Medical electives in sub-Saharan Africa

a host perspective

Ben Kumwenda (Lead / Corresponding author), Jon Dowell, Katy Daniels, Neil Merrylees

    Research output: Contribution to journalArticle

    21 Citations (Scopus)

    Abstract

    CONTEXT Electives are part of most Western medical school curricula. It is estimated that each year 3000-4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate.

    OBJECTIVES The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub-Saharan Africa from a host perspective.

    METHODS A qualitative analysis of 14 semi-structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio-recorded data.

    RESULTS Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under-resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care.

    CONCLUSIONS The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts' perspective, but individually host institutions lack the opportunity or ability to achieve change.

    Original languageEnglish
    Pages (from-to)623-633
    Number of pages11
    JournalMedical Education
    Volume49
    Issue number6
    DOIs
    Publication statusPublished - Jun 2015

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    Africa South of the Sahara
    Students
    Zambia
    Malawi
    Aptitude
    Tanzania
    Urban Hospitals
    Medical Schools
    Medical Students
    Ethics
    Teaching Hospitals
    Curriculum
    Developing Countries
    Patient Care
    Teaching
    Learning
    Organizations
    Interviews
    Delivery of Health Care
    Safety

    Cite this

    Kumwenda, Ben ; Dowell, Jon ; Daniels, Katy ; Merrylees, Neil. / Medical electives in sub-Saharan Africa : a host perspective. In: Medical Education. 2015 ; Vol. 49, No. 6. pp. 623-633.
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    abstract = "CONTEXT Electives are part of most Western medical school curricula. It is estimated that each year 3000-4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate.OBJECTIVES The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub-Saharan Africa from a host perspective.METHODS A qualitative analysis of 14 semi-structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio-recorded data.RESULTS Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under-resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care.CONCLUSIONS The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts' perspective, but individually host institutions lack the opportunity or ability to achieve change.",
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    Medical electives in sub-Saharan Africa : a host perspective. / Kumwenda, Ben (Lead / Corresponding author); Dowell, Jon; Daniels, Katy; Merrylees, Neil.

    In: Medical Education, Vol. 49, No. 6, 06.2015, p. 623-633.

    Research output: Contribution to journalArticle

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    AU - Daniels, Katy

    AU - Merrylees, Neil

    N1 - © 2015 John Wiley & Sons Ltd.

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    N2 - CONTEXT Electives are part of most Western medical school curricula. It is estimated that each year 3000-4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate.OBJECTIVES The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub-Saharan Africa from a host perspective.METHODS A qualitative analysis of 14 semi-structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio-recorded data.RESULTS Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under-resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care.CONCLUSIONS The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts' perspective, but individually host institutions lack the opportunity or ability to achieve change.

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