortality, disproportionately affecting the poor and marginalized, including moral difficulties of perceived care rationing?
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Affiliation(s)
- Alexandra L Coria
- Global Health Institute and Division of Pediatric Hospital Medicine, Maimonides Medical Center, Brooklyn, NY, USA. .,State University of New York Downstate College of Medicine, Brooklyn, NY, USA.
| | - Tracy L Rabin
- Office of Global Health & Yale Primary Care Internal Medicine Residency Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Amy R L Rule
- University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Perinatal Institute and Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Heather Haq
- Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) at Texas Children's Hospital, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - James C Hudspeth
- Department of Medicine, Section of General Internal Medicine, Boston University, Boston, MA, USA
| | - Leah Ratner
- Harvard Medical School, Boston, MA, USA.,Division of Respiratory Diseases, Boston Children's Hospital, Boston, MA, USA.,General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Ingrid Walker-Descartes
- State University of New York Downstate College of Medicine, Brooklyn, NY, USA.,Division of Medical Education, Maimonides Children's Hospital, Brooklyn, NY, USA
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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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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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Archuleta S, Chew N, Ibrahim H. The Value of International Research and Learning in Graduate Medical Education. J Grad Med Educ 2019; 11:1-4. [PMID: 31428250 PMCID: PMC6697296 DOI: 10.4300/jgme-d-19-00478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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