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      Host community perspectives on trainees participating in short-term experiences in global health.

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          Abstract

          High-income country (HIC) trainees are undertaking global health experiences in low- and middle-income country (LMIC) host communities in increasing numbers. Although the benefits for HIC trainees are well described, the benefits and drawbacks for LMIC host communities are not well captured.

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          Ethics and Best Practice Guidelines for Training Experiences in Global Health

          John Crump, Jeremy Sugarman (2010)
          Academic global health programs are growing rapidly in scale and number. Students of many disciplines increasingly desire global health content in their curricula. Global health curricula often include field experiences that involve crossing international and socio-cultural borders. Although global health training experiences offer potential benefits to trainees and to sending institutions, these experiences are sometimes problematic and raise ethical challenges. The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) developed a set of guidelines for institutions, trainees, and sponsors of field-based global health training on ethics and best practices in this setting. Because only limited data have been collected within the context of existing global health training, the guidelines were informed by the published literature and the experience of WEIGHT members. The Working Group on Ethics Guidelines for Global Health Training encourages efforts to develop and implement a means of assessing the potential benefits and harms of global health training programs.
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            Global health training and international clinical rotations during residency: current status, needs, and opportunities.

            Pierce Gardner, Kelley M Skeff, Kelley M Skeff … (2009)
            Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, despite inadequate guidance and support from most accreditation organizations and residency programs. Surveys of global health training, including international clinical rotations, highlight the benefits of global health training as well as the need for a more coordinated approach. In particular, international rotations broaden a resident's medical knowledge, reinforce physical examination skills, and encourage practicing medicine among underserved and multicultural populations. As residents recognize these personal and professional benefits, a strong majority of them seek to gain international clinical experience. In conclusion, with feasible and appropriate administrative steps, all residents can receive global health training and be afforded the accreditation and programmatic support to participate in safe international rotations. The next steps should address accreditation for international rotations and allowance for training away from continuity clinics by residency accreditation bodies, and stipend and travel support for six or more weeks of call-free elective time from residency programs.
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              Beyond Medical "Missions" to Impact-Driven Short-Term Experiences in Global Health (STEGHs): Ethical Principles to Optimize Community Benefit and Learner Experience.

              Melissa Melby, Lawrence Loh, Jessica Evert … (2016)
              Increasing demand for global health education in medical training has driven the growth of educational programs predicated on a model of short-term medical service abroad. Almost two-thirds of matriculating medical students expect to participate in a global health experience during medical school, continuing into residency and early careers. Despite positive intent, such short-term experiences in global health (STEGHs) may exacerbate global health inequities and even cause harm. Growing out of the "medical missions" tradition, contemporary participation continues to evolve. Ethical concerns and other disciplinary approaches, such as public health and anthropology, can be incorpo rated to increase effectiveness and sustainability, and to shift the culture of STEGHs from focusing on trainees and their home institutions to also considering benefits in host communities and nurtur ing partnerships. The authors propose four core principles to guide ethical development of educational STEGHs: (1) skills building in cross-cultural effective ness and cultural humility, (2) bidirectional participatory relationships, (3) local capacity building, and (4) long-term sustainability. Application of these principles highlights the need for assessment of STEGHs: data collection that allows transparent compar isons, standards of quality, bidirectionality of agreements, defined curricula, and ethics that meet both host and sending countries' standards and needs. To capture the enormous potential of STEGHs, a paradigm shift in the culture of STEGHs is needed to ensure that these experiences balance training level, personal competencies, medical and cross-cultural ethics, and educational objectives to minimize harm and maximize benefits for all involved.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Med Educ
                Title: Medical education
                Publisher: Wiley-Blackwell
                ISSN (Electronic): 1365-2923
                ISSN (Print): 0308-0110
                Publication date (Electronic): Nov 2016
                Volume: 50
                Issue: 11
                Affiliations
                [1 ] Department of Medicine-Infectious Disease, Stanford University School of Medicine, Stanford, California, USA. tkung@stanford.edu.
                [2 ] Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
                [3 ] Department of Medicine-Infectious Disease, Stanford University School of Medicine, Stanford, California, USA.
                [4 ] Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA.
                [5 ] Department of Medicine-General Disciplines, Stanford University School of Medicine, Stanford, California, USA.
                [6 ] Child Family Health International, San Francisco, California, USA.
                [7 ] Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, USA.
                Article
                DOI: 10.1111/medu.13106
                PubMed ID: 27762010
                SO-VID: a1273cca-822d-4d68-a453-087cf46b9d10
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