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Fülbert H, Schäfer LN, Gerspacher LM, Bösner S, Schut C, Krolewski R, Knipper M. Elective course "Climate-sensitive health counselling" - prevention as an opportunity for people and planet? An interactive, student-led project focusing on prevention and agency in physician's climate communication. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc34. [PMID: 37377566 PMCID: PMC10291343 DOI: 10.3205/zma001616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 12/15/2022] [Accepted: 02/06/2023] [Indexed: 06/29/2023]
Abstract
Objective According to the WHO, anthropogenic climate change poses the greatest threat to human health in the 21st century. However, the link between climate change and human health is not an integral part of medical education in Germany. Within a student-led project, an elective clinical course was designed and successfully implemented, which has been made accessible to undergraduate medical students at the Universities of Giessen and Marburg. The implementation and didactic concept are explained in this article. Methodology In a participatory format, knowledge is imparted using an action-based, transformative approach. Topics discussed are, amongst others, interactions of climate change and health, transformative action, and health behavior, as well as "green hospital" and the simulation of a "climate-sensitive health counselling". Lecturers from different disciplines within and beyond medicine are invited as speakers. Results Overall, the elective was evaluated positively by the participants. The fact that there is a high demand among students for participation in the elective, as well as for the transfer of concepts underlines the need for including this topic into medical education. The implementation and further development of the concept at two universities with different study regulations demonstrates its adaptability. Conclusion Medical education can raise awareness of the multiple health consequences of the climate crisis, can have a sensitizing and transformative effect on various levels, and can promote climate-sensitive action ability in patient care. In the long term, however, these positive consequences can only be guaranteed by including mandatory education on climate change and health in medical curricula.
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Affiliation(s)
- Hannah Fülbert
- Justus Liebig University Giessen, Medical Faculty, Giessen, Germany
- Health for Future Giessen, Giessen, Germany
| | - Louis N. Schäfer
- Philipps University Marburg, Medical Faculty, Marburg, Germany
- Health for Future Marburg, Marburg, Germany
| | - Laura M. Gerspacher
- Justus Liebig University Giessen, Medical Faculty, Giessen, Germany
- Health for Future Giessen, Giessen, Germany
| | - Stefan Bösner
- Philipps University Marburg, Department of General Practice/Family Medicine, Marburg, Germany
| | - Christina Schut
- Justus Liebig University Giessen, Institute of Medical Psychology, Giessen, Germany
| | - Ralph Krolewski
- Academic teaching practice of the University of Cologne, Gummersbach, Germany
| | - Michael Knipper
- Justus Liebig University Giessen, Institute for History of Medicine, Giessen, Germany
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Kutalek R, Lahlal M, Kaawa-Mafigiri D, Ryan-Coker M, Böll S, Parisi S, Cheah PY, Pritsch M. Putting global health high on the agenda of medical schools. Wien Med Wochenschr 2022; 173:131-137. [PMID: 36229742 PMCID: PMC9559117 DOI: 10.1007/s10354-022-00974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022]
Abstract
In this opinion paper, we reflect on global health and global health education as well as challenges that the coming generation are likely to face. As the field is rapidly changing, it is vital to critically reflect categories of “global south” and “global north” as geographical boundaries, and rather think in terms of inequalities that are present in all countries. Global perspectives on health are useful to analyze structural challenges faced in all health care systems and help understand the diversity of cultures and patients’ concepts of disease. We first discuss burning questions and important challenges in the field and how those challenges are tackled. Rather than going into detail on topical issues, we reflect on approaches and attitudes that we think are important in global health education and present opportunities and challenges for young scholars who are interested in working in this field.
