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 development.
Keywords: Communication Skills, Cultural Diversity/Cultural Competency, Curriculum Development/Evaluation, Global Health, Professionalism
Topics: CREOG & APGO Annual Meeting, 2017, Clerkship Director, Residency Director, Professionalism, Interpersonal & Communication Skills, GME, UME, Global Health,
James Aluri, M.A., Johns Hopkins University School of Medicine; Bryn Carroll, M.D.; Antony Gatebe Kironji, M.S.; Dane Moran, M.P.H.; Jill Edwardson, MD, MPH; Chi Chiung Grace Chen, M.D.
