ABSTRACT
Trainees and clinicians from high-income countries are increasingly engaging in global health (GH) efforts, particularly in resource-limited settings. Concomitantly, there is a growing demand for these individuals to be better prepared for the common challenges and controversies inherent in GH work. This is a state-of-the-art review article in which we outline what is known about the current scope of trainee and clinician involvement in GH experiences, highlight specific considerations and issues pertinent to GH engagement, and summarize preparation recommendations that have emerged from the literature. The article is focused primarily on short-term GH experiences, although much of the content is also pertinent to long-term work. Suggestions are made for the health care community to develop and implement widely endorsed preparation standards for trainees, clinicians, and organizations engaging in GH experiences and partnerships.
Subject(s)
Community Health Services/economics , Community Health Services/methods , Global Health/economics , Health Personnel/economics , Health Resources/economics , Community Health Services/trends , Global Health/trends , Health Personnel/psychology , Health Personnel/trends , Health Resources/trends , HumansSubject(s)
Child Advocacy , Child Health , Global Health , Physician's Role , Child , Communicable Diseases , Humans , Pediatrics , Population Dynamics , Travel , VaccinationABSTRACT
Traditionally, family members were excluded from viewing invasive procedures and cardiopulmonary resuscitation in the pediatric emergency department. The concept of family-centered care in the emergency department has now become more widespread. Consequently, family member presence during routine invasive procedures such as venipuncture, intravenous cannulation, urethral catheterization, and lumbar puncture has become more accepted. Survey evidence indicates parents' overwhelming desire to be present for invasive procedures and cardiopulmonary resuscitation. Healthcare provider opinions about family witnessed resuscitation lack similar uniformity. Variations in approval of witnessed resuscitation are influenced by occupation, level of training and experience, and prior exposure to family member presence practices. Although several organizations formally support family presence policies, citing benefits for grieving relatives, critics point to a lack of rigor in a large body of the research cited to underpin these endorsements. We review the literature from the perspective of pediatric emergency physicians, offer suggestions for family member presence, and provide directions for future study.
