Development of a theoretical framework for assessment of quality of primary care medical service trips in Latin America

Abstract

Objectives Short-term medical service trips (MSTs) are a controversial modality for addressing the health of marginalized populations. Despite their prevalence, there are no routinely used evaluative frameworks. This study used stakeholder consensus to validate a literature-based framework for MST best practices. Methods A recent systematic review was used to construct a preliminary list of best practices for short-term MSTs. We then recruited a multidisciplinary panel of academics, medical professionals, program coordinators, and non-medical volunteers for a three-round e-Delphi consensus-building exercise to review the list. A 7-point Likert scale was used, with mean scores 4-7 representing rejection, scores \ 2 representing acceptance, and elements scoring in between being redistributed for discussion. ResultsThe literature review identified 30 best practices. Twenty-six stakeholders were recruited for the e-Delphi panel, with 73.1% responding to all three rounds. Eighteen elements were accepted into the final framework. Conclusions This framework identifies essential MST best practices and enables volunteers to compare organizations. Future research should translate this framework into an assessment tool and initiate dialogue between host communities, local clinicians, and sending organizations.

Long-Term Impact of Interprofessional Medical Mission Service Trips in Sierra Leone

“…The mission service trips to Sierra Leone were conducted with emphasis on promoting the transfer of knowledge and clinical skills, determined through observation and collaboration with local practitioners in their daily responsibilities. This process allowed mission teams to identify areas of growth potential and improve current local practice in line with capacity-building best practice recommendations ( 22 ). Maintaining relationships with local staff, investing time in necessary preparatory work, as well as returning to the same site granted opportunities to modify educational content and accommodate local needs, ensuring both efficacy and continuity.…”

Global health training in Canadian family medicine residency programmes

“…It is encouraging to see that 82% of established Canadian resident international electives have an exchange component or Canadian faculty teaching for the host community medical residents and/or staff. When developing these international GH partnerships, we encourage programmes to refer to a framework for medical service trips that has been proposed following a literature review and stakeholder consensus to ensure ethical and productive experiences for both learners and the host community 25. The 18 recommendations centred around the domains of sustainability, education, efficiency, impact and safety, preparedness and cost-effectiveness would be applicable in international and domestic GH settings 25…”

Using a Health Equity Lens to Evaluate Short-Term Experiences in Global Health (STEGH)

“…Take, for example, a common example in literature: the STEGH that provides primary care to disadvantaged populations around the world. Stories abound of volunteers visiting communities, setting up ad-hoc clinics in local churches or school, providing medical services like consultations for a variety of ailments, dental services like cleaning of teeth, and even health promotion activities such as education around nutritious foods to eat or brushing teeth [28][29][30][31]. There is almost always Tylenol that can be given for a cold; parasitic medication to reduce the burden of parasites; and laughing and smiling faces as volunteers explain food groups and ways to stay healthy.…”