Browsing by Author "Buchner, Denise L."

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    Global Health Electives: Ethical Engagement in Building Global Health Capacity
    (2018-09-19) De Visser, Adriena; Hollaar, Gwen L.; Hatfield, Jennifer M.; Ellaway, Rachel H.; Buchner, Denise L.
    Increasingly, medical trainees are seeking global health electives (GHEs) as part of their medical education. However, little is known about the impact medical trainees undertaking global health electives have on host institutions, staff, local trainees, patients or communities in low-and middle-income countries. The goal of this study was to explore the relationship dynamics associated with global health electives as perceived by stakeholders at three sites in sub-Saharan Africa. More specifically, I examined stakeholder perspectives in Mwanza, Tanzania and Mbarara and Rugazi, Uganda where the University of Calgary Cumming School of Medicine (CSM) has long-standing institutional collaborations. In this case-based interpretive phenomenological study, thirty-four host stakeholders (health facility administrators, physicians, clinical officers, registrars, nurses, and community liaison members) participated in semi-structured interviews and twenty-eight host stakeholders (medical students, residents, interns, and patients) participated in focus groups. Participant experiences were described using interpretive phenomenological analysis techniques. The findings revealed that although GHEs are well-established and a common experience for host stakeholders there are many indistinct aspects which are poorly understood by host stakeholders. Participants acknowledged that there are a variety of benefits they gain because of GHEs, but overall visiting medical trainees benefit the most from this unique learning opportunity. Despite reluctance to directly admit to harms, host stakeholders described significant challenges and burdens of GHEs and recommended ways in which GHEs could be improved to ensure that the relationships they depend on are mutually beneficial and equitable. One of the main recommendations from this study is that to work towards an equitable, effective, and ethical elective, GHEs should occur between collaborating institutions with a bidirectional focus.