Global surgery for medical students – is it meaningful? A mixed-method study

Abstract

Introduction There has been an increase in global health courses at medical universities in high-income countries. Their effect on students, however, is poorly understood. In 2016 an elective global surgery course was introduced for medical students at Karolinska Institutet in Sweden. The course includes a theoretical module in Sweden and a two-week clinical rotation in Uganda. The present study aimed to assess the format and determine its effect on students’ knowledge of global surgery and approach towards patients of non-Swedish origin. Method A mixed-methods design was used. Semi-structured case-based interviews were conducted individually with 18 students and analysed using qualitative content analysis. Examination scores and the course evaluation were analysed with Kruskal Wallis one-way analysis of variance, Pearson’s Chi-square and a Wilcoxon signed-rank test as appropriate. Results The course was appreciated and students reported gained insights and interest in global surgery. Students’ ability to reason about global surgery issues was improved after the course. Students considered complicating aspects in the meeting with patients of non-Swedish origin. Students with abroad clinical experience felt less compelled to act on preconceptions. Discussion The global surgery course at Karolinska Institutet is appreciated and students gained valuable knowledge. The case-based interviews acted as a catalyst for reflection and showed that students felt insecure as they lacked knowledge about globally common surgical conditions and struggled with generalized preconceptions of patients of non-Swedish origin. To further support students to integrate theoretical knowledge and professional development, we suggest the introduction of problem-based learning. Conclusion The ability of the course to inspire students’ commitment to global surgery is promising as this engagement is the key to reaching the goal of equitable health globally. Offering such courses is a step towards inspiring and recruiting the future clinicians and researchers needed for expanding the field of global surgery.

A Bibliometric Analysis of the Landscape of Problem-Based Learning Research (1981–2021)

“…PBL was most used in the first 2 years of medical courses, replacing traditional teaching methods in anatomy, pharmacology, and physiology ( Devine et al, 2020 ). Today, PBL has been widely used in business, dentistry, health sciences, law, engineering, education ( Huth et al, 2021 ; Kühner et al, 2021 ; Michalsky and Cohen, 2021 ).…”

Students’ perspectives on global surgery and its integration into formal medical education

“…This confirms that seminars providing basic knowledge, tackling common misconceptions and discussing cost-effectiveness, ethical considerations and health systems management should be primarily directed towards bachelor's students [7,19]. These pre-clinical seminars could be complemented by international internship opportunities to motivated students in the clinical years [7,17,23]. Current international internship opportunities are often short and unilateral, running the risk of straining local health systems and harming patients or falling into medical tourism and neo-colonialism [19,21,24].…”

“…Few established pre-clinical courses on global surgery exist [21,22]. Novel global surgery curricula have emphasized a tailored approach based on a student's progression through medical school [19,[21][22][23][24]. In our study, master's students were less interested in additional exposure to global surgery, less likely to agree that it is a relevant topic and less likely to want compulsory global surgery education.…”

Elective Courses in Global Surgery for Undergraduate Medical Students: A Narrative Review and a Proposal for European Universities

“…The search strategy retrieved 649 results, of which 12 studies were included in this review (Figure 1). [17][18][19][20][21][22][23][24][25][26][27][28] In total there were eight projects -labeled alphabetically from A to H -in GS were been offered worldwide by universities to undergraduate medical students (Table 1), as five articles referred to project A. [17][18][19][20][21] While five projects (from A to E) were explained in detail, information on the remaining three was superficial and fragmented (projects from F to H).…”