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Affiliation(s)
- Ruth Kutalek
- Medical University of Vienna, Department of Social and Preventive Medicine, Unit Medical Anthropology and Global Health, Kinderspitalgasse 15, 1090, Vienna, Austria.
| | - Mina Lahlal
- Department of Trauma Surgery, Wilhelminenspital, Vienna, Austria
| | - David Kaawa-Mafigiri
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Marcella Ryan-Coker
- Department of Surgery, University of Nairobi, Nairobi, Kenya.,College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Simone Böll
- Medical University of Vienna, Department of Social and Preventive Medicine, Unit Medical Anthropology and Global Health, Kinderspitalgasse 15, 1090, Vienna, Austria.,Department of Dermatology, Inselspital, Bern, Switzerland
| | - Sandra Parisi
- Department for General Practice, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
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3
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Wu A, Maddula V, Singh J, Sagoo MG, Chien CL, Wingate R, Kielstein H, Traxler H, Brassett C, Waschke J, Vielmuth F, Sakurai T, Zeroual M, Olsen J, El-Batti S, Viranta-Kovanen S, Kitahara S, Keay K, Kunzel C, Bernd P, Noël GPJC. Alternatives to Student Outbound Mobility-Improving Students' Cultural Competency Skills Online to Improve Global Health Without Travel. MEDICAL SCIENCE EDUCATOR 2021; 31:1441-1451. [PMID: 34123512 PMCID: PMC8184130 DOI: 10.1007/s40670-021-01332-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 06/12/2023]
Abstract
Introduction Student outbound mobility is a major element in internationalization of medical education and global health education. However, this approach is often criticized, as it is inherently inequitable. Internationalization at home is a newer concept that aims to provide students with international skills and experiences without exchange travel. We report detailed outcomes of an international online program during the COVID-19 pandemic, which aimed to include acquisition of cultural awareness and competency-similar to what the students would have obtained if they had travelled abroad. Method Sixty-eight students from 12 international universities participated in international small peer group collaborative work, and online networking. Perceived improvement of cultural competency using Likert scale and open-ended questions was used as a measure of success. Furthermore, students' definition of cultural competency in the different countries was obtained. Results Students improved their cultural competency skills. Data analysis supported statistically significant improvement of the above skills after the program, in comparison to the start of the program. Discussion Internationalization of medical education can be achieved at home-via structured online peer exchanges-and can provide students with intercultural skills and networking opportunities that are typically achieved via international in-person travel. The above represents a socially just and equitable way to reach all students and can result in improvement of their cultural competency, preparing them for their work in global health, and thereby resulting in improvement of global health. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-021-01332-9.
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Affiliation(s)
- Anette Wu
- Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
| | - Vinay Maddula
- College of Dental Medicine, Columbia University, New York, NY USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Kevin Keay
- The University of Sydney, Sydney, Australia
| | - Carol Kunzel
- College of Dental Medicine, Columbia University, New York, NY USA
| | - Paulette Bernd
- Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
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4
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Khoza-Shangase K, Moroe N, Neille J. Speech-Language Pathology and Audiology in South Africa: Clinical Training and Service in the Era of COVID-19. Int J Telerehabil 2021; 13:e6376. [PMID: 34345349 PMCID: PMC8287713 DOI: 10.5195/ijt.2021.6376] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION AND PURPOSE The novel coronavirus (COVID-19) presented new and unanticipated challenges to the provision of clinical services, from student training to the care of patients with speech-language and hearing (SLH) disorders. Prompt changes in information and communication technologies (ICT), were required to ensure that clinical training continued to meet the Health Professions Council of South Africa's regulations and patients received effective clinical care. The purpose of this study was to investigate online clinical training and supervision to inform current and future training and clinical care provision in SLH professions. METHODOLOGY A scoping review was conducted using the Arksey and O'Malley (2005) framework. The electronic bibliographic databases Science Direct, PubMed, Scopus, MEDLINE, and ProQuest were searched to identify publications about online clinical training and supervision and their impact on clinical service during COVID-19. Selection and analysis were performed by three independent reviewers using pretested forms. RESULTS AND CONCLUSIONS The findings revealed important benefits of teletraining and telepractice with potential application to South African clinical training and service provision. Five themes emerged: (1) practice produces favorable outcomes, (2) appreciation for hybrid models of training and service delivery, (3) cost effectiveness is a "big win" (4) internationalization of remote clinical training and service provision, and (5) comparable modality outcomes. These findings may have significant implications for teletraining and telepractice in low-and-middle income countries (LMICs) in the COVID-19 era and beyond, wherein demand versus capacity challenges (e.g., in human resources) persist. Current findings highlight the need for SLH training programmes to foster a hybrid clinical training model. Few studies were conducted in LMICs, indicating a gap in such research.
