Virtual global health through longitudinal case-based rounds.

Abstract

The COVID-19 pandemic rapidly transferred medical education curricula to online platforms. Due to travel bans, students were cut off from traditional global health experiences. This project was developed to confront the travel restrictions, time restraints and cost barriers associated with global health during the pandemic. Now, with fewer travel restrictions, this programme continues to offer learning opportunities: it could be extended to practice medical language proficiency in non-English speaking countries, compliment in-person experiences and increase the sustainability of global health programs. We provided American and Tanzanian students with a longitudinal, global health experience through an interactive, online collaboration. The cohort engaged in bi-weekly meetings using live video conferencing. During the 3-hour calls, students presented and discussed de-identified patient-cases representative of cases seen in outpatient primary care clinics at their home institutions. Additionally, follow-up reports from previous cases were presented to incorporate an element of longitudinal care. Six medical students from an urban hospital in the United States (USA) and physician-assistant students from a rural Tanzanian hospital were led by an attending physician in their respective countries. The pilot program's efficacy was assessed through anonymously reviewed qualitative surveys at its initiation in December 2021, midpoint, and conclusion in April 2022. Student testimonies from the US cohort were acquired before and after the study using a Likert scale to determine student growth, global health interest and clinical skill acquisition. Although analysis was limited by the cohort's size, students indicated an increase in self-reported global health experiences, knowledge of health care limitations and benefits in resource-limited countries, primary care patient presentations proficiency and a decrease in student burnout. We have demonstrated the ability to deploy a virtual global health experience for medical students. This program is unique in its bi-directionality: students and attending physicians from two continents directly communicated and discussed cases, as opposed to traditional lecture-based global health courses. Along with the increased exposure to primary care cases, students expressed a sense of community and mentorship in these cohorts, as upper-class students provided points of guidance to students in their first and second years of training. To increase student interaction between countries and sense of community during the 6-month course, we implemented a brief introduction into each class called ‘About Me.’ Each week, two students would present a 5-minute talk describing their personal goals, hobbies and background to the group. Students experienced cultural variations in medical practice, as they were introduced to country-specific pathologies and guided through each country's approach to providing a diagnosis and treatment plans. Occasionally, there would be differences and innovations that justified additional discussion. At the end of classes, we allowed time for a student to briefly present a topic of their choosing discussed during the previous week. This program also lends itself to annual continuation, as students strengthen their bond with their international counterparts and naturally progress from inexperienced mentees to experienced mentors in the context of global health. The authors meet conditions 1, 2, 3 and 4. All authors have given final approval of the paper.