Towards global citizenship: investigating and measuring empathy for the other in global health education

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.

There are several challenges and opportunities in health education in global health. Given the field’s rapid expansion, demand for including systems thinking and One Health (a unifying approach that considers human, animal, and environmental health) in global health courses has recently increased. Simulation activities provide an avenue to attain and assess learning objectives that foster critical and systems thinking. This study carried out a One Health simulation activity in an undergraduate global health course, conducted a focus group discussion, and obtained responses from written questionnaires from students who participated in the activity. Data were analyzed using thematic analysis. Results show that the One Health simulation was instrumental for students to understand the complex interactions between different actors and stakeholders in global health systems. The One Health simulation also improved class dynamics, peer-to-peer interactions, and collaborations in the remaining part of the course. The activity helped assess two of the critical thinking learning objectives of the course, and there was some evidence that student agency and confidence may have been improved. Evidence shows that the activity helped students understand the principles of systems thinking and apply them in complex scenarios. Findings support including interactive simulation activities in global health courses to include elements of system science and One Health into classroom activities innovatively and engagingly.

BackgroundThere is increasing interest in global health teaching among medical schools and their students. Schools in the UK and internationally are considering the best structure, methods and content of global health courses. Academic work in this area, however, has tended to either be normative (specifying what global health teaching ought to look like) or descriptive (of a particular intervention, new module, elective, etc.).MethodsWhile a number of studies have explored student perspectives on global health teaching, these have often relied on tools such as questionnaires that generate little in-depth evidence. This study instead used qualitative methods to explore medical student perspectives on global health in the context of a new global health module established in the core medical curriculum at a UK medical school.ResultsFifth year medical students participated in a structured focus group session and semi-structured interviews designed to explore their knowledge and learning about global health issues, as well as their wider perspectives on these issues and their relevance to professional development. While perspectives on global health ranged from global health ‘advocate’ to ‘sceptic’, all of the students acknowledged the challenges of prioritising global health within a busy curriculum.ConclusionsStudents are highly alert to the diverse epistemological issues that underpin global health. For some students, such interdisciplinarity is fundamental to understanding contemporary health and healthcare. For others, global health is merely a topic of geographic relevance. Furthermore, some students appeared to accept global health as a specialist area only relevant to professionals working overseas, while others considered it to be an essential part of working in the globalised world and therefore relevant to all medical professionals. Students also clearly noted that including ‘soft’ subjects and more discursive approaches to teaching and learning often sits awkwardly in a programme where ‘harder’ forms of knowledge and didactic methods tend to dominate. This suggests that more work needs to be done to explain the relevance of global health to medical students at the very beginning of their studies.

BackgroundThis study assesses the impact of the Interprofessional Global Health Course (IPGHC) on students’ fundamental global health knowledge and personal viewpoints on global health domains. It explores the evolution of students’ understanding of global health specifically in relation to the COVID-19 pandemic.MethodsNinety-nine students were selected from 123 McGill student applicants based on their motivation and commitment to take part in IPGHC’s ten-week 2020 curriculum. These IPGHC students were eligible to participate in the study. The study’s design is sequential explanatory mixed methods. The cross-sectional survey (quantitative phase) appraises students’ global health learning outcomes using pre- and post-course surveys, with the use of 5-point Likert-scale questions. The descriptive qualitative survey (qualitative phase) further explores the impact of IPGHC on student’s understanding of global health and the reflections of students on the COVID-19 pandemic after IPGHC. The post-course survey included a course evaluation for quality improvement purposes.ResultsOf the 99 students, 81 students across multiple undergraduate and graduate disciplines participated in the study by completing the course surveys. Mean knowledge scores of the following 11 global health topics were increased between pre- and post-course survey: Canadian Indigenous health (P < 0.001), global burden of disease (P < 0.001), global surgery (P < 0.001), infectious diseases and neglected tropical diseases (P < 0.001), refugee and immigrant health (P < 0.001), research and development of drugs (P < 0.001), role of politics and policies in global health (P = 0.02), role of technology in global health (P < 0.001), sexual violence (P < 0.001), systemic racism in healthcare (P = 0.03), and trauma in the global health context (P < 0.001). A positive change in student viewpoints was observed in response to questions regarding their perception of the importance of global health education in their own professional health care programs (P < 0.001), and their understanding of the roles and responsibilities of other healthcare professionals (P < 0.001). In the post-course survey open-ended questions, students exemplified their knowledge gained during the course to create a more informed definition of global health. Several recurring themes were identified in the student reflections on the COVID-19 pandemic, notably policy and politics, followed by access to healthcare and resources.ConclusionThis study emphasizes the need for interprofessional global health education at the university level and demonstrates how rapidly global health learners can apply their knowledge to evolving contexts like the COVID-19 pandemic.

