Introduction

Despite medical advances of the past century more than 8 million children under 5 years of age die each year from preventable causes.1 This harsh reality highlights a critical need for the development of leaders and human capacity in global child health.

Few formal training programs provide physicians with the skills and mentorship necessary to become global pediatricians.2 In response to this need we piloted a Global Child Health Elective for pediatric residents at the University of Connecticut School of Medicine interested in a career in global child health.

Global Pediatricians in Training: An Innovative Curriculum Preparing Pediatric Residents to

Engage in Global Health ExperiencesLeigh Sweet MD MPH 1,2,3 and Melissa Held MD 2,3

1 Baylor College of Medicine, 1st year Pediatric Infectious Diseases Fellow2 University of Connecticut School of Medicine, 3 Connecticut Children’s Medical Center

Globalization has heightened awareness of health disparities in the world and increased medical trainee interest in humanitarian efforts.

The benefits of global health experiences include: greater appreciation for working with limited resources, increased clinical skills and confidence, and heightened cultural sensitivity.5

In response to learner interest we piloted a curriculum in Global Child Health with pediatric residents at the University of Connecticut School of Medicine in the fall of 2011 and 2012.

Texas Pediatric Society Electronic Poster Contest

Background

Objective

To develop a competency-based curriculum that provides pediatric residents with:

Medical knowledge

Communication skills

Cultural sensitivity

Humanistic values

… needed to care for the world’s children and their families.

Design

Core Didactic Topics Included:

Child morbidity & mortality

Social determinants of health

Malnutrition

Reproductive health

Infectious diseases

Tropical medicine

Health systems

Environmental health

Skill-Building Workshops On:

Leadership and management

Effective communication

Developing community-based health initiatives

Visits to Refugee Communities in Hartford, CT and Cultural Immersion in Guatemala Highlighted:

Major global inequalities

Cultural sensitivity

Humanistic patient care in resource-poor settings

Assessment

Residents completed pre- and post-elective assessments of:

Global health knowledge

Self-perceived advocacy skills

Ability to identify community and global health resources

Results

Global Health Knowledge:

Pre-test mean – 48%

Post-test mean – 75% n = 8; p-value <0.001

All Residents Reported Gaining:

Significant knowledge and skills

Increased confidence in ability to improve child health locally and globally

Affirmation of their desire to integrate global health work into their careers

Conclusions

The Global Child Health Elective at the University of Connecticut School of Medicine provides learners with global health knowledge, skills and experiences.

These experiences highlight health disparities locally and globally, while introducing participants to skill sets that allow them to begin to approach these challenges.

Such early exposures allow learners to affirm their interest in global health and further pursue opportunities that fit within their career goals.

Future Directions

Further development of local and international partnerships

Development of Global Child Health Pathway

Acknowledgments Catholic Charities Migration, Refugee and Immigration Services Hartford, CT

Niños de Guatemala, staff and students at Nuestro Futuro School Ciudad Vieja, Guatemala and El Porvenir School San Lorenzo el Cubo, Guatemala

Abstract

Less than half of residents whose career plans include taking part in global child health activities after graduation receive adequate training in content areas considered essential for individuals working in the field.3 The global pediatrician “understands the state of child health locally and globally and has the knowledge, skills, attitudes and behaviors to improve the lives of children individually and in the world community.”4

We developed a curriculum that introduces residents interested in a career in global child health to the major concepts and tools necessary to become global pediatricians. Our learners reported gaining significant knowledge and skills during the elective as well as increased confidence in their ability to improve child health locally and globally. The pilot program’s success prompted the residency program administration to approve the development of an educational pathway dedicated to training in Global Child Health.

Methods

Residents interested in the Global Child Health Elective applied for 1 of 4 available PGY-1 spots upon acceptance into the pediatric residency program.

The month-long elective consisted of didactic, interactive and immersion experiences.

References 1. You et al. Levels and trends in child mortality, 1990-2009. Lancet.

2010;376(9745):931-933.

2. Nelson B, Herlihy J, and Burke T. Proposal for fellowship training in pediatric global health. Pediatrics. 2008 June; 1261-1262.

3. Anspacher et al. Global health education for pediatric residents: a national survey. Pediatrics. 2011 October;128(4):e959-65.

4. Armstrong, RW. The global pediatrician: is there such a person, or can there be? Journal of Pediatrics. 2010 April; 156(4): 517-518.

5. Haq C, Rothenberg D, Gjerde C, et al. New world views: preparing physicians in training for global health work. Fam Med 2000;32:566-572.