Global Health Informatics: Novel Approaches & Applications: Jacqueline Wolting and Brianna McKelvie
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The 2008 MedLink project aimed to enhance medical students' understanding of global health through cross-cultural partnerships and alternative medical education models. Participants reported increased knowledge about their partners' countries and improved preparedness for future international medical experiences, although fewer respondents completed post-surveys. The project received positive feedback, with 98.1% of respondents supporting its continuation and 94.1% recommending it to peers.
Global Health Informatics: Novel Approaches & Applications: Jacqueline Wolting and Brianna McKelvie
- 1. The 2008 MedLINK Project: Objectives, Outcomes and Future Goals
- 2. MedLINK Leadership Team Dr. Richard Kitto, PhD Faculty of Education, UWO Dr. David Cechetto, PhD Schulich Faculty of Medicine, UWO NUR Medical Students: David Ntirushwa Steven Sabiiti Gatare Swaibu UWO Medical Students: Brianna McKelvie Jacqueline Wolting Stephen Zborovski Eileen Cheung Kelly MacDonald Christina Morgan Janelle Rekman
- 3. MedLINK Project Objectives 1) To facilitate student learning about principals related to global health, including: cross-cultural partnerships alternate models of medical education and healthcare delivery culturally-driven perceptions about health and healthcare ethical/logistical challenges in global health medicine
- 4. MedLINK Project Objectives To facilitate learning about partners’ home country, with respect to culture, politics, healthcare system, medical education system, common disease entities To build upon the existing relationship between the faculties of Nursing and Medicine at the NUR and UWO To accomplish the above in a cost-effective, time-efficient manner
- 5. Project Design: Program Framework Volunteer participants from two medical schools Partners randomly assigned Each pair assigned MedLINK Executive Team Liason Correspondence between students for three months Regular contact and support by Executive Team
- 6. Project Design: Program Features Introductory information sessions Five optional educational modules Thank-you meal for participants (Canada)
- 7. Project Design: Research Framework Research question: What effects will the 2008 MedLINK Project have on medical student participants?
- 8. Project Design: Research Framework Hypotheses: Students will gain a valuable educational experience Students will increase their knowledge of their partner’s country/culture in key areas Students’ attitudes will change with respect to their future involvement in global health projects
- 9. Project Design: Research Framework Research Ethics approval obtained at UWO (#13898E) Pre- and Post-Partnership surveys administered online using surveymonkey.com Results analysed using mixed-methods and emergent theory
- 10. Project Design: Surveys 23 questions 5 sections: logistics, philosophy, knowledge, prior experiences/future intentions, MedLINK team Pre-Partnership Post-Partnership 30 questions same 5 sections added section on learning outcomes and future of MedLINK
- 11. Project Design: Timeline Oct. 2007 Nov. 2007 Jan. 2008 Feb. 2008 Mar. 2008 Apr. 2008 May. 2008 MedLINK team formed, Students polled for interest Surveys finalized, Ethics submitted Ethics accepted, UWO participants finalized, NUR holiday extended NUR term begins, Participants finalized, Pre-partnership surveys administered All-participant meetings, Partnerships begin, Module 1 Trouble shooting, Module 2, 3 Module 4 Module 5, “Thank-you Lunch” (Canada), Post-partnership surveys administered
- 12. Challenges Anticipated: Matching even number of students Medical students’ time constraints Ongoing motivation for discussion Requests for electives at UWO/NUR Research partnership logistics
- 13. Challenges Unanticipated: Start date delayed by four weeks Email access/function barriers Language barriers Shared administrative tasks Validity of survey results
- 14. Outcomes: Quantitative NUR respondents – pre 47 and post 28 UWO respondents – pre 41 and post 26 Level of commitment to project (Post): Logistics 1-not very committed 2 3 4 5-very committed NUR 1 1 18 10 6 UWO 0 2 15 8 0
- 15. Outcomes: Quantitative Preferred method of contact: email Frequency of contact: Logistics 4+/wk 2-3/wk 1/wk 2-3/mo 1/mo <1/mo NUR 1 3 7 12 7 6 UWO 0 0 0 9 8 9
