Workshop on global health trends for health professional education

Global finance, trade, communication, media, politics, and the cultivation of overseas relationships to advance U.S. interests are among the forces that have engendered what we now know as globalization, a historical development towards worldwide interconnectedness. While manifest in diverse realms, globalization powerfully influences human health and health services and poses challenges for physicians and other health care professionals. To review these challenges and their ramifications, a workshop was convened at Howard University to consider the implications of global health trends for medical education. Highlights of the discussion are summarized here.     

A critical narrative review of transfer of basic science knowledge in health professions education

Context

‘Transfer’ is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential. This review systematically identifies interventions described in the health professions education (HPE ) literature that document the transfer of basic science knowledge to clinical reasoning, and considers teaching and assessment strategies.

Methods

A systematic search of the literature was conducted. Articles related to basic science teaching at the undergraduate level in HPE were analysed using a ‘transfer out’/’transfer in’ conceptual framework. ‘Transfer out’ refers to the application of knowledge developed in one learning situation to the solving of a new problem. ‘Transfer in’ refers to the use of previously acquired knowledge to learn from new problems or learning situations.

Results

Of 9803 articles initially identified, 627 studies were retrieved for full text evaluation; 15 were included in the literature review. A total of 93% explored ‘transfer out’ to clinical reasoning and 7% (one article) explored ‘transfer in’. Measures of ‘transfer out’ fostered by basic science knowledge included diagnostic accuracy over time and in new clinical cases. Basic science knowledge supported learning – ‘transfer in’ – of new related content and ultimately the ‘transfer out’ to diagnostic reasoning. Successful teaching strategies included the making of connections between basic and clinical sciences, the use of commonsense analogies, and the study of multiple clinical problems in multiple contexts. Performance on recall tests did not reflect the transfer of basic science knowledge to clinical reasoning.

Conclusions

Transfer of basic science knowledge to clinical reasoning is an essential component of HPE that requires further development for implementation and scholarship.

     

The emergence of global health partnerships as facilitators of access to medication in Africa: A narrative policy analysis

Over the last decade global health partnerships (GHPs) have been formed to provide a better policy response to Africa's health problems. This paper uses narrative policy analysis to explain the historical processes and challenges facing national and global health policy in facilitating access to medication in African countries. An overview of the historical context of events leading to the creation of GHPs is followed by a content and context analysis of two GHPs – Roll Back Malaria partnership and the Accelerating Access Initiative. The historical narratives implicitly reflect the context in which policy decisions are produced and implemented. The deployment of GHPs in Africa reflects a convergence of the competing and conflicting narratives, in relating to strategies previously promoted by various multilateral and bilateral development agencies, international civil society organizations, and the private commercial industry to facilitate access to medication.     

A narrative review of alcohol consumption as a risk factor for global burden of disease

Since the original Comparative Risk Assessment (CRA) for alcohol consumption as part of the Global Burden of Disease Study for 1990, there had been regular updates of CRAs for alcohol from the World Health Organization and/or the Institute for Health Metrics and Evaluation. These studies have become more and more refined with respect to establishing causality between dimensions of alcohol consumption and different disease and mortality (cause of death) outcomes, refining risk relations, and improving the methodology for estimating exposure and alcohol-attributable burden. The present review will give an overview on the main results of the CRAs with respect to alcohol consumption as a risk factor, sketch out new trends and developments, and draw implications for future research and policy.     

Making the case for human rights in global health education, research and policy

If the 2010 CPHA conference is a bellwether of mainstream Canadian public and global health practice, its dearth of human rights papers suggests that, outside a small scholarly cohort, human rights remain marginal therein. This potential 'rights gap' conflicts with growing recognition of the relationship between health and human rights and ergo, the importance of human rights education for health professionals. This gap not only places Canadian health research outside the growing vanguard of academic research on health and human rights, but also ignores a potentially influential tool for achieving health equity. I suggest that human rights make a distinctive contribution to such efforts not replicated within other social justice and equity approaches, making human rights education a crucial complement to other ethical training. These contributions are evident in the normative specificity of the right to health in international law and its legally binding nature, in the success of litigation, the successful advocacy for AIDS treatment and the growing adoption of rights-based approaches to health. Canadian academic and research institutions should take up their rightful place within health and human rights research, education and practice globally, including by ramping up human rights-oriented education for health professionals within Canadian universities.     

安徽省全球基金艾滋病项目健康教育材料开发需求调查与评估

目的：了解项目地区群众艾滋病健康教育的现状和需求，为IEC策略的制定及传播材料的设计提供依据。方法：定量和定性调查方法相结合。结论：项目地区农村初中学生和15—49岁的妇女是IEC策略的优先目标人群；目标人群喜欢的传播媒介是小媒介（作文本、围裙）；喜欢的传播形式分别是漫画故事和顺口溜；健康教育传播的核心信息是艾滋病预防和治疗的知识。     

A global strategy for medical education: partners in reform

Summary. The onrush of beneficial change which now flows in medical education has never been stronger since the start of this century. Such activity has not been seen since the era of Flexner. There can be no doubt that the world scene is now set for decisive, effective action. The many tributaries of the stream of reform converge this year at Edinburgh, to diverge again into six Regional Conferences during 1994 in Africa, the Americas, the Eastern Mediterranean, Europe, South-East Asia and the Western Pacific. The centres of activity and connection cited below do not in any way make up a comprehensive catalogue. Rather, each development and each reform is a link in a chain, a module with which the World Federation for Medical Education (WFME) has been implicated. Each name given, each title stated, is intended as a marker, a nexus. These are among the partners to be mobilized and brought together for the task.     

A grounded theory study of the narrative behind Indian physiotherapists global migration

It is estimated that an additional 6.4 million allied health professionals are required to address India's health challenges. Physiotherapy is amongst the largest of these professions. Over the last decade, thousands of Indian physiotherapists have sought to study and work overseas. In this study, 19 physiotherapists from across India were interviewed. Data were collected and analysed using construct+ivist grounded theory methods. The findings indicate that the Indian physiotherapy profession faces many political and clinical hierarchical challenges within the Indian healthcare infrastructure. The profession's education provision has developed, and the private clinical sector has grown, but there are significant disparities in quality and standards across the sector. The profession in India has variable autonomy, is not nationally regulated, is poorly paid, and the leadership has been divided. The political, educational, and clinical context in Indian physiotherapy impacts upon physiotherapists' ability to practise effectively to their professional satisfaction. Individual physiotherapists are frustrated by their workplace and travel overseas where they hear that the physiotherapy profession and practice is different. Whilst the disjunctures influencing these factors continue, and overseas physiotherapy practice is perceived as different and superior, Indian physiotherapists will continue to seek to migrate overseas, and facilitating their return will be challenging.     

Reproductive health for global women

1.Introduction Global Health Journal (GHJ) covers general and special issues of health with importance for the global women across the globe.Many topics publish...