ABSTRACT
PURPOSE: The global mobility of medical student and trainee populations has drawn researchers' attention to consider internationalization in medical education. Recently, researchers have focused on cultural diversity, predominately drawing on Hofstede's cross-cultural analysis of cultural dimensions from general population data to explain their findings. However, to date no research has been specifically undertaken to examine cultural dimensions within a medical student or trainee population. This is problematic as within-country differences between gender and professional groups have been identified within these dimensions. We address this gap by drawing on the theoretical concept of national context effects: specifically Hofstede's six-dimensional perspective. In doing so we examine medical students' and trainees' country profiles across dimensions, country-by-gender clustering, and differences between our data and Hofstede's general population data. METHODS: We undertook a cross-cultural online questionnaire study (eight languages) containing Hofstede's 2013 Values Survey. Our questionnaire was live between 1st March to 19th Aug 2018, and December 2018 to mitigate country holiday periods. We recruited undergraduate medical students and trainees with at least 6-months' clinical training using school-specific methods including emails, announcements, and snowballing. RESULTS: We received 2,529 responses. Sixteen countries were retained for analyses (n = 2,307, 91%): Australia, Chile, China, Hong Kong, India, Indonesia, Ireland, Israel, Japan, Malaysia, New Zealand, Pakistan, South Africa, South Korea, Sri-Lanka, Taiwan. Power distance and masculinity are homogenous across countries. Uncertainty avoidance shows the greatest diversity. We identified four country clusters. Masculinity and uncertainty are uncorrelated with Hofstede's general population data. CONCLUSIONS: Our medical student and trainee data provides medical education researchers with more appropriate cultural dimension profiles than those from general population data. Country cluster profiles stimulate useful hypotheses for further research, especially as patterning between clusters cuts across traditional Eastern-Western divides with national culture being stronger than gendered influences. The Uncertainty dimension with its complex pattern across clusters is a particularly fruitful avenue for further investigation.
ABSTRACT
BACKGROUND: Education and training of undergraduate health science students in public health are insufficient in many parts of the world. This lack is a risk as early interest in specialist training options is a predictor of future training choices. A special interest group (SIG) is one mechanism to engage students, increase awareness and generate interest in public health. The purpose of this case study was to create and study such a group at an African university. CASE PRESENTATION: An action research study design was used to create and study the SIG. All interested students were invited to participate in the SIG and in the data collection procedures. Data were collected via paper-based and online questionnaires. Records of activities were documented, and a reflective diary was kept by the researcher. Seven SIG meetings were held which were less than planned-some sessions were cancelled due to general student unrest. The composition of the SIG fluctuated, but the core group of 16 students consisted of 12 females (75%) and 4 males (25%). Despite faculty-wide marketing, all the participants were medical students. The most successful marketing strategy was done by two lecturers. A total of 12 participants' motivation (75%) was to learn more about public health. Despite the range of participants being over 4-year groups with varying schedules and commitments, a convenient day and meeting time were identified. The social capital of lecturers was harnessed to invite external guest lecturers as planned field trips proved impractical. At the mid-year point, six students (38%) thought that they would consider public health as a career choice. A decision was made to recruit new members via a seminar, and 37 possible new members were identified in the process. CONCLUSIONS: A SIG appears to be an effective strategy to increase public health interest among students. This finding is key in settings with particular health workforce shortages and high burdens of disease. A foundation phase with high levels of academic support by those already qualified is needed to allow student leadership to emerge. Despite the modified and reduced number of sessions, the SIG was still successful in increasing awareness about public health and possible career choices: both positive consequences of engaging with students within a SIG.
ABSTRACT
BACKGROUND: A large number of maternal and neonatal deaths occur during birth and 48 h after birth. The benefits of postnatal care to the mother and newborn cannot be overemphasized as this is another opportunity where complications that might arise from pregnancy and childbirth can be treated, as well as the time to provide important information on maternal and newborn care after delivery. This study aimed to determine the information needs of mother-baby pairs in the first 6 weeks after birth. METHODS: An exploratory qualitative study using in-depth interviews at three points in time was conducted with 15 women who had their births at Moi Teaching and Referral Hospital, Kenya. The first interview was done within 48 h after birth followed by a telephone interview at 2 weeks and at 6 weeks after birth. Data were audio recorded and transcribed. Transcripts and field notes were analyzed using thematic content analysis and NVIVO 11 software. Ethical approval was obtained before commencement of studies and permission to conduct the study granted by the chief executive of the hospital. RESULTS: The only health needs that participants reported were unmet health information needs. Four major themes emerged from the study. 'Connecting with baby' centered on understanding and meeting baby's needs, monitoring growth and progress and protecting the baby. The second theme: "Birth as a unique encounter' is a blend of what was found to be new and a unique. The theme 'Regaining self' is a combination of managing self as a mother and handling discomfort related to birth. The final theme: 'Disconnected information' is a collection of unmet information needs, the need for clarity in information booklets and conflicting information by different providers. CONCLUSIONS: Participants used the hospital stay as an opportunity to receive more detailed information on how to take care of their babies both directly after birth and in the longer term. Participants had a range of unmet health information needs that extended beyond family planning and fertility. Needs extended to their own care and management of discomforts. The need for consistency in health information by different providers and updated printed material on postnatal care that includes sensitive information and allows opportunities for personalized information was highlighted.
