Rwandan family medicine residents expanding their training into South Africa: the use of South-South medical electives in enhancing learning experiences

BMC Medical Education

Jan De Maeseneer²  Vincent Kalumire Cubaka¹  Gboyega Ogunbanjo³  Maaike Flinkenflögel² 

[1]Center for Global Health, Department of Public Health, Aarhus, Denmark

[2]Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium

[3]Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, South Africa (previously known as University of Limpopo – Medunsa Campus, South Africa), Limpopo, South Africa

关键词: Ethics;    Africa;    South-South;    Family medicine training;    Learning outcomes;    Medical education;    Global health;    Global electives;    International medical electives;   

Others  :  1224508
DOI  :  10.1186/s12909-015-0405-3

 received in 2015-03-08, accepted in 2015-07-06,  发布年份 2015

【 摘 要 】

Background

International medical electives are well-accepted in medical education, with the flow of students generally being North–South. In this article we explore the learning outcomes of Rwandan family medicine residents who completed their final year elective in South Africa. We compare the learning outcomes of this South-South elective to those of North–South electives from the literature.

Methods

In-depth interviews were conducted with Rwandan postgraduate family medicine residents who completed a 4-week elective in South Africa during their final year of training. The interviews were thematically analysed in an inductive way.

Results

The residents reported important learning outcomes in four overarching domains namely: medical, organisational, educational, and personal.

Conclusions

The learning outcomes of the residents in this South-South elective had substantial similarities to findings in literature on learning outcomes of students from the North undertaking electives in the Southern hemisphere.

Electives are a useful learning tool, both for Northern students, and students from universities in the South. A reciprocity-framework is needed to increase mutual benefits for Southern universities when students from the North come for electives. We suggest further research on the possibility of supporting South-South electives by Northern colleagues.

【 授权许可】

   
2015 Flinkenflogel et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Mutchnick I, Moyer C, Stern D. Expanding the boundaries of medical education: evidence for cross-cultural exchanges. Acad Med. 2003; 78(10 suppl):S1-5.
• [2]Holmes D, Zayas L, Koyfman A. Student objectives and learning experiences in a global health elective. J Community Health. 2012; 37:927.
• [3]Jeffrey J, Dumont R, Kim G, Kuo T. Effects of international health electives on medical student learning and career choices: Results of a systematic literature review. Fam Med. 2011; 43(1):21-8.
• [4]Harth S, Leonard N, Fitzgerald S, Thong Y. The educational value of clinical electives. Med Educ. 1990; 24:344-53.
• [5]Kumwenda B, Royan D, Ringsell P, Dowell J. Western medical students’ experiences on clinical electives in sub-Saharan Africa. Med Educ. 2014; 48:593-603.
• [6]Cherniak WA, Drain PK, Brewer TF. Educational objectives for international medical electives: a literature review. Acad Med. 2013; 88(11):1778-81.
• [7]Niemandsverdriet S, Majoor G, van der Vleuten C, Scherpbier A. I found myself to be a down to earth Dutch girl. Med Educ. 2004; 38:749-57.
• [8]Ramsay A, Haq C, Gjerde C, Rothenberg D. Career influence of an international health experience during medical school. Fam Med. 2004; 36(6):412-6.
• [9]Grudzen C, Legome E. Loss of international medical experiences- knowledge, attitudes and skills at risk. BMC Med Educ. 2007; 7:47. BioMed Central Full Text
• [10]Abedini NC, Danso-Bamfo S, Moyer CA, Danso KA, Mäkiharju H, Donkor P et al.. Perceptions of Ghanaian Medical Students Completing a Clinical Elective at the University of Michigan Medical School. Acad Med. 2014; 89(7):1014-7.
• [11]Martin D. The debate over electives - 1899. Acad Med. 1995; 70(11):960.
• [12]Dowell J, Merrylees N. Elective: isn’t it time for a change? Med Educ. 2009; 23:121-8.
• [13]Crump JA. Ethical considerations for short-term experiences by trainees in global health. JAMA. 2008; 300(12):1456.
• [14]Crump JA, Sugarman J. Ethics and Best Practice Guidelines for Training Experiences in Global Health. Am J Trop Med Hyg. 2010; 83(6):1178-82.
• [15]Gupta R, Farmer PE. International electives: maximizing the opportunity to learn and contribute. Medscape Gen Med. 2005; 7(2):78.
• [16]Bozinoff N, Dorman K, Ker D, Roebellen E, Rogers E, Hunter A et al.. Toward reciprocity; host supervisor perspectives on international medical electives. Med Educ. 2014; 48:397-404.
• [17]Ahluwalia P, Cameron D, Cockburn L, Ellwood L, Mori B, Nixon SA. Analyzing international clinical education practices for Canadian rehabilitation students. BMC Med Educ. 2014; 14(1):187. BioMed Central Full Text
• [18]Hugo J, Allan L. Doctors for tomorrow. Family Medicine in South Africa. NISC, South Africa; 2008.
• [19]Training in Family Medicine and Primary Health Care in South-Africa and Flanders: report of a study visit. Belgium; 1997 Sep. Report No.: Projectnr. ZA.96.11.
• [20]Flinkenflogel M, Essuman A, Chege P, Ayankogbe O, De Maeseneer J. Family medicine training in sub-Saharan Africa: South-South cooperation in the Primafamed project as strategy for development. Fam Pract. 2014; 31(4):427-36.
• [21]Mash RB, Reid S. Statement of consensus on Family Medicine in Africa. Afr J Prim Health Care Fam Med. 2010; 2(1):4.
• [22]Family and Community Medicine (FAMCO). Faculty of Medicine, National University of Rwanda; 2008.
• [23]World Health Organisation. Global Health Observatory [Internet]. [cited 2014 Sep 22]. Available from:. www. who.int/gho/countries/en/ webcite
• [24]Ventres WB, Wilson CL. Beyond ethical and curricular guidelines in global health: attitudinal development on international service-learning trips. BMC Med Educ [Internet]. 2015 Dec [cited 2015 May 28];15(1). Available from:. http://www. biomedcentral.com/1472-6920/15/68 webcite