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Affiliation(s)
- Katijah Khoza-Shangase
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Nomfundo Moroe
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne Neille
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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5
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Kreitlow A, Steffens S, Jablonka A, Kuhlmann E. Support for global health and pandemic preparedness in medical education in Germany: Students as change agents. Int J Health Plann Manage 2021; 36:112-123. [PMID: 33704858 PMCID: PMC8207038 DOI: 10.1002/hpm.3143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/24/2021] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
The COVID‐19 pandemic has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the drivers for change. Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hanover Medical School, March/April 2020. Target groups were undergraduate medical students (n = 384) and additionally lecturers (n = 172), and finally new multiprofessional teaching courses initiated by students and developed collaboratively. The results reveal only slow pace of change on the level of the education system, while demand for global health education has increased markedly in all actor groups, but strongest in the group of students in the preclinical phase. Implementation of global health programmes illustrates how students can become change agents and enhance institutional innovation bottom‐up. However, in order to achieve wider transformative potential, these efforts must be flanked by macro‐level policy changes and integrated in future pandemic preparedness strategies.
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Affiliation(s)
- Annika Kreitlow
- Globalisation and Health Initiative, bvmd - German Medical Students' Association, Berlin, Germany.,Dean's Office, Hannover Medical School, Hannover, Germany
| | | | - Alexandra Jablonka
- Clinic for Rheumatology and Clinical Immunology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research, Hannover, Germany
| | - Ellen Kuhlmann
- Dean's Office, Hannover Medical School, Hannover, Germany.,Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
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6
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Schuster A, Anton N, Grosse P, Heintze C. Is time running out? The urgent need for appropriate global health curricula in Germany. BMJ Glob Health 2020; 5:bmjgh-2020-003362. [PMID: 33214175 PMCID: PMC7678235 DOI: 10.1136/bmjgh-2020-003362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 12/27/2022] Open
Abstract
Recently, representatives of politics, health officials and academia in Germany have advocated a greater role for Germany in matters concerning global health. However, health professionals in Germany are rarely taught about global health topics and accordingly real expertise in this field is lacking. To advance knowledge and competencies at German universities and adequately equip health professionals to achieve Germany’s political goals, global health curricula must be developed at medical schools and other institutions. Such ambitions raise questions about the required content and dimensions of global health curricula as the field is currently highly heterogeneous and ill defined. To systematically identify strengths and shortcomings of current curricula, we scrutinised the global health curriculum at our institution, Charité—Universitätsmedizin Berlin, using an analytical framework that integrates the various approaches of global health. Our analysis identified that four (technical, social justice, security and humanitarian) of five approaches are present in our core global health curriculum. Local and global aspects of the field are equally represented. We propose that the use of such a structured analytical framework can support the development of GH curricula for all health professionals—in Germany and elsewhere. But it can also help to evaluate existing curricula like ours at Charité. This framework has the potential to support the design of comprehensive GH trainings, serving German aspirations in politics and academia to promote health worldwide.
