Global Health Rotations Research Articles

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences

BackgroundGlobalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, and self-development; influence career objectives; and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship. ObjectiveWe conducted a qualitative assessment of trainee-reported critical incidents to more deeply understand the impact of our global health experience on trainees. MethodsA cross-sectional survey was administered to trainees who had participated in a 2-month elective in Kenya from January 1989 to May 2013. We report the results of a qualitative assessment of the critical incident reflections participants (n = 137) entered in response to the prompt, “Write about one of your most memorable experiences and explain why you chose to describe this particular one.” Qualitative analyses were conducted using thematic analysis and crystallization immersion analytic methods based on the principles of grounded theory, employing a constructivists' research paradigm. FindingsFour major themes emerged. These themes were Opening Oneself to a Broader World View; Impact of Suffering and Death; Life-Changing Experiences; and Commitment to Care for the Medically Underserved. ConclusionsCircumstances that learners encounter in the resource-scarce environment in Kenya are eye-opening and life-changing. When exposed to these frame-shifting circumstances, students elaborate on or transform existing points of view. These emotionally disruptive experiences in an international health setting allowed students to enter a transformational learning process with a global mind. Students can see the world as an interdependent society and develop the capacity to advance both their enlightened self-interest and the interest of people elsewhere in the world as they mature as global citizens. Medical schools are encouraged to foster these experiences by finding ways to integrate them into curriculum.

Miles Away Milestones: A Framework for Assessment of Pediatric Residents During Global Health Rotations

Miles Away Milestones: A Framework for Assessment of Pediatric Residents During Global Health Rotations

Beyond the learning curve: length of global health electives.

Beyond the learning curve: length of global health electives.

Exploring the psychological effects of global health rotations on first year medical students through the analysis of student reflection.

Exploring the psychological effects of global health rotations on first year medical students through the analysis of student reflection.

Activated learning; providing structure in global health education at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA)- a pilot study.

BackgroundGlobal health rotations are increasingly popular amongst medical students. The training abroad is highly variable and there is a recognized need for global health curriculum development. We sought to create and evaluate a curriculum, applicable to any global health rotation, that requires students to take an active role in their education and promotes engagement.MethodsProspective, observational, mixed method study of 4th year medical students enrolled in global health courses at UCLA in 2011–12. Course directors identified 4 topics common to all rotations (traditional medicine, health systems, limited resources, pathology) and developed activities for students to complete abroad: observation, interview and reflection on resources, pathology, medical practices; and compare/contrast their experience with the US healthcare system. Students posted responses on a discussion board moderated by US faculty. After the rotation, students completed an anonymous internet-based evaluative survey. Responses were tabulated. Qualitative data from discussion board postings and free response survey items were analyzed using the framework method.Results14 (100 %) students completed the Activated Learning assignment. 12 submitted the post rotation survey (85.7 %). Activated Learning enhanced GH education for 67 % and facilitated engagement in the local medical culture for 67 %. Qualitative analysis of discussion board posting demonstrated multiple areas of knowledge gain and analysis of free response survey items revealed 5 major themes supporting Activated Learning: guided learning, stimulation of discussion, shared interactions, cultural understanding, and knowledge of global healthcare systems. Increased interactivity emerged as the major theme for future improvement.ConclusionThe results of this study suggest that an Activated Learning program may enhance education, standardize curricular objectives across multiple sites and promote engagement in local medical culture, pathology and delivery systems. Increased interaction between students and faculty may augment the impact of such a program.

Making Global Health Rotations a Two-Way Street: A Model for Hosting International Residents.

As US residency programs are increasingly offering global health electives for their trainees, there is a growing call for these opportunities to include bidirectional exchanges—where residents from both the US and international partner institutions rotate at the other’s site. Curricular, logistical, and funding challenges of hosting residents from an international site may be barriers to developing these programs. In this report, the authors describe an 8-year experience of a US institution hosting residents from a resource-limited international partner and provide a framework for others institutions to develop bidirectional exchanges. They also report the visiting international residents’ perceptions of the impact of the exchange on their clinical practice, teaching, career paths, and their home institution.

Novel use of a medical database smart phone application improves clinical learning experience during a global health rotation in Tena, Ecuador

Novel use of a medical database smart phone application improves clinical learning experience during a global health rotation in Tena, Ecuador

Global health preparation and reentry modules: An innovative, interactive, online, open-access, modular curriculum for global health rotations and projects

Global health preparation and reentry modules: An innovative, interactive, online, open-access, modular curriculum for global health rotations and projects

Global Health Telemedicine Conferences: The System We Save May Be Our Own.

