Enriching health-professional programs in global health: Development and implementation of an interdisciplinary and integrated approach.

BACKGROUND: Globalization results in a rapidly diversifying population, increased inequities, and more complex health problems affecting populations. This forces medical schools to integrate global health (GH) into the training of health-care professionals from curriculum development to practical learning activities, here and abroad. APPROACH: The approach aims at enriching existing programs in GH competencies in an interdisciplinary context. The goal is to ensure that all health-science students develop a certain level of GH competency. The main actions are the mobilization of key stakeholders, the development of a competency framework (CF) to perform gap analysis, tool formalization, and monitoring and evaluation activities. Subsequent to scoping review and stakeholder consultations, ten principles are identified and used to guide the enrichment process. RESULTS: Actual outputs cover a broad scope, from key decision-makers' support and endorsement to the formalization of tools and the consolidation and creation of activities such as service-learning activities, rotations among underserved populations, and training for international rotations. CONCLUSION: While this unique approach is proving to be a major challenge, the preliminary results are well worth the effort. The project's tangible impacts on health-sciences teaching, the GH competence of graduates, and care delivery are topics of interest for future investigation.

[Not Available]. / Pratique réflexive et responsabilité sociale en médecine de famille: Les impacts de l'expérience des stages internationaux menés dans les pays en voie de développement.

OBJECTIF: Explorer les retombées perçues d'un stage électif en santé internationale dans le processus d'apprentissage des résidents en médecine de famille. TYPE D'ÉTUDE: Étude qualitative de type collaborative reposant sur des entrevues semi-dirigées. CONTEXTE: Québec. PARTICIPANTS: Un total de 12 résidents en médecine de famille et 9 superviseurs de stages internationaux (N = 21). MÉTHODES: Entrevues semi-dirigées menées auprès de résidents et de superviseurs de stages. PRINCIPALES OBSERVATIONS: Tous les participants ont tiré des avantages tant sur le plan technique que sur le plan relationnel. Sur le plan technique, ils ont renforcé leurs connaissances des pathologies tropicales; ils ont également appris à élargir leur examen clinique. Sur le plan relationnel, ils ont bénéficié d'une expérience riche du point de vue des interactions avec d'autres milieux de soins et avec des populations vivant majoritairement dans des conditions précaires. C'est au niveau des compétences relationnelles (communication, empathie, etc.) avec les patients vulnérables que l'impact du stage a été le plus bénéfique. Tous les participants ont en effet été confrontés à d'autres formes de thérapies locales et à d'autres interprétations de symptômes et d'étiologie des maladies. CONCLUSION: L'impact de cette étude au niveau des retombées pédagogiques est important puisque nous avons pu situer la façon dont les résidents vivaient un tel stage et ce qu'ils en retiraient en matière de compétences médicales et d'approche pédagogique dans la rencontre avec les patients. Une approche collaborative avec des superviseurs de stages nous a permis d'effectuer une triangulation des données et de mieux situer les apports d'un stage international dans la formation universitaire. Enfin, les résultats obtenus permettraient de soutenir et de renforcer les programmes académiques en médecine sociale et préventive et de mieux préparer les futurs médecins de famille à agir dans des contextes socioculturels pluriels.

Reflective practice and social responsibility in family medicine: Effect of performing an international rotation in a developing country.

OBJECTIVE: To explore the perceived effect of an elective international health rotation on family medicine resident learning. DESIGN: Qualitative, collaborative study based on semistructured interviews. SETTING: Quebec. PARTICIPANTS: A sample of 12 family medicine residents and 9 rotation supervisors (N = 21). METHODS: Semistructured interviews of residents and rotation supervisors. MAIN FINDINGS: Residents and supervisors alike reported that their technical skills and relationship skills had benefited. All increased their knowledge of tropical pathologies and learned to expand their clinical examinations. They benefited from having very rich interactions in other care settings, working with vulnerable populations. The rotations had their greatest effect on relationship skills (communication, empathy, etc) and the ability to work with vulnerable patients. All of the participants were exposed to local therapies and local interpretations of disease symptoms and pathogenesis. CONCLUSION: The findings of this study will have a considerable effect on pedagogy. The residents' experiences of their international health rotations and what they learned in terms of medical skills and pedagogic approaches in working with patients are described. Using a collaborative approach with the rotation supervisors, the data were triangulated and the benefits of an international rotation on academic training were more accurately defined. The findings can now be used to enrich academic programs in social and preventive medicine and more adequately prepare future family physicians for work in various social and cultural settings.