Global health competencies and approaches in medical eduation: A literature review

Faculty of Medicine, McGill University, Montreal, Canada.
BMC Medical Education (Impact Factor: 1.22). 12/2010; 10(1):94. DOI: 10.1186/1472-6920-10-94
Source: PubMed


Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training.
A literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools.
Using a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches.
This review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

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    • "Global health experiences can be a rewarding experience for the participants and, many claim, the recipients (Rekart et al. 2003). A number of undergraduate global health programs exist, and many pre-health professions students are interested in volunteering in resource poor countries (Battat et al. 2010). They are eager to help and to try their hands in the clinical setting. "
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    ABSTRACT: The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in "voluntourism," health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data.
    Full-text · Article · Jul 2014 · HEC Forum
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    • "Students of public health enter into short-term projects with a disparate array of previous experience and skills, and while some may have undertaken public health courses, they often have not had the standardization of skills, socialization, and clinical experience to which medical students are exposed prior to departure. They are also less supported by literature on the ethics, best practices, and conventions of global health than their clinical colleagues (9). Short-term projects often focus on knowledge development though observational projects or data collection. "
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    ABSTRACT: Background A large number of global public health students seek international experience as part of their academic curriculum. These placements are often short, given the constraints of cost and time available within the academic calendar. In contrast to international electives for clinical students there are few published guidelines on practical, ethical or feasible projects. This paper describes a ten-day sanitation mapping project in Mumbai, India and explores the broader implications for global public health student electives. Methods Three graduate public health students conducted a geographic review of sanitation facilities in Cheeta Camp informal settlement, Mumbai. Forty-six toilet blocks with 701 individual seats were identified. The project was reviewed ethically, educationally and logistically as a possible model for other short-term international projects. Conclusions Clearer guidelines are needed to support non-clinical placements by global public health students. Projects that are feasible, relevant and meaningful should be foster maximise benefit for learners and host communities.
    Full-text · Article · Jun 2014 · Global Health Action
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    • "Some suggest providing “academic, logistic and financial support for international rotations”, and promoting GHEs as a “routine part of medical education” [2]. While there does not yet exist a formal consensus among educators for curriculum content or educational opportunities in global health [19], there is agreement that several topics including context-relevant biomedical competencies [20,21] and cultural sensitivity development [11,22,23] should be included. "
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    ABSTRACT: Growing numbers of medical trainees now participate in global health experiences (GHEs) during their training. To enhance these experiences we sought to explore expectations inherent in the relationships between GHE stakeholder groups. 20 open-ended, semi-structured interviews probed participant perceptions and assumptions embedded in GHEs. A fundamental qualitative descriptive approach was applied, with conventional content analysis and constant comparison methods, to identify and refine emerging themes. Thematic structure was finalized when saturation was achieved. Participants all had experience as global health participants (10 trainees, 10 professionals) from an urban, academic, Canadian medical centre. We identified three stakeholder groups: participants (trainees and professionals), host communities, and sponsoring institutions. During interviews, four major themes emerged: (i) cultural challenges, (ii) expectations and perceptions, (iii) relationships and communication, and (iv) discordant objectives. Within each theme, participants recurrently described tensions existing between the three stakeholder groups. GHE participants frequently face substantial tensions with host communities and sponsoring agencies. Trainees are particularly vulnerable as they lack experience to navigate these tensions. In the design of GHEs, the needs of each group must be considered to ensure that benefits outweigh potential harms. We propose a conceptual model for developing educational objectives that acknowledge all three GHE stakeholder groups.
    Full-text · Article · Oct 2013 · BMC Medical Education
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