Academic medicine : journal of the Association of American Medical Colleges
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The disparity in health status between Indigenous and non-Indigenous people in Australia and New Zealand is widely known, and efforts to address this through medical education are evidenced by initiatives such as the Committee of Deans of Australian Medical Schools' Indigenous Health Curriculum Framework. These efforts have focused primarily on formal curriculum reform. ⋯ They describe the Critical Reflection Tool as a potential resource through which educators might begin to identify the dimensions of their institution's hidden curricula. If used effectively, the process may guide institutions to better equip medical school graduates with the training necessary to advance changes in Indigenous health.
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Medical students' interest in global health outreach work is intense and growing. Yet, medical students' global health outreach work is fraught with ethical complexity: Students must make challenging resource allocation decisions in an unfamiliar setting while providing complicated care with evolving expertise across power gradients and geographical as well as cultural boundaries. Inadequate training in the recognition and resolution of the ethical issues inherent in this work likely endangers future service work participation and undercuts the efficacy of medical students' global health outreach work. ⋯ To achieve this goal, he proposes a curriculum in the ethics of global health outreach to train students to understand (1) the ethical justifications for global health outreach work, (2) the drivers of global health disparities, (3) the key ethical issues raised by global health outreach, and (4) how to resolve ethical quandaries encountered during global health outreach work through collaboration. Beyond specific topical content, a medical school curriculum in the ethics of global health outreach should emphasize the importance of local collaboration and longitudinal mentorship of medical students. Medical school training in the recognition and resolution of the ethical issues attendant on global health outreach work prepares students not only for more sophisticated work in international settings but also for the ethical complexities of medical practice closer to home.
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The Accreditation Council for Graduate Medical Education recommends the structured portfolio as a preferred assessment tool for assessing all six of its core physician competencies. However, compared with other evaluation measures, it may be one of the most resource-intensive for learners and evaluators. ⋯ These include gaining staff acceptance, staging implementation, enhancing learner participation, training mentors, choosing paper versus electronic formats, and selecting assessment methods. Their blueprint for implementing a portfolio is informed by their five-year experience with a portfolio rollout in one internal medicine residency, from 2006 to 2011.