INTERNATIONAL HEALTH ELECTIVE 2014-2015
COURSE REQUIREMENTS
Schedule:1. November 14, 2014: Submission deadline for application materials
ü Application Packet + Learning Objectives and Annotated Bibliography
ü Drop-off locations: KUMC Office of International Programs/Academic or Wichita Student Affairs.
2. February, 2015: Elective participants travel to their respective International sites.
3. March 27, 2015: Paper and poster submission deadline.
4. April 20th, 2015: Kansas City International Health Showcase Day
ü Citation Award presentations: 11am-noon
ü General Poster Session (all students): noon-1pm.
PMED 950 Course Assignments: Scholarly Paper and Poster
Academic credit for this elective is linked directly to a focused, evidence-based exploration of a public health, clinical, health care system, medical training, or other related topic.
Timeline:BEFORE you leave for International Health Experience:
1. Select your research topic:
(Two options)
a. One overarching topic (e.g., child/maternal health, HIV/AIDs, or tuberculosis)
b. Integrate a clinical topic and healthcare system topic (e.g., socialized healthcare, medical training)
2. Conduct a comprehensive literature/reputable website research
3. Develop specific learning objectives (described below)
4. Develop annotated bibliography based on learning objectives with 5 annotations (described below)
ON-SITE in the country
Ø Experiential learning at your respective international site
Ø Identify key individual for patient/key informant narrative
UPON RETURN to U.S. from International Health Experience
Ø Complete & turn in Scholarly Paper
Ø Complete and turn in poster for International Health Showcase
Note: Your scholarly paper research will not involve the collection of data.
Data collection would involve human subjects’ approval, which is beyond the scope of this project
Pre-Travel Academic Deliverables Due by November 14:
1. Develop 5 focused Learning Objectives (clear, precise and observable)
2. Complete literature search and Annotated Bibliography with 5 annotations
3. E-mail your assigned academic advisor in advance to schedule an appointment with him/her.
4. Present your learning objectives and annotated bibliography (both in typed form) to your assigned academic advisor
***(Your advisor needs to approve your learning objectives and annotated bibliography prior to you submitting them AND your internal application to the Office of International Programs in November).
** Special Note: If, once you arrive at your elective site, you determine that you are unable to address the Learning Objectives developed and approved a priori, you MUST revise your Learning Objectives.Notify your faculty advisor of any changes in your Learning Objectives as soon as materially possible. Most students will have Internet access while at their sites and should e-mail their faculty advisor immediately with their revised set of Specific Learning Objectives once it is determined that a revision is necessary. For the few with no Internet access during the duration of their International Health experience, you must notify your faculty advisor as soon as you return to the United States or otherwise have Internet access.
Learning Objectives:
§ Develop 5 learning objectives (Objectives must be clear, precise, and ‘observable).
STAY AWAY from stating your objectives with ‘covert’ verbs (verbs that cannot be observed/measured) – such as, “To determine…; To understand…”. Use ‘overt’ action verbs – such as, “To identify…; To articulate; To assess…; To classify…’ To compare…; To construct…; To critique…; To define…; To examine…”, etc.
Example 1: HIV & AIDS in South Africa
1. To identify the epidemiology of HIV/AIDS in South Africa;
2. To report the clinical treatments available for treating HIV/AIDS in South Africa;
3. To describe the health service delivery system in South Africa and how this system affects the prevention of disease and/or care of patients and the epidemic at large;
4. To identify cultural barriers impacting HIV/AIDS education;
5. To articulate the barriers to the widespread dissemination of anti-retroviral medications in South Africa.
Example 2: Malnutrition in Papua New Guinea
1. To evaluate the significance and extent of malnutrition in the pediatric population of Papua New Guinea (PNG);
2. To identify the epidemiological factors influencing malnutrition in PNG children;
3. To examine medical treatment methods and prevention of malnutrition in PNG children;
4. To identify the views of PNG women towards breast feeding;
5. To extrapolate and convey possible interventions to improve the nutritional status of PNG children.
Annotated Bibliography:
§ Conduct a comprehensive literature review and write an annotated bibliography that includes a minimum of 5 scientific articles related to the topic you intend to study.
§ The annotated bibliography must include:
a. Article citation (full, unabbreviated)
b. A brief description of the article in your own words (DO NOT re-type or copy and paste article abstracts).
c. A brief description of how this source informs your topic
Examples:
Ferguson, et al. Linking Women Who Test HIV Positive in Pregnancy-Related Services to Long-Term HIV Care and Treatment Services: A Systematic Review. Tropical Medicine International Health. 17.5. (2012 May): 564-580.
This article is a literature review examining whether low to middle income women who test HIV positive during pregnancy continue to access long-term HIV care and treatment. Eighty percent of articles gathered participants from sub-Saharan Africa. In general, it found that an estimated 18% of women who may have required HAART actually initiated HAART treatment. Differing reasons were given for attrition. In a Tanzanian study, 38% of women failed to register at the HIV clinic. There were multiple and varied reasons for these high attrition rates, including gaps in the referral process, negative provider-client interactions, failure to address social factors such as poverty, women’s fears regarding confidentiality, transportation costs, and many others were at fault. This article contends that there are such a high number of factors negatively affecting access to HIV treatment that single changes in service only will partially solve the problem. Family focused interventions have shown promise, but these programs have difficulties with sustainability due to external funding sources.
Relevance to chosen international health elective topic: HAART treatment for HIV only is effective if it is initiated and completed as recommended by clinical guidelines. This article cites potential multiple-influence reasons for treatment non-compliance that may be translated in to intervention programs to improve HAART treatment compliance.
Antwi S. Malnutrition: missed opportunities for diagnosis.Ghana Med J.2008;42:101–4.
