S-PACK: A Modular and Modifiable, Comprehensive Predeparture Preparation Curriculum for Global Health Experiences

Abstract

Problem Approximately 25% of trainees participate in a global health elective during their undergraduate or graduate medical education. Increasingly, educators in the United States and international partners are calling for improved predeparture preparation training for global health experiences. Yet, freely available, easily modifiable curricula are rare. Approach Educators who created the Simulation Use for Global Away Rotations (SUGAR) curriculum formed a workgroup in September 2017 to develop the SUGAR Pre-Departure Activities Curricular Kit (S-PACK). Using Kern’s 6-step approach to curriculum development, they identified 10 essential domains for global health preparation, developed learning objectives, created interactive activities pertinent to those domains using different education strategies, piloted and refined the curriculum, packaged it for online facilitator training, and disseminated it in March 2018. Outcomes The S-PACK curriculum includes 6 interactive, modifiable modules that use a variety of educational strategies to enable educators to comprehensively prepare trainees for global health electives. Modules incorporate simulations, procedural training, small-group case-based discussions, and reflection exercises on topics ranging from providing treatment when resources are limited to mitigating culture shock to considering wellness while away. Each module includes a facilitator training packet, curricular resources, and introduction videos. All are freely available at sugarprep.org. Next Steps Since an initial in-person workshop at a national conference, the S-PACK curriculum has been available online. Further evaluation is underway, including developing assessments for educators to measure trainee readiness for global health electives. Piloting the feasibility of regional S-PACK preparation bootcamps to support training programs with limited global health resources is planned.

Pre-departure and Post-elective Requirements for Global Health Electives: Survey of Canadian Royal College Emergency Medicine Programs

“…Previous research has demonstrated unclear results as to the level of training offered to, and required of, residents prior to GH electives. A 2013 survey of US residency training programs found that 66% offered some pre-departure preparation, with 40% of EM programs offering this training [2,3]. Another 2013 study showed that only 15.4% of EM programs offered training for working internationally [10].…”

“…The popularity of Global Health (GH) has surged over the last two decades. The availability of GH opportunities influences the ranking of medical schools and residency programs for many applicants, and approximately 25% of United States (US) undergraduate and postgraduate trainees complete a GH elective [1][2]. Similarly, 86% of US Emergency Medicine (EM) residents reported having incorporated the availability of GH electives into their residency program ranking decisions [3].…”

The Minnesota Model: A Residency Global Health Track Framework

“…17 Recently, we collaborated with the Midwest Consortium of Global Child Health Educators 27,28 to develop an open-access facilitator training package, S-PACK, which incorporates much of this work. 14,29 Knowledge assessment. All residents must pass (³ 80%) an online Medical Knowledge for Service Abroad (MKSA) examination that we created and was peer-reviewed by GH educators at outside institutions and is updated regularly.…”

“…These collaborations have fostered the sharing of ideas that have improved our GH track and led to innovations that would not have been possible to undertake as a single institution, such as the creation of the SUGARPREP predeparture curricula. 8,9,14,15,28 We have also learned the importance of flexibility in finding creative ways to adapt our GH track as residency requirements, schedules, and the overall landscape of residency education have changed, most recently with the development of the GH Track Passport.…”

“…Over the course of administering our track, we have published several curricular components, which we developed with international and stateside partners, to aid educators looking to implement GH tracks at their institutions. [7][8][9][12][13][14][15][16][17] These articles have described specific components of the track but do not take into account the evolving nature of our track and lessons learned along the way. In this article, we will comprehensively describe our GH track model, together with outcomes and resources, and provide a concise, replicable GH track framework for educators seeking to create more formal GH education within residency programs.…”