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Affiliation(s)
- Angela Schuster
- Insitute of General Practice, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Nora Anton
- Charité Global Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Pascal Grosse
- Dean of education office, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Christoph Heintze
- Insitute of General Practice, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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7
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Wu A, Noël GPJC, Wingate R, Kielstein H, Sakurai T, Viranta-Kovanen S, Chien CL, Traxler H, Waschke J, Vielmuth F, Sagoo MG, Kitahara S, Kato Y, Keay KA, Olsen J, Bernd P. An International Partnership of 12 Anatomy Departments - Improving Global Health through Internationalization of Medical Education. Ann Glob Health 2020; 86:27. [PMID: 32166068 PMCID: PMC7059426 DOI: 10.5334/aogh.2665] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background At a time of global interconnectedness, the internationalization of medical education has become important. Anatomy as an academic discipline, with its close connections to the basic sciences and to medical education, can easily be connected with global health and internationalization of medical education. Here the authors present an international program based on a partnership between twelve anatomy departments in ten countries, on four continents. Details of a proposed plan for the future direction of the program are also discussed. Objective The aim is to improve global healthcare by preparing future global healthcare leaders via early international networking, international collaboration and exchange, intercultural experience, and connecting two seemingly distant academic disciplines - anatomy and global health - via internationalization of medical education. Methods Based in the anatomy course, the program involved early international collaboration between preclinical medical and dental students. The program provided a stepwise progression for learning about healthcare and intercultural topics beyond pure anatomy education - starting with virtual small groups of international students, who subsequently presented their work to a larger international audience during group videoconferences. The above progressed to in-person visits for research internships in the basic sciences within industrialized countries. Findings Students appreciated the international and intercultural interaction, learned about areas outside the scope of anatomy (e.g., differences in healthcare education and delivery systems, Public and Global Health challenges, health ethics, and cultural enrichment), and valued the exchange travel for basic sciences research internships and cultural experience. Conclusions This unique collaboration of international anatomy departments can represent a new role for the medical anatomy course beyond pure anatomy teaching - involving areas of global health and internationalization of medical education - and could mark a new era of international collaboration among anatomists.
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Affiliation(s)
- Anette Wu
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, US
| | | | | | - Heike Kielstein
- Institute for Anatomy and Cell Biology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), DE
| | - Takeshi Sakurai
- Medical Innovation Center of Kyoto University, Graduate School of Medicine, Kyoto, JP
| | | | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, TW
| | - Hannes Traxler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, AT
| | - Jens Waschke
- Institute of Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, DE
| | - Franziska Vielmuth
- Institute of Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, DE
| | | | - Shuji Kitahara
- Department of Anatomy, Tokyo Women’s Medical University, Tokyo, JP
| | - Yojiro Kato
- Department of Surgery, Kidney Center, Tokyo Women’s Medical University, Tokyo, JP
| | - Kevin A. Keay
- Discipline of Anatomy and Histology, University of Sydney, Sydney, AU
| | - Jørgen Olsen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, DK
| | - Paulette Bernd
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, US
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8
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Deliz JR, Fears FF, Jones KE, Tobat J, Char D, Ross WR. Cultural Competency Interventions During Medical School: a Scoping Review and Narrative Synthesis. J Gen Intern Med 2020; 35:568-577. [PMID: 31705475 PMCID: PMC7018865 DOI: 10.1007/s11606-019-05417-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/15/2019] [Accepted: 09/16/2019] [Indexed: 02/04/2023]
Abstract
Many medical accreditation bodies agree that medical students should be trained to care for diverse patient populations. However, the teaching methods that medical schools employ to accomplish this goal vary widely. The purpose of this work is to summarize current cultural competency teaching for medical students and their evaluation methods. A scoping review was completed by searching the databases PubMed, Scopus, MedEdPORTAL, and MEDLINE for the search terms "medical education" and "cultural competency" or "cultural competence." Results were summarized using a narrative synthesis technique. One hundred fifty-four articles on cultural competency interventions for medical students were systematically identified from the literature and categorized by teaching methods, length of intervention, and content. Fifty-six articles had a general focus, and ninety-eight articles were focused on specific populations including race/ethnicity, global health, socioeconomic status, language, immigration status, disability, spirituality at the end of life, rurality, and lesbian, gay, bisexual, transgender, and queer. About 54% of interventions used lectures as a teaching modality, 45% of the interventions described were mandatory, and 9.7% of interventions were not formally evaluated. The authors advocate for expansion and more rigorous analysis of teaching methods, teaching philosophies, and outcome evaluations with randomized controlled trials that compare the relative effectiveness of general and population-specific cultural competency interventions.
