Monroe-Wise Aliza, Kibore Minnie, Kiarie James, Nduati Ruth, Mburu Joseph, Drake Frederick Thurston, Bremner William, Holmes King, Farquhar Carey
Department of Medicine, University of Washington, Seattle, USA.
Department of Global Health, University of Washington, Seattle, USA.
BMC Med Educ. 2014 Dec 30;14:1043. doi: 10.1186/s12909-014-0246-5.
Despite evidence that international clinical electives can be educationally and professionally beneficial to both visiting and in-country trainees, these opportunities remain challenging for American residents to participate in abroad. Additionally, even when logistically possible, they are often poorly structured. The Universities of Washington (UW) and Nairobi (UoN) have enjoyed a long-standing research collaboration, which recently expanded into the UoN Medical Education Partnership Initiative (MEPI). Based on MEPI in Kenya, the Clinical Education Partnership Initiative (CEPI) is a new educational exchange program between UoN and UW. CEPI allows UW residents to partner with Kenyan trainees in clinical care and teaching activities at Naivasha District Hospital (NDH), one of UoN's MEPI training sites in Kenya.
UW and UoN faculty collaborated to create a curriculum and structure for the program. A Chief Resident from the UW Department of Medicine coordinated the program at NDH. From August 2012 through April 2014, 32 UW participants from 5 medical specialties spent between 4 and 12 weeks working in NDH. In addition to clinical duties, all took part in formal and informal educational activities. Before and after their rotations, UW residents completed surveys evaluating clinical competencies and cross-cultural educational and research skills. Kenyan trainees also completed surveys after working with UW residents for three months.
UW trainees reported a significant increase in exposure to various tropical and other diseases, an increased sense of self-reliance, particularly in a resource-limited setting, and an improved understanding of how social and cultural factors can affect health. Kenyan trainees reported both an increase in clinical skills and confidence, and an appreciation for learning a different approach to patient care and professionalism.
After participating in CEPI, both Kenyan and US trainees noted improvement in their clinical knowledge and skills and a broader understanding of what it means to be clinicians. Through structured partnerships between institutions, educational exchange that benefits both parties is possible.
尽管有证据表明国际临床选修课程对来访学员和当地学员在教育和职业方面都有益处，但美国住院医师在国外参与这些机会仍然具有挑战性。此外，即使在后勤方面可行，这些机会的安排往往也很糟糕。华盛顿大学（UW）和内罗毕大学（UoN）有着长期的研究合作关系，最近这种合作扩展到了内罗毕大学医学教育伙伴关系倡议（MEPI）。基于肯尼亚的MEPI，临床教育伙伴关系倡议（CEPI）是内罗毕大学和华盛顿大学之间的一个新的教育交流项目。CEPI使华盛顿大学的住院医师能够与肯尼亚学员在奈瓦沙区医院（NDH）合作开展临床护理和教学活动，NDH是内罗毕大学在肯尼亚的MEPI培训地点之一。
华盛顿大学和内罗毕大学的教员合作制定了该项目的课程和架构。华盛顿大学医学系的一名总住院医师在NDH协调该项目。从2012年8月到2014年4月，来自5个医学专业的32名华盛顿大学参与者在NDH工作了4至12周。除了临床工作外，所有人都参加了正式和非正式的教育活动。在轮转前后，华盛顿大学的住院医师完成了评估临床能力以及跨文化教育和研究技能的调查。肯尼亚学员在与华盛顿大学住院医师共事三个月后也完成了调查。
华盛顿大学的学员报告称，接触各种热带病和其他疾病的机会显著增加，自我依赖感增强，尤其是在资源有限的环境中，并且对社会和文化因素如何影响健康有了更好的理解。肯尼亚学员报告称，临床技能和信心都有所提高，并且赞赏学习了不同的患者护理方法和职业素养。
参与CEPI后，肯尼亚和美国的学员都指出他们的临床知识和技能有所提高，并且对成为临床医生的意义有了更广泛的理解。通过机构间的结构化合作关系，实现互利的教育交流是可能的。
