Global Health Education: a cross-sectional study among German medical students to identify needs, deficits and potential benefits (Part 2 of 2: Knowledge gaps and potential benefits).

Peter Tinnemann,Kirsten Schubert,Kayvan Bozorgmehr,Johannes Menzel-Severing

doi:10.1186/1472-6920-10-67

Peter Tinnemann, Kirsten Schubert + Show 2 more

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https://doi.org/10.1186/1472-6920-10-67

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Abstract

BackgroundIn Germany, educational deficits or potential benefits involved in global health education have not been analysed till now.ObjectiveWe assess the importance medical students place on learning about social determinants of health (SDH) and assess their knowledge of global health topics in relation to (i) mobility patterns, their education in (ii) tropical medicine or (iii) global health.MethodsCross-sectional study among medical students from all 36 medical schools in Germany using a web-based, semi-structured questionnaire. Participants were recruited via mailing-lists of students' unions, all medical students registered in 2007 were eligible to participate in the study. We captured international mobility patterns, exposure to global health learning opportunities and attitudes to learning about SDH. Both an objective and subjective knowledge assessment were performed.Results1126 online-replies were received and analysed. International health electives in developing countries correlated significantly with a higher importance placed on all provided SDH (p ≤ 0.006). Participation in tropical medicine (p < 0.03) and global health courses (p < 0.02) were significantly associated with a higher rating of 'culture, language and religion' and the 'economic system'. Global health trainings correlated with significantly higher ratings of the 'educational system' (p = 0.007) and the 'health system structure' (p = 0.007), while the item 'politics' was marginally significant (p = 0.053).In the knowledge assessment students achieved an average score of 3.6 (SD 1.5; Mdn 4.0), 75% achieved a score of 4.0 or less (Q25 = 3.0; Q75 = 4.0) from a maximum achievable score of 8.0. A better performance was associated with international health electives (p = 0.032), participation in tropical medicine (p = 0.038) and global health (p = 0.258) courses.ConclusionThe importance medical students in our sample placed on learning about SDH strongly interacts with students' mobility, and participation in tropical medicine and global health courses. The knowledge assessment revealed deficits and outlined needs to further analyse education gaps in global health. Developing concerted educational interventions aimed at fostering students' engagement with SDH could make full use of synergy effects inherent in student mobility, tropical medicine and global health education.

Highlights

In Germany, educational deficits or potential benefits involved in global health education have not been analysed till
These students achieved a significantly (p = 0.038) higher score in the knowledge assessment than students who had never participated in a course of tropical medicine, the assessment contained no questions directly related to tropical medicine and infectious diseases. (Figure 10) iii) Performance by participation in global health courses 9.0% of our sample had already participated at least once in a global health course of undetermined length [4]
In relative terms, learning about important social determinants of health (SDH) such as the economic system is given a lower value by students in our sample than learning about determinants related to the cultural context, the health system, educational system or general politics (Figure 1) of a country

Summary

Introduction

In Germany, educational deficits or potential benefits involved in global health education have not been analysed till now. A good example of these processes and the reduction of barriers is the increasing mobility of medical students during their studies, with an increasing proportion completing their electives abroad. It is noteworthy that the reduction of physical, legal, cultural and psychological barriers has influenced the spread of diseases and risk-factors within and between populations, but has re-emphasised the role of the social determinants of health (SDH) in understanding and tackling root causes of ill health and health inequities within and across countries. Acknowledging the role of health professionals in reducing health inequities on regional, national, international and global levels [6], the commission recommended in its final report to the World Health Organisation (WHO):

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