1. 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

2. 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

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

4. 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

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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

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

13. 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),

14. Questions? Thank you! Zack Lipsman Mark Ryan
Steve Crossman Michael Stevens