Practising beyond one's scope while working abroad

Doobay-Persaud, Ashti; Evert, Jessica; DeCamp, Matthew; Evans, Charlesnika T.; Jacobsen, Kathryn H.; Sheneman, Natalie; Goldstein, Joshua; Nelson, Brett D.

doi:10.1016/s2214-109x(19)30291-8

Cited by 9 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another study found that including an ethics workshop prior to a global health elective for medical students improved students' self-rating of preparedness to manage ethical dilemmas [3]. Even though a number of residency programs and organizations (e.g., Consortium of Universities for Global Health and the American Academy of Pediatrics) have created structured global health guidelines and competencies to address the challenges most commonly faced by medical students and faculty from HICs while working abroad, these need to be put into practice [3,6,18,20]. In addition, trainees would benefit from ongoing mentorship before, during, and after their STEGH to provide more opportunities for critical reflection and transformative learning [5].…”

Section: Introductionmentioning

confidence: 99%

Perspectives and Solutions from Clinical Trainees and Mentors Regarding Ethical Challenges During Global Health Experiences

Kasper

Mulye²,

Doobay-Persaud³

et al. 2020

Annals of Global Health

Self Cite

View full text Add to dashboard Cite

Background: Clinical trainees face challenges throughout short-term experiences in global health (STEGH) that are not routinely addressed. Objectives: Describe common professional and ethical dilemmas faced by clinical trainees and identify gaps and solutions for pre, during, and post-STEGH training and mentoring. Methods: We conducted a mixed-methods study among trainees and mentors involved in global health. The study utilized focus groups with trainees (November-December 2015) and online surveys of trainees, in-country and stateside faculty mentors (October 2016-April 2017). Results: 85% (17/20) of students reported feeling prepared for their STEGH; however, 59% (23/39) of faculty felt students were unprepared. A majority of both students (90%) and faculty (77%) stated students would likely experience an ethical dilemma during STEGH. Major themes relating to meaningful global health work were elucidated: personal and inter-professional skills; interpersonal networks and collaboration; and awareness of power dynamics and bias. Conclusions: The most common challenges faced by trainees during STEGH related to leadership, bias, ethics and interprofessional collaboration. Redirecting trainee energies from a focus on 'doing' and deliverables to attitudes (e.g., humility, professionalism) that cultivate personal and professional growth will help create lifelong global health learners and leaders.

show abstract

Section: Introductionmentioning

confidence: 99%

Perspectives and Solutions from Clinical Trainees and Mentors Regarding Ethical Challenges During Global Health Experiences

Kasper

Mulye²,

Doobay-Persaud³

et al. 2020

Annals of Global Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Two articles published in 2018 and 2019 highlight the issue of ensuring that students and trainees are qualified to perform assigned duties while working in another country. 6,7 If a trainee feels incompetent and uncomfortable, mistakes are more likely to occur. Many trainees will perform the requested duty if they are commanded to do so by a superior or owing to altruistic motivations to help a patient who is experiencing pain.…”

Section: Resultsmentioning

confidence: 99%

Ethical considerations when participating in global mission trips before dental school

Shick¹,

Woodmansey²

2020

The Journal of the American Dental Association

View full text Add to dashboard Cite

During a dental school admissions interview, an applicant, Steve, excitedly talked of how he became interested in becoming a dentist. He told the story of a lifechanging dental mission in a low-and middle-income country (LMIC) during high school with a group of volunteer dentists. The interviewing faculty listened, always interested to hear how applicants decide to apply to dental school. Steve continued to tell the story of visiting a rural part of the country with few or no practicing dentists nearby. As with most international trips, the group saw many people with pain and infection who had never visited a dentist before then. Steve was able to provide assistance and affirmed that dentistry would be his future career choice. One particular patient experience convinced him to become a dentist. An older adult man came in with an infected molar that needed to be extracted. After administering local anesthetic, the volunteer dentist looked at Steve, who was assisting, held the dental forceps toward him, and asked if he wanted to extract the tooth. Steve replied that he was excited for that experience and wanted to learn how to extract teeth. The dentist allowed Steve to extract the tooth. What are the ethical issues surrounding this scenario?

show abstract

“…16 Visiting trainees may feel compelled or be asked to practice outside their scope of practice or with minimal supervision causing significant harm to patients, who may be unaware of their individual expertise particularly in a new context. 17 Returning trainees have also reported feeling inadequately prepared to handle the ethical dilemmas encountered during these experiences. 18 Numerous initiatives have been launched to respond to these concerns and establish consensus on ethical guidelines for global health partnerships and rotations.…”

Section: Introductionmentioning

confidence: 99%

From Creation to Evaluation: A Comprehensive Global Health Scholars Program for Graduate Medical Education Trainees

Morgan

Galvin

Goldstein

et al. 2020

Journal of Medical Education and Curricular Development

Self Cite

View full text Add to dashboard Cite

Introduction: Recently, participation in clinical global health rotations has significantly increased among graduate medical education (GME) trainees. Despite the many benefits these experiences provide, many ethical challenges exist. Well-intentioned partnerships and participants often encounter personal and professional dilemmas related to safety, social responsibility, and accountability. We designed a curriculum to provide trainees of all specialties with a comprehensive educational program aimed at delivering culturally mindful and ethically responsible clinical care in resource-constrained settings. Methods: The McGaw Global Health Clinical Scholars Program (GHCS) at Northwestern University offers a 2-year curriculum for selected GME trainees across specialties interested in global health. Each trainee must complete the following components: core lectures, peer journal club, specialty-specific lectures, a mentorship agreement, ethics and skill-based simulations, a global health field experience, a poster presentation, and a mentored scholarly project. Results: Since 2014, 84 trainees from 13 specialties have participated in the program with 50 current trainees and 39 graduates. Twenty-five trainees completed exit surveys, of which 95% would recommend this program to other trainees and 84% felt more prepared to deliver global health care. In addition, 78% reported career plans that included global health and/or work with underserved populations. Trainees described “acceptance of differences and respect for those differences” and “understanding sustainability” as learning points from the program. Discussion: Providing a comprehensive global health education program across specialties can be feasible and effective. GME trainees who participated in this program report feeling both more prepared for clinical experiences and more likely to serve the underserved anywhere.

show abstract

Practising beyond one's scope while working abroad

Cited by 9 publications

References 11 publications

Perspectives and Solutions from Clinical Trainees and Mentors Regarding Ethical Challenges During Global Health Experiences

Perspectives and Solutions from Clinical Trainees and Mentors Regarding Ethical Challenges During Global Health Experiences

Ethical considerations when participating in global mission trips before dental school

From Creation to Evaluation: A Comprehensive Global Health Scholars Program for Graduate Medical Education Trainees

Contact Info

Product

Resources

About