Academic journal article Canadian Journal of Public Health

How Are Canadian Universities Training and Supporting Undergraduate Medical, Physiotherapy and Occupational Therapy Students for Global Health Experiences in International Low-Resource Settings?

Academic journal article Canadian Journal of Public Health

How Are Canadian Universities Training and Supporting Undergraduate Medical, Physiotherapy and Occupational Therapy Students for Global Health Experiences in International Low-Resource Settings?

Article excerpt

Global health (GH) is an increasingly popular topic in health in general, and also in public health.1-5 GH and public health share similarities:5,6 both view health in terms of physical, mental and social well-being, rather than merely the absence of disease, and both address the root causes of ill health through a broad array of scientific, social, cultural and economic strategies.7 However, GH is more specific where health issues, determinants and solutions have to be explored within a transnational lens.5,6,8 GH is commonly defined as an area for study, research and practice that places a priority on improving health and achieving health equity for all people worldwide.6,9 Students increasingly show an interest in global health experiences (GHEs), defined as placements in international low-resource (ILR) settings.3,5,8,10 In 2009, 43.2% of graduating medical students had participated in a GHE during their studies, an increase of 13.2% since 2007.8,11 GHEs are known to increase public health awareness, improve clinical and communication skills and deepen one's understanding of the multifactorial influences on health.1,12 GHEs are also linked to future practice patterns in public health, multicultural settings and local underserviced areas.1,3,12,13 Along with these positive outcomes, moral hazards exist within GHEs, such as students practicing beyond their scope of knowledge,3,8,10,14,15 the tendency to focus on student learning rather than community needs12 and the student's lack of contextual understanding.16 A growing consensus therefore exists that, to maximize positive outcomes and lessen moral hazards, universities have the obligation to support and train students throughout their GHEs.2,5,8 Many recommendations have been formulated with regards to this process, which can be summarized into establishing a student selection process, training students before they leave, ensuring adequate supervision during the GHE and formally debriefing students upon their return.3,12,17 If a clear consensus is emerging in the literature about universities' responsibilities, little is known about current practices within Canadian universities. Some examples are found in the literature1,8,11,18 but do not provide a comparison across Canadian health programs, nor do they discuss them with recent recommendations that have emerged in the literature. This study therefore aimed to investigate the current state of GHE support and training in Canadian undergraduate medical (MD), physiotherapy (PT) and occupational therapy (OT) programs, and to discuss areas of strengths and for improvement by comparing current practices with recommended practices found in the literature.

METHODS

Ethics approval was obtained from our University's Research Ethics Board. An Internet-based, self-administered questionnaire was developed in the fall of 2014, based on the results of a scoping review we conducted which identified recommendations for GHE support and training. More concretely, we used our findings to structure the survey in four sections, namely what universities do to: select students, prepare them before their GHE, support them during their GHE, and debrief them upon their return. The survey collected descriptive information on GHE support and training for all Canadian MD, PT and OT programs, and questions explored if and how the recommended content was covered (see Appendix A for copy of questionnaire). We limited our survey to these disciplines as we consider their training shares commonalities and as our University's pre-departure training (PDT) is geared towards MD, PT and OT. We consulted with experienced colleagues from our local MD, PT and OT programs to help interpret the literature and pilot the survey. Changes in content were made to reduce the survey's length in order to maximize response rates and focus only on the core aspects of GHE support and training. The final version of the survey included 24 close-ended questions and 18 open-ended questions. …

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