Building Programs that Strengthen Global Health Leadership: Towards Canadian National Guidelines for Global Health Concentrations David Matthews and Jessica Sleeth
Rationale Growing demand for global health education 30.5% of graduating US medical students have participated in a global health experience during their medical training Medical schools often struggle to address this need 44.8% of graduating Canadian medical students feel that instruction in global health is inadequate Programs often lack structure and supports to provide students with comprehensive training Association of American Medical Colleges. Canadian Medical School Graduation Questionnaire - All Schools Summary Report. 2011.
Our Vision Provide a framework for building capacity for medical students to gain the adequate knowledge and skills to advance the health of marginalized communities both internationally and locally"
Why Concentration? Concentration acknowledges that students are undertaking an enhanced program of global health learning, can include both curricular and extracurricular elements Provides flexibility to schools to adapt program to their specific circumstances
Process Inspired by Making the Links program at University of Saskatchewan Guidelines developed by CFMS Global Health Program in consultation with AFMC Global Health Interest Group Presentations at Montreal Global Health Conference (GHEC, CUGH, CSIH) in November 2011 and Canadian Conference on Medical Education in April 2012
Guiding Theory Global Health linking local and global the social determinants of health can be linked anywhere in the world but not, as a matter of course, everywhere, or in the same way Service Learning combines community service with intentional learning and opportunities for reflection
Concentration Guidelines Expected that programs will include ALL Major Criteria and several Minor Criteria though combination of curricular and extracurricular activities Leadership development and advocacy as overarching themes throughout components Incorporate Aboriginal health in all criteria where possible
Major Criteria Global Health Coursework Local Community Engagement Low-Resources Setting Elective Pre-Departure Training and Post-Return Debriefing Student Evaluation Covering the Core Competencies recommended by GHEC Community partnership in service learning model for 1 year Immersion for 4-6 weeks Training as described in AFMC and CFMS Guidelines May include portfolio or written reports
Minor Criteria Extracurricular Global Health Learning Opportunities Language Training Including lecture series, journal clubs etc. In preparation for electives Global Health Mentorship Mentors provide career guidance Knowledge Translation Project Synthesize learning to larger scale project
National Survey Surveyed faculty leaders at 14 English Canadian medical schools Key questions focused on: Criteria validity Critique of criteria Existing programs that would meet criteria Response from 12 schools
National Survey Preliminary Findings Major Criteria Validity Existing Programs Global Health Coursework 12/12 12/12 Local Community Engagement Low-Resources Setting Elective Pre-Departure Training and Post-Return Debriefing 12/12 12/12 12/12 12/12 12/12 12/12 Student Evaluation 12/12 8/12
National Survey Preliminary Findings Minor Criteria Validity Existing Programs Extracurricular Global Health Learning Opportunities 12/12 12/12 Language Training 10/12 3/12 Global Health Mentorship Knowledge Translation Project 12/12 2/12 12/12 5/12
Discussion Growing consensus and availability of Global Health Coursework Low-Resource Setting Electives Pre-Departure Training Barriers remain in implementing other criteria and structuring cohesive programs
Local Community Engagement Difficult to arrange and sustain respectful long-term relationships with partners Requires close faculty and administrative oversight
Student Evaluation Many possible modalities: portfolio, written reports, blogs, presentations Resource- and time-intensive to implement and monitor Importance of incorporating community and partner feedback for placements and electives
Language Training Hard to achieve language competency in short period of time Need to be realistic about fluency required for clinical practice Schools often lack resources to provide training
Mentorship Seen as critical aspect of successful programs Area for possible interprofessional education Resource intensive in terms of organization and Faculty time May tie in with evaluation frameworks
Conclusions Criteria are generally seen as valid by Faculty leaders across Canada Most schools offer programs covering Major Criteria Implementation of Minor Criteria more challenging Opportunity exists to create cohesive concentrations for students interested in global health
Next Steps Revision of guidelines based on Faculty feedback Reach out to remaining medical schools Formal adoption and publication of guidelines in early 2013
Acknowledgements Dr. Ryan Meili, Dr. Videsh Kapoor, Dr. Jenn Carpenter, and all of our Faculty contributors Rita Watterson, Paxton Bach, Mary Halpine, and the members of the CFMS Global Health Program AFMC Global Health Interest Group
Thank you! david.matthews@utoronto.ca jessica.sleeth@queensu.ca