Abstract
Background
Preparation for residents participating in global health (GH) experiences is critical.
Active preparatory curricula allowing residents to experience and debrief emotional
challenges they may encounter abroad are generally lacking. We sought to evaluate
a novel simulation curriculum designed to prepare residents for emotions they may
experience in response to challenges abroad.
Methods
Pediatric GH educators from 7 institutions developed case vignettes incorporating
common challenges residents experience abroad. Residents participating in a GH training
track or planning to participate in a GH rotation from the 7 institutions were eligible
to participate in the simulation curriculum. Participants and trained facilitators
completed postsimulation evaluations that were analyzed using descriptive statistics
and thematic analysis of written comments to assess the utility of the curriculum,
emotions evoked, and changes residents anticipated making to their GH rotation preparation.
Results
Fifty-one residents and 16 facilitators completed 160 and 52 evaluations, respectively.
Overall, respondents found the simulations useful (mean [SD] resident score 4.49 [0.82]
and facilitator score 4.85 [0.36] on a 5-point scale [1 = completely useless, 5 = very
useful]). Residents reported strong emotions in 153 (98%) of 156 comments. After the
sessions, 131 (96%) of 137 comments reflected anticipated changes to GH rotation preparation
plans.
Conclusions
Active preparation for GH rotations using simulated cases appears to be a useful tool
that can be implemented across a variety of sites with minimal facilitator training
or simulation experience. The curriculum successfully elicited powerful emotions in
residents and provided an opportunity to debrief these experiences before encountering
them abroad.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic PediatricsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global health training and international clinical rotations during residency: current status, needs, and opportunities.Acad Med. 2009; 84: 320-325
- A survey of Canadian general surgery residents’ interest in international surgery.Can J Surg. 2008; 51: 125-129
- Global health in general surgery residency: a national survey.J Am Coll Surg. 2009; 208: 426-433
- Availability and potential impact of international rotations in emergency medicine residency programs.J Emerg Med. 2013; 44: 499-504
- Global health training in radiology residency programs.Acad Radiol. 2011; 18: 782-791
- Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties.Can J Surg. 2012; 55: S191-S199
- Results of a national survey of surgical resident interest in international experience, electives, and volunteerism.J Am Coll Surg. 2009; 208: 304-312
- Global health training in pediatric residency programs.Pediatrics. 2008; 122: 28-33
- Ethical issues encountered by medical students during international health electives.Med Educ. 2011; 45: 704-711
- International health electives: thematic results of student and professional interviews.Med Educ. 2010; 44: 683-689
- International medical student rotations: ethical and emotional dilemmas.J Global Health Perspect. 2013; (Available at:) (Accessed August 7, 2013)
- Preparing students for overseas electives.Acad Med. 1991; 66: 92
- International child health electives for pediatric residents.Arch Pediatr Adolesc Med. 1999; 153: 1297-1302
- The medical student global health experience: professionalism and ethical implications.J Med Ethics. 2008; 34: 375-378
- A proposed model curriculum in global child health for pediatric residents.Acad Pediatr. 2012; 12: 229-237
- A successful international child health elective: the University of Colorado Department of Pediatrics’ experience.Arch Pediatr Adolesc Med. 2006; 160: 191-196
- Global health training for pediatric residents.Pediatr Ann. 2008; 37 (792–786): 786-787
- Global health training in pediatric residency: a qualitative analysis of faculty director insights.Acad Pediatr. 2012; 12: 238-244
- International electives at the university of Minnesota global pediatric residency program: opportunities for education in all Accreditation Council for Graduate Medical Education competencies.Acad Pediatr. 2012; 12: 245-250
- Eight years of the Mayo International Health Program: what an international elective adds to resident education.Mayo Clin Proc. 2010; 85: 734-741
- Toward reciprocity: host supervisor perspectives on international medical electives.Med Educ. 2014; 48: 397-404
- Medical students’ experiences and perception of support following the death of a patient in the UK, and while overseas during their elective period.Postgrad Med J. 2014; 90: 69-74
- The use of simulation for training teamwork skills in health care: how low can you go?.Qual Saf Health Care. 2004; 13: i51-i56
- Emergency and critical care pediatrics: use of medical simulation for training in acute pediatric emergencies.Curr Opin Pediatr. 2006; 18: 266-271
- Simulation-based team training in healthcare.Simul Healthc. 2011; 6: S14-S19
- The role of high-fidelity simulation in training pediatric emergency medicine fellows in the United States and Canada.Pediatr Emerg Care. 2013; 29: 1-7
- A critical review of simulation-based medical education research: 2003–2009.Med Educ. 2010; 44: 50-63
- Adding emotional stressors to training in simulated cardiopulmonary arrest enhances participant performance.Med Educ. 2010; 44: 1006-1015
- The emotional and cognitive impact of unexpected simulated patient death: a randomized controlled trial.Chest. 2014; 145: 958-963
- Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial.JAMA Pediatr. 2013; 167: 528-536
- Collecting and Interpreting Qualitative Materials.Sage Publications, Thousand Oaks, Calif1998
- Objective structured assessment of debriefing: bringing science to the art of debriefing in surgery.Ann Surg. 2012; 256: 982-988
Article Info
Publication History
Accepted:
May 16,
2014
Received:
November 2,
2013
Footnotes
Walter Eppich is a member of the board of directors for the Society for Simulation in Healthcare, for which he is reimbursed travel expenses (no commercial interest), receives salary support from the Center for Medical Simulation, Boston, Mass (paid for by the institution), to teach simulation instructor courses, and received a per-diem honorarium from PAEDSIM eV to teach simulation instructor courses in Germany. The other authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
