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Umphrey L, Lenhard N, Lam SK, Hayward NE, Hecht S, Agrawal P, Chambliss A, Evert J, Haq H, Lauden SM, Paasi G, Schleicher M, McHenry MS. Virtual global health in graduate medical education: a systematic review. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:230-248. [PMID: 36057978 PMCID: PMC9911141 DOI: 10.5116/ijme.62eb.94fa] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To synthesize recent virtual global health education activities for graduate medical trainees, document gaps in the literature, suggest future study, and inform best practice recommendations for global health educators. METHODS We systematically reviewed articles published on virtual global health education activities from 2012-2021 by searching MEDLINE, EMBASE, Cochrane Library, ERIC, Scopus, Web of Science, and ProQuest Dissertations & Theses A&I. We performed bibliography review and search of conference and organization websites. We included articles about primarily virtual activities targeting for health professional trainees. We collected and qualitatively analyzed descriptive data about activity type, evaluation, audience, and drivers or barriers. Heterogeneity of included articles did not lend to formal quality evaluation. RESULTS Forty articles describing 69 virtual activities met inclusion criteria. 55% of countries hosting activities were high-income countries. Most activities targeted students (57%), with the majority (53%) targeting trainees in both low- to middle- and high-income settings. Common activity drivers were course content, organization, peer interactions, and online flexibility. Common challenges included student engagement, technology, the internet, time zones, and scheduling. Articles reported unanticipated benefits of activities, including wide reach; real-world impact; improved partnerships; and identification of global health practice gaps. CONCLUSIONS This is the first review to synthesize virtual global health education activities for graduate medical trainees. Our review identified important drivers and challenges to these activities, the need for future study on activity preferences, and considerations for learners and educators in low- to middle-income countries. These findings may guide global health educators in their planning and implementation of virtual activities.
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Affiliation(s)
- Lisa Umphrey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nora Lenhard
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Suet Kam Lam
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Shaina Hecht
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Priya Agrawal
- Mid-Atlantic Permanente Medical Group, Washington, DC, USA
| | - Amy Chambliss
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jessica Evert
- Child Family Health International, El Cerrito, California, USA
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Texas, USA
| | - Stephanie M. Lauden
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - George Paasi
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Mary Schleicher
- Cleveland Clinic Floyd D. Loop Alumni Library, Cleveland, OH, USA
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International medical electives during and after the COVID-19 pandemic - current state and future scenarios: a narrative review. Global Health 2022; 18:44. [PMID: 35459191 PMCID: PMC9026059 DOI: 10.1186/s12992-022-00838-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background International medical electives are an important and popular component of the academic curriculum in many medical schools and universities worldwide. The purpose of abroad electives is to provide medical students with an opportunity to gain a better understanding of education and healthcare in an international context. The COVID-19 pandemic, however, has substantially changed the international elective landscape. Travel restrictions, closures of international elective programs and the expansion of virtual methods for education caused a widespread disruption to abroad electives. A comprehensive analysis with regard to other consequences for abroad electives, however, has not been done before. Thus, we sought to a) summarize the current transformation of the international medical elective and b) to address potential challenges for post-pandemic international medical electives. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on international electives during the last two years of the COVID-19 pandemic. Results Students worldwide had electives postponed or canceled. Apart from evident immediate pandemic-related consequences (such as the substantial decline in global electives and impaired elective research opportunities for educators), there are other several problems that have received little attention during the last two years. These include challenges in the elective application process, poorly-understood consequences for host institutions, and growing global (ethical) disparities that are likely to increase once elective programs will gradually re-open. There is ample evidence that the post-pandemic elective landscape will be characterized by increasing elective fees, and a more competitive seat-to-applicant ratio. Ethical problems for international electives arising from an unequal global vaccine distribution will pose an additional challenge to students and elective coordinators alike. Conclusion The COVID-19 pandemic transformed the international medical elective landscape in an unprecedented way, and future generations of medical students will face a series of additional challenges when applying for global medical electives.
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Coria AL, Rabin TL, Rule ARL, Haq H, Hudspeth JC, Ratner L, Walker-Descartes I. Global Health Crisis, Global Health Response: How Global Health Experiences Prepared North American Physicians for the COVID-19 Pandemic. J Gen Intern Med 2022; 37:217-221. [PMID: 34561829 PMCID: PMC8475882 DOI: 10.1007/s11606-021-07120-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic plunged hospital systems into resource-deprived conditions unprecedented since the 1918 flu pandemic. It brought forward concerns around ethical management of scarcity, racism and distributive justice, cross-disciplinary collaboration, provider wellness, and other difficult themes. We, a group of medical educators and global health educators and clinicians, use the education literature to argue that experience gained through global health activities has greatly contributed to the effectiveness of the COVID-19 pandemic response in North American institutions. Support for global health educational activities is a valuable component of medical training, as they build skills and perspectives that are critical to responding to a pandemic or other health system cataclysm. We frame our argument as consideration of three questions that required rapid, effective responses in our home institutions during the pandemic: How can our health system function with new limitations on essential resources? How do we work at high intensity and volume, on a new disease, within new and evolving systems, while still providing high-quality, patient-centered care? And, how do we help personnel manage an unprecedented level of morbidity and mortality, disproportionately affecting the poor and marginalized, including moral difficulties of perceived care rationing?
