Radiation Medicine Program, Princess Margret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
Department of Radiation Oncology, University of Toronto, Toronto, Canada.
J Cancer Educ. 2021 Aug;36(4):787-794. doi: 10.1007/s13187-020-01705-5.
Despite proposed advantages of global curricular harmonization including physician mobility and improving the quality of care, the challenges and unintended consequences require greater study. The aim of this study was to problematize the concept and implementation of global oncology curricula and their relationship to local contexts of power and culture. Fourteen international participants involved in the development and implementation of global oncology curricula completed in-depth, one-on-one semi-structured interviews lasting 40-60 min. Snowball sampling was employed. Through iterative analyses, using an abductive approach, the study team discussed and reviewed the data and made revisions through collaborative analysis to enhance comprehensiveness and to improve credibility. In the final analysis the meaning and implication of the themes were discussed yielding a conceptual analysis. Our data have articulated 5 key challenges for global curricula including 1) Ambiguous or conflicting perspectives on the purpose and scope of Global Oncology Curricula 2) Insufficient representation of diverse perspectives and realities in the creation of the final curricula 3) A rigid conceptualization of competency requirements 4) A mismatch between the curricular requirements and local context and 5) The influence of power relationships and decision makers. Leveraging the strengths of diversity including fostering representation, addressing power differentials and factoring local contexts may be an approach to mitigating these challenges. Global oncology curricula may serve important advocacy roles within the healthcare system. Leveraging diversity may positively impact the common challenges in the construction and implementation of global oncology curricula.
尽管全球课程协调具有医师流动和提高护理质量等优势,但仍需要进一步研究这些挑战和意外后果。本研究旨在探讨全球肿瘤学课程的概念和实施及其与权力和文化地方背景的关系。14 名参与全球肿瘤学课程开发和实施的国际参与者完成了时长 40-60 分钟的深入一对一半结构化访谈。采用了滚雪球抽样法。通过使用归纳法的迭代分析,研究小组讨论并审查了数据,并通过协作分析进行了修订,以提高全面性和可信度。在最终分析中,讨论了主题的意义和影响,得出了概念分析。我们的数据阐明了全球课程的 5 个主要挑战,包括 1)全球肿瘤学课程目的和范围的观点不明确或存在冲突 2)在制定最终课程时,多样性观点和现实的代表性不足 3)对能力要求的僵化概念化 4)课程要求与地方背景之间的不匹配 5)权力关系和决策者的影响。利用多样性的优势,包括促进代表性、解决权力差异和考虑地方背景,可能是缓解这些挑战的一种方法。全球肿瘤学课程在医疗保健系统中可能具有重要的倡导作用。利用多样性可能会对构建和实施全球肿瘤学课程的共同挑战产生积极影响。