This document discusses medical student electives in developing countries. It notes potential benefits like exposure to rare diseases and personal growth, but also flags ethical issues. Electives could exploit local health systems and raise false expectations. They may perpetuate neo-colonial practices by benefiting students and health systems in wealthy countries more than local populations. The document also examines how non-governmental organizations can undermine public health systems and calls for electives to minimize harm, respect local needs, and establish long-term exchange programs to provide mutual benefit.
3. January 24 Group Discussion: Impact of Nursing History for 2011 Nursing Practice 43-70
Contemporary Trends Impacting Nursing and Health Care (2) 71-84
This presentation highlights challenges facing the future of education in general and nursing education in particular. Listed are strategies to prepare for future health care. Of note are details of events occuring internationally which impact on higher education.
To achieve the goal of Health Equity we need changes principles and values in healthcare and healthcare education, changes in systems for health and the use of patient driven data (Big Data) in order to develop a learning healthcare system.
3. January 24 Group Discussion: Impact of Nursing History for 2011 Nursing Practice 43-70
Contemporary Trends Impacting Nursing and Health Care (2) 71-84
This presentation highlights challenges facing the future of education in general and nursing education in particular. Listed are strategies to prepare for future health care. Of note are details of events occuring internationally which impact on higher education.
To achieve the goal of Health Equity we need changes principles and values in healthcare and healthcare education, changes in systems for health and the use of patient driven data (Big Data) in order to develop a learning healthcare system.
The ICF has potential to improve communication and collaboration (through its universal concepts and language) among health professionals working within multidisciplinary teams in research and practice to impact health outcomes for patients. Thus, it is timely for clinicians and trainees working in health-related fields to incorporate its framework into practice and research. It is hoped that professional programs will model our approach to develop similar courses within their professional curriculum to build capacity for application of the ICF. Education and training through a combination of peer support and mentorship for health professionals in the use of the ICF could assist with facilitating its uptake.
Human Resources in Fragile and Conflict-Affected settings - cross sectoral is...ReBUILD for Resilience
Overview presentation by Tim Martineau for seminar on human resources in health and education in fragile and conflict affected settings, organised by HEART in June 2016.
Nick Goodwin: making a success of care co-ordinationThe King's Fund
Nick Goodwin, Chief Executive at the International Foundation for Integrated Care, looks at how care could be better co-ordinated around people with complex needs, and the challenges around delivering joined-up care.
New technological trends in nursing uqu oct2015gracegrace lindsay
This presentation provides a short historical overview of the evolving use of technology in nursing practice by means of an introduction to the topic. A review is then presented on the latest classes of devices in use in healthcare delivery (with examples), their supporting communication systems and considerations of their strengths and limitations. A key meesage to the healthcare sector is that this technological advancement is speeding ahead of policy, procedural and infrastuctural considerations. The personal use of devices has become embedded in practice leading to random and unregulated use and limited attention to codes of safe practice and recommended standards of care.
Cooperative Extension's National Focus on Health literacySUAREC
Please presentation, that was presented as a webinar focuses on the National Land-grant's role on Health Literacy. The presenters of this webinar were Dr. Sonja Koukel, New Mexico State University Extension and Dr. Fatemeh Malekian, Southern University Agricultural Research and Extension Center.
The ICF concept of health provides perspectives on people’s lives through the lens of functioning. This view of health promotes an integration of a patient’s body functions
and structures, activities performed in daily life, and the personal and social roles that constitute their participation in life situations.
Service providers (health, education, welfare) engaged in the habilitation process have varied disciplinary language, training and culture that all emphasize certain
domains of patient’s functioning over others. However, adoption of the ICF allows that all members of a clinical team are motivated to improve their patient’s functioning
within a common conceptual approach. This can be used to describe the different goals of intervention, negotiate priorities and communicate among different disciplines
and with patients and parents.
