Core Educational Experiences for First-year Medical Students Traveling to Honduras Steve Crossman, MD and Allison Behrle, M2 Virginia Commonwealth University Richmond, VA 34th Annual STFM Predoctoral Education Conference January 24-27, 2008 Portland, Oregon

Objectives We hope that by participating in this lecture-discussion session, you will: -understand the importance of appropriate preparation of students for travel abroad, -be able to describe key lecture topics that our students found helpful, -possess a framework for developing your own lecture series, and -be motivated to develop or enhance international service-learning experiences for your students.

Introduction and Opening Discussion

About Our Group Honduras Outreach Medical Brigada Relief Effort (HOMBRE)

History Initiated 8 years ago at VCU School of Medicine by first-year students Now independent 501©3 non-profit organization with 12-member Board of Directors Student trip to two sites every June

Mission To improve the health of underserved communities in Honduras and other developing countries To enhance the education of health professions students

Core Values collaboration in sustainable partnerships service to others humility and respect students take on key leadership roles fiscal responsibility

Sites Two sites Los Pinares, a community in the rural region of Intibuca (in affiliation with Shoulder to Shoulder, Inc and Thundermist Health Center) NPH, an orphanage in the center of the country where there are over 600 children

Faculty Experiences students were dedicated, passionate, and compassionate - students at times though seemed overwhelmed - first year students are focused on complete, normal H & P - many had never traveled to Honduras or Central America - 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 Basics How to use an interpreter Honduran history and culture

Core Lecture Series Goal 2: gain knowledge of the broader determinants of health Poverty and determinants of health Site specifics

Core Lecture Series Goal 3: improve basic clinical skills Intro to history taking and differential diagnoses Specific common chief complaints of children and adults Tropical medicine

Core Lecture Series Adult: Peds: Headache (hypertension) Increased thirst (diabetes) Missed period (pregnancy) Vaginal discharge (STD’s) Peds: Rash (infectious dermatoses) Fever (acute infections) Stomachache (parasites, malnutrition) Breathing trouble (asthma, bronchitis)

Student Evaluation Data: Goal 1: Cultural Competency

Student Evaluation Data: Goal 2: Determinants of Health

Student Evaluation Data: Goal 3: Clinical Skills

Student Evaluation Data: Additional Data

Wrap-up and Brainstorming

Thank you! Allison Behrle Steve Crossman behrleal@vcu.edu 804-828-9779 scrossman@mcvh-vcu.edu