ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization , 2018. World Health Statistics 2018: Monitoring Health for the SDGs, Sustainable Development Goals. Available at: https://www.who.int/gho/publications/world_health_statistics/2018/EN_WHS2018_TOC.pdf?ua=1. Accessed November 30, 2021.
-
2.
Pak-Gorstein S et al.2019. Global health education for pediatric residents: trends, training experiences, and career choices. Pediatrics 143: e20181559.
-
3.
St Clair NE et al.2017. Global health: preparation for working in resource-limited settings. Pediatrics 140: e20163783.
-
4.
Butteris SM et al.2015. Global health education in US pediatric residency programs. Pediatrics. 136: 458--465.
-
5.
St Clair NE et al., 2018. Global Health in Pediatric Education: An Implementation Guide for Program Directors. American Board of Pediatrics Global Health Task Force Publication, in collaboration with the American Academy of Pediatrics Section on International Child Health and the Association of Pediatric Program Directors Global Health Learning Community. September, 2018. Available at: //bit.ly/globalhealthpedspdguide. Accessed November 1, 2021.
-
6.
Jeffrey J, Dumont RA, Kim GY, Kuo T , 2011. Effects of international health electives on medical student learning and career choice: results of a systematic literature review. Fam Med. 43: 21--28.
-
7.
Crump JA et al.2010. Ethics and best practice guidelines for training experiences in global health. Am J Trop Med Hyg 83: 1178–1182.
-
8.
Balmer DF, Marton S, Gillespie SL, Schutze GE, Gill A , 2015. Reentry to pediatric residency after global health experiences. Pediatrics 136: 680–686.
-
9.
Lu PM et al., 2018. Impact of global health electives on us medical residents: a systematic review. Ann Glob Heal. 84: 692--703.
-
10.
Harrison J, Logar T, Le P, Glass M , 2016. What are the ethical issues facing global-health trainees working overseas? A multi-professional qualitative study. Healthcare 4: 43.
-
11.
Raine SP , 2017. Ethical issues in education: medical trainees and the global health experience. Best Pract Res Clin Obstet Gynaecol 43: 115–124.
-
12.
Loh LC, Chae SR, Heckman JE, Rhee DS , 2015. Ethical considerations of physician career involvement in global health work: a framework. J Bioeth Inq 12: 129–136.
-
13.
Peluso MJ, Kallem S, Elansary M, Rabin TL, 2018. Ethical dilemmas during international clinical rotations in global health settings: Findings from a training and debriefing program. Med Teach 40: 53--61.
-
14.
Lopez L, Vranceanu AM, Cohen AP, Betancourt J, Weissman JS , 2008. Personal characteristics associated with resident physicians’ self-perceptions of preparedness to deliver cross-cultural care. J Gen Intern Med 23: 1953–1958.
-
15.
Batra M, Pitt MB, St Clair NE, Butteris SM , 2018. Global health and pediatric education: opportunities and challenges. Adv Pediatr 65: 71–87.
-
16.
Johnston N, Sandys N, Geoghegan R, O’Donovan D, Flaherty G , 2018. Protecting the health of medical students on international electives in low-resource settings. J Travel Med 25. doi: 10.1093/jtm/tax092.
-
17.
St Clair N et al.2019. S-PACK: a modular and modifiable, comprehensive pre-departure preparation curriculum for global health experiences. Acad Med 94: 1916–1921.
-
18.
Pitt MB, Gladding SP, Butteris SM , 2016. Using simulation for global health preparation. Pediatrics 137: e20154500.
-
19.
Webber S, Lauden SM, Fischer PR, Beyerlein L, Schubert C , 2020. Predeparture activities curricular kit (PACK) for wellness: a model for supporting resident well-being during global child health experiences. Acad Pediatr 20: 136–139.
-
20.
Luthar SS, Cicchetti D , 2000. The construct of resilience: implications for interventions and social policies. Dev Psychopathol 12: 857–885.
-
21.