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Affiliation(s)
- Alexandra L Coria
- Global Health Institute and Division of Pediatric Hospital Medicine, Maimonides Medical Center, Brooklyn, NY, USA. .,State University of New York Downstate College of Medicine, Brooklyn, NY, USA.
| | - Tracy L Rabin
- Office of Global Health & Yale Primary Care Internal Medicine Residency Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Amy R L Rule
- University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Perinatal Institute and Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Heather Haq
- Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) at Texas Children's Hospital, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - James C Hudspeth
- Department of Medicine, Section of General Internal Medicine, Boston University, Boston, MA, USA
| | - Leah Ratner
- Harvard Medical School, Boston, MA, USA.,Division of Respiratory Diseases, Boston Children's Hospital, Boston, MA, USA.,General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Ingrid Walker-Descartes
- State University of New York Downstate College of Medicine, Brooklyn, NY, USA.,Division of Medical Education, Maimonides Children's Hospital, Brooklyn, NY, USA
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Shalan FH, Ambia S, Martinez B, Jon E, Okorafor U, Yang K, Yim E, Chamberlain RM, Sohler N, Msami K, Kahesa C, Mwaiselage J, Soliman AS. Field Research Experience of Medical Students: Learning and Translation from Global to Underserved US Settings. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:62-68. [PMID: 34075543 PMCID: PMC8169428 DOI: 10.1007/s13187-021-02036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
While most medical schools in the USA provide opportunities for global health experiences, global health education is not included consistently or emphasized adequately in many medical school curricula. The City University of New York Medical School (CSOM) has a mission to educate and train students who are traditionally underrepresented in medicine to practice primary care in medically underserved communities in New York. This manuscript documents the experience of the CSOM in expanding global health education by introducing a new global health cancer training program, partnering with clinicians at the Ocean Road Cancer Institute (ORCI) in Tanzania. This manuscript illustrates the following points: (1) the CSOM curriculum that focuses on community health and social medicine; (2) the process by which students learn by developing research proposals for global cancer; (3) the field research experience and lessons learned; (4) learning about cancer and medicine in a developing country; and (5) lessons learned for translation from global to domestic underserved populations. We also suggest a checklist for future students interested in pursuing global cancer education and research, and recommendations for maximizing learning and career development of students interested in global cancer research and its application to underserved populations in the USA.
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Affiliation(s)
- Fatma H Shalan
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Shanjida Ambia
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Beatriz Martinez
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Eric Jon
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Ugochukwu Okorafor
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Kristen Yang
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Elizabeth Yim
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Robert M Chamberlain
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nancy Sohler
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
| | - Khadija Msami
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | | | | | - Amr S Soliman
- The City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA.
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Utilizing Virtual Exchange to Sustain Global Health Partnerships in Medical Education. Ann Glob Health 2021; 87:24. [PMID: 33747799 PMCID: PMC7954178 DOI: 10.5334/aogh.3179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Integrating global health (GH) training in medical education has become prevalent in the United States over the last two decades. Many medical school graduates participate in some type of international learning experience during their undergraduate/graduate training, with plans to make this a part of their life-long learning experiences. Recognizing this trend, many pediatric national organizations, such as the American Academy of Pediatrics, the Association of Pediatric Program Directors, and the American Board of Pediatrics, have developed initiatives integrating GH education into existing curricula. We report our experience with using virtual learning on a cloud-based platform to remain connected with our GH training partners, and utilize this opportunity to further strengthen our existing relationships during the ongoing COVID-19 pandemic. Overall, our experience thus far shows that this is an effective way to maintain communication even when international travel is not possible. It allows for the ongoing exchange of ideas and the development of long-term sustainable relationships. There are many important lessons our trainees can learn from such partnerships.
