Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Learning, Informatics, Management and Ethics, Cultural Medicine, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2021 Oct 7;16(10):e0257297. doi: 10.1371/journal.pone.0257297. eCollection 2021.
There has been an increase in global health courses at medical universities in high-income countries. Their effect on students, however, is poorly understood. In 2016 an elective global surgery course was introduced for medical students at Karolinska Institutet in Sweden. The course includes a theoretical module in Sweden and a two-week clinical rotation in Uganda. The present study aimed to assess the format and determine its effect on students' knowledge of global surgery and approach towards patients of non-Swedish origin.
A mixed-methods design was used. Semi-structured case-based interviews were conducted individually with 18 students and analysed using qualitative content analysis. Examination scores and the course evaluation were analysed with Kruskal Wallis one-way analysis of variance, Pearson's Chi-square and a Wilcoxon signed-rank test as appropriate.
The course was appreciated and students reported gained insights and interest in global surgery. Students' ability to reason about global surgery issues was improved after the course. Students considered complicating aspects in the meeting with patients of non-Swedish origin. Students with abroad clinical experience felt less compelled to act on preconceptions.
The global surgery course at Karolinska Institutet is appreciated and students gained valuable knowledge. The case-based interviews acted as a catalyst for reflection and showed that students felt insecure as they lacked knowledge about globally common surgical conditions and struggled with generalized preconceptions of patients of non-Swedish origin. To further support students to integrate theoretical knowledge and professional development, we suggest the introduction of problem-based learning.
The ability of the course to inspire students' commitment to global surgery is promising as this engagement is the key to reaching the goal of equitable health globally. Offering such courses is a step towards inspiring and recruiting the future clinicians and researchers needed for expanding the field of global surgery.
在高收入国家的医科大学中，全球健康课程的数量有所增加。然而，人们对这些课程对学生的影响知之甚少。2016 年，瑞典卡罗林斯卡学院为医学生开设了一门全球外科选修课程。该课程包括在瑞典的理论模块和在乌干达的为期两周的临床轮转。本研究旨在评估该课程的模式，并确定其对学生全球外科知识和对非瑞典裔患者态度的影响。
采用混合方法设计。对 18 名学生进行了单独的半结构化基于案例的访谈，并使用定性内容分析进行了分析。考试成绩和课程评估采用 Kruskal Wallis 单向方差分析、Pearson Chi-square 检验和适当的 Wilcoxon 符号秩检验进行分析。
该课程受到了学生的赞赏，学生报告说从中获得了对全球外科的深入了解和兴趣。学生在课程结束后，解决全球外科问题的能力得到了提高。学生认为在与非瑞典裔患者会面时存在复杂的问题。有海外临床经验的学生觉得自己没有那么强烈的冲动去根据先入为主的观念行事。
卡罗林斯卡学院的全球外科课程受到了学生的赞赏，学生获得了宝贵的知识。基于案例的访谈起到了催化剂的作用，使学生感到不安，因为他们缺乏关于全球常见手术情况的知识，并且对非瑞典裔患者的普遍成见感到困扰。为了进一步支持学生将理论知识与专业发展相结合，我们建议引入基于问题的学习。
该课程激发学生对全球外科事业的投入的能力很有前途，因为这种投入是实现全球公平健康目标的关键。提供这样的课程是朝着激励和招募未来扩大全球外科领域所需的临床医生和研究人员迈出的一步。
