The Resident Decision-Making Process in Global Health Education

Abstract

The globalization of pediatric graduate medical education is ongoing; thus, this study was conducted to begin to explore the nature of resident interest in global health (GH) training and to further identify potentially modifiable factors influencing participation in away rotations. The authors surveyed all residents at Cincinnati Children's Hospital Medical Center to identify factors influencing participation in education efforts and away rotations. With a participation rate of 79.4% (n = 143), 5 key factors emerged as most significant in the decision-making process amid all participants. Among residents who had previous experience, 82.1% were interested in participating in an away elective compared with 58.3% of those without experience (P = .002). Residents with previous experience abroad were also more likely to plan to integrate GH into their careers (61.7% vs 26.7%, P < .0001). This article describes specific obstacles to resident participation in GH education and documents the association between previous experience and significant interest in long-term involvement.

Comparative Analysis: Potential Barriers to Career Participation by North American Physicians in Global Health

“…Comparing the published barriers to participation in short-term educational experiences to employment requirements for various global health positions identifies potential barriers which might limit wider career involvement by physicians in global health. These include limited financial compensation, time and scheduling constraints, lack of global health education or skills, personal/family commitments, security concerns, differences in opportunities by specialty, and ethical considerations [18]. Our comparative analysis of the literature also identified a number of potential solutions to these proposed barriers, listed in Table 1.…”

International health experiences in postgraduate medical education: A meta-analysis of their effect on graduates’ clinical practice among underserved populations

“…21 For example, financial support, the presence of an established partner host site, adequate supervision while away, and mentorship at the home site, are key factors influencing residents' choice to participate in international health electives. 22 Such program characteristics may impact the quality of learning experience residents receive as well as which types of residents the program attracts, both of which may play a role in determining an IHE's impact on future practice. Russ et al found that cumulative time spent on IHEs was strongly associated with future work in underserved or global health settings, more so than availability of mentorship or established partner host site.…”

“…When comparing residents with previous IHE experience to those approaching an IHE for the first time, Castillo et al found that residents' plans for a career involving global health was an influencing factor for 62% of IHE-experienced residents but only 27% of IHE-naïve residents (P < .0001). 22 In short, e77…”

The Role of Graduate Medical Education in Global Health: Proceedings From the 2013 Academic Emergency Medicine Consensus Conference

“…Despite increasing interest in global health training experiences for residents, significant administrative barriers exist. The most commonly reported are lack of financial support, scheduling conflicts, difficulty in finding a preestablished clinical training site, paucity of faculty supervision at the site, and concerns over personal safety . Similar challenges exist for residency program directors, including staffing time lost from resident clinical rotations and lack of administrative and financial support .…”