Abstract

BackgroundHealth professionals from high-income countries are increasingly becoming involved in international service-learning trips in low and low/middle-income countries. While much has been written about the ethics and curricular guidelines related to such endeavors, scant attention has been paid to the attitudes with which trainees and clinicians enter into or return from them. In this essay the authors explore how attitudes contribute to the success or failure of international service-learning trips.DiscussionThe authors submit that the attitudes with which visiting health professionals approach international service-learning trips are much more critical to the success of these experiences than their demonstrated knowledge base or specialized skill sets. They list five attitudes that can aid those participating in international service-learning trips. They list five troubling attitudes that, while common, those participating in international service-learning trips can learn to recognize and avoid. They suggest five strategies key to learning respectful attitudes that can foster success in such cross-cultural activities. Lastly, the authors review several concepts related to attitude development in short or long-term global health work.SummaryThe attitudes with which visiting health professionals approach international service-learning activities can be important components of the success or failure of the experiences. Through thoughtful consideration of attitudes and approaches, participants on such trips can build a framework for rich and rewarding experiences in global medicine and global health.

Highlights

  • Health professionals from high-income countries are increasingly becoming involved in international service-learning trips in low and low/middle-income countries

  • We review a variety of attitudes crucial to the success or failure of any international service-learning trips (ISLTs), basing this review on insights gained from many years practicing global medicine [13], teaching global health [14], observing the clinical work of other professionals internationally [15], and studying issues of health equity worldwide [16,17]

  • Attitudinal goals Effective ISLTs are bidirectional in scope, combining service and teaching contributions of visiting health professionals with learning from local contexts and cultures

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Summary

Discussion

Attitudinal goals Effective ISLTs are bidirectional in scope, combining service and teaching contributions of visiting health professionals with learning from local contexts and cultures. Recognizing context is key to success ISLTs are destined to fail if their participants lack thoughtful consideration of local explanations of illness, the causes and effects of social determinants, and the influences of geography, politics, history, and economics on health and disease. Summary ISLTs can introduce health professionals in training and practice from HICs to the complexities of working in L/LMICs, provide grounded perspectives on the responsibilities inherent in global medicine and public health, and whet appetites for launching or expanding long-term careers in global health, both domestically and overseas These projects offer health professionals a chance to explore “making a difference” in settings of significant need. A Professor Emeritus of family medicine and public health, he has many years’ experience working to develop family medicine in Ecuador, Jordan, and Rwanda

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