Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

Abstract

BackgroundRecognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs.MethodsA working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training.ResultsThe main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies.ConclusionsThe shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied to other aspects of residency curriculum development.

Ethical Considerations When Sending Medical Trainees Abroad for Global Health Experiences

“…Such training before travel increases knowledge of the region and of global health in general. 2,5 Finally, we expect the traveling student to utilize in-country standards of care, obtained either from World Health Organization guidelines or the local ministry of health. 3.…”

“…[1][2][3] Estimates are that 25%-38% of medical students and 40%-68% of residents have a global experience during their training. 1,2 Although there have been many papers focusing on the ethical concerns involved in conducting research in developing nations, much less attention has been given to the ethical considerations surrounding education and service experiences for learners in those settings. 3 There are many ethical concerns in sending trainees abroad, but no formal guidelines to address them.…”

Development of a Global Health Curriculum for Family Medicine Based on ACGME Competencies

“…Elements of this "global knowledge" have implications for all family medicine (FM) residents, including the preparation of residents to provide effective care to underserved communities, with the goal of reducing health disparities. [1][2][3] Participation in global health education activities has steadily increased. In 1984, 6.2% of graduating U.S. and Canadian medical students participated in international health rotations; by 2004, this rate had increased to 22.3% and by 2008, rose to 28%.…”

“…Efforts to develop comprehensive, competency-based curricula for global health education in residency are emerging. 2,[13][14][15][16] The Division of Global Pediatrics at the Univeristy of Minnesota developed a comprehensive global health pediatric curriculum based on the ACGME competencies in collaboration with Ugandan pediatricians. 13 We describe our adaptation and implementation of this curriculum for the Global Family Medicine (GFM) pathway in the Department of Family Medicine and Community Health at the University of Minnesota (DFMCH).…”

Medical Ethics in Undergraduate Medical Education in Pakistan: Towards a Curricular Change

“…(Redwood-Campbell, Pakes, Rouleau, MacDonald, Arya, Purkey, et al 2011). The frameworks developed show the need for a context specific but unified core curriculum for the globe.…”