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      A comparative study of Taiwan's short-term medical missions to the South Pacific and Central America

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          Abstract

          Background

          Taiwan has been dispatching an increasing number of short-term medical missions (STMMs) to its allied nations to provide humanitarian health care; however, overall evaluations to help policy makers strengthen the impact of such missions are lacking. Our primary objective is to identify useful strategies by comparing STMMs to the South Pacific and Central America.

          Methods

          The data for the evaluation come from two main sources: the official reports of 46 missions to 11 countries in Central America and 25 missions to 8 countries in the South Pacific, and questionnaires completed by health professionals who had participated in the above missions. In Central America, STMMs were staffed by volunteer health professionals from multiple institutions. In the South Pacific, STMMs were staffed by volunteer health professionals from single institutions.

          Results

          In comparison to STMMs to Central America, STMMs to the South Pacific accomplished more educational training for local health providers, including providing heath-care knowledge and skills (p<0.05), and training in equipment administration (p<0.001) and drug administration (p<0.005). In addition, language constraints were more common among missions to Central America (p<0.001). There was no significant difference in the performance of clinical service between the two regions.

          Conclusions

          Health-care services provided by personnel from multiple institutions are as efficient as those from single institutions. Proficiency in the native language and provision of education for local health-care workers are essential for conducting a successful STMM. Our data provide implications for integrating evidence into the deployment of STMMs.

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          Most cited references28

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          Strengths and challenges in the use of interpretive description: reflections arising from a study of the moral experience of health professionals in humanitarian work.

          Interpretive description is a qualitative research methodology aligned with a constructivist and naturalistic orientation to inquiry. The aim of interpretive description, a relatively new qualitative methodology, is to generate knowledge relevant for the clinical context of applied health disciplines. To date there has been little discussion in the literature of the particular merits and limitations of this methodological framework. In this article I draw on my experience of using interpretive description as methodology for an inquiry into the moral experience of clinicians in humanitarian work. I identify and discuss strengths and challenges that can arise in the application of interpretive description. Strengths identified include a coherent logic and structure, an orientation toward the generation of practice-relevant findings, and attention to disciplinary biases and commitments. Challenges include limited resources for situating the methodology, challenges in employing a lesser-known methodology, and uncertainty regarding the degree of interpretation to seek.
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            Educational effects of international health electives on U.S. and Canadian medical students and residents: a literature review.

            To evaluate the educational effects of international health electives (IHEs) on participants. IHEs are a popular component of many medical school and residency program curricula, and are reported to provide benefits in knowledge, skills, and attitudes. The authors reviewed all studies reported in Medline and ERIC databases that have assessed the educational effects of IHEs on U.S. and Canadian medical students and residents. Data extracted from eligible studies included type and duration of IHE, details of survey instrument, response rate, comparison group, and outcomes. Seven of the eight eligible studies assessed educational effects on participants using self-reported questionnaires; a single study used an objective measurement of knowledge. Eight studies involving 522 medical students and 166 residents met inclusion criteria. IHEs appear to be associated with career choices in underserved or primary care settings and recruitment to residency programs. They also appear to have positive effects on participants' clinical skills, certain attitudes, and knowledge of tropical medicine. IHEs appear to have positive educational influences on participants' knowledge, skills, and attitudes. Furthermore, IHEs may play some role both in recruiting residents and in their choices of careers in primary care and underserved settings. Future directions for research in this field are discussed.
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              Health impact assessment and short-term medical missions: A methods study to evaluate quality of care

              Background Short-term medical missions (STMMs) are a well-established means of providing health care to the developing world. Despite over 250 million dollars and thousands of volunteer hours dedicated to STMMs, there is a lack of standardized evaluation to assess patient safety, quality control, and mission impact. The objective of this project is to design and implement an assessment tool that defines objective parameters of quality of care as identified by STMMs. Methods The study was conducted in 3 phases: 1) Base-need analysis to determine factors critical to the quality of STMMs, 2) Design of 5 surveys for mission personnel and patients to enable 360-degree evaluation based on factors from phase 1, and 3) Field testing of the surveys with 5 STMMs. Results An evaluation tool was created assessing 6 major and 30 minor factors identified as important to the quality of STMMs. 5 mission directors, 43 personnel, 10 local hosts, and 55 patients completed the surveys. Of the 6 major measures of quality, missions performed best in Cost (mean score 86%), and Impact (84%). The poorest performance was in Education (64%). Efficiency, Sustainability, and Preparedness showed mean scores of 76%, 77%, and 73%, respectively. Conclusion Our study provides a novel standardized tool for STMM evaluation. Use of the assessment instrument identified areas of strength and weakness of a particular mission, and delineated general trends in performance compared to other STMMs. We anticipate that the use of this tool may improve the quality of care provided by missions, and stimulate solution-sharing and scholarly discussion among missions.
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                Author and article information

                Journal
                BMC Int Health Hum Rights
                BMC Int Health Hum Rights
                BMC International Health and Human Rights
                BioMed Central
                1472-698X
                2012
                27 December 2012
                : 12
                : 37
                Affiliations
                [1 ]Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
                [2 ]Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
                [3 ]Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
                [4 ]International Cooperation and Development Fund, Taipei, Taiwan
                [5 ]Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
                [6 ]School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
                [7 ]Taiwan Health Corps, Taipei, Taiwan
                Article
                1472-698X-12-37
                10.1186/1472-698X-12-37
                3546052
                23270459
                c178f01a-0643-4188-8962-da43f3ed2228
                Copyright ©2012 Chiu et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 August 2012
                : 18 December 2012
                Categories
                Research Article

                Health & Social care
                medical missions,health professional,language,education,efficiency
                Health & Social care
                medical missions, health professional, language, education, efficiency

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