Reciprocity? International Preceptors’ Perceptions of Global Health Elective Learners at African Sites

Abstract

Background: Short-term global health electives (STGHEs) have become increasingly common, with evidence showing educational and clinical benefits for short-term learners (STLs). Despite increased recognition that STGHEs should be mutually beneficial for host sites and STLs, evidence demonstrating the impact on international host preceptors is lacking. Objectives: To understand international host preceptors’ perceptions regarding benefits and burdens of hosting STLs. Methods: Focus group discussions with a convenience sample of 10 of 18 eligible preceptors were conducted at pediatric STGHE sites in Malawi and Lesotho. Qualitative content analysis was performed to identify themes using a deductive-inductive approach. Findings: Common themes regarding benefits to preceptors included increased knowledge and resources for learning from STLs, broadened differential diagnoses, and the satisfaction of teaching. Regarding burdens, preceptors perceived that supervising STLs decreases efficiency. Preceptors identified the burden of having to intervene in instances that could lead to patient harm. Some preceptors perceived that STLs under-valued preceptors’ clinical decision-making in resource-limited contexts. Conclusions: Our findings emphasize the need for institutions to identify mutuality of benefits between STLs and host sites when developing STGHEs. Host preceptors identified robust pre-departure training for STLs, lengthened duration of STGHEs, and formal preceptor orientation as ways to enhance mutuality of benefits.

The Preparing Residents for International Medical Experiences (PRIME) Simulation Workshop: Equipping Surgery and Anesthesia Trainees for International Rotations

“…International clinical rotations present a variety of benefits to trainees, including exposure to different populations, pathogens, and pathologies often presenting at a more advanced stage than is common in high-resource settings. 8 , 11 These benefits, however, come at a cost both for learners and sending institutions, which incur financial costs and safety risks associated with sending trainees abroad, 7 , 12 , 20 and for hosting providers and institutions, which may be burdened by the impact of learners on clinical flow and decision-making. 12 , 21 Improved predeparture training has been advocated by educators from both sending and hosting institutions as a means to mitigate some of these challenges, 1 , 22 – 24 but practical descriptions of implementing such programs in surgery and anesthesiology training are scarce.…”

“… 3 In response to this high interest, up to 61% of anesthesiology and 34% of surgery training programs report having an international health experience. 4 , 5 Although proposals for a strategic approach to international medical education, including programs aimed at exposing trainees to sociocultural dynamics, do exist 6 – 8 and negative host perceptions regarding visiting trainee attitudes and practices have been documented, 9 there remains a lack of standardization in the global health curriculum in GME.…”

Global Health Opportunities in Pediatric Fellowships

“…Data suggest rotations ,1 month long may be more burdensome than beneficial to hosts. [20][21][22] However, .70% of fellowship programs offering international electives report either no minimum or a minimum duration of ,1 month for an elective abroad suggesting an opportunity for a This variable was missing for 1 GHT/F program. b This number represents the total average cost to the institution for additional expenses incurred by GH activities beyond typical fellowship program salary and activities including travel, required curricular components, and advanced degree coursework.…”

American Medical Trainee Perspectives on Ethical Conflicts during a Short-Term Global Health Rotation in Ethiopia: A Qualitative Analysis of 30 Cases

“…8,14 They are more likely to dedicate their clinical career to disadvantaged populations and demonstrate higher rates of humanitarianism. 15,16 There have been fewer studies regarding the impact of STGHEs on host institutions, but STGHEs appear to provide broader knowledge and educational resources to the host institution 17 and strengthen direct patient care. 18 Despite the many benefits, participating in global health experiences can produce ethical challenges that stem from collaborations in which medical practice, cultural norms, and access to resources among partners are dramatically different than what medical trainees from high-income countries are accustomed to.…”