Harvard Medical School Global Mental Health: Trauma and Recovery Course: What is the Global Impact? Three Year’s Results

Abstract

Purpose: This paper describes and documents an innovative blended learning Global Mental Health: Trauma and Recovery certificate training course. This course combines a two-week face-to-face training in Orvieto, Italy with a five-month follow-up online virtual training as a learning experience for global health care practitioners. Continuing medical education (CME) accreditation is offered upon completion. This course utilized an innovative blended learning model with a community of practice approach, a combination of lectures and discussions, and online in-depth group case study discussions. Methodology: Data was collected by self-reported anonymous evaluation by participants of three continuous years of the CME Global Mental Health: Trauma and Recovery certificate training course sponsored by Harvard Medical School. One hundred fifty-five participants (n= 39 in 2011; n = 57 in 2012; n=59 in 2013) underwent a pre- and post-course evaluation to determine sustained confidence in performing medical and psychiatric care to traumatized patients and communities, as well as to determine their learning of the Global Mental Health Action Plan (GMHAP). Results: Over the course of three independent years, a total of 155 participants were evaluated. There was evidence for significant improvement in their confidence levels in all clinical areas (diagnosis; treatment of trauma; use of psychotropic medication) when comparing baseline to completion of the six-month course. All ten dimensions of the GMHAP and nine medical and psychiatric aspects of treatment revealed significant improvement in confidence levels. Regression analysis also indicated similar results after the adjustment of demographic covariates. Physicians and participants with mental health and social work background had significantly higher confidence. Participants who were MD’s or psychiatrists had higher confidence in most of the categories of confidence except for self-care, understanding culture, collaboration, and policy and financing. The model showed no difference in learning based upon gender and level of development of country of origin. Conclusion: The evaluation of this blended learning CME program provides evidence of significant enhancement of clinical practice and planning skills in health care practitioners working with highly traumatized patients and communities worldwide. This successful training over the past 18 years has gone far to achieve the health and mental health capacity building as requested by the Ministers of Health from post-conflict societies in the historic Rome meeting in 2004.