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Affiliation(s)
- Juan R Deliz
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA.
| | - Fayola F Fears
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA
| | - Kai E Jones
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA
| | - Jenny Tobat
- Washington University School of Medicine, 660 S Euclid Ave, CB 8126, St. Louis, MO, 63110, USA
| | - Douglas Char
- Department of Emergency Medicine, Washington University School of Medicine, Campus Box 8072, 660 South Euclid Ave, St. Louis, MO, USA
| | - Will R Ross
- Division of Nephrology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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9
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Wu A, Kielstein H, Sakurai T, Noel G, Viranta-Kovanen S, Chien CL, Bernd P. Internationalization of Medical Education-Building a Program to Prepare Future Leaders in Healthcare. MEDICAL SCIENCE EDUCATOR 2019; 29:535-547. [PMID: 34457511 PMCID: PMC8368475 DOI: 10.1007/s40670-019-00695-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In a globally interconnected world, internationalization of medical education has become increasingly important. While many programs focus on international programs for clinical students, the number of programs for preclinical medical and dental students is small. Based in the Anatomy course, the program presented here involves early international collaborations between preclinical students from six countries. Our work involves small-group video sessions and a large international student videoconference (including cultural and didactic components). The online connections progress with in-person basic sciences summer internships undertaken at the international partner institutions. This collaborative program features unique elements that facilitate cultural exchange and help develop leadership skills in healthcare early in a student's career. We present recommendations for international program implementation.
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Affiliation(s)
- Anette Wu
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
| | - Heike Kielstein
- Department of Anatomy and Cell Biology, Medical Faculty, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06108 Halle (Saale), Germany
| | - Takeshi Sakurai
- Department of Drug Discovery Medicine, Medical Innovation Center, Kyoto University Graduate School of Medicine, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Geoffroy Noel
- Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, Canada
| | - Suvi Viranta-Kovanen
- Department of Anatomy, School of Medicine, University of Helsinki, Helsinki, Finland
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Paulette Bernd
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
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10
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Hommes F, Drees S, Geffert K, von Philipsborn P, Stratil JM. Representation of social determinants of health in German medical education: protocol of a content analysis study. BMJ Open 2018; 8:e020696. [PMID: 30121594 PMCID: PMC6104802 DOI: 10.1136/bmjopen-2017-020696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/09/2018] [Accepted: 05/21/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Action on the social determinants of health has been key for improving health and prolonging life in the past, and remains so today. Against this background, WHO's Commission on Social Determinants of Health has called for increased efforts to create health workforces trained in recognising, understanding and acting on the social determinants of health. However, little is known about the extent to which current medical education systems prepare graduates for this challenge. We, therefore, aim to analyse the extent to which the medical curriculum in Germany incorporates content on the social determinants of health. METHODS AND ANALYSIS We will conduct a qualitative and quantitative content analysis of four key document groups which influence medical education in Germany: the national medical catalogue of learning objectives; examination content outlines provided by the German Institute for Medical and Pharmaceutical Examination Questions; the online textbook most widely used for final examination preparation and the full set of questions from two national medical licensing examinations. We will analyse these documents based on a coding system, which we derived deductively from the report of WHO's Commission on Social Determinants of Health as well as other key publications of WHO. We will report quantitative indicators, such as the percentage of text related to social determinants of health for each document type. Moreover, we will conduct a semiqualitative analysis of relevant content. ETHICS AND DISSEMINATION This study is based on the analysis of existing documents which do not contain personal or otherwise sensitive information. Results from the study will be published in a scientific peer-reviewed journal.
