School of Medicine, Medical Education Institute, University of Dundee, Dundee, UK.
Med Educ. 2014 Jun;48(6):593-603. doi: 10.1111/medu.12477.
Electives commonly represent a valued, enjoyed and formative part of medical training. However, there is little empirical evidence about students' preparedness, practices and perceptions of medical electives in resource-poor settings. Exploring what students do, why and under what circumstances is therefore worthwhile.
This study aimed to evaluate students' views on the processes, outcomes and impacts of medical electives in three low-income countries.
A qualitative study using purposeful sampling and semi-structured interviews was conducted. Participants were 29 Western students on medical electives at seven host sites in sub-Saharan Africa. A framework approach was used to analyse 872 minutes of audio-recorded data.
Students were highly positive about their experiences and seemed aware of their clinical limitations. Pre-departure training offered by some institutions was beneficial, but the content was perceived to be of little clinical relevance. Language barriers were the main challenges faced by students, even in places where English was the second language. Students who stayed longer, were nearer qualification or were based in rural units (rather than teaching centres) contributed more to patient care. Supervision was considered adequate but this appeared to be judged in a local context. Deliberate inappropriate practice was not encountered, but on occasion misunderstanding arose over the student's status.
Students who undertake electives in resource-poor countries appear to have clearly thought out and positive intentions, but current systems cause concern with reference to student activities and staff time, and require improvement. Instead of focusing on education benefits alone, students (and their sending institutions) need to consider other approaches through which host communities can more clearly benefit. Effective pre-departure preparation should become a requirement.
选修课通常是医学培训中一个有价值、受欢迎和有成效的部分。然而，在资源匮乏的环境中，关于学生对医学选修课的准备、实践和看法的实证证据很少。因此，探索学生在做什么、为什么以及在什么情况下做是值得的。
本研究旨在评估学生在三个低收入国家对医学选修课的过程、结果和影响的看法。
采用目的抽样和半结构化访谈进行定性研究。参与者是来自 7 个撒哈拉以南非洲东道国的 29 名西方医学生选修生。采用框架方法对 872 分钟的录音数据进行分析。
学生对他们的经验高度评价，似乎意识到自己的临床局限性。一些机构提供的出国前培训是有益的，但内容被认为与临床相关性不大。语言障碍是学生面临的主要挑战，即使在英语是第二语言的地方也是如此。停留时间较长、接近资格或在农村单位（而不是教学中心）的学生对患者护理的贡献更大。监督被认为是足够的，但这似乎是在当地背景下进行的判断。没有遇到故意不适当的做法，但有时会因学生的身份而产生误解。
在资源匮乏国家从事选修的学生似乎已经深思熟虑并抱有积极的意图，但目前的制度在学生活动和工作人员时间方面令人担忧，需要改进。学生（及其派遣机构）需要考虑其他方法，让东道社区能够更清楚地受益，而不仅仅关注教育效益。有效的出国前准备应成为一项要求。
