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Ethical dilemmas during international clinical rotations in global health settings: Findings from a training and debriefing program

机译：全球健康环境中国际临床旋转期间的伦理困境：从培训和汇报计划中的调查结果

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Purpose: This study describes the impact of an open-access, case-based global health ethics workshop and describes the breadth of dilemmas faced by students to inform future interventions.Methods: Eighty-two medical students who undertook electives at 16 international sites between 2012 and 2015 received web-based surveys at three time points, incorporating quantitative and free-text probes of knowledge, skills, and attitudes related to global health clinical ethics dilemmas. Sixty students (73%) completed the pre-workshop survey, 38 (46%) completed the post-workshop survey, and 43 (52%) completed the post-trip survey.Results: Analysis demonstrated improvement following the workshop in self-rated preparedness to manage ethical dilemmas abroad, identify ways to prepare for dilemmas, engage support persons, and manage related emotions (all comparisons, p0.001). Participants described 245 anticipated or actual dilemmas, comprising nine domains. Nearly one-third of the dilemmas that were experienced involved the student as an active participant. Only 21% of respondents experiencing a dilemma discussed the dilemma with a local support person.Conclusions: This analysis describes an ethics curriculum that prepares students to face ethical dilemmas during international clinical rotations. It broadens the representation of the dilemmas that students face, and highlights areas for curricular focus and optimization of on-site and post-trip student support resources.
机译：目的：本研究介绍了开放式，基于案例的全球卫生道德研讨会的影响，并描述了学生面临的困境，以通知未来的干预。方法：八十二名在2012年间国际遗址进行选修课2015年，在三个时间点收到了基于网络的调查，包括与全球健康临床伦理困境有关的知识，技能和态度的定量和自由文本探讨。六十名学生（73％）完成了研讨会调查，38名（46％）完成了研讨会调查后，43（52％）完成了旅行后的调查。结果：分析在自我评价的研讨会之后表现出改进在国外进行道德困境的准备，确定为困境做准备的方法，接受支持人员，并管理相关的情绪（所有比较，P <0.001）。参与者描述了245个预期或实际困境，包括九个域。近三分之一的困境，涉及学生作为积极参与者。只有21％的受访者遇到困境的困境与当地支持人员讨论了困境。结论：该分析描述了一种伦理课程，准备学生在国际临床旋转期间面对道德困境。它拓宽了学生面临的困境的代表，并突出了课外焦点和现场优化以及旅行后学生支持资源的领域。

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