Background: Responding to demand from medical trainees, educators
have developed a spate of short-term, global learning opportunities. However,
it is uncertain how well the literature has reported and analyzed the ethical
challenges for medical trainees participating in these new programs. This
knowledge is important for those designing and reforming global health
programs. Therefore, we conducted a systematic review to evaluate the
literature addressing ethics preparation and experiences of medical trainees
who pursue short-term global health trips.
Methods: We devised a set of inclusion and exclusion criteria.
Inclusion criteria were four main components: (1) global health, (2) ethics,
(3) medical trainees, and (4) short term trips. Articles were excluded if (1)
they described or analyzed programs or experiences not supported by a USMLE or
ACGME accredited program or (2) were written in a language other than English.
Search strategies were developed in consultation with a librarian for
five databases: Pubmed, Embase, Education Source, Academic Search Complete, and
Web of Science (Core Collection). A single author analyzed the search results
based on the inclusion and exclusion criteria and a team of authors conducted a
qualitative content analysis of the resulting papers.
Results: The search protocol returned 530 unique papers, of
which 56 were qualified based on the inclusion and exclusion criteria.
Identified papers fit into three broad categories: (1) Case reports (n=14).
These narratives described curriculum or program development, and addressed
curricular ethics content aimed at preparation for short-term trips. (2)
Non-empirical papers (n=26). Often drawing on personal experience from program
development or participation, these essays contained reflective analysis and
narratives. (3) Research papers (n=16) that used research methodology to
describe the ethical challenges faced by medical trainees on short-term trips.
Discussions: Our preliminary results show a nascent literature on ethics
for medical trainees embarking on short term, international trips. The case
studies and essays are helpful for exchanging program ideas; however, more
systematic, empirical studies would be useful to evaluate and guide curricular
Keywords: Communication Skills, Cultural Diversity/Cultural
Competency, Curriculum Development/Evaluation, Global Health, Professionalism