Greenhill J, Fielke KR, Richards JN, Walker LJ, Walters LK , 2015. Towards an understanding of medical student resilience in longitudinal integrated clerkships. BMC Med Educ 15: 137.
-
22.
Dyrbye LN et al.2010. Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of US medical students. Med Educ 44: 1016–1026.
-
23.
Kemper KJ et al.2020. Do mindfulness and self-compassion predict burnout in pediatric residents? Acad Med 94: 876–884.
-
24.
Olson K, Kemper KJ, Mahan JD , 2015. What factors promote resilience and protect against burnout in first-year pediatric and medicine-pediatric residents? J Evidence-Based Complement Altern Med. 20: 192--198.
-
25.
Wald HS, Borkan JM, Taylor JS, Anthony D, Reis SP , 2012. Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing. Acad Med 87: 41–50.
-
26.
Lauden S, Gladding S, Slusher T, Howard C, Pitt M , 2019. Learning abroad: residents narratives of clinical experiences from a global health elective. J Grad Med Educ 11 (4 Suppl): 91–99.
-
27.
Gladding S, Zink T, Howard C, Campagna A, Slusher T, John C , 2012. International electives at the University of Minnesota global pediatric residency program: opportunities for education in all accreditation council for graduate medical education competencies. Acad Pediatr 12: 245–250.
-
28.
Rutledge et al.2014. Evolution of medical students’ understanding of systems-based practice: a qualitative account. Qualitative Rep 19: 1–9.
-
29.
Isaac V, McLachlan CS, Walters L, Greenhill J , 2019. Screening for burn-out in Australian medical students undertaking a rural clinical placement. BMJ Open 9: e029029.
-
30.
McDermott A, Brook I, Ben-Isaac E , 2017. Peer-debriefing after distressing patient care events: a workshop for pediatric residents. MedEdPORTAL J Teach Learn Resour13: 10624.
-
31.
Pitt MB, Slusher TM, Howard CR, Cole VB, Gladding SP , 2017. Pediatric resident academic projects while on global health electives: ten years of experience at the University of Minnesota. Acad Med 92: 998–1005.
-
32.
Monroe-Wise A et al.2014. The clinical education partnership initiative: an innovative approach to global health education. BMC Med Educ 14: 1043.
-
33.
Gupta AR, Wells CK, Horwitz RI, Bia FJ, Barry M , 1999. The International Health Program: the fifteen-year experience with Yale University’s internal medicine residency program. Am J Trop Med Hyg 61: 1019–1023.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1662 | 767 | 17 |
| Full Text Views | 136 | 24 | 2 |
| PDF Downloads | 107 | 19 | 3 |
Using Reflective Writing to Explore Resident Resilience during Global Health Electives
Amy R. L. Rule
Amy R. L. Rule
Division of Hospital Medicine, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;
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Stephen Warrick
Stephen Warrick
Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;
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David W. Rule
David W. Rule
Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, Ohio;
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Sabrina M. Butteris
Sabrina M. Butteris
Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin;
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Sarah A. Webber
Sarah A. Webber
Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin;
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Lynne Smith
Lynne Smith
College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, Ohio;
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Chuck Schubert
Chuck Schubert
Division of Emergency Medicine, Cincinnati, Children’s Hospital Medical Center, University of Cincinnati College of Medicine, and Department of Family and Community Medicine, Cincinnati, Ohio
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ABSTRACT.
Pediatric residents participating in global health electives (GHEs) report an improved knowledge of medicine and health disparities. However, GHEs may pose challenges that include cost, personal safety, or individual mental health issues. The objective of this study was to describe the use of guided reflections to understand resident resilience during GHEs. Forty-five residents enrolled in two pediatric training programs were asked to respond in writing to weekly prompts during a GHE and to complete a post-trip essay. Analysis of the reflections and essays, including an inductive thematic analysis, was completed. Two coders performed a second analysis to support classification of themes within the Flinders Student Resilience (FSR) framework. Four themes emerged from the initial analysis: 1) benefits, 2) stresses and challenges, 3) career development, and 4) high-value care. Analysis using the FSR framework revealed the following themes: acknowledgment of personal limitations, importance of relationships in coping throughout the GHE, and discernment of career focus. Reflective writing provided insight into how residents mitigate GHE challenges and develop resilience. Despite statements of initial distress, residents focused on their personal benefits and growth during the GHE. The FSR framework revealed the residents’ robust self-awareness of limitations and that strong relationships on the ground and at home were associated with perceived benefits and growth. Programs should consider helping residents to identify healthy coping practices that can promote personal resilience during GHEs as part of pre-departure preparation and debriefing, as well as providing for supportive communities during the GHE.
