Ann Glob Health. 2017 May - Aug;83(3-4):596-604. doi: 10.1016/j.aogh.2017.07.005. Epub 2017 Aug 15.

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences.

Litzelman DK1, Gardner A2, Einterz RM3, Owiti P4, Wambui C5, Huskins JC6, Schmitt-Wendholt KM7, Stone GS8, Ayuo PO5, Inui TS9, Umoren RA10.

Author information

1

Department of Medicine, Indiana University School of Medicine and Center for Global Health, Indianapolis, IN. Electronic address: dklitzel@iu.edu.

2

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.

3

Department of Medicine, Indiana University School of Medicine and Center for Global Health, Indianapolis, IN.

4

Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.

5

Department of Medicine, Moi University School of Medicine, Eldoret, Kenya.

6

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.

7

Regenstrief Institute, Indianapolis, IN.

8

Department of Medicine, Massachusetts General Hospital (MGH), Boston, MA; Global Medicine Program, MGH Global Health, Boston, MA.

9

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.

10

Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.

Abstract

BACKGROUND:

Globalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, and self-development; influence career objectives; and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship.

OBJECTIVE:

We conducted a qualitative assessment of trainee-reported critical incidents to more deeply understand the impact of our global health experience on trainees.

METHODS:

A cross-sectional survey was administered to trainees who had participated in a 2-month elective in Kenya from January 1989 to May 2013. We report the results of a qualitative assessment of the critical incident reflections participants (n = 137) entered in response to the prompt, "Write about one of your most memorable experiences and explain why you chose to describe this particular one." Qualitative analyses were conducted using thematic analysis and crystallization immersion analytic methods based on the principles of grounded theory, employing a constructivists' research paradigm.

FINDINGS:

Four major themes emerged. These themes were Opening Oneself to a Broader World View; Impact of Suffering and Death; Life-Changing Experiences; and Commitment to Care for the Medically Underserved.

CONCLUSIONS:

Circumstances that learners encounter in the resource-scarce environment in Kenya are eye-opening and life-changing. When exposed to these frame-shifting circumstances, students elaborate on or transform existing points of view. These emotionally disruptive