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Affiliation(s)
| | - Simon Drees
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Karin Geffert
- Medical Faculty, Julius-Maximilians Universität Würzburg, Würzburg, Germany
| | - Peter von Philipsborn
- Institute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Muenchen, Germany
| | - Jan M Stratil
- Institute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Muenchen, Germany
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11
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Mews C, Schuster S, Vajda C, Lindtner-Rudolph H, Schmidt LE, Bösner S, Güzelsoy L, Kressing F, Hallal H, Peters T, Gestmann M, Hempel L, Grützmann T, Sievers E, Knipper M. Cultural Competence and Global Health: Perspectives for Medical Education - Position paper of the GMA Committee on Cultural Competence and Global Health. GMS JOURNAL FOR MEDICAL EDUCATION 2018; 35:Doc28. [PMID: 30186938 PMCID: PMC6120152 DOI: 10.3205/zma001174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/01/2018] [Accepted: 06/11/2018] [Indexed: 05/11/2023]
Abstract
Introduction: Routine medical care in Germany, Austria and Switzerland is being increasingly impacted by the cultural and linguistic diversity of an ever more complex world. Both at home and as part of international student exchanges, medical students are confronted with different ways of thinking and acting in relation to health and disease. Despite an increasing number of courses on cultural competence and global health at German-speaking medical schools, systematic approaches are lacking on how to integrate this topic into medical curricula. Methodological approach: This paper is based on a structured consensus-building process by a multidisciplinary committee composed of faculty and students. In a first step, a qualitative online survey was carried out in order to establish an inventory of definitions and concepts. After the second step, in which a literature search was conducted and definitions of global health and transcultural and intercultural competence were clarified, recommendations were formulated regarding content, teaching and institutional infrastructure. Based on small-group work and large-group discussions, different perspectives and critical issues were compiled using multiple feedback loops that served to ensure quality. Results: An inventory on the national and international level showed that great heterogeneity exists in regard to definitions, teaching strategies, teaching formats and faculty qualification. Definitions and central aspects considered essential to medical education were thus established for the use of the terms "cultural competence" and "global health". Recommendations are given for implementation, ranging from practical realization to qualification of teaching staff and education research. Outlook: High-quality healthcare as a goal calls for the systematic internationalization of undergraduate medical education. In addition to offering specific courses on cultural competence and global health, synergies would be created through the integration of cultural competence and global health content into the curricula of already existing subject areas. The NKLM (the national competence-based catalogue of learning objectives for undergraduate medical education) would serve as a basis for this.
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Affiliation(s)
- Claudia Mews
- University Medical Center Hamburg-Eppendor,f Department of General Practice/Primary Care , Hamburg, Germany
- *To whom correspondence should be addressed: Claudia Mews, University Medical Center Hamburg-Eppendor,f Department of General Practice/Primary Care , Martinistr. 52, D-20246 Hamburg, Germany, Phone: +49 (0)40/7410-56854, Fax: +49 (0)40/7410-53681, E-mail:
| | - Sylvie Schuster
- University Hospital Basel, Head of Program on Diversity Management, Basel, Switzerland
| | - Christian Vajda
- Medical University of Graz, Department of Medical Psychology and Psychotherapy, Graz, Austria
| | - Heide Lindtner-Rudolph
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Institute and Outpatients Clinic Medical Psychology, Research Group on Migration and Psychosocial Health (MiPH), Hamburg, Germany
| | - Luise E. Schmidt
- University of Greifswald, Department of Psychiatry and Psychotherapy, Greifswald, Germany
- Helios Hanseklinikum Stralsund, Department of Psychiatry and Psychotherapy, Stralsund, Germany
| | - Stefan Bösner
- University of Marburg, Department of General Practice/Family Medicine, Marburg, Germany
| | - Leyla Güzelsoy
- Paracelsus Medical Private University, Nuremberg Hospital, Department of Psychosomatic Medicine and Psychotherapy, Psychosomatic Consultation and Liaison Service, Nuremberg, Germany
| | - Frank Kressing
- Ulm University, Institute of the History, Philosophy and Ethics of Medicine, Ulm, Germany
| | - Houda Hallal
- University of Cologne, Faculty of Medicine, Cologne, Germany
| | - Tim Peters
- Ruhr-University Bochum, Medical Faculty, Center for Medical Education, Bochum, Germany
| | - Margarita Gestmann
- University of Duisburg-Essen, Medical Faculty, Dean's office for student affairs, Essen, Germany
| | - Linn Hempel
- University of Dusseldorf, Medical Faculty, Psychosomatic and Psychotherapy, Dusseldorf, Germany
| | - Tatjana Grützmann
- RWTH Aachen University, Dean's office for student affairs, Aachen, Germany
| | - Erika Sievers
- Academy of Public Health Services, Düsseldorf, Germany
| | - Michael Knipper
- Justus Liebig University Giessen, Institute for the History of Medicine, Giessen, Germany
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