Human Resources for Health in Post-Conflict settings - Findings from ReBUILD ...ReBUILD for Resilience
Presentation given in June 2016 by Sophie Witter on the ReBUILD programme's findings on Human Resources for Health in Post-Conflict settings, at a meeting exploring cross-sectoral learning on human resources in health and education sectors in fragile settings
The theory of holistic review is easy enough to grasp - but how do you put it into practice? This presentation digs into the nuts and bolts of holistic review implementation, using the AAMC's experience as a foundation.
PRIME Centre Wales
Long Term Conditions Consensus Meeting
Tuesday 10th November 2015, St Mary's Priory, Abergavenny, NP7 5ND
http://www.primecentre.wales/ltc-consensus-meeting.php
The ICF has potential to improve communication and collaboration (through its universal concepts and language) among health professionals working within multidisciplinary teams in research and practice to impact health outcomes for patients. Thus, it is timely for clinicians and trainees working in health-related fields to incorporate its framework into practice and research. It is hoped that professional programs will model our approach to develop similar courses within their professional curriculum to build capacity for application of the ICF. Education and training through a combination of peer support and mentorship for health professionals in the use of the ICF could assist with facilitating its uptake.
Human Resources in Fragile and Conflict-Affected settings - cross sectoral is...ReBUILD for Resilience
Overview presentation by Tim Martineau for seminar on human resources in health and education in fragile and conflict affected settings, organised by HEART in June 2016.
Nick Goodwin: making a success of care co-ordinationThe King's Fund
Nick Goodwin, Chief Executive at the International Foundation for Integrated Care, looks at how care could be better co-ordinated around people with complex needs, and the challenges around delivering joined-up care.
New technological trends in nursing uqu oct2015gracegrace lindsay
This presentation provides a short historical overview of the evolving use of technology in nursing practice by means of an introduction to the topic. A review is then presented on the latest classes of devices in use in healthcare delivery (with examples), their supporting communication systems and considerations of their strengths and limitations. A key meesage to the healthcare sector is that this technological advancement is speeding ahead of policy, procedural and infrastuctural considerations. The personal use of devices has become embedded in practice leading to random and unregulated use and limited attention to codes of safe practice and recommended standards of care.
Cooperative Extension's National Focus on Health literacySUAREC
Please presentation, that was presented as a webinar focuses on the National Land-grant's role on Health Literacy. The presenters of this webinar were Dr. Sonja Koukel, New Mexico State University Extension and Dr. Fatemeh Malekian, Southern University Agricultural Research and Extension Center.
The ICF concept of health provides perspectives on people’s lives through the lens of functioning. This view of health promotes an integration of a patient’s body functions
and structures, activities performed in daily life, and the personal and social roles that constitute their participation in life situations.
Service providers (health, education, welfare) engaged in the habilitation process have varied disciplinary language, training and culture that all emphasize certain
domains of patient’s functioning over others. However, adoption of the ICF allows that all members of a clinical team are motivated to improve their patient’s functioning
within a common conceptual approach. This can be used to describe the different goals of intervention, negotiate priorities and communicate among different disciplines
and with patients and parents.
Human Resources for Health in Post-Conflict settings - Findings from ReBUILD ...ReBUILD for Resilience
Presentation given in June 2016 by Sophie Witter on the ReBUILD programme's findings on Human Resources for Health in Post-Conflict settings, at a meeting exploring cross-sectoral learning on human resources in health and education sectors in fragile settings
The theory of holistic review is easy enough to grasp - but how do you put it into practice? This presentation digs into the nuts and bolts of holistic review implementation, using the AAMC's experience as a foundation.
PRIME Centre Wales
Long Term Conditions Consensus Meeting
Tuesday 10th November 2015, St Mary's Priory, Abergavenny, NP7 5ND
http://www.primecentre.wales/ltc-consensus-meeting.php
Profile Picture1 posts ReTopic 2 DQ 1It is essentia.docxbriancrawford30935
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Re:Topic 2 DQ 1
It is essential to note that we actually live in a diverse nation and overcoming the shortcomings associated with cultural preferences and beliefs is a big obstacle for healthcare professionals today. In the article “Health Disparity and Cultural Conflict” cultural diversity is singled out to be more than one race. It is important for healthcare workers to know that addressing cultural diversity is far more than just understanding the values, practices, customs, and beliefs (Hughes, 2011). Apart from national origin and racial classification, there are various kinds of cultural diversity and these include language, age, religious affiliation, and geographical location.
