Quality Improvement Project on Global Health Trips- Student Orientation & Rotation Information

Background: Medical student education varies widely from school to school. Some students, both osteopathic and allopathic, report feeling unprepared as they transition into junior doctors following graduation. This study looks at the impact of global health rotations on providing supplemental education and training to student doctors attending Oklahoma State University College of Medicine (OSU-COM). These rotations offer early hands-on opportunities to learn communication skills, clinical diagnosis skills, and cultural competency in a setting where technology and supplies may be scarce. Each rotation is unique in highlighting common diseases and public health concerns localized to specific regions or countries, especially for patients living in underserved communities. Previous studies have found that students who participate in global health rotations typically score higher in knowledge of preventive medicine and public health on exams such as NBME Part II.

Methods: Pre- and post-rotation surveys were created to assess student level of confidence on important components of running a clinic on a global health trip. This is quantified using objective answer choices and Likert scales. The goal of this QI project is to measure an increase in student confidence by 10% over the course of the most recent 10-day global health rotation- with plans to expand this project for future use in medical student training. Specifically, medical student knowledge on common disease processes, common pharmacy abbreviations, and components of a SOAP note were evaluated. The pre-rotation survey was used to establish a baseline for student level of education and training before initiation of the trip. The post-rotation survey objectively quantifies change in student confidence and medical knowledge upon rotation completion.

Results: Survey data was collected from 20 medical students following a global health trip to Athens, Greece. Pre-rotation survey response rate was 50%. Students overall reported a mean pre-rotation score of 3.8 out of 9 respectively for confidence with prescription abbreviations, managing common disease processes, clinical use and dosage of common medications, and usage/presentation of SOAP notes. Post-rotation survey response rate was 85%. Students overall reported a significant increase in confidence for the aforementioned metrics with a mean post-rotation score of 5.7 out of 9. Students were also questioned on their perceived interest in a detailed pre-rotation packet covering all previously mentioned topics in preparation for an upcoming rotation. It is noteworthy to address the 100% response in favor of providing a detailed pre-rotation packet for future rotations.

Conclusions: Insufficient information from previous OSU-COM Global Health rotations exists to establish a baseline for approaching trips with students- especially for those with limited clinical experience. This project’s preliminary data from a single global health rotation demonstrates a significant benefit to student confidence in prescription abbreviations, managing common diseases, the clinical use and dosage of common medications, and the usage/presentation of SOAP notes. It further reveals an overwhelmingly 100% positive perceived student interest in a pre-rotation packet covering these topics for future rotations. Thus, the systematic development of this approach to assess medical student knowledge will help guide subsequent preparation for future trips to come.