Resident, Obstetrics and Gynecology, Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard Medical School.
Resident, Anesthesiology, Brigham and Women's Hospital and Harvard Medical School.
MedEdPORTAL. 2020 Dec 8;16:11038. doi: 10.15766/mep_2374-8265.11038.
Over 20% of U.S. medical students express interest in global health (GH) and are searching for opportunities within the field. In addition, domestic practice increasingly requires an understanding of the social factors affecting patients' health. Unfortunately, only 39% of medical schools offer formal GH education, and there is a need to incorporate more GH into medical school curricula.
We designed a longitudinal case-based curriculum for the core clerkships. We conducted an institution-wide survey to determine baseline GH interest and developed three case-based sessions to incorporate into medicine, surgery, and pediatrics clerkships. The cases included clinical learning while exploring fundamental GH concepts. Cases were developed with GH faculty, and the pilot was implemented from October to December 2019 with 55 students. We used pre- and postdidactic surveys to assess interest in GH and elicit qualitative feedback. A follow-up survey assessed students' identification of barriers faced by their patients domestically.
Students felt that clinical management, physical exam skills, epidemiology, and social determinants of health were strengths of the sessions and that they were able to apply more critical thinking skills and cultural humility to their patients afterwards. Students felt that simulation would be a great addition to the curriculum and wanted both more time per session and more sessions overall.
Integrating GH didactics into the core clerkships has potential to address gaps in GH education and to help students make connections between clinical learning and GH, enhancing their care of patients both domestically and in future GH work.
超过 20%的美国医学生对全球健康(GH)感兴趣,并正在该领域寻找机会。此外,国内实践越来越需要了解影响患者健康的社会因素。不幸的是,只有 39%的医学院提供正规的 GH 教育,因此需要在医学院课程中纳入更多的 GH 内容。
我们为核心实习课程设计了一个纵向案例式课程。我们进行了一项全机构调查,以确定 GH 兴趣的基线,并开发了三个基于案例的课程,纳入内科、外科和儿科实习课程。这些案例包括在探索基本 GH 概念的同时进行临床学习。案例由 GH 教师开发,试点从 2019 年 10 月至 12 月实施,共有 55 名学生参与。我们使用课前和课后问卷调查来评估对 GH 的兴趣,并征求定性反馈。后续调查评估了学生对其患者在国内面临的障碍的识别。
学生们认为临床管理、体检技能、流行病学和健康的社会决定因素是课程的优势,并且他们能够在之后将更多的批判性思维技能和文化谦逊应用于他们的患者。学生们认为模拟将是课程的一个很好的补充,他们希望每个课程都有更多的时间,并希望增加总体课程数量。
将 GH 教学融入核心实习课程有可能弥补 GH 教育的差距,并帮助学生将临床学习与 GH 联系起来,增强他们对国内和未来 GH 工作中患者的护理。