Author Notes
Authors’ addresses: Amy R. L. Rule, Division of Hospital Medicine, Perinatal Institute, Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH, E-mail: amy.rule@cchmc.org. Stephen Warrick, Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, E-mail: stephen.warrick@cchmc.org. David Rule, Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, OH, E-mail: woodyrule@gmail.com. Sabrina M. Butteris and Sarah A. Webber, Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, WI, E-mails: sawebber@wisc.edu and sbutteris@pediatrics.wisc.edu. Lynne Smith, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH, E-mail: drsmifff@gmail.com. Chuck Schubert, Division of Emergency Medicine, Cincinnati, Children’s Hospital Medical Center, University of Cincinnati College of Medicine, and Department of Family and Community Medicine, Cincinnati, OH, E-mail: chuck.schubert@cchmc.org.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
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-
1.
World Health Organization , 2018. World Health Statistics 2018: Monitoring Health for the SDGs, Sustainable Development Goals. Available at: https://www.who.int/gho/publications/world_health_statistics/2018/EN_WHS2018_TOC.pdf?ua=1. Accessed November 30, 2021.
-
2.
Pak-Gorstein S et al.2019. Global health education for pediatric residents: trends, training experiences, and career choices. Pediatrics 143: e20181559.
-
3.
St Clair NE et al.2017. Global health: preparation for working in resource-limited settings. Pediatrics 140: e20163783.
-
4.
Butteris SM et al.2015. Global health education in US pediatric residency programs. Pediatrics. 136: 458--465.
-
5.
St Clair NE et al., 2018. Global Health in Pediatric Education: An Implementation Guide for Program Directors. American Board of Pediatrics Global Health Task Force Publication, in collaboration with the American Academy of Pediatrics Section on International Child Health and the Association of Pediatric Program Directors Global Health Learning Community. September, 2018. Available at: //bit.ly/globalhealthpedspdguide. Accessed November 1, 2021.
-
6.
Jeffrey J, Dumont RA, Kim GY, Kuo T , 2011. Effects of international health electives on medical student learning and career choice: results of a systematic literature review. Fam Med. 43: 21--28.
-
7.
Crump JA et al.2010. Ethics and best practice guidelines for training experiences in global health. Am J Trop Med Hyg 83: 1178–1182.
-
8.
Balmer DF, Marton S, Gillespie SL, Schutze GE, Gill A , 2015. Reentry to pediatric residency after global health experiences. Pediatrics 136: 680–686.
-
9.
Lu PM et al., 2018. Impact of global health electives on us medical residents: a systematic review. Ann Glob Heal. 84: 692--703.
-
10.
Harrison J, Logar T, Le P, Glass M , 2016. What are the ethical issues facing global-health trainees working overseas? A multi-professional qualitative study. Healthcare 4: 43.
-
11.
Raine SP , 2017. Ethical issues in education: medical trainees and the global health experience. Best Pract Res Clin Obstet Gynaecol 43: 115–124.
-
12.
Loh LC, Chae SR, Heckman JE, Rhee DS , 2015. Ethical considerations of physician career involvement in global health work: a framework. J Bioeth Inq 12: 129–136.
-
13.
Peluso MJ, Kallem S, Elansary M, Rabin TL, 2018. Ethical dilemmas during international clinical rotations in global health settings: Findings from a training and debriefing program. Med Teach 40: 53--61.
-
14.
