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Global Is Local: Does Formal Resident Global Health Medical Education Improve Clinical Care in the United States?

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  • 1 Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota Medical School, Minneapolis, Minnesota;
  • | 2 Economics, Statistics and Data Science, St. Olaf College, Northfield, Minnesota;
  • | 3 Department of Medicine, Hennepin Healthcare Services, Minneapolis, Minnesota;
  • | 4 Department of Medicine, Global Medicine, University of Minnesota Medical School, Minneapolis, Minnesota;
  • | 5 Departments of Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota;
  • | 6 HealthPartners, Regions Hospital, Department of Medicine, Saint Paul, Minnesota;
  • | 7 HealthPartners Institute, Bloomington, Minnesota;
  • | 8 Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota

ABSTRACT.

We administered a standardized 41-item questionnaire to a convenience sample of graduates of five residency programs with formal global health pathways and compared findings to a national cohort of practicing physicians to evaluate the comparative effectiveness of an overarching global health pathway on residency program graduates. Compared with the national cohort database, global health pathway graduates self-reported that they felt better prepared to treat immigrants, refugees, patients with limited English proficiency (LEP), racial/ethnic minorities, those with non-Western health beliefs, international travelers, and military veterans (P < 0.05). They were more likely to report using best practices when working with lesbian, gay, bisexual, transgender, queer/questioning patients, immigrant and refugee patients, patients with non-Western health beliefs, patients with LEP, and patients communicating via American Sign Language (P < 0.05). They also reported being more familiar with 11 of 14 high-impact or common infections encountered in travelers, immigrants, and military personnel (P < 0.05). Our findings suggest that formal postgraduate training focused on global health improves knowledge, attitudes, and self-reported medical practices when caring for diverse and marginalized populations in the United States.

    • Supplemental Materials (PDF 199 KB)

Author Notes

Address correspondence to Serin Edwin Erayil, Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota Medical School, 420 Delaware Street, SE, MMC 250, Minneapolis, MN 55455. E-mail: erayi001@umn.edu

Disclosure: Anonymous data from previous surveys conducted by Critical Measures was provided to the investigators. The study design, execution, data analysis, and manuscript preparation were performed by the investigators without input from Critical Measures. The final manuscript was reviewed by Mr. Hunt for accuracy and to ensure an accurate description of the survey tool, the data collection in the comparison group, and the role of Critical Measures in previous work and in this study. Preliminary data were presented as a poster at the Best Practices in Health Sciences Education Conference, April 29, 2020, Minneapolis, MN.

Authors’ addresses: Serin Edwin Erayil, Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota Medical School, Minneapolis, MN, E-mail: erayi001@umn.edu. Heriberto Lopez, Economics, Statistics and Data Science, St. Olaf College, Northfield, MN, E-mail: lopez12@stolaf.edu. Megan Shaughnessy, Department of Medicine, Division of Infectious Diseases, Hennepin Healthcare Services, Department of Medicine, Global Medicine, University of Minnesota Medical School, Minneapolis, MN, and Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota Medical School, Minneapolis, MN, E-mail: megan.shaughnessy@hcmed.org. Hope Pogemiller, Departments of Medicine and Pediatrics, Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, E-mail: poge0008@umn.edu. Rachel Silva, Department of General Internal Medicine, Hennepin Healthcare Services, Minneapolis, MN, and Department of Medicine, Global Medicine, University of Minnesota Medical School, Minneapolis, MN, E-mail: rachel.silva@hcmed.org. Andrew P. J. Olson, Departments of Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, MN, E-mail: apjolson@umn.edu. Brett Hendel-Paterson, HealthPartners, Regions Hospital, Department of Medicine, Saint Paul, MN, and Department of Medicine, Global Medicine, University of Minnesota Medical School, Minneapolis, MN, E-mail: bhendel1@gmail.com. Patricia Walker, Department of Medicine, Global Medicine, University of Minnesota Medical School, HealthPartners, Regions Hospital, Department of Medicine, Saint Paul, MN, and HealthPartners Institute, Bloomington, MN, E-mail: patricia.f.walker@healthpartners.com. William M. Stauffer, Departments of Medicine and Pediatrics, Division of Infectious Diseases and International Medicine, University of Minnesota Medical School, and Department of Medicine, Global Medicine, University of Minnesota Medical School, Minneapolis, MN, HealthPartners Institute, Bloomington, MN, and Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, E-mail: stauf005@umn.edu.

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