Healthcare providers are expected to diligently accommodate the varying needs of the individuals they meet in their service provision. The needs actually range from the different cultural backgrounds to the learning styles and preferences as well as the mixed opinions that define their health and well-being (Lochman, 2012). The issue of language barrier is a big problem to many healthcare providers.
Nurses are normally exposed to various beliefs and cultures as they work in their healthcare fields. Apart from diversity, it is important
to consider the level of education plus the style of learning. This will enable the nurse to formulate the best teaching method relevant for the patient. Patients with various cultural differences can sometimes not be willing to take part in education or take in the teachings. In order to initiate any formal kind of teaching, trust must be developed (Campinha, 2003). Nurses should assess the values and ideas related to the illness and health of the patients, treatment provided, medication being taken, and the expectations to ensure effective teaching or learning.
Healthcare professional should pay very close attention to the cultural needs of their patients including expression and language. For example, a Chinese patient who has been disregarding signs unusual signs and symptoms of rectal bleeding for a long time. He has come to the hospital and diagnosed with colon cancer. The early treatment process however needs colon resection. The treatment process is discussed with the patient and risk also explained, particularly blood loss. In the process of surgery, the patient loses a lot of blood and the level of haemoglobin reduces below the normal range. This required immediate blood transfusion. However, the culture of the patient did not accept blood transfusion. The transfusion process had to be delayed since the patient refused. Such kind of cultural affiliations can affect the manner which care delivery is done and providers must be aware of them and teach the patients. Teaching should actually be a multidisciplinary team work which includes social work, dietician, and therapy department. Nurses should also be aware of their own values and beliefs before interacting with the various different culture.
Design Thinking as innovation tool for Smart Nation: Cancer healthcareShah Widjaja
Presentation done as part of Singapore Design Week Festival 2017
Summary:
How does design thinking change mindsets and culture so that a nation like Singapore can continue to innovate and lead the transformation for a better future? Harnessing the power of design thinking to build a ‘Smart Nation’ for Singapore, this workshop aims to give audiences the opportunity to realize the potential this methodology has.
A user-centered way of solving problems, design thinking involves collaboration across user segments, through strategies like customer journey mapping, design research and rapid prototyping. While design is often used to describe an end-product, in reality if applied properly, can be used to address problems or issues across a variety of field including social issues.
Health Policy Project 2:
Precious Teasley
Southern New Hampshire University
Health Policy and Law 22TW5
Dr. Jim Dockins
July 21,2022
Health Policy Project 2: Continuation
Stakeholder Needs
Low compensation for immunization services is a problem for physicians, so the government must ensure that they are reimbursed adequately. Immunizations are too costly for vulnerable populations whose medical insurance does not cover them. Due to the exorbitant expense of these vaccines in private hospitals and pharmacies, these individuals cannot access them. Adult vaccines may also be unavailable due to the inability of the most vulnerable individuals to travel to distant public health centers in quest of vaccinations. For doctors and pharmacists to purchase vaccines from pharmaceutical companies, a large amount of funds is necessary. In addition, they require funding for the purchase of new, high-tech storage facilities, as the preservation of vaccines requires the usage of specific substances. Pharmaceutical businesses need funding for disease-related research and the installation of intricate systems for creating and monitoring vaccinations. In addition, they need cash to purchase huge, specialized storage containers so that vaccines are accessible everywhere. To provide vaccines to the public, health insurance companies require funding to meet the vaccine administration needs of their consumers.
Taking the financial demands of stakeholders into account when making decisions about low adult immunization rates can assist assure optimal vaccine supply and distribution, enhanced following and monitoring requirements, and vaccine availability. Consideration of the requests will result in shared provider contacts and public-private partnerships, which will speed up adult immunization.
