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How to integrate and embed global health in medical curricula to create global doctors: a case study from Newcastle University Medical School

Lookup NU author(s): Abi Deivanayagam, Professor Richard Walker, Professor Steve Jones, Dr David Kennedy, Dr Kenneth McKeegan

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Abstract

Background: The importance of sound global health education (GHE) in producing tomorrow’s doctors is well documented (1). The Lancet report on Health Professionals for a New Century calls for GHE which creates a workforce sensitive to an increasingly diverse patient population, and able to take action on public health (2). Medical students’ desire to learn about global health is also well documented: a survey of 500 medical students from 75 countries found that 94% believed GHE was important, yet only 33% felt teaching was sufficient (3). GHE involves equipping individuals with the right attitude and awareness of risks, technologies, politics, transnational flow of diseases and other factors influencing the health of different populations across the world (4). However, the structure of content and methods for delivery in medical curricula are less clear. Since the definition and role of global health continues to evolve in an increasingly globalised world (5), delivering good quality teaching on a dynamic, socially derived concept poses a challenge unique to this subject. Core compulsory GHE at Newcastle University Medical School currently includes lectures and seminars on public health and epidemiology in first, second and fourth years. Optional teaching includes a 6-week long student selected component (SSC) on global health for fourth year medical students with rapidly increasing popularity since 2007 (6). The current reform of the Newcastle curriculum brings the opportunity to document and reflect on the experience of embedding global health in a medical curriculum to create the global doctors that we need in today’s world. This study focuses on the practicalities of the integration process. Methodology: A retrospective case study on delivering GHE, which includes qualitative data through surveys from a curriculum steering group and comparisons with GMC standards for medical education and training (7). We comment on the following aspects of education: curriculum structure, methods of delivery and content. Curriculum structure refers to the time during which course content is delivered and duration of delivery. Methods of delivery refer to lectures, seminars and self-directed learning. Content refers to themes to be covered based on existing recommendations from stakeholders (8). Data will be categorised by year group and labelled as core, optional or pre-elective GHE, as per the Lancet Global Health Learning Outcomes Working Group (8). The change in curriculum structure will lead to a shorter SSC lasting 4 weeks in 2019, therefore the SSC will be evaluated to assess adaptation to the new structure.Teaching in first and second years will shift from a modular to case-led approach therefore a list of GH learning outcomes paired with relevant cases will be created. A reflection of human factors involved in curriculum planning will also be documented through surveys from members of the board of medical studies. Results: The initiative began in December 2017 therefore results will be available to present at ASME 2018. In terms of content and curriculum structure, we expect pre-elective teaching with a focus on safety and ethics to continue to be delivered in third and fourth year. Moving from modular to case-led learning will result in the generation of learning outcomes suited to specific clinical cases with attached online resources. In terms of human factors, the current involvement of a recent Newcastle graduate in steering curriculum mapping alongside members of the board is in line with GMC standards. Discussion: Overall, fellow institutions around the UK will benefit from reflections on the practicalities of creating an integrated approach GHE. We have a valuable insight into suitable clinical cases where learning outcomes related to global health may be embedded. If global health is well integrated in medical curricula, tomorrow’s doctors may be more likely to take the holistic approach towards global health we need in an increasingly globalised world. References: 1. General Medical Council. Outcomes for graduates [Internet]. Manchester: General Medical Council; 2018 p. 3. Available from: https://www.gmcuk.org/static/documents/content/Outcomes_for_graduates_Dec_16.pdf2. Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet. 2010;376(9756):1923-1958. 3. Göpfert A, Mohamedbhai H, Mise J, Driessen A, Shakil A, Fitzmaurice A et al. Do medical students want to learn about global health?. Global Health Action. 2014;7(1):23943.4. Rowson M, Smith A, Hughes R, Johnson O, Maini A, Martin S et al. The evolution of global health teaching in undergraduate medical curricula. Globalization and Health. 2012;8(1):35.5. Buse K, Hawkes S. Health in the sustainable development goals: ready for a paradigm shift?. Globalization and Health. 2015;11(1).207. Dotchin C, Van Den Ende C, Walker R. Delivering global health teaching: the development of a global health option. The Clinical Teacher. 2010;7(4):271-275.7. General Medical Council. Promoting excellence: standards for medical education and training [Internet]. General Medical Council; 2016 p. R5.2. Available from: https://www.gmc-uk.org/education/27394.asp8. Johnson O, Bailey S, Willott C, Crocker-Buque T, Jessop V, Birch M et al. Global health learning outcomes for medical students in the UK. The Lancet.2012;379(9831):2033-2035.


Publication metadata

Author(s): Deivanayagam TA, Walker R, Jones S, Kennedy DJ, McKeegan K

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Association for the Study of Medical Education Annual Scientific Meeting

Year of Conference: 2018

Pages: 206-207

Online publication date: 11/07/2018

Acceptance date: 02/04/2018

Publisher: Association for the Study of Medical Education

URL: https://www.asme.org.uk/images/Abstract_Book_Combined_Final_150618.pdf


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