BackgroundPrioritizing global health is important for positive health outcomes. Doctors play a pivotal role in addressing health issues that they need to recognize the importance of global health practice. However, medical education in global health is still in its early stages in many countries, including South Korea.MethodsThis study is a quantitative cross-sectional study. Medical students were recruited from all 40 Korean medical schools and data collection was conducted in 2021. Stratified proportional quota sampling was employed as the sampling method. The study examined medical students’ interest in global health as the dependent variable. Independent variables included whether individuals had taken global health courses as part of their medical curriculum, while covariates included student background and institutional factors. Logistic regression was used to determine if taking a global health class was associated with global health interests.ResultsThe study included 2450 participants and almost 32% of medical students (n = 781) were interested in global health. Taking global health classes in school was associated with a higher likelihood of developing an interest in global health (OR: 1.29, 95% CI: 1.00-1.67). The likelihood of being interested in global health decreased across the academic year (OR: 0.70, 95% CI: 0.53–0.94). Individuals in graduate entry programs were associated with an interest in global health (OR: 1.32, 95% CI: 1.01–1.72).ConclusionThis study provides the first comprehensive nationwide assessment of medical students’ perspectives on global health education in South Korea. The findings underscore the importance of early and sustained exposure to global health topics in medical education in fostering interest in global health. These results can serve as valuable evidence for medical educators seeking to integrate global health education into their curricula.

Challenges and constraints in global health practice such as inadequate international cooperation, cultural sensitivity, and interdisciplinary collaboration inform key gaps and opportunities to strengthen global health education, including technical skills and competencies needed for the next generation of global health leaders. We describe an innovative model of global health education leveraging advances in educational technology, co-developed and implemented by universities within the Association Pacific Rim Universities. The model was developed to address challenges and opportunities to strengthen global health education and has been implemented in two global health courses—one on leadership and one on ethics—for almost 10 years. The model was innovative in providing a virtual global learning environment in collaboration with multiple universities in diverse contexts, a novel approach back in 2015 and one that to this day is not widely available across universities. An evaluation of the model was conducted in 2025, and findings are reported. To evaluate the global health education model, we applied a mixed methods approach including surveys and discussion groups with students and faculty participating in the global health leadership course in the past 2 years. Approximately 83% of students (148/179) responded to the student survey and more than 80% of respondents reported high levels of mastery of course learning objectives and competencies, while 97% of students reported satisfaction with the course, with an emphasis on the model’s benefits for developing and practicing global collaboration and communication. Faculty reported high satisfaction with the course’s inclusion and modelling of a decolonized approach to global health education with the diversity of participating learners, guest speakers, and case studies and readings in the course. Developing and implementing effective global health education is critical for improving education and practice. Our intention in sharing this case study is to offer readers the opportunity to learn about and adapt this model in their own curricula and settings as desired as we collectively strive for improved global health education. The more such models are implemented across various topics and settings, the more we can achieve increased scalability and success in key components of global health training and practice.

Dental education has seen increases in global health and international educational experiences in many dental schools' curricula. In response, the Consortium of Universities for Global Health's Global Oral Health Interest Group aims to develop readily available, open access resources for competency-based global oral health teaching and learning. The aim of this study was to develop and evaluate a Global Health Starter Kit (GHSK), an interdisciplinary, competency-based, open access curriculum for dental faculty members who wish to teach global oral health in their courses. Phase I (2012-17) evaluated longitudinal outcomes from two Harvard School of Dental Medicine pilot global health courses with 32 advanced and 34 predoctoral dental students. In Phase II (2018), the Phase I outcomes informed development, implementation, and evaluation of the open access GHSK (45 enrollees) written by an interdisciplinary, international team of 13 content experts and consisting of five modules: Global Trends, Global Goals, Back to Basics: Primary Care, Social Determinants and Risks, and Ethics and Sustainability. In Phase III (summer and fall 2018), five additional pilot institutions (two U.S. dental schools, one U.S. dental hygiene program, and two dental schools in low- and middle-income countries) participated in an early adoption of the GHSK curriculum. The increase in perceived knowledge scores of students enrolled in the pilot global health courses was similar to those enrolled in the GHSK, suggesting the kit educated students as well or better in nearly all categories than prior course materials. This study found the GHSK led to improvements in learning in the short term and may also contribute to long-term career planning and decision making by providing competency-based global health education.

