Core Educational Experiences for First-year Medical Students Global Health Trips Steve Crossman, MD Mark Ryan, MD Michael Stevens, MD, MPH Zack Lipsman, MS2 Virginia Commonwealth University Richmond, VA AAFP Family Medicine Global Health Workshop Minneapolis, MN September 6-8, 2012

Objectives for today At the end of the session today, participants will Understand the importance of preparation of students for global trips Be able to describe useful lecture topic areas Possess a framework for developing a core lecture series Be motivated to enhance your local efforts

Mission To improve the health of underserved communities in Honduras, Peru, Ghana, and the DR To enhance the education of health professions students

Core Values Service to others Humility and respect Collaboration in sustainable partnerships Service to others Humility and respect Students take on key leadership roles Fiscal responsibility

Sites Multiple sites within Honduras as well as Peru, Ghana, and the Dominican Republic

History of the course Students were dedicated, passionate, and compassionate – going on self-led trips for years Students at times though seemed overwhelmed, sought faculty partnership First year students are trained in complete, normal H & P Many had never traveled on service trips to developing countries Some without any exposure to poverty

Literature Review: Why student experience in Global Health is important? GH experiences encourage students to: *enter primary care specialties *practice medicine serving minorities and the poor *maintain idealism GH experiences can also: *help recruitment *improve student clinical skills Students desire quality GH experiences as part of their medical education 57.4% of VCU graduating med students in 2007 felt GH teaching was inadequate, which is comparable to other studies

Core Lecture Series – Goal 1 Improve knowledge and understanding of cultural competency Know the core attributes of culture and the ways different cultural backgrounds can impact patients Recognize key behaviors students should emulate and those to avoid while abroad Demonstrate an ability to work with an interpreter in language discordant settings

Core Lecture Series - Goal 2 Gain knowledge of the broader determinants of health Understand poverty’s impact on patients and health Identify differences in developed vs. developing countries

Core Lecture Series – Goal 3 Improve basic clinical skills Specific common chief complaints of children and adults History taking and intro to forming a differential diagnosis Tropical Medicine / Tropical Dermatology

Core Lecture Series - Overall Four 4-hour blocks on Saturday mornings Specific topics including: Poverty, social determinants of health Global health and tropical medicine Quality of care in under-resourced settings Intro. to history taking and differential diagnoses Women’s Health Dermatology basics and tropical dermatology Pediatric growth and nutrition Case studies of common chief complaints Re-entry Reflection essay upon return – to fulfill service- learning requirements

Student Evaluation Data Average Overall Lecture Series Rating by Year Rating: 4 = very effective 1 = not at all effective

Feedback and Future Improvements Keep what’s good Make it specific Breakout sessions by site to drive home concepts Share results with larger group Add ethics Recent literature has pointed toward the benefit of ethics training in global health preparatory lectures1,2 Consider more general focus on safety 1 Pinto AD, Upshur REG: Global health ethics for students. Developing WorldBioethics 2007, 9(1):1-10. 2 Lahey, T. (2012). Perspective: A proposed medical school curriculum to help students recognize and resolve ethical issues of global health outreach work. Academic medicine, 87(2), 210-215.

Questions? Thank you! Zack Lipsman Mark Ryan lipsmanzw@vcu.edu mryan2@mcvh-vcu.edu Steve Crossman Michael Stevens scrossman@mcvh-vcu.edu mstevens@mcvh-vcu.edu