Career choices and global health engagement: 24-year follow-up of U.S. participants in the Indiana University-Moi University elective

Umoren, Rachel; Gardner, Adrian; Stone, Geren S.; Helphinstine, Jill; Machogu, Emily P.; Huskins, Jordan C.; Johnson, Cynthia S.; Ayuo, Paul; Mining, Simeon; Litzelman, Debra K.

doi:10.1016/j.hjdsi.2015.10.001

Cited by 26 publications

(25 citation statements)

References 24 publications

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“…Short-term international experiences can improve medical knowledge and clinical skills, 1 influence career objectives, 2 provide insights on ethical and societal issues, 3 and self-development. 4,5 However, little is known about the process and theoretical underpinning of learning through these experiences. Global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship.…”

Section: Introductionmentioning

confidence: 99%

“…Participants have described their experiences through the exchange as life-changing, challenging, incredible , and enlightening . 5,15–17 …”

Section: Introductionmentioning

confidence: 99%

“…Details about the survey method and quantitative results, including impact on future career choice and practice locations, have been previously described. 5 Two open-ended survey questions focused on the influence of the Kenya elective rotation on their career choices and practice patterns. Of the 176 who completed the survey, 137 trainees wrote reflective narratives to these open-ended questions.…”

Section: Introductionmentioning

confidence: 99%

“…Many years out of training, participants were more likely to be generalists working with underserved populations, to be cost-conscious in their healthcare decision-making, and to be involved in global health, public health or public policy. 5 In this manuscript, we focus on a qualitative assessment of the written critical incident reflections participants entered in response to the final survey prompt: “Write about one of their most memorable experiences and explain why you chose to describe this particular one.”…”

Section: Introductionmentioning

confidence: 99%

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On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences

Litzelman

Gardner

Einterz

et al. 2017

Annals of Global Health

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Background Globalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, self-development, influence career objectives, and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship. Objective We conducted a qualitative assessment of trainee-reported critical incidents to more deeply understand the impact of our global health experience on trainees. Method A cross-sectional survey was administered to trainees who had participated in a two-month elective in Kenya from January 1989 to May 2013. We report the results of a qualitative assessment of the critical incident reflections participants (n=137) entered in response to the prompt: “Write about one of their most memorable experiences and explain why you chose to describe this particular one.” Approach Qualitative analyses were conducted using thematic analysis and crystallization immersion analytic methods based on the principles of grounded theory, employing a constructivists’ research paradigm. Results Four major themes emerged. These themes included: Opening Oneself to a Broader World View; Impact of Suffering and Death; and Life Changing Experiences; and Commitment to Care for the Medically Underserved. Conclusions Circumstances that learners encounter in the resource-scarce environment in Kenya are eye-opening and life-changing. When exposed to these frame-shifting circumstances, students elaborate upon or transform existing points of view. These emotionally disruptive experiences in an international health setting allowed students to enter a transformational learning process with a global mind. Students can see the world as an interdependent society and develop the capacity to advance both their enlightened self-interest and the interest of people elsewhere in the world as they mature as global citizens. Medical schools are encouraged to foster these experiences by finding ways to integrate them into curriculum.

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Section: Introductionmentioning

confidence: 99%

“…Participants have described their experiences through the exchange as life-changing, challenging, incredible , and enlightening . 5,15–17 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences

Litzelman

Gardner

Einterz

et al. 2017

Annals of Global Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…The skills learned while participating in a STEGH may correlate with Accreditation Council for Graduate Medical Education competencies [19] and are associated with career choices focused on caring for underserved populations [20,21]. Despite these benefits, ethical concerns remain regarding individuals’ motives and unintended impacts on host institutions and populations [22], particularly with short-term experiences as they are often unsustainable and lack adequate follow-up and supervision [23–31].…”

Section: Introductionmentioning

confidence: 99%

The Practitioner’s Guide to Global Health: an interactive, online, open-access curriculum preparing medical learners for global health experiences

