• Carmi Z Margolis, Robert M Rohrbaugh, Luisa Tsang, Jennifer Fleischer, Mark J Graham, Anne Kellett, and Janet P Hafler.
• Medical School for International Health Moshe Prywes Center for Medical Education, Ben-Gurion University of the Negev, Beersheba, Israel. Electronic address: carmizm@gmail.com.
• Ann Glob Health. 2017 Mar 1; 83 (2): 333-338.

BackgroundMany of the 70,000 graduating US medical students [per year] have reported participating in a global health activity at some stage of medical school. This case study design provided a method for understanding the student's experience that included student's learning about culture, health disparities, exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. We need to understand the student's experience in order to help design appropriate curricular experiences [and valid student assessment].ObjectiveOur research aim was to analyze medical student reflection papers to understand how they viewed their Global Clinical Experience (GCE).MethodsA qualitative case study design was used to analyze student reflection papers. All 28 students who participated in a GCE from 2008-2010 and in 2014-2015 and submitted a reflection paper on completion of the GCE were eligible to participate in the study. One student did not submit a reflection paper and was not included in the study.FindingsAll 27 papers were coded by paragraph for reflection and for themes. System of Care/Range of Care was mentioned most often, Aids to Adjustment Process was mentioned least. The theme, "Diseases," referred to any mention of a disease in the reflection papers, and 44 diseases were mentioned in the papers. The analysis for depth of reflection yielded the following data: Observation, 81/248 paragraphs; Observation and Interpretation, 130/248 paragraphs; and Observation, Interpretation, and Suggestions for change, 36/248 paragraphs; 9 reflection papers contained 27 separate accounts of a transformational experience.ConclusionsThis study provided a method for understanding the student's experience that included student's learning about culture, health disparities, and exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. How we might design a curriculum to facilitate transformational learning experiences needs further research.Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

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