Financial Influence
The primary financial stakeholders are pharmaceutical corporations, which conducted the research, developed the vaccines, and brought them to market. The patient's financial situation is gently adjusted despite the moral obligation of pharmaceutical companies to ensure that the market can afford their product; the patient, as the product's recipient, experiences hidden impacts. It is essential to be aware of these elements in order to develop an effective health policy. If the underlying reasons for the problem are not addressed, it is impossible to find a remedy. The role of government is to ensure equality for all citizens while safeguarding commercial interests. Before the government can assist the poor with their health issues, it must decide who controls prices and costs (Chaudhary et al., 2020). During the planning and decision-making process, not only the patient and doctors but also the company must be protected and assisted.
Benefits and Disadvantages
In numerous ways, the issue is advantageous to the stakeholders. They will be able to get monies quickly from prom commitments made in the face of emergency illness epidemics t ...
5. Overseas electives
Different cultural and
organisational setting
See diseases rare in UK
Personal development
Travel
Experience different
medico-social context
6. A tale of two electives…
Adams and Sheather, 2001. Elective
Ethics. sBMJ 9; p.305-356.
7.
8. Medical tourism
Self-serving
Raise unmet expectations
Ineffective
Impose burdens on local
health facilities
Inappropriate
If under colonialism natural resources and human labour
were exploited;
Are western societies now using under-developed
nature of developing countries as training grounds for
their own teachers and other professionals?
Are medical electives the new neo-
colonialism?
10. Practising ethics
• Ambassadors abroad
• Discomfort about suddenly being expected to
“see patients”
• Poor supervision
• Limited resources
• Huge health needs
Justifies acting
role of doctor?
11. Practising ethics
Patients have right to know are being cared by
students
Ethics of intervening
Legal ground
Moral boundaries
12. Risk to the poor – benefit to the
rich
• Medical students profit from
international elective experience and
practise within USA/Europe
benefits in training transferred to
patients in developed world
• burden of harm is placed on the
population in the developing world
and most benefit is accrued by
patients in developed nations
exploitation might emerge
13. The Elective Industry
Parallels to Gap Year industry
Diverse organisations
Simplistic definition of development
14. The Elective Industry
SPW is a true development
organization. We will not send you on
an exotic holiday where you can also
indulge in a little teaching, or
environmental work. You will
know that if you participate in one of
our programmes you will be helping
to make a real difference - not only
for your CV, but for the people you are
working with.
Original emphasis, Student Partnership
Worldwide, 2002
Does the idea of travel to far off
destinations appeal to you? How about
the adventure of joining an expedition into
the world’s greatest mountain ranges? And
I expect you’d like to help a
disadvantaged community and acquire
new skills while working on an aid
project . . . . At the same time you’re
probably thinking about how your Gap
Year will fit into the broader picture, will it
be something to impress future employers
and how will it look on your CV?
Venture Co., 2002, p. 1
15. Incorrect representation of
‘developing world’
Limited critical engagement
allows students to confirm their
presumptions, with added
authority of ‘experience’
Fatalistic faith in the ‘luck of
the draw’
‘Lotto logic’
Outgoing reflections of students
What the gap year industry lacks is a pedagogy for social
justice
16.
17. The route to internationalisation?
Authors question whether
electives enable students
to meet requirements of
globalisation
Comprehensive
programme of international
health teaching
Preaching to the converted
Edwards et al, 2004. Understanding global health issues: are
international medical electives the answer?
18. Curricula for change
• WHO qualities of ‘5 star
doctor’
• Community oriented
• Reconciling individual and
community needs
• Initiating actions on behalf of
community
Tomorrow’s Doctors:
Public health medicine
prominent in curriculum
Health promotion;
illness prevention;
Assessment and targeting of
population needs
Awareness of environmental
and social factors in disease
19. International Health electives
Karolinska Institute,
Sweden
Global Multiculturalism
Track, Massachusetts,
USA
University College
London, UK
20. Health Systems
Developing countries face
severe health workforce
shortages
4 million health workers
needed to fill gap (World
Health Organisation)
NGOs can lure qualified
people from Ministry of
Health and into private
sector
21. Parallel health systems
NGOs can high more staff
at higher salaries
Can acquire specialised
equipment
Or create idealised projects
serving one limited
population in a geographic
area
Result is a fragmented
and inequitable health
system
22. I. NGOs will engage in hiring practices
that ensure long-term health system
sustainability.