Jacquet

Umoren

Hayward

et al. 2018

Medical Education Online

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Background: Short-term experiences in global health (STEGH) are increasingly common in medical education, as they can provide learners with opportunities for service, learning, and sharing perspectives. Academic institutions need high-quality preparatory curricula and mentorship to prepare learners for potential challenges in ethics, cultural sensitivity, and personal safety; however, availability and quality of these are variable.Objective: The objective of this study is to create and evaluate an open-access, interactive massive open online course (MOOC) that prepares learners to safely and effectively participate in STEGH, permits flexible and asynchronous learning, is free of charge, and provides a certificate upon successful completion.Methods: Global health experts from 8 countries, 42 institutions, and 7 specialties collaborated to create The Practitioner’s Guide to Global Health (PGGH): the first course of this kind on the edX platform. Demographic data, pre- and posttests, and course evaluations were collected and analyzed.Results: Within its first year, PGGH enrolled 5935 learners from 163 countries. In a limited sample of 109 learners, mean posttest scores were significantly improved (p < 0.01). In the course’s second year, 213 sampled learners had significant improvement (p < 0.001).Conclusion: We created and evaluated the first interactive, asynchronous, free-of-charge global health preparation MOOC. The course has had significant interest from US-based and international learners, and posttest scores have shown significant improvement.

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Ensuring the Health, Safety and Preparedness of U.S. Medical Students Participating in Global Health Electives Overseas

2016

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Global health electives based in resource-poor countries have become extremely popular with medical students from resource rich ones. As the number of such programs and participants increase, so too do the absolute health and safety risks. It is clear from a number of published reports that many institutions provide little or no meaningful preparedness for students and do little to ensure their health and safety. These deficiencies together can affect students, their foreign hosts, and sponsoring institutions. The School of Public Health at the State University of New York, Downstate Medical Center, and its predecessor, the Department of Preventive Medicine and Community Health, have sponsored a 6-8 week global health elective for fourth year medical students since 1980. The purposes of this elective are to provide students with an opportunity to observe the health care and public health systems in resource-poor countries, provide medical service, and have a cross-cultural experience. Over the course of the past 35 years, 386 students have participated in this global health elective in more than 41 resource-poor countries. Recent annual applications for this elective have been as high as 44 out of a class of 200 students. Over the past 10 years, annual acceptance rates have varied, ranging from a low of 32 % in 2007-2008 to a high of 74 % in 2010-2011 and 2013-2014. Careful screening, including a written application, review of academic records and personal interviews, has resulted in the selection of highly mature, adaptable, and dedicated students who have performed well at overseas sites. Appropriately preparing students for an overseas global health experience in resource-poor countries requires the investment of much professional and staff time and effort. At the SUNY Downstate School of Public Health, these resources have underpinned our Global Health in Developing Countries elective for many years. As a result, the elective is characterized by meticulous organization, extensive preparedness measures for students, and continuous monitoring of site and country safety. The health of students is ensured by one-on-one assessment of immunization needs, anti-malarials, and the provision of a five-day supply of post-exposure HIV prophylaxis. Students sign agreements regarding the legal issues, immunizations, and anti-malarials recommended as well as HIV post-exposure prophylaxis. They are also required to obtain medical evacuation insurance provided by the university, and medical care insurance valid overseas. Student travel plans are also approved as is in-country lodging. The focus of our 6-8 week global health elective is not clinical medicine. Rather, it is to enable students to learn about the health care and public health systems in a resource-poor country. Through that focus, they also come to understand the causes of health and health care disparities that exist in the country to which they are assigned. Our students are greatly advantaged with regard to cross-cultural understanding since our school is loca...

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Career choices and global health engagement: 24-year follow-up of U.S. participants in the Indiana University-Moi University elective

Cited by 26 publications

References 24 publications

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences

The Practitioner’s Guide to Global Health: an interactive, online, open-access curriculum preparing medical learners for global health experiences

Ensuring the Health, Safety and Preparedness of U.S. Medical Students Participating in Global Health Electives Overseas

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