Purpose: War negatively impacts health professional education when health care is needed most. The aims of this scoping review are to describe the scope of barriers and targeted interventions to maintaining health professional education during war and summarise the research. Methods: We conducted a scoping review between 20 June 2018 and 2 August 2018. The search was restricted to English publications including peer-reviewed publications without date ranges involving war and health professional education (medical school, residency training and nursing school), with interventions described to maintain educational activities. Two independent reviewers completed inclusion determinations and data abstraction. Thematic coding was performed using an inductive approach allowing dominant themes to emerge. The frequency of barrier and intervention themes and illustrative quotes were extracted. Articles were divided into modern/postmodern categories to permit temporal and historical analysis of thematic differences. Results: Screening identified 3271 articles, with 56 studies meeting inclusion criteria. Publication dates ranged from 1914-2018 with 17 unique wars involving 17 countries. The studies concerned medical students (61.4%), residents (28.6%) and nursing students (10%). Half involved the modern era and half the postmodern era. Thematic coding identified five categories of barriers and targeted interventions in maintaining health professions education during war: curriculum, personnel, wellness, resources, and oversight, with most involving curriculum and personnel. The distribution of themes among various health professional trainees was similar. The frequency and specifics changed temporally reflecting innovations in medical education and war, with increased focus on oversight and personnel during the modern era and greater emphasis on wellness, curriculum, and resources during the postmodern era. Conclusions: There are overarching categories of barriers and targeted interventions in maintaining health professional education during war which evolve over time.
Between 1976 and 1991, central Beirut, repository of centuries of historic structures, was substantially destroyed by civil war. In 1994, a private company known by its French acronym Solidère was created by government decree and given the task of reconstructing the center of Beirut. Despite political problems, the Solidère project brought the hope of social recovery through economic renewal; yet progress should not come at the cost of memory.How can Beirut, destroyed, be a site of both recovery and erasure? Even though traditional legal and political discourses acknowledge that cultural heritage holds a powerful position in reconstruction, there are few tools for capturing its functions. Using heuristics originally employed in archeology and art history, this article addresses psychological aspects of reconstruction by discussing contemporary Lebanese art. If culture is defined not only as what people do buthow they make sense of what they have done, the enormity of the political problems of post–civil war reconstruction become clear. National governments hoping to consolidate authority would do well to consider how best to approach public places resonant with emotionally charged memories.Policymakers should consider the complex benefits of negative heritage in drafting laws that will enable its protection. Legal reform carried out with the goal of balanced heritage policies that accommodate negative heritage is key for postconflict urban spaces. By acknowledging the weight of the past, such policies would also bolster confidence in the emergent government and the political process.
Objectives In the 2016 Peace Accord with the Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised to reincorporate 14,000 ex‐combatants into the healthcare system. However, FARC ex‐combatants have faced significant challenges in receiving healthcare, and little is known about physicians’ abilities to address this population's healthcare needs. Methods An electronic questionnaire sent to the Colombian Emergency Medicine professional society and teaching hospitals assessed physicians’ knowledge, attitudes, and experiences with the FARC ex‐combatant reincorporation process. Results Among 53 participants, most were male (60.4%), and ∼25% were affected by the FARC conflict (22.6%). Overall knowledge of FARC reincorporation was low, with nearly two‐thirds of participants (61.6%) scoring in the lowest category. Attitudes around ex‐combatants showed low bias. Few physicians received training about reincorporation (7.5%), but 83% indicated they would like such training. Twenty‐two participants (41.5%) had identified a patient as an ex‐combatant in the healthcare setting. Higher knowledge scores were significantly correlated with training about reincorporation (r = 0.354, n = 53, P = 0.015), and experience identifying patients as ex‐combatants (r = 0.356, n = 47, P = 0.014). Conclusion Findings suggested high interest in training and low knowledge of the reincorporation process. Most physicians had low bias, frequent experiences with ex‐combatants, and cared for these patients when they self‐identify. The emergency department (ED) serves as an entrance into healthcare for this population and a potential setting for interventions to improve care delivery, especially those related to mental healthcare. Future studies could evaluate effects of care delivery following training on ex‐combatant healthcare reintegration.
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