ABSTRACT
Increased migration and im/migrant (i.e. migrant and immigrant) inequities, particularly during COVID-19, call for experiential global public health teaching to adequately prepare future leaders. We evaluated student perspectives on the benefits, drawbacks, and lessons learned from a migrant health field course in the U.S.-Mexico border region. We analyzed qualitative data from reflexive diary-writing assignments and post-course evaluations from graduate and undergraduate students (N = 12). Students highlighted personal growth and reflexivity, professional development opportunities, and benefits and drawbacks of the immersive course design as key themes. Tri-national learning across Canada, Mexico and the U.S., and an interdisciplinary, cross-cultural learning model allowed for deeper understandings of globally relevant and politically and socially complex issues through community engagement and 'real-world' approaches. Students described benefits of reflexive learning, bridging classroom-based learning with field experiences, and learning about community-engaged research in advancing im/migrant justice, though acknowledged challenges of intensive course design. Narratives highlighted unique needs in navigating challenges inherent in reflexive learning on sensitive topics, such as structural inequities faced by asylum seekers. This evaluation provides unique empirical evidence to inform future experiential learning opportunities rooted in equity-oriented approaches, which are crucial for advancing hands-on learning regarding global issues. Appropriate approaches must ensure ethical, respectful community engagement and ongoing support for students.Copyright © 2021 Institute of Health Promotion and Education.
ABSTRACT
Increased migration and im/migrant (i.e. migrant and immigrant) inequities, particularly during COVID-19, call for experiential global public health teaching to adequately prepare future leaders. We evaluated student perspectives on the benefits, drawbacks, and lessons learned from a migrant health field course in the U.S.–Mexico border region. We analyzed qualitative data from reflexive diary-writing assignments and post-course evaluations from graduate and undergraduate students (N = 12). Students highlighted personal growth and reflexivity, professional development opportunities, and benefits and drawbacks of the immersive course design as key themes. Tri-national learning across Canada, Mexico and the U.S., and an interdisciplinary, cross-cultural learning model allowed for deeper understandings of globally relevant and politically and socially complex issues through community engagement and ‘real-world’ approaches. Students described benefits of reflexive learning, bridging classroom-based learning with field experiences, and learning about community-engaged research in advancing im/migrant justice, though acknowledged challenges of intensive course design. Narratives highlighted unique needs in navigating challenges inherent in reflexive learning on sensitive topics, such as structural inequities faced by asylum seekers. This evaluation provides unique empirical evidence to inform future experiential learning opportunities rooted in equity-oriented approaches, which are crucial for advancing hands-on learning regarding global issues. Appropriate approaches must ensure ethical, respectful community engagement and ongoing support for students. © 2021 Institute of Health Promotion and Education.
ABSTRACT
INTRODUCTION: Postoperative pulmonary complications and mortality rates during the COVID-19 pandemic have been higher than expected, leading to mass cancellation of elective operating in the UK. To minimise this, the Guy's and St Thomas' Hospital NHS Foundation Trust elective surgery hub and the executive team at London Bridge Hospital (LBH) created an elective operating framework at LBH, a COVID-19 minimal site, in which patients self-isolated for two weeks and proceeded with surgery only following a negative preoperative SARS-CoV-2 polymerase chain reaction swab. The aim was to determine the rates of rates of postoperative COVID-19 infection. METHODS: The collaboration involved three large hospital trusts, covering the geographic area of south-east London. All patients were referred to LBH for elective surgery. Patients were followed up by telephone interview at four weeks postoperatively. RESULTS: Three hundred and ninety-eight patients from 13 surgical specialties were included in the analysis. The median age was 60 (IQR 29-71) years. Sixty-three per cent (252/398) were female. In total, 78.4% of patients had an American Society of Anesthesiologists grade of 1-2 and the average BMI was 27.2 (IQR 23.7-31.8) kg/m2. Some 83.6% (336/402) were 'major' operations. The rate of COVID-19-related death in our cohort was 0.25% (1/398). Overall, there was a 1.26% (5/398) 30-day postoperative all-cause mortality rate. Seven patients (1.76%) reported COVID-19 symptoms, but none attended the emergency department or were readmitted to hospital as a result. CONCLUSION: The risk of contracting COVID-19 in our elective operating framework was very low. We demonstrate that high-volume major surgery is safe, even at the peak of the pandemic, if patients are screened appropriately preoperatively.