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Reece J, Dionne C, Krupica T, Lerfald N, Sizemore J, Sofka S. Can global health opportunities lead to an increase in primary care physicians? J Glob Health 2020; 10:020387. [PMID: 33282217 PMCID: PMC7688187 DOI: 10.7189/jogh.10.020387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Josephine Reece
- West Virginia University School of Medicine Department of Medicine, Morgantown, West Virginia, USA
| | - Christopher Dionne
- West Virginia University School of Medicine Department of Medicine, Morgantown, West Virginia, USA
| | - Troy Krupica
- West Virginia University School of Medicine Department of Medicine, Morgantown, West Virginia, USA
| | - Nathan Lerfald
- West Virginia University School of Medicine Department of Medicine, Morgantown, West Virginia, USA
| | - Jenna Sizemore
- West Virginia University School of Medicine Department of Medicine, Morgantown, West Virginia, USA
| | - Sarah Sofka
- West Virginia University School of Medicine Department of Medicine, Morgantown, West Virginia, USA
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Pritchard J, Bartels SA, Collier A. Pre-departure and Post-elective Requirements for Global Health Electives: Survey of Canadian Royal College Emergency Medicine Programs. Cureus 2020; 12:e11680. [PMID: 33442500 PMCID: PMC7796702 DOI: 10.7759/cureus.11680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: Global Health (GH) electives offer unique learning opportunities; however, risks to trainees and host populations should be minimized through pre-departure training and post-elective debriefing. In a 2016 study, only three Canadian residency programs mandated such training, although specific data on Emergency Medicine (EM) programs is lacking. This study aimed to identify GH elective requirements and perceived training gaps among EM programs. Methods: We conducted two email surveys (one each for EM program directors [PDs] and residents) regarding training requirements and perceived gaps for GH electives. We also contacted university postgraduate medical education (PGME) and GH offices, via their online publicized emails, to assess university-wide requirements and resources. Results: Nine PDs responded, with 78% reporting having residents participate in GH electives. Many PDs (67%) believed residents were moderately prepared for GH electives, while 33% felt they were unprepared to some degree. Forty seven out of an estimated 380 EM residents responded with 35% having completed a GH elective during residency. Of those, only one (6%) reported feeling very prepared, and 43% believed there was a need to improve trainings. Uncertainty around training requirements was reported, and residents identified challenges faced on electives, as well as priority topics for training. Responses from PGME and GH offices indicated that pre-departure training and post-elective debriefing were required or available at more universities than was indicated by the PD and resident respondents. However university requirements varied widely, with some exclusively requiring basic travel information and Health and Safety checklists or modules. The disparate responses indicate that residents and PDs may either be unaware of university requirements or not utilize available training resources for GH electives. Conclusions: Although Canadian EM residents participate in GH electives, the majority of training programs do not require pre-departure training or post-elective debriefing. PDs and residents report varying levels of preparedness, and residents acknowledge a variety of challenges during GH electives. This information can be used to inform pre-departure training and post-elective debriefing and encourage EM residents to access available university-wide training.
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Affiliation(s)
| | - Susan A Bartels
- Emergency Medicine and Public Health Sciences, Queen's University, Kingston, CAN
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Perspectives and Solutions from Clinical Trainees and Mentors Regarding Ethical Challenges During Global Health Experiences. Ann Glob Health 2020; 86:34. [PMID: 32257834 PMCID: PMC7101005 DOI: 10.5334/aogh.2721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Clinical trainees face challenges throughout short-term experiences in global health (STEGH) that are not routinely addressed. Objectives Describe common professional and ethical dilemmas faced by clinical trainees and identify gaps and solutions for pre, during, and post-STEGH training and mentoring. Methods We conducted a mixed-methods study among trainees and mentors involved in global health. The study utilized focus groups with trainees (November-December 2015) and online surveys of trainees, in-country and stateside faculty mentors (October 2016-April 2017). Results 85% (17/20) of students reported feeling prepared for their STEGH; however, 59% (23/39) of faculty felt students were unprepared. A majority of both students (90%) and faculty (77%) stated students would likely experience an ethical dilemma during STEGH. Major themes relating to meaningful global health work were elucidated: personal and inter-professional skills; interpersonal networks and collaboration; and awareness of power dynamics and bias. Conclusions The most common challenges faced by trainees during STEGH related to leadership, bias, ethics and interprofessional collaboration. Redirecting trainee energies from a focus on 'doing' and deliverables to attitudes (e.g., humility, professionalism) that cultivate personal and professional growth will help create lifelong global health learners and leaders.
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Ridde V, Dagenais C, Daigneault I. It's time to address sexual violence in academic global health. BMJ Glob Health 2019; 4:e001616. [PMID: 31139462 PMCID: PMC6509593 DOI: 10.1136/bmjgh-2019-001616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 04/06/2019] [Indexed: 11/04/2022] Open
Affiliation(s)
- Valery Ridde
- IRD (French Institute For Research on sustainable Development), CEPED (IRD-Université de Paris), Universités de Paris, ERL INSERM SAGESUD, Paris, France
| | - Christian Dagenais
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
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