Support for global health and pandemic preparedness in medical education in Germany: Students as change agents

Perception and reaction of undergraduate critical disability studies students to six short films depicting neuro-advancements

Advancements in neurosciences and neurotechnologies pose various ethical and social challenges, warranting public/stakeholder engagement. Art, such as short films, can expose audiences to the social aspects of neuro-advancements. The 2019 BIO·FICTION Film Festival, for instance, examined how neurotechnologies shape society, the human body, and mind. Students are one important group of stakeholders, as they are expected to be critical thinkers and change agents. The lived reality of disabled people is impacted by neuro-advancements in many ways. Critical disability studies students are therefore key stakeholders, as their programs and courses encourage them to identify and address social challenges faced by disabled individuals. Therefore, they need to be able to evaluate the social impacts of neuro-advancements. Few studies exist that ascertain the views of critical disability studies students on the social impact of neuro-advancements. Our study sought to amplify the voices of critical disability studies students by analyzing the responses of 89 undergraduates from three courses to six top films from the BIO·FICTION festival. Conducted asynchronously due to COVID restrictions, students watched the films independently and responded to four guiding questions about: a) general thoughts about the films, b) their perceived impact on those watching, c) implications for their anticipated careers involving disabled people, and d) the social impact of neuro-advancements on disabled people. Our findings indicated that the topical (non-)fictional short films effectively prompted students to reflect on the social aspects of neuro-advancements and were well received. However, responses also indicated a need for follow-up discussions - virtual or in-person - to address questions about film content and deepen the discussion and class engagement. Such discussion setups could also inform film festivals aiming to raise awareness about the societal implications of emerging technologies.

Germany's role in global health at a critical juncture

In 2017, we set out-along with a larger group of authors-to assess Germany's contribution and potential leadership role in global health. We considered the ambitions and manifold efforts of Chancellor Angela Merkel's administration to become a trusted leader in global health governance and a reliable supporter of multilateral institutions, especially WHO. Based on the recommendations of our 2017 paper, in this Review we determine whether the country has indeed lived up to its vision and ambitions expressed in the Global Health Strategy adopted by the cabinet in 2020. Also, we outline what challenges Germany is now facing in a more complex global health environment and geopolitical situation, where leadership in the field is being redefined following the impact of the COVID-19 pandemic and amid broader shifts in the international order.

Psychological distress among healthcare professionals in Mbarara, following the 2022 Ebola Virus Disease outbreak in Uganda: a mixed methods study

BACKGROUND

The 2022 Ebola Virus Disease (EVD) outbreak occurred at a time when Uganda was still battling the social and psychological challenges of the COVID-19 pandemic; placing health care professionals (HCPs) at a much higher risk of developing psychological distress. Psychological distress among HCPs can cause decreased workplace productivity and ineffective management of their patients. The current study aimed to investigate and understand psychological distress among HCPS in Mbarara city in Southwestern Uganda following the 2022 EVD outbreak.

METHOD

We enrolled 200 HCPs through convenient sampling from one private and one public health facility in Mbarara city in Southwestern Uganda, in a cross-sectional convergent parallel mixed method approach where qualitative and quantitative data were collected concurrently. Quantitative data, utilizing the Kessler Psychological Distress (K10) Scale, provided us with a quantitative measure of the prevalence of psychological distress among HCPs, and were analyzed using STATA version 16. Qualitative data, on the other hand, offered deeper insights into the nature, perceptions, and contextual factors influencing this distress, and were analyzed using emergent theme analysis.

RESULTS

The prevalence of psychological distress was 59.5% and it was higher among females (63.9%) compared to males (36.1%). HCPs vividly expressed distress and anxiety, with heightened suspicion that every patient might be an EVD carrier, creating a pervasive sense of unsafety in the workplace. However, the outbreak had an educational affect where concerns about the announcement of another EVD outbreak were diverse, with HCPs expressing anxiety, despair, and dissatisfaction with the country's management of potential outbreaks.

CONCLUSION

High levels of psychological distress were experienced by HCPs in Southwestern Uganda as a result of the 2022 EVD pandemic. HCPs express a wide range of feelings, such as dread, anxiety, despair, pessimism, and discontent with the way the outbreaks are handled throughout the nation. We recommend implementation of comprehensive psychosocial support programs tailored to the unique needs of HCPs, including counseling services, stress management workshops, and peer support networks.

Mentoring & support practices for final year medical students during a pandemic - 'The covid doctors'

BACKGROUND

Transition from final-year medical student to newly graduated doctor is challenging with evidence of associated increased patient mortality and medical errors. Previous work suggests tackling preparedness alone does not 'solve' this transition. The current focus on mentoring and support provision during this period and is an under-researched area. The COVID-19 pandemic represents a unique disruptive critical incident in which to examine mentoring and support practices, exposing strengths and weaknesses. The perspectives of this cohort and their implications remains an under-researched area.

METHODS

Individual semi-structured interviews were conducted with nine graduate-entry final-year medical students. An inductive latent phenomenological approach explored individual experiences of mentoring and support practices during final-year and transition to professional practice.

RESULTS

Three major themes emerged: 1) Mentoring & Support; 2) Clinical Exposure; 3) Graduation & Transition. A journey metaphor was used to aid the description of participants' lived experience of mentoring and support practices during their final year. Final year medical students (FYMs) felt under-supported and found practices inadequate. Reduced clinical exposure yielded unpreparedness and regression, potentially impacting future careers. Positive experiences were variable and unstructured. 'The COVID Doctors', subtheme provided rich insights into shared narratives and identities amongst participants.

CONCLUSIONS

This study provides qualitative evidence for perceived inadequate mentoring and support provision for final year medical students at transition during a critical incident (the COVID-19 pandemic). Several themes using the metaphor of a journey explore the lived experience of this unique cohort determining their perceptions on the delivery of their medical education and their identity as 'covid doctors'. There are several implications for this study in a post-pandemic era and for pandemic-preparedness, both rapidly growing areas of research in medical education. Recommendations include updating contingency plans, balancing clinical exposure with patient safety issues, and providing support to 'bottom-up' mentoring practices.

Global child health in higher education in Germany: a mixed-methods study

Background

Germany has an ambitious global health strategy, yet its universities provide few opportunities for global child health researchers. Improved understanding of the reasons and the academic role of global child health is needed.

Objective

The objective of this study is to offer insights into Germany’s academic global child health landscape by describing the actors and their priorities in research and education and by analysing perceived barriers and opportunities.

Methods

We used a sequential exploratory mixed-method design. Participants were selected purposively to represent German global child health academics. Information was gathered first from a 33-item online survey and from interviews conducted four to six months post-survey. Surveys were analysed descriptively. A joint thematic approach using content analysis was used to analyse interview transcripts.

Results

Four categories emerged: training and professional orientation; professional realities; representation and advocacy, and barriers. Of the 20 survey participants (median [IQR] age 55 years [17], five female), seven agreed to be interviewed. Research experiences abroad shaped individuals’ career choices in global child health. They engaged in global child health education, primary health care and access to health services, frequently in clinical and humanitarian settings, but spent little time on global child health-related activities. Participants were active and valued in international networks and keen to extend their activities. Yet they felt under-represented academically and reported multiple structural and individual barriers in Germany. They perceived a lack of leadership positions, career paths, funding opportunities, and institutional and project support which limits academic advancement.

Conclusions

Germany’s global child health experts are motivated to engage with global child health-related topics but face difficulties in advancing academically. Academic actors may need to intensify research and training efforts in order to expand global child health’s scientific base in Germany.