Global Health Telemedicine Conferences: The System We Save May Be Our Own.

Simulation Use for Global Away Rotations (SUGAR): Preparing Residents for Emotional Challenges Abroad—A Multicenter Study

BackgroundPreparation for residents participating in global health (GH) experiences is critical. Active preparatory curricula allowing residents to experience and debrief emotional challenges they may encounter abroad are generally lacking. We sought to evaluate a novel simulation curriculum designed to prepare residents for emotions they may experience in response to challenges abroad. MethodsPediatric GH educators from 7 institutions developed case vignettes incorporating common challenges residents experience abroad. Residents participating in a GH training track or planning to participate in a GH rotation from the 7 institutions were eligible to participate in the simulation curriculum. Participants and trained facilitators completed postsimulation evaluations that were analyzed using descriptive statistics and thematic analysis of written comments to assess the utility of the curriculum, emotions evoked, and changes residents anticipated making to their GH rotation preparation. ResultsFifty-one residents and 16 facilitators completed 160 and 52 evaluations, respectively. Overall, respondents found the simulations useful (mean [SD] resident score 4.49 [0.82] and facilitator score 4.85 [0.36] on a 5-point scale [1 = completely useless, 5 = very useful]). Residents reported strong emotions in 153 (98%) of 156 comments. After the sessions, 131 (96%) of 137 comments reflected anticipated changes to GH rotation preparation plans. ConclusionsActive preparation for GH rotations using simulated cases appears to be a useful tool that can be implemented across a variety of sites with minimal facilitator training or simulation experience. The curriculum successfully elicited powerful emotions in residents and provided an opportunity to debrief these experiences before encountering them abroad.

Teaching global mental health at home and abroad

Although much has been published in the USA, and elsewhere, about global health rotations for medical students, including consensus guidelines, 1 A collaboration of AMSAGHECIFMSA-USAR4WHDeveloping Global Health Curricula: a guidebook for US medical schools, 2006. http://goo.gl/VXtgzB Google Scholar few papers have addressed global mental health education, and those that do focus largely on post-graduate training. 2 Marienfeld C Rohrbaugh RM Impact of a global mental health program on a residency training program. Acad Psychiatry. 2013; 37: 276-280 Crossref PubMed Scopus (8) Google Scholar , 3 Van Dyke C Tong L MacK K Global mental health training for United States psychiatric residents. Acad Psychiatry. 2011; 35: 354-359 Crossref PubMed Scopus (14) Google Scholar This Comment examines the lessons learned from present global health training models and recommends ways to improve educational experiences about global mental health.

Guidelines for Safety of Trainees Rotating Abroad: Consensus Recommendations from the Global Emergency Medicine Academy of the Society for Academic Emergency Medicine, Council of Emergency Medicine Residency Directors, and the Emergency Medicine Residents' Association

The goal of a global health elective is for residents and medical students to have safe, structured, and highly educational experiences. In this article, the authors have laid out considerations for establishing a safe clinical site; ensuring a traveler's personal safety, health, and wellness; and mitigating risk during a global health rotation. Adequate oversight, appropriate mentorship, and a well-defined safety and security plan are all critical elements to a successful and safe experience.

A Pilot Study of Real-Time Experience Sampling Method to Evaluate Student Engagement in a Global Health Rotation

International experiences are increasingly popular among medical students, but few have been rigorously evaluated. We used ESM to characterize the experience of medical students participating in the one-month University of Chicago Geographic Medicine Scholars Program (GMSP) in Hyderabad, India. Participants wore watches programmed to randomly beep eight times daily, during the first and third weeks. When alerted, students reported their activity and rated their level of engagement and emotion in booklets. All 11 student participants responded to 59% of 816 alerts. 41% of beeps occurred during GMSP formal structured activities (i.e., lecture, clinic). Students reported structured activities to be more interesting (6.05 versus 4.14;P<0.001), more important to their future goals (6.48 versus 5.71;P<0.001), more challenging (3.75 versus 2.48;P<0.001), and more enjoyable (6.08 versus 5.36;P<0.001) than unstructured activities. Our results show that future global health efforts should augment the use of structured activities.