Redefining Global Health through Local and National Experiential Learning Javeed Sukhera Melanie Katsivo Leah Mawhinney Patricia Potter George Kim CCME 2015

Office of Global Health CCME 2014

Global Health Awareness: A fundamental ability to link and transfer local issues to global contexts and vice versa. CCME 2014

Vision: To optimize integration of global health into student learning at the Schulich School of Medicine & Dentistry. Mission: To provide the best global health learning experience to all medical, dental and basic medical science students at the Schulich School of Medicine & Dentistry. CCME 2014

Why go Local? Common areas under accreditation (ED10 topics) Cross-cultural issues include diverse communities within national boundaries Common mission: Ethical community engagement Clinical practice with limited resources ED 10: The curriculum of a medical education program must include behavioral and socioeconomic subjects in addition to basic science and clinical disciplines. ED10 topics include communication skills, community health, complementary/alternative health care, cultural competence, domestic violence, global health issues, health care financing/systems, health disparities, medical ethics/humanities, medical socioeconomics, population based medicine and substance abuse CCME 2014

Consensus Global Health Competencies Global burden of disease Social and Environmental Determinants of Health Health Implications of Migration, Travel, and Displacement Globalization, Health and Healthcare Health as a Human Right and Resource for Development Health in Low Resource Settings Ethical and Sustainable Collaborations to Address Global Health Issues Office of Global Health’s curriculum program includes global health competencies that have considerable overlap with local, regional and national underserved communities.

Local, Regional and National GLOBAL HEALTH Electives CCME 2014

Local Electives Recruited community sites and infrastructure Expanded existing local sites from 4 to 7 Recruited students Examples of Local Global Health Sites Community family medicine Local public health unit Child and adolescent psychiatry Geriatric medicine Southwestern Ontario Aboriginal Health Access Centre CCME 2014

Local case study: LIHC Core site for local global health Offers health and social services to those experiencing barriers to care (including poverty, homelessness, chronic health conditions, mental health and addictions) Extensive engagement and time investment required to build mutually beneficial relationship Strong parallels with ethical international partnership development Considerable effort and time went into building a relationship with LIHC which offers the most clinical time to students interested in local global health. As a community organization under increasing pressure and fiscal constraint, it is important to ensure that the organization is not simply a vehicle to provide students with placements and rather has a positive and ethical relationship with the medical school and university. CCME 2014

Regional Electives Aligning work with existing Distributed Medical Education (DME) infrastructure Collaborating with DME leadership and existing preceptor recruitment processes Goal is sustainable recruitment of preceptors with ‘global health awareness’ Established faculty awareness scale The medical school is undergoing a significant restructuring in our DME program with new leadership and strategic planning. It was important for OGH to avoid duplicating efforts with DME and collaborate to recruit preceptors through existing DME approaches. Rather than overwhelming community preceptors with requests from multiple programs within the same medical school, it became of vital importance to align both areas and collaborate. This has slowed preceptor recruitment, however, emphasis is on sustainable recruitment to build relationships with preceptors that are sustainable and mutually beneficial. CCME 2014

National Electives Built directory of global health related electives at accredited Canadian partner schools open to visiting students. Hope to build upon existing infrastructure and improve collaboration on global health learning within Canada. Planning for aggressive marketing and recruitment campaign. CCME 2014

Assessment & Evaluation Linked to Broader UME Metrics (baseline, 3 year and 5 year measures) Review/synthesis of key words related to global health in course/module content Data from AAMC Canadian Graduation Questionnaire End of course survey data (course-specific) BCOE survey data (course-specific) OGH Specific Metrics (baseline, 3 year and 5 year measures) Percent of students who participate in local/international experiential learning Percent of graduates working with in the global health field Revised pre and post experiential learning questionnaire Focus Groups with collaboration from students Pre-departure Training Evaluation OSCE data from Clerkship OSCE CCME 2014

Preliminary Results 700% increase in student participation in local/regional/national global health Some students are combining local/regional/national global health with international clinical science electives in fourth year Possibility that aligned approach will be further integrated into undergraduate curriculum with service learning CCME 2014