Rybarczyk Megan M, Muck Andrew, Kolkowitz Ilan, Tupesis Janis P, Jacquet Gabrielle A
Department of Emergency Medicine Brigham and Women's Hospital Boston MA.
University of Texas Health Science Center San Antonio San Antonio TX.
AEM Educ Train. 2020 Apr 27;5(2):e10451. doi: 10.1002/aet2.10451. eCollection 2021 Apr.
Formal education in global health (GH) and short-term experiences in GH (STEGH) are offered by many emergency medicine (EM) residency programs in the United States. In an increasingly connected world, training in GH and STEGH can provide essential knowledge and practical skills to trainees, particularly at the graduate medical education level. The current core programmatic components and the essential competencies and curricula that support ethical and effective STEGH, however, still vary widely. The authors conducted a survey of the 228 EM residency programs in the United States to describe the current state of GH training and STEGH.
An online survey was developed in REDCap by a team of GH faculty. In July 2018, programs were invited to participate via individual invitation of program directors from a directory. The programs received two reminders to participate until January 2019.
Of the 84 programs that responded, 75% offer STEGH and 39% have longitudinal GH curricula. Within these programs, only 55% have dedicated GH faculty and only 70% have dedicated sites. Both faculty and residents encounter funding and insurance barriers; most notably, only 20% of programs that offer STEGH provide evacuation insurance for their residents. Most residents (95%) engage in clinical work along with teaching and other activities, but 24% of programs do not allow these activities to fulfill any residency requirements. Finally, only 80 and 85% of programs offer preparatory and debriefing activities for residents, respectively.
While the results of this survey show progress relative to prior surveys, there are still barriers to implementing GH curricula and supporting safe, ethical, and effective STEGH, particularly in the form of continued financial and logistic support for faculty and for residents, in U.S. EM training programs.
美国许多急诊医学住院医师培训项目都提供全球健康（GH）方面的正规教育以及全球健康短期体验（STEGH）。在这个联系日益紧密的世界中，GH和STEGH培训可为学员提供重要知识和实践技能，尤其是在研究生医学教育层面。然而，目前支持符合伦理且有效的STEGH的核心项目组成部分以及基本能力和课程仍存在很大差异。作者对美国228个急诊医学住院医师培训项目进行了一项调查，以描述GH培训和STEGH的现状。
由一组GH教员在REDCap中开发了一项在线调查。2018年7月，通过从一份名录中逐个邀请项目主任的方式，邀请各项目参与。这些项目收到了两次参与提醒，直至2019年1月。
在回复的84个项目中，75%提供STEGH，39%有纵向GH课程。在这些项目中，只有55%有专门的GH教员，只有70%有专门的地点。教员和住院医师都遇到资金和保险方面的障碍；最显著的是，提供STEGH的项目中只有20%为其住院医师提供撤离保险。大多数住院医师（95%）在参与教学和其他活动的同时还从事临床工作，但24%的项目不允许这些活动满足任何住院医师培训要求。最后，分别只有80%和85%的项目为住院医师提供预备和汇报活动。
虽然本次调查结果显示相对于之前的调查有进步，但在美国急诊医学培训项目中，实施GH课程以及支持安全、符合伦理且有效的STEGH仍存在障碍，特别是在为教员和住院医师提供持续的资金和后勤支持方面。