Lopez L, Vranceanu AM, Cohen AP, Betancourt J, Weissman JS , 2008. Personal characteristics associated with resident physicians’ self-perceptions of preparedness to deliver cross-cultural care. J Gen Intern Med 23: 1953–1958.
-
15.
Batra M, Pitt MB, St Clair NE, Butteris SM , 2018. Global health and pediatric education: opportunities and challenges. Adv Pediatr 65: 71–87.
-
16.
Johnston N, Sandys N, Geoghegan R, O’Donovan D, Flaherty G , 2018. Protecting the health of medical students on international electives in low-resource settings. J Travel Med 25. doi: 10.1093/jtm/tax092.
-
17.
St Clair N et al.2019. S-PACK: a modular and modifiable, comprehensive pre-departure preparation curriculum for global health experiences. Acad Med 94: 1916–1921.
-
18.
Pitt MB, Gladding SP, Butteris SM , 2016. Using simulation for global health preparation. Pediatrics 137: e20154500.
-
19.
Webber S, Lauden SM, Fischer PR, Beyerlein L, Schubert C , 2020. Predeparture activities curricular kit (PACK) for wellness: a model for supporting resident well-being during global child health experiences. Acad Pediatr 20: 136–139.
-
20.
Luthar SS, Cicchetti D , 2000. The construct of resilience: implications for interventions and social policies. Dev Psychopathol 12: 857–885.
-
21.
Greenhill J, Fielke KR, Richards JN, Walker LJ, Walters LK , 2015. Towards an understanding of medical student resilience in longitudinal integrated clerkships. BMC Med Educ 15: 137.
-
22.
Dyrbye LN et al.2010. Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of US medical students. Med Educ 44: 1016–1026.
-
23.
Kemper KJ et al.2020. Do mindfulness and self-compassion predict burnout in pediatric residents? Acad Med 94: 876–884.
-
24.
Olson K, Kemper KJ, Mahan JD , 2015. What factors promote resilience and protect against burnout in first-year pediatric and medicine-pediatric residents? J Evidence-Based Complement Altern Med. 20: 192--198.
-
25.
Wald HS, Borkan JM, Taylor JS, Anthony D, Reis SP , 2012. Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing. Acad Med 87: 41–50.
-
26.
Lauden S, Gladding S, Slusher T, Howard C, Pitt M , 2019. Learning abroad: residents narratives of clinical experiences from a global health elective. J Grad Med Educ 11 (4 Suppl): 91–99.
-
27.
Gladding S, Zink T, Howard C, Campagna A, Slusher T, John C , 2012. International electives at the University of Minnesota global pediatric residency program: opportunities for education in all accreditation council for graduate medical education competencies. Acad Pediatr 12: 245–250.
-
28.
Rutledge et al.2014. Evolution of medical students’ understanding of systems-based practice: a qualitative account. Qualitative Rep 19: 1–9.
-
29.
Isaac V, McLachlan CS, Walters L, Greenhill J , 2019. Screening for burn-out in Australian medical students undertaking a rural clinical placement. BMJ Open 9: e029029.
-
30.
McDermott A, Brook I, Ben-Isaac E , 2017. Peer-debriefing after distressing patient care events: a workshop for pediatric residents. MedEdPORTAL J Teach Learn Resour13: 10624.
-
31.
Pitt MB, Slusher TM, Howard CR, Cole VB, Gladding SP , 2017. Pediatric resident academic projects while on global health electives: ten years of experience at the University of Minnesota. Acad Med 92: 998–1005.
-
32.
Monroe-Wise A et al.2014. The clinical education partnership initiative: an innovative approach to global health education. BMC Med Educ 14: 1043.
-
33.
Gupta AR, Wells CK, Horwitz RI, Bia FJ, Barry M , 1999. The International Health Program: the fifteen-year experience with Yale University’s internal medicine residency program. Am J Trop Med Hyg 61: 1019–1023.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1662 | 767 | 17 |
| Full Text Views | 136 | 24 | 2 |
| PDF Downloads | 107 | 19 | 3 |