II. NGOs will enact employee
compensation practices that
strengthen the public sector.
III. NGOs pledge to create and maintain
human resources training and support
systems that are good for the
countries where they work.
IV. NGOs will minimize the NGO
management burden for ministries.
V. NGOs will support Ministries of Health
as they engage with communities.
VI. NGOs will advocate for policies that
promote and support the public sector.
23. Funding
Electives operate in
context of inequality
Consider how you
spend your money
Ethics of funding?
24. What can you do?
Before you leave:
think what you hope to
gain and what you are
capable of doing
question medical school on
when to ask for help and
what to do when not
forthcoming
knowledge and skills of
health context
Broad learning on
determinants of disease
25. What can you do?
Once you’re there:
discuss with supervisor
what is expected and
how you can be most
helpful
offer something in return
relevant research
On return:
future student or research
exchanges
Reflect on experience
Develop global
understanding
26. Final remarks
We live in a global
economy; surely we
should practise global
medicine?
One-way process
Strive to minimise the
risk: benefit ratio
27. Essential reading
UCL Elective Pack
Available at:
http://student.bmj.com/international/elective_pack.php
Improving health for the world’s poor: what
can health professionals do?
http://www.bma.org.uk/ap.nsf/content/Improvinghealth
Electives are part of the medical course often most eagerly anticipated by students – something interesting, in a new environment, and chance to combine with exciting travel plans
Most students receive info on immunisations, HIV prophylaxis and antimalarials; less frequently given any decent preparation for the broader experience of a medical elective
Electives
40-70% students in the UK travel to developing countries for their elective
The lack of preparation before the elective, a lack of analysis of educational objectives, and of benefits for the
hosting institution, have led to some people denouncing electives as a period of medical tourism, where
usually the most affluent students benefit.
question is of moral boundaries – of knowing where to draw the line between those activities which are and are not clinically appropriate
One of elective’s great virtues is that sometimes students may be able to undertake more procedures than back home – provided that these are well supervised – even from a distance – and patients agree to be attended by students, there is no problem
perhaps we would hear of more law suits if the patients injured were wealthier, more vocal and more aware of their rights
Patients who find themselves being treated by elective students are likely to be the poorest, with the lowest expectations of health care
rather in structures and systems in which we all participate, and which are, ultimately, open to change
combines full-time 5 week course in GH issues with a 2 week stay in Tanzania, India or Cuba
(2) aims to improve ‘cultural competency’ of medical students among local immigrant and refugee populations. Programme combines local family placements, language training, community service projects and seminars with an international visit to a developing country that is linguistically and culturally similar to the relevant local population
(3) provides a 4 week taught programme on global health issues and a 6 week elective in a developing country. Latter includes involvement in a community health project and peer education with local students
“where we can count HIV viral loads, but a woman dying in childbirth can’t get a cesarean sections; where one district has a state of the art hospital while the next district has only an empty cement-block building without running water or electricity."
The processes that allow young westerners to access the financial resources, and moral imperatives, necessary to
travel and volunteer in a ‘third world country’, are the same as the ones that make the reverse process almost impossible
If you are expecting to have to treat patients, make sure that you learn as much as possible about relevant diseases, the available treatments, public health issues and the social set-up before you go, and ask the advice of the people around you when you are there
Under the current situation, the elective period is a one-way process, with its benefits and balanced towards those who can afford to go to a foreign institution - namely students from wealthy nations.
aims to inspire health professionals and their organisations to realise the powerful role they can play in improving health for the world's poorest people.