Abstract
Background: Conflicts negatively impact health professional education when healthcare is needed most. The aim of this systematic review was to describe the barriers and interventions identified in maintaining health professional education during times of conflict and war to inform key stakeholders and policy makers. Methods: We searched PubMed, EMBASE, and ERIC between June 20, 2018 and March 29, 2019, restricting our search to publications in English, using key search terms “war” “armed conflicts” “conflicts” “medical education” and “nursing education”. We included only peer reviewed publications without date ranges involving conflict or war, health professional education (medical school, residency training, and nursing school), with interventions described to maintain educational activities. Studies regarding continuing medical education and professional development were excluded. Two independent reviewers completed inclusion determinations, data abstraction, and thematic coding of results using Covidence. Outcomes were barriers and interventions identified in maintaining health professional education during conflict.Findings: Screening using MESH terms identified 3,271 articles, with 56 studies meeting final inclusion criteria. Publication dates ranged from 1914-2018 with 16 unique conflicts involving 35 countries. The majority of studies involved medical students (61.4%) followed by residents (28.6%) and nursing students (10% ). Thematic coding identified 5 distinct types of barriers and interventions in maintaining health professions education during conflict; curriculum, personnel, wellness, resources, and oversight. Interpretations: There are consistent and predictable barriers and enabling interventions identified in maintaining health professional education during times of conflict and war that should be considered when supporting and stabilizing these vital efforts. Funding Statement: Grant funding from Open Society Foundation’s Higher Education Support Program (OSF HESP).Declaration of Interests: We declare no conflicts of interests.Ethics Approval Statement: IRB Approval- Protocol #:2019P000131 Brigham and Women’s Hospital/Partners Healthcare.
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