Article

Behavioral science education and the international medical graduate.

6125 Clayton Avenue, Suite 222, Saint Louis, MO 63139, USA.
Academic Medicine (Impact Factor: 3.47). 03/2006; 81(2):164-70. DOI: 10.1097/00001888-200602000-00015
Source: PubMed

ABSTRACT International medical graduates (IMGs), many of whom are recent immigrants to the United States, are filling an increasing proportion of U.S. family medicine residency positions. Therefore, assumptions about the training experiences of first-year residents may no longer apply to a large percentage of incoming residents. The authors sought to improve the behavioral science education in their residency program by learning about IMGs' previous training and experience in behavioral science before coming to the United States.
Ten first-, second-, and third-year family medicine residents, representing medical school training from India, Macedonia, Bosnia-Herzegovina, The Philippines, Egypt, and Iraq, were individually interviewed using an inductive, qualitative approach. Transcripts were reviewed and double coded. Categories and story lines were identified, and member checking was employed.
Segments were classified into seven categories: residents' behavioral medicine training prior to coming to the United States; reflections on the inclusion of mental health and psychosocial content in clinical family medicine; training in medical interviewing; reflections on the physician-patient relationship; perceptions of U.S. family life; recommendations for improving IMGs' understanding of psychosocial aspects of patient care; and specific challenges residents face as IMGs.
The narrative data suggested several possible modifications to the family medicine curriculum, including expanding new resident orientation content about U.S. health care, introducing behavioral science content sooner, and having IMGs observe quality physician-patient interactions. Interview data also yielded concrete suggestions for improving residents' psychiatric interview knowledge and skills, such as instruction in specific wording of questions.

0 Bookmarks
 · 
142 Views
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The demand for health professionals continues to increase, partially due to the aging population and the high proportion of practitioners nearing retirement. The University of British Columbia (UBC) has developed a program to address this demand, by providing support for internationally trained Physiotherapists in their preparation for taking the National Physiotherapy competency examinations.The aim was to create a program comprised of the educational tools and infrastructure to support internationally educated physiotherapists (IEPs) in their preparation for entry to practice in Canada and, to improve their pass rate on the national competency examination. The program was developed using a logic model and evaluated using program evaluation methodology. Program tools and resources included educational modules and curricular packages which were developed and refined based on feedback from clinical experts, IEPs and clinical physical therapy mentors. An examination bank was created and used to include test-enhanced education. Clinical mentors were recruited and trained to provide clinical and cultural support for participants. The IEP program has recruited 124 IEPs, with 69 now integrated into the Canadian physiotherapy workforce, and more IEPs continuing to apply to the program. International graduates who participated in the program had an improved pass rate on the national Physiotherapy Competency Examination (PCE); participation in the program resulted in them having a 28% (95%CI, 2% to 59%) greater possibility of passing the written section than their counterparts who did not take the program. In 2010, 81% of all IEP candidates who completed the UBC program passed the written component, and 82% passed the clinical component. The program has proven to be successful and sustainable. This program model could be replicated to support the successful integration of other international health professionals into the workforce.
    BMC Medical Education 10/2013; 13(1):140. · 1.41 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Physical activity (PA) and nutrition are key health behaviors underlying the design and implementation of prevention strategies for non-communicable diseases (NCDs) in Latin America. Nevertheless, research still reports low prevalence of PA and fruit and vegetable consumption throughout the region. This paper aims at reviewing the ways in which models of behavior change theory have been applied in study development and implementation regarding nutrition and PA in Latin America. In August 2011 we conducted a systematic literature review of the behavior change studies that targeted such NCDs risk factors published until then. Out of 4279 surveyed abstracts, only 29 corresponded to articles that met our inclusion criteria. Twenty-six articles reported the application of behavior change theory, with the trans-theoretical model (n = 12) being the most frequently used. Other theories and models included the socio-ecological model (n = 4), cognitive theory (n = 3), social cognitive theory (n = 2) and theories related to health education and counseling (n = 5). Based on this review, we recommend that the application of behavior change theory be explicitly reported in Latin American peer-reviewed articles, and that outcome evaluations include behavior change constructs so as to better assess their contribution to the effectiveness of nutrition and PA interventions in the region. Furthermore, we state the need for a better understanding of the behavior change mechanisms that may be specific to the Latin American context.
    Global Health Promotion 12/2013; 20(4 Suppl):65-81.

Full-text (2 Sources)

Download
10 Downloads
Available from
Sep 8, 2014