The Impact of an International Elective on Anesthesiology Residents as Assessed by a Longitudinal Study

Abstract

Introduction: Participation of anesthesiology residents in international electives may lead to the acquisition of skills as described in the Accreditation Council for Graduate Medical Education (ACGME) competencies. There is great interest in participating in such electives, but it is not clear there are educational or professional benefits. The purpose of this study was to evaluate the educational benefits of participating in overseas electives among anesthesiology residents. Methods: A longitudinal study design was used between 2010 and 2015 to survey all anesthesiology residents selected to participate in the nationally competitive Society for Education in Anesthesia-Health Volunteers Overseas (SEA-HVO) Traveling Fellowship Program in which third-year residents receive scholarships and ABA credit for 1-month teaching electives in a low-resource country. Pre-elective and post-elective surveys were sent via de-identified e-mails during the third year of residency. We investigated residents’ expectations, plans, and comfort level with teaching techniques prior to the elective and after and asked about perceived benefits. Results: The response rate was 68.8% of the 45 residents who received the survey. Participants were motivated by professional and humanitarian goals. Residents reported improved comfort with teaching techniques, especially lecturing and giving feedback. Participants acquired better skills in assessing the learning needs of students. There was a slight but nonsignificant increased comfort dealing with cultural and language barriers. The major self-perceived unique benefit of international electives was improvement in intercultural communication. The systems’ changes reported by residents as the most important to improve were those that affected patient safety. Conclusion: Global health electives have a small positive effect on teaching, cultural proficiency, and systems assessment skills. Residents improve in their ability to identify educational needs and to give feedback. Patient safety during anesthetic care is appreciated as the most important systems’ need.

Global health competencies in postgraduate medical education: a scoping review and mapping to the CanMEDS physician competency framework

“…Physicians in the CanMEDS 10 Communicator role 'form relationships with patients and their families that facilitate the gathering and sharing of essential information for effective health care' (p. 16). Given the recognized need for effective information exchange, and the frequency with which physicians encounter patients and their families whose language does not align with that of the physician, we feel that this should strongly be considered for incorporation into future iterations of CanMEDS competencies to allow for safe, effective, patient-centered care.…”

“…10 Much of the PGME level Global Health education literature has centered around description of program development, ethical and preparatory requirements for electives, resident interest, and perceived benefits of Global Health training. Numerous publications describe the benefit of Global Health on resident learning, from both a program and resident perspective, 4,5,[11][12][13][14][15][16][17] with one recent study on Global Health electives identifying self-perceived benefits across several of the CanMEDS roles. 18 A qualitative review of resident narrative reports from Global Health electives identified competency themes, with suggested mapping to both Accreditation Council for Graduate Medical Education (ACGME) core competencies and CanMEDS roles.…”