BackgroundGlobal health education (GHE) in Italy has spread since the first decade of 21st century. The presence of global health (GH) courses in Italy was monitored from 2007 to 2013. In 2019, a new survey was proposed to assess the availability of educational opportunities in Italian medical schools.MethodsAn online survey was carried out using a questionnaire administered to a network of interested individuals with different roles in the academic world: students, professors, and members of the Italian Network for Global Health Education. The features of courses were analysed through a score.ResultsA total of 61 responses were received from affiliates of 33 out of the 44 medical schools in Italy. The national mean of GH courses for each faculty was 1.2, reflecting an increase from 2007. The courses increased nationwide, resulting in a dispersed GHE presence in northern, central and southern Italy. One of the most critical points was related to the nature of “elective” courses, which were not mandatory in the curricula. Enrollees tended to be students genuinely interested in GH issues. Some community and service-learning experiences, referred to as GH gyms, were also detected at national and international levels.ConclusionsGHE has spreading in Italy in line with the vision of the Italian Network for Global Health Education. Although progress has been made to disperse GH courses around the country, more academic commitment is needed to include GH in the mandatory curricula of medical schools and other health faculties.

Education systems and pedagogical practices in global public health are facing substantive calls for change during the current and ongoing ‘decolonising global health’ movement. Incorporating antioppressive principles into learning communities...

Today, health has transcended national boundaries and become more multifaceted. Global health has evolved as a new paradigm and is recently being identified as a thrust area now in India. Despite an existing need for a standardized global health curriculum, there is little information available on its education and curriculum in medical and health education space. In the Indian context, we are yet to have a fuller picture of the current status, including, content, structure, selection, teaching methods of global health, and how students are evaluated in India. The objective of this study was to map courses relating to studies on global health in India and analyze its mode of delivery. A detailed Internet search was carried out to identify global health courses and analyzed for: (i) whether global health is a part of the teaching curriculum, (ii) mode of teaching, (iii) broad contents, (iv) instructional formats, (v) assessment, and (vi) selection process. It was found that delivery of global health education in India was fragmented with limited focus at the undergraduate and postgraduate levels. Global health teaching was largely based on certificate courses or online courses, with hardly any institutions imparting a distinct global health education program. There is also no definite specification as to which institutes can impart teaching on global health education and what the specific eligibility requirements are. Our analysis suggests that efforts should be directed toward integrating global health education into broader public health curriculum. At the same time, the need for generation of global health leaders, creation of a common forum for addressing merits and demerits of global health issues, as well as creation of more opportunities for placements are recognized.

Despite the increasing demand for global health education, relatively few global health courses currently are offered in Korea. This mixed-methods study examined the need for global health competency and global health education experience for nursing students. A survey of 208 nursing students was conducted from May 2020 to August 2020, and three focus groups were conducted with 12 nursing students. The average score of global health nursing competencies was 2.8 ± 0.7 on a scale ranging from 1 to 4. Female, higher academic achievement, fluent English, and higher global health education experience had a significant effect on global health competency. The most influential factor was more experience with global health education. Nursing students' perceptions and educational needs related to global health education were classified into four subthemes. The development of global health education programs for nursing students is needed. [J Nurs Educ. 2023;62(2):75-82.].