This prospective study investigated the extent of under-diagnosis of the prevalence of wasting among children <5 years old in a teaching hospital in Ghana. The study enrolled patients 3 months to 5 years old after they saw a physician in the outpatient clinic and measured weight and height. The weight-for-height standard deviation score (Z-score) was calculated, which determined whether a patient qualified as moderately or severely malnourished. When compared to the diagnoses from the physicians’ visits, only 5.9% of patients with malnutrition were identified.
Relevance to chosen international health elective topic: Low resource clinics likely measure both height and weight on a less than optimal frequency. Accurate measurements and weight-for-height calculations are necessities for diagnosing acute malnutrition. Early diagnosis and management of malnutrition prevents associated complications and mortality. Increased awareness and incorporation of weight-for-height calculation in Ghanaian clinics would be one intervention to address the high prevalence of malnutrition in this population.
Post-Travel Academic Deliverables Due by March 27, 2014:
1. Scholarly paper
2. Poster
Scholarly Paper:
Paper Guidelines: Final papers for the international health elective should reflect the specific learning objectives set forth prior to the rotation and one related clinical patient-oriented narrative. The focus of the paper should be the medical or public health practices experienced overseas.
§ References: This paper should be of professional, graduate-level quality that is supported by scientific literary references. Each paper should incorporate at least 5 peer-reviewed articles that pertain to your specific learning objectives. These articles should be used:
ü (a) to highlight the significance of the problem;
ü (b) to discuss the empirical prevention and/or treatment of the condition in question; and
ü (c) to provide insights as to how the target population differs from other populations and what is needed to better serve the target population. In the absence or irrelevance of population-based evidence, the reliance on case studies is allowed.
§ Length: Papers must be 10 pages (excluding cover page, tables, figures, and references), double-spaced, and typed in standard 12-pt font. The following guideline is recommended for all papers:
I. Cover Page – Include your name, year of elective, and city and country to which you traveled.
II. Executive Summary – A 250-word summary of your experience organized by the following: 1) Background (include a compelling ‘attention grab’ statement regarding your clinical/health system topic & elective site location), 2) Key/Important Points that whet the readers’ appetite and summarize the poignant points outlined in the paper and incorporates the patient narrative contained in the paper (this is not meant to be a word-for-word reiteration of the learning objectives), 3) Conclusions and Recommendations that summarize main conclusions stated in the paper in a concise manner. The executive summary IS included in the 10-page paper limit.
III. Introduction – Specify the nature of the clinical rotation site, a description of your clinical experience at this site, and the objectives set prior to the visit. (1 pg)
IV. Evidence-Based Practice/Public Health – Reflect on the specific public health, clinical, health care system, or medical training explored during the rotation. A critical discussion should be made to present the significance of the topic and its prevention and/or treatment (when applicable). Contrasts should be made between your experience and: a) what is considered evidence-based medicine, or b) how the issue is addressed typically in the United States or elsewhere. (5 pgs)
V. Cultural Relativism – Cultural influences impact the way in which people approach health care practices. This is equally true in remote or developing countries as well as within developed regions. Critically discuss the impact of culture on preventive health and/or treatment and discuss the benefits and drawbacks of the cultural influence as you see them. Pay special attention to ensuring that your discussion is professional in nature. (1 pg)
VI. Patient/Key Informant Narrative – Incorporate a narrative ‘case study’ of a key individual with whom you became acquainted at your elective site. This person may be a patient, clinician, medical student from your elective site country, or other person (e.g., traditional healer). Use your learning objectives as the basis for developing a personalized ‘story’ about this individual that incorporates and integrates cultural, psychosocial, and/or geopolitical factors that contribute to their corresponding health, healthcare access, healthcare utilization, professional training, etc. Put yourself in this person’s ‘shoes’ and describe things like how they are able to navigate to receive health care, linguistic barriers that may exist, cultural barriers/facilitators to healthcare utilization, barriers to accessing healthcare, health system attributes that impact care quality or access, local/national government influence on healthcare access, etc. Use your creative license in this section. (1 pg)
VII. Conclusion – A summary or personal reflection of your experience abroad, particularly in terms of whether set objectives are met and how the overall experience will help you to become a better clinician or scientist, and, if that is not the case, why not. (1 pg)
VIII. References – Reference all citations using AMA style.
IX. Travel Suggestions – Supply a brief list of practical suggestions for students who will travel in the future to the same international site.
Paper Submission Due Date:
ü Kansas City students: An electronic copy of your paper must be sent to and as a Word document on or before March 27th, 2014.
ü Wichita students: Please send an electronic copy of your paper to on or before March 27th, 2014.
Posters for Group Poster Session:
§ Posters are limited to 15 slides (each slide is one 8½ x11 inch page).
§ Posters must include:
§ Title slide (1 slide)
- Poster Title
- Your Name
- City and Country visited
§ Objectives (1 slide)
§ Description of site and hospital/clinic (1-2 slides)
§ Background literature that supports/led to your Specific Learning Objectives choice (i.e., scientific literary sources/references) (1-2 slides)
§ Summary of your specific Learning Objectives (1 slide)
§ Encapsulated summary of your integrated personalized patient/key informant summary (1 slide)
§ Key points learned related to your Learning Objectives (5-6 slides maximum)
§ Conclusions/Suggestions – Concluding summary points regarding the topic(s) covered in your Learning Objectives and suggestions for how to address the issues put forth (if relevant) (1 slide)
§ References (1 slide)
Poster Submission Due Date:
ü Kansas City students: An electronic copy of your poster slides must be sent to and as a Word document on or before March 27th, 2014.
ü Wichita students: Please send an electronic copy of your poster slides to on or before March 27th, 2014.
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