An undergraduate medical education framework for refugee and migrant health: Curriculum development and conceptual approaches

Abstract

Background International migration, especially forced migration, highlights important medical training needs including cross-cultural communication, human rights, as well as global health competencies for physical and mental healthcare. This paper responds to the call for a ‘trauma informed’ refugee health curriculum framework from medical students and global health faculty. Methods We used a mixed-methods approach to develop a guiding medical undergraduate refugee and migrant health curriculum framework. We conducted a scoping review, key informant interviews with global health faculty with follow-up e-surveys, and then, integrated our results into a competency-based curriculum framework with values and principles, learning objectives and curriculum delivery methods and evaluation. Results The majority of our Canadian medical faculty respondents reported some refugee health learning objectives within their undergraduate medical curriculum. The most prevalent learning objective topics included access to care barriers, social determinants of health for refugees, cross-cultural communication skills, global health epidemiology, challenges and pitfalls of providing care and mental health. We proposed a curriculum framework that incorporates values and principles, competency-based learning objectives, curriculum delivery (i.e., community service learning), and evaluation methods. Conclusions The results of this study informed the development of a curriculum framework that integrates cross-cultural communication skills, exploration of barriers towards accessing care for newcomers, and system approaches to improve refugee and migrant healthcare. Programs should also consider social determinants of health, community service learning and the development of links to community resettlement and refugee organizations.

Divergence and Convergence of the Public Health Leadership Competency Framework Against Others in Undergraduate Medical Education: A Scoping Review

“…Various methods to develop frameworks were used including: 1) reviews (n = 8/13, 61%) [34,38,39,41,42,46,52,54] 2) interviews (n = 6/13, 46%) [34,37,38,45,52,56], surveys (n = 4/13, 30%) [34,36,38,56], and consensus studies (n = 3/13, 23%) [38,43,54]. Four studies used three or more methods to triangulate the information [34,38,54,56]…”

A toolkit for decolonizing global emergency medicine education

“…Meanwhile, refugee and immigrant communities face unique health challenges related to access to care, language barriers, and global health epidemiology. Increased exposure to global health curricula, particularly those focused on cultural humility and immigrant health, can better equip healthcare workers to address healthcare disparities in migrants and refugees (Gruner et al, 2022).…”

Evaluation of cross-cultural competence among German health care professionals: A quasi-experimental study of training in two hospitals

“…In addition, cross-cultural competence has the potential to promote person-centered care, which in turn promotes efficient care processes and cost savings [ 9 , 10 ]. Therefore, promoting cross-cultural competence in health care professional education is becoming increasingly important [ [11] , [12] , [13] , [14] , [15] , [16] ]. Compared to research conducted in other countries, there are significant gaps in Germany when it comes to quantitative research on the cross-cultural competence of health professionals despite, an increasing need for sustainable cross-cultural competence training through evidence-based training beginning at the professional development level [ [17] , [18] , [19] , [20] ].…”