The Minnesota Model: A Residency Global Health Track Framework

Pitt, Michael B.; Slusher, Tina M.; Gladding, Sophia P.; Moskalewicz, Risha L.; Howard, Cynthia R.

doi:10.4269/ajtmh.19-0463

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…This diversity may be in part attributable to non-Hispanic heterogeneous, refugee and immigrant groups from southeast Asia and Africa that have been previously studied in overlapping geographies 15 and due to Minnesota's tradition as a refugee resettlement state. 16,17…”

Section: Discussionmentioning

confidence: 99%

Association of limited English proficiency with emergency department irregular departures and return visits: A cross‐sectional cohort study in the Upper Midwest between January 2018 and December 2021

Bower

Campbell

Mullan

et al. 2023

Academic Emergency Medicine

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ObjectivesPatients with limited English proficiency (LEP) have been shown to experience disparities in emergency department (ED) care. The objectives of this study were to examine the associations between LEP and irregular ED departures and return ED visits.MethodsWe conducted a multicenter cross‐sectional analysis of 18 EDs within an integrated health system in the upper Midwest from January 1, 2018, to December 31, 2021. ED visits of pediatric and adult patients who were discharged on the index visit were included for analysis. We analyzed the association of LEP with irregular departures, 72‐h and 7‐day return visits, and ED disposition at the time of that return visit. Multivariable model associations were calculated using generalized estimating equations and reported as odds ratios (OR) with 95% confidence intervals (CIs).ResultsA total of 745,464 total ED visits were analyzed, including 27,906 (3.7%) visits among patients with LEP. The most common preferred languages among patients with LEP were Spanish (12,759; 45.7%), Somali (4978; 17.8%), and Arabic (3185; 11.4%). After multivariable adjustment there were no differences in proportions of irregular departures (OR 1.09, 95% CI 0.99–1.21), 72‐h returns (OR 0.99, 95% CI 0.92–1.06), or 7‐day returns (OR 0.99, 95% CI 0.93–1.05) between patients with LEP or English proficiency. Patients with LEP returning within 72 h (OR 1.19, 95% CI 1.01–1.40) and 7 days (OR 1.15, 95% CI 1.01–1.33) were more likely to be admitted to the hospital.ConclusionsAfter multivariable adjustment, we did not find an increased frequency of irregular ED departures or 72‐h or 7‐day returns among patients with LEP compared with people proficient in English. However, we did find that higher proportions of patients with LEP were admitted to the hospital at the time of the return ED visit.

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Section: Discussionmentioning

confidence: 99%

Association of limited English proficiency with emergency department irregular departures and return visits: A cross‐sectional cohort study in the Upper Midwest between January 2018 and December 2021

Bower

Campbell

Mullan

et al. 2023

Academic Emergency Medicine

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“…Further curriculum details are found in The Minnesota Model. 4 The first cohort of pediatric and medicine-pediatric residents graduated in 2008. Since then, an average of 54% of residents on the track completed the requirements to receive a global pediatrics track certificate.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Impact of Global Pediatrics Curriculum, Experience, and Mentorship in Pediatric Residency

Ojo

Lauden

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Global health education is offered increasingly during residency training. The University of Minnesota has offered a global pediatrics track to residents since 2005. This study aimed to understand the impacts of a global pediatrics track on graduates’ career choices, skills, and current engagement in global health. An electronic survey was sent to 110 track graduates in February to April 2020. Data were analyzed with descriptive statistics and paired t-tests. Content analysis of written comments was conducted. The response rate was 62% overall, varying by question. Overall, 75% of responding graduates reported global pediatrics track participation affected their career choices. Eighty-four percent recalled plans to work in global health after graduation and 64% of respondents reported working in global health abroad or at home at the time of the survey. Incorporation of public health and global research represented the greatest percentage change in career plans from the time of enrollment to graduation (24% and 27%, respectively). Ninety-five percent of respondents reported that track participation improved their ability to elicit information about cultural beliefs and practices, and 86% reported improvement in cost-conscious care. An increase in global health knowledge and skills was the most common category of impact cited by respondents. Neonatal resuscitation, bubble continuous positive airway pressure, and homemade spacers for metered-dose inhalers were the most used global health-adapted skills. Our study found that graduates of the global pediatrics track perceive their participation affected their knowledge, skills, and attitudes positively, with the potential to improve clinical care and promote health equity locally and globally.

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“…Calls have been made to increase the focus on global health training in U.S. medical residency programs as early as 2003. 2 Although core competencies to guide a global health curriculum development have been defined, 3,4 there are limited published data on the impact of global health training on students or residents. A systematic review summarized the benefits and challenges of global health electives for U.S.-based residents as follows: 1) improvement of medical knowledge, physical examination, and procedural skills; 2) improvement in resourcefulness and cost-effectiveness; 3) improvement in cultural and interpersonal competence; and 4) professional and career development.…”

Section: Introductionmentioning

confidence: 99%

“…The UMN Internal Medicine, Pediatrics, and Medicine/Pediatrics (Med/Peds) Residency Programs and the HHS Internal Medicine and Emergency Medicine/Internal Medicine (EM/ IM) Residency Programs have had highly organized, formal, and structured "global health" programs stretching back more than 2 decades. 3 Since the inception of these programs, they have operated on, and been justified by, the premise that "the global is local." This premise recognizes that increasing human mobility and health disparities not only affect people overseas but are important drivers of infections, noncommunicable diseases, and health outcomes in every health setting in the United States.…”

Section: Introductionmentioning

confidence: 99%

Global Is Local: Does Formal Resident Global Health Medical Education Improve Clinical Care in the United States?

Erayil

Lopez

Shaughnessy

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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We administered a standardized 41-item questionnaire to a convenience sample of graduates of five residency programs with formal global health pathways and compared findings to a national cohort of practicing physicians to evaluate the comparative effectiveness of an overarching global health pathway on residency program graduates. Compared with the national cohort database, global health pathway graduates self-reported that they felt better prepared to treat immigrants, refugees, patients with limited English proficiency (LEP), racial/ethnic minorities, those with non-Western health beliefs, international travelers, and military veterans (P < 0.05). They were more likely to report using best practices when working with lesbian, gay, bisexual, transgender, queer/questioning patients, immigrant and refugee patients, patients with non-Western health beliefs, patients with LEP, and patients communicating via American Sign Language (P < 0.05). They also reported being more familiar with 11 of 14 high-impact or common infections encountered in travelers, immigrants, and military personnel (P < 0.05). Our findings suggest that formal postgraduate training focused on global health improves knowledge, attitudes, and self-reported medical practices when caring for diverse and marginalized populations in the United States.

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The Minnesota Model: A Residency Global Health Track Framework

Cited by 6 publications

References 26 publications

Association of limited English proficiency with emergency department irregular departures and return visits: A cross‐sectional cohort study in the Upper Midwest between January 2018 and December 2021

Association of limited English proficiency with emergency department irregular departures and return visits: A cross‐sectional cohort study in the Upper Midwest between January 2018 and December 2021

Long-Term Impact of Global Pediatrics Curriculum, Experience, and Mentorship in Pediatric Residency

Global Is Local: Does Formal Resident Global Health Medical Education Improve Clinical Care in the United States?

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