In the era of globalization the health problem is no long one country' s problem. It is necessary for medical schools to develop global health education in the conception of global health. Medical education objective should reflect the demands of global health. The curriculum should includes global health courses. Global health education resources in worldwide should be utilized. Through global healt education medical students should be qualified to deal with global health problems, to understand various cultures and to tackle the global health challenges in the 21st century. Key words: Global health; Global health education; Medical school

This chapter describes the development of a multidisciplinary global health program in the Icahn School of Medicine at Mount Sinai. Key features were (1) a deliberate early decision to focus scarce resources on education in global health; (2) creation of a three-tiered educational program that offered introductory training in global health to all medical students, in-depth education to students interested in global health careers, and postgraduate education in global health tracks to selected residents in Medicine, Pediatrics, Emergency Medicine and Psychiatry; (3) the creation of a strong global health track in the MPH program; and (4) creation of a post-residency teaching fellowship in global health. Two external factors strongly assisted program growth: (1) consistent fiscal and intellectual support from the Dean of the Medical School and the Dean for Medical Education which culminated in the introduction of a stand-alone course in global health to the mandatory core curriculum of the medical school, and (2) the building of a strong base of philanthropic support with support from the Medical School’s office of Development that culminated in formation of the recently endowed Arnhold Global Health Institute at Mount Sinai. Program evaluation and continuous improvement were essential at every stage.

# Background The field of global health has traditionally been taught at the graduate level, but there are a small number of undergraduate level global health programs in the U.S. The development of undergraduate global health programs poses important questions for program administrators in terms of developing competencies and navigating overlap between undergraduate and graduate programs. Specifically, which competencies should undergraduate students be expected to master and how do these intersect with those of graduate programs? # Methods Faculty at a university in the Mid-Atlantic region of the U.S. were invited to participate in an in-depth interview about course content and their expectations for undergraduate students in global health programs. Interviews covered courses they teach (e.g., prerequisites, readings, course competencies) and competencies relevant at the undergraduate level. A total of 7 faculty members were interviewed. Interviews were recorded and transcribed in Microsoft Word (Microsoft Inc, Seattle, WA, USA), and then analyzed for common themes. # Results Interview responses indicate diverse discipline-specific approaches in undergraduate global health courses. When asked to articulate what they expect undergraduate students to learn from global health courses, participants noted that basic concepts can serve as a foundation for further studies or work experiences. Some participants noted that undergraduate global health programs should provide a foundation, but expected students to continue their global health education. Others thought employment opportunities should be achievable with an undergraduate degree in Global Health. There is consensus that, independent of discipline, field-based practicum opportunities are recommended to apply classroom concepts in real-world settings. # Conclusions These findings present faculty perspectives on undergraduate global health programs, expectations of students, and core competencies. A salient challenge for course instructors is to identify where undergraduate curriculum should end and graduate curriculum should begin. Future research should expand to institutions with established undergraduate and graduate degree programs in Global Health. Future studies are already underway using an online questionnaire to capture faculty perspectives from a range of institutions.

# Background The field of global health has traditionally been taught at the graduate level, but there are a small number of undergraduate level global health programs in the U.S. The development of undergraduate global health programs poses important questions for program administrators in terms of developing competencies and navigating overlap between undergraduate and graduate programs. Specifically, which competencies should undergraduate students be expected to master and how do these intersect with those of graduate programs? # Methods Faculty at a university in the Mid-Atlantic region of the U.S. were invited to participate in an in-depth interview about course content and their expectations for undergraduate students in global health programs. Interviews covered courses they teach (e.g., prerequisites, readings, course competencies) and competencies relevant at the undergraduate level. A total of 7 faculty members were interviewed. Interviews were recorded and transcribed in Microsoft Word (Microsoft Inc, Seattle, WA, USA), and then analyzed for common themes. # Results Interview responses indicate diverse discipline-specific approaches in undergraduate global health courses. When asked to articulate what they expect undergraduate students to learn from global health courses, participants noted that basic concepts can serve as a foundation for further studies or work experiences. Some participants noted that undergraduate global health programs should provide a foundation, but expected students to continue their global health education. Others thought employment opportunities should be achievable with an undergraduate degree in Global Health. There is consensus that, independent of discipline, field-based practicum opportunities are recommended to apply classroom concepts in real-world settings. # Conclusions These findings present faculty perspectives on undergraduate global health programs, expectations of students, and core competencies. A salient challenge for course instructors is to identify where undergraduate curriculum should end and graduate curriculum should begin. Future research should expand to institutions with established undergraduate and graduate degree programs in Global Health. Future studies are already underway using an online questionnaire to capture faculty perspectives from a range of institutions.