Neerav A. Desai, MD, MD, Vanderbilt University, Nashville, TN, Lindy Fenlason, MD, Vanderbilt University, Nashville, TN
Background: Students in health care professions are eager to participate in international medical work. Short-term medical endeavors can be limited in impact and are associated with ethical risks to visiting and host groups. Global health courses can serve as a method to emphasize core competencies of medical education. The aim of this initiative was to provide a global health course that focused on global health ethics, multidisciplinary teaching and learning, care for chronic medical conditions, and cultural competence.
Methods: The 12-week interdisciplinary course, incorporated didactic, case-based, and experiential learning in three phases: preparation, immersion, and processing and presentation. The preparation phase included weekly sessions lead by a multidisciplinary team of specialists and focused on the impacts of diabetes, cardiovascular disease, nutrition, cultural competence, and global health ethics as it pertained to Nicaraguan health care. Students designed teaching modules, skits, and handouts to engage Nicaraguan patients about care for chronic medical conditions. The 10-day immersion phase involved supervised observation and participation in pediatric and adult clinical care, and delivery of Spanish patient education sessions and educational materials. Assessment of the intervention was accomplished through student course evaluations and Nicaraguan patients and staff cultural competency surveys.
Results: Results of Nicaraguan surveys showed 94% strongly agree that cultural sensitivity goals were attained, and 96% agreed teaching module objectives were attained. Student evaluations revealed 76% agreed that this course would stimulate pursuit of global health opportunities. Students and patients also provided practical and constructive feedback in summative questions about course outcomes.
Conclusions: This course served as an effective introduction to global health and selected core competencies for pre-clinical students, and demonstrated that education-based interventions are an effective way to impact health of patients in a time-limited setting. This method could be implemented at other institutions to help students understand the importance of global health stewardship. Next steps include peer review of the curriculum, and improving the sustainability of the project by engaging Nicaraguan health care providers in education and collaboration.