Host Preceptor’s Positive Perceptions Toward Global Health Rotations: A Literature Review Nicole Tittarelli, PA-S, Teresa Thetford, DHSc, M.S., PA-C , Eric Nemec, PharmD, MEHP, BCPS, Gerald Kayingo*, PhD Sacred Heart University Physician Assistant Studies - Fairfield, CT University of California Davis – Sacramento, CA Masters Capstone Presentation – Stamford, Connecticut – April 27, 2018 Conclusion Discussion v This study reveals reported benefits of GHRs from the perspective of host preceptors. v GHRs contribute valuable components toward local education, host institutions, and patient care 1-8 . v The gap in literature remains due to few studies identifying the value of global health rotations toward host country institutions. v Continued research advocated so mutual benefits among partners is substantiated. Implications for Future Research v The available literature uses survey and interview study methods of data collection, and different study designs should be investigated. v Future studies should research quantitative value of GHRs. Quantitative studies can include evidence of improved cost, patient care, and institutional value. v Common themes separately researched give a more accurate understanding of how each brought value or can be improved. Methodology Literature Review Abstract Background: Health care institutions from around the globe have established relationships that provide opportunities for medical professionals to participate in Global Health Rotations (GHRs). This includes sending trainees from high- resource institutions to learn in low-resource settings in an effort to enhance clinical training 1 . Low-resource settings expose trainees to clinical experiences that they may not see in their home country, including different cultures, healthcare delivery systems, and diseases 1 . While there are many studies to support the value of GHRs on the high-resource sending institution, there is minimal evidence to show how GHRs benefit the low-resource host institution. Purpose: This literature review will provide evidence that host preceptors perceive GHRs to bring value to their institution. The goal is to validate current studies demonstrating that institutions participating in GHRs have mutually beneficial collaborations. v A key word literature search was conducted using Boolean Logic to find articles from electronic databases. Inclusion Criteria v Study designs with an approved method- survey- Likert scale, or interview style data collection. v Participants must be hospital affiliated or medical personnel working with PA students, medical students or residents in a low resource setting in any geographical location. v The benefit or value of global health rotations from the perspective of the preceptor is the primary outcome measured v GHRs within all specialties will be considered. Exclusion Criteria v Articles with study participants who are not in low resource settings v Perspective pieces that did not provide data driven outcomes. v No validated tool for ROB of Qualitative Data Qualitative Analysis and Data Extraction v Selected articles were reviewed and content pertaining to value was extracted based on a theoretical framework (Table 1). v Data was gathered, grouped in to common themes, and analyzed (Table 2). Three Overarching Themes Identified Benefits Toward Education v Motivated preceptors to enhance their medical education and training 1-6 . v Benefit through shared knowledge and experiences among guests, local trainees, and local supervisors 1-6 . v Exchange in healthcare delivery systems, patient care, and skills 1-2,4-5,7-8 . v Enhanced student learning and approach to patient care 1-6 . v Global health rotations lead to long term partnerships which give local students opportunities for scholarships and training experiences abroad 3-8 v Local students enhance clinical skills and training 1-2, 4-5, 7-8. v Local students experience different health systems 1-2, 4-5, 7-8 . Benefits Toward Institution v A rise in prestige by the local community 1,5,6 . v Donated supplies and resources the institution did not previously have 1,3,4,5 . v Current and future funding and research 3-6. Benefits Toward Patient Care v Filling the gap in staff shortage 1,3,4,6 . v Supplies and donations provide treatment that was not available 2 . References 1.Bozinoff N, Dorman KP, Kerr D, et al. Toward reciprocity: host supervisor perspectives on international medical electives. Medical Education. 2014;48(4):397-404. doi: 10.1111/medu.12386 2. Elobu AE, Kintu A, Galukande M, et al. Evaluating international global health collaborations: Perspectives from surgery and anesthesia trainees in Uganda. Surgery. 2014;155(4):585-592. doi:10.1016/j.surg.2013.11.007 3. Kolars JC, Cahill K, Donkor P, et al. Perspective: Partnering for Medical Education in Sub-Saharan Africa. Academic Medicine. 2012;87(2):216-220. doi:10.1097/ACM.0b013e31823ede3 4. Kraeker C, Chandler C. “We Learn From Them, They Learn From Us”: Global Health Experiences and Host Perceptions of Visiting Health Care Professionals. Academic Medicine. 2013;88(4):483-487. doi:10.1097/ACM.0b013e3182857b8a 5. Kumwenda B, Dowell J, Daniels K, Merrylees N. Medical electives in sub-Saharan Africa: a host perspective. Medical Education. 2015;49(6):623-633. doi:10.1111/medu.12727 6. Kung TH, Richardson ET, Mabud TS, Heaney CA, Jones E, Evert J. Host community perspectives on trainees participating in short-term experiences in global health. Medical Education. 2016;50(11):1122-1130. doi:10.1111/medu.13106 7. Lukolyo H, Rees CA, Keating EM, et al. Perceptions and Expectations of Host Country Preceptors of Short-Term Learners at Four Clinical Sites in Sub-Saharan Africa. Academic Pediatrics. 2016;16(4):387-393. doi:10.1016/j.acap.2015.11.002 8. O’Donnell S, Adler DH, Inboriboon PC, Alvarado H, Acosta R, Godoy-Monzon D. Perspectives of South American physicians hosting foreign rotators in emergency medicine. International Journal of Emergency Medicine. 2014;7(1). doi: 10.1186/s12245-014-0024-5 9. Pitt MB, Gladding SP, Majinge CR, Butteris SM. Making Global Health Rotations a Two-Way Street: A Model for Hosting International Residents. Global Pediatric Health. 2016;3:2333794X1663067. doi:10.1177/2333794X16630671 10.Russ CM, Ganapathi L, Marangu D, et al. Perspectives of host faculty and trainees on international visiting faculty to paediatric academic departments in East Africa. BMJ Global Health. 2016;1(3):e000097. doi: 10.1136/bmjgh-2016-000097 Strengths v Consistency in data extraction methods Weaknesses v Heterogeneous study outcomes v Did not research disadvantages v No statistical analysis of qualitative evidence v Small sample size v No control group Limitations v Limited database search v One researcher- data analysis, extraction v No quantitative data v Poor response rate due to unavailable participants v No specific geographical location is recognized v Host preceptors have similar perspectives regarding the value of GHRs. v The primary finding of this review is that faculty from countries with low- resource healthcare institutions perceive global health rotations provide valuable contributions to the host faculty, students, institution, and the patients. v Distributing surveys and interviewing host preceptors is the most common study method used in current studies.