Abstract
BackgroundMany of the 70,000 graduating US medical students [per year] have reported participating in a global health activity at some stage of medical school. This case study design provided a method for understanding the student's experience that included student’s learning about culture, health disparities, exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. We need to understand the student’s experience in order to help design appropriate curricular experiences [and valid student assessment]. ObjectiveOur research aim was to analyze medical student reflection papers to understand how they viewed their Global Clinical Experience (GCE). MethodsA qualitative case study design was used to analyze student reflection papers. All 28 students who participated in a GCE from 2008-2010 and in 2014-2015 and submitted a reflection paper on completion of the GCE were eligible to participate in the study. One student did not submit a reflection paper and was not included in the study. FindingsAll 27 papers were coded by paragraph for reflection and for themes. System of Care/Range of Care was mentioned most often, Aids to Adjustment Process was mentioned least. The theme, “Diseases,” referred to any mention of a disease in the reflection papers, and 44 diseases were mentioned in the papers. The analysis for depth of reflection yielded the following data: Observation, 81/248 paragraphs; Observation and Interpretation, 130/248 paragraphs; and Observation, Interpretation, and Suggestions for change, 36/248 paragraphs; 9 reflection papers contained 27 separate accounts of a transformational experience. ConclusionsThis study provided a method for understanding the student's experience that included student’s learning about culture, health disparities, and exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. How we might design a curriculum to facilitate transformational learning experiences needs further research.
Highlights
Data from the Association of American Medical Colleges Medical School Graduation Questionnaire show that between 2008-2012, 30% of graduating US medical students, amounting to approximately 70,000 students, reported participating in a global health activity at some stage of medical school.[1]
Peluso et al[2] suggested that all students should have training in global health (GH), or should even participate in a Global Clinical Experience (GCE), and 1 international school has required GH training, including an international clerkship, since 2002.3 Underlying this large expenditure of resources on GCEs is the hope that medical students will learn unique competencies, including cultural sensitivity and clinical problem solving, and will gain an understanding of health disparities and the effect of migration and marginalization on health.[4]
A qualitative case study design was used in order to analyze student reflection papers
Summary
Data from the Association of American Medical Colleges Medical School Graduation Questionnaire show that between 2008-2012, 30% of graduating US medical students, amounting to approximately 70,000 students, reported participating in a global health activity at some stage of medical school.[1]. Some programs have been using reflection papers to demonstrate student enthusiasm or to verify participation in a GCE.[5,6] Our research aim was to analyze student reflection papers to understand how the students viewed their experience. This case study design provided a method for understanding the student’s experience that included student’s learning about culture, health disparities, exposure and reaction to a range of diseases encountered. OBJECTIVE Our research aim was to analyze medical student reflection papers to understand how they viewed their Global Clinical Experience (GCE). METHODSA qualitative case study design was used to analyze student reflection papers. One student did not submit a reflection paper and was not included in the study. The analysis for depth of reflection yielded the following data: Observation, 81/248 paragraphs; Observation and Interpretation, 130/248 paragraphs; and Observation, Interpretation, and Suggestions for change, 36/248 paragraphs; 9 reflection papers contained 27 separate accounts of a transformational experience
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