- 16. Outcomes: Quantitative Knowledge (UWO Responses) Pre mentorship Post mentorship Healthcare system Mean 1.2 SD 0.55 Mean 1.96 SD 0.99 Medical school Mean 1.05 SD 0.22 Mean 2.15 SD 0.97 Common diseases Mean 1.68 SD 0.75 Mean 2.08 SD 1.16 Challenges faced by students Mean 1.17 SD 0.5 Mean 2.19 SD 1.09 Challenges faced by healthcare Mean 1.17 SD 0.71 Mean 2.08 SD 1.16 Political history Mean 1.78 SD 0.94 Mean 2.23 SD 1.07 Current politics Mean 1.44 SD 0.74 Mean 2.00 SD 1.12
- 17. Outcomes: Quantitative Knowledge (NUR Responses) Pre mentorship Post mentorship Healthcare system Mean 1.18 SD 0.44 Mean 2.54 SD 1.10 Medical school Mean 1.23 SD 0.60 Mean 2.54 SD 1.26 Common diseases Mean 1.25 SD 0.58 Mean 2.46 SD 1.28 Challenges faced by students Mean 1.23 SD 0.65 Mean 2.48 SD 1.14 Challenges faced by healthcare Mean 1.23 SD 0.41 Mean 2.28 SD 0.96 Political history Mean 1.26 SD 0.54 Mean 1.96 SD 1.12 Current politics Mean 1.37 SD 0.57 Mean 2.32 SD 1.33
- 18. Outcomes: Quantitative MedLINK team Desired support from MedLINK team: Contact from team member 1x/mo One meeting/ semester Monthly emails w/ discussion questions Email quizzes to pairs to exchange Online forum for discussion NUR 62% 68% 79% 64% 87% UWO 44% 58% 90% 63% 39%
- 19. 32% of NUR students and 50% UWO students had participated in an international exchange. There was a medical basis to the exchange for 73% of NUR students and 27% of UWO students. Outcomes: Quantitative Prior Experiences
- 20. Would you now feel more comfortable traveling to your match's home country for a MEDICAL ELECTIVE than you did before this project? Outcomes: Quantitative Future Intentions
- 21. Do you feel more equipped for future cross-cultural medical experiences when traveling to ANY other country than you did before this project? Outcomes: Quantitative Future Intentions
- 22. Would you recommend participation in the MedLINK project to students at your school? Outcomes: Quantitative Future Intentions
- 23. Do you think the MedLINK partnership between the NUR and UWO should continue? Outcomes: Quantitative Future of MedLINK
- 24. Outcomes: Qualitative Coding using AtlasTI version 5.0 Inter-rater reliability of 84-96% Respondents did not identify any negative effects from the project
- 25. Outcomes: Qualitative Respondents identified the following as benefits: connection with a medical student in another country (26%) increased knowledge of partner country culture (24%) greater understanding of partner country healthcare and/or medical education system (22%) increased general non-medical knowledge (14%) greater understanding of medicine in general (14%)
- 26. Outcomes: Qualitative Respondents identified the following as the most important thing they learned through participating in the project: knowledge of the medical system of their partner’s country (31%) cultural awareness and sensitivity (28%) the common experiences of medical students (10%) strategies for self-improvement (9%)
- 27. Summary of Results 1) Fewer respondents to the post- mentorship survey than to the pre- mentorship survey 2) Majority of students at both schools were “moderately committed” to the project; most communicated 2-3 times/ month
- 28. Summary of Results Majority of UWO students felt that after the project they WERE NOT better prepared for a medical elective in Rwanda or any other country The majority of students at the NUR felt that after the project they WERE better prepared for a medical elective in Canada or any other country
- 29. Summary of Results 5) Mean response value increased between the pre and post surveys in every sphere of knowledge tested, for students at both schools 6) 98.1% of all respondents thought the MedLINK project should continue in the future and 94.1% would recommend participation to other students at their school
- 30. Future of MedLINK: MedLINK 2009 40 pairs of students longer partnership duration (as long as 8 months) fewer formal modules monthly postings in classrooms (Canada) survey analysis handed over to NUR, with support no results as of yet
- 31. Future Goals prepare students for clinical/research exchange match students for research collaborations match students for clinical exchanges engage students not involved in global health initiatives
- 32. THANK YOU!