Pre-departure preparation for international clinical work: a handbook

Abstract

International clinical experiences are increasingly popular among medical students, residents, fellows, and practitioners. Adequate pre-departure training is an integral part of a meaningful, productive, and safe international experience. At Johns Hopkins University School of Medicine, we have developed a pre-departure handbook to assist practitioners in preparing for global health work. The handbook draws from current global health education literature, existing handbooks, and expert experiences, and includes information about logistical and cultural preparations. While a pre-departure handbook cannot serve as a substitute for a comprehensive pre-departure training program, it can be a useful introduction to the pre-departure process.

Are you ready? A systematic review of pre-departure resources for global health electives

“…Of the 55 articles included, 21 were single program evaluations [32–52], 17 were multiple program evaluations [4, 53–68], nine were commentaries or guidelines [69–77], and eight were reviews [26, 78–84]. Articles included in the systematic review were published between 1996 to 2018, with 33 articles (60%) published within the last 5 years.…”

“…The majority of ( n = 33) articles discussed global health elective preparation for medical students [33–35, 37, 39–47, 49, 50, 52–54, 57, 59, 60, 62, 63, 65, 66, 71, 72, 76, 79–82, 84], followed by preparation for residents and fellows ( n = 17) [4, 26, 33, 35, 49, 55, 56, 64, 65, 67–69, 71, 73, 75, 79, 81, 83], nursing students ( n = 6) [36, 44, 54, 58, 66, 77], undergraduate students ( n = 6) [38, 44, 54, 58, 70, 74], and other graduate students, which included midwifery, pharmacy, physiotherapy and public health students ( n = 8) [32, 35, 44, 48, 51, 61, 66, 78]. Twelve papers included information about multiple trainee populations [32, 33, 35, 44, 49, 54, 58, 65, 66, 71, 79, 81].…”

“…The most commonly addressed themes were Culture ( n = 37) [4, 26, 32, 34–36, 38, 40–46, 48, 51–53, 55–57, 63–66, 68–74, 76–81, 83], Project-specific Knowledge ( n = 30) [32, 34, 36, 40–46, 48, 50, 52, 54, 57–59, 61, 62, 64, 65, 67, 69–71, 74, 76–79] and Safety ( n = 29) [4, 34–38, 41–44, 53, 54, 57, 59, 61, 63, 65, 66, 68–70, 74, 76–78, 80–83]. Far fewer articles discussed Mentorship ( n = 11) [26, 44, 59, 69, 71, 74, 76, 77, 79, 81, 83], Professionalism ( n = 8) [4, 26, 44, 59, 68, 76, 81, 83] and Emotional Wellness and Culture Shock ( n = 7) [4, 36, 38, 44, 54, 55, 63]. Eighty-four percent of articles ( n = 46) addressed multiple thematic domains.…”

“…Eighty-four percent of articles ( n = 46) addressed multiple thematic domains. Nine articles (16.4%) included six or more domains [4, 44, 59, 65, 68, 71, 74, 76, 77], while only one study included eight domains [76]. No studies included all nine domains and 11 articles (20%) included only one domain [33, 39, 47, 49–51, 55, 60, 67, 75, 84].…”

Improving the Safety and Security of Those Engaged in Global Health Traveling Abroad

“…Few published articles exist that document safety and security training as part of pre-departure preparations for students, residents, or faculty involved in global health work abroad 29 – 31 . Even fewer studies document whether programs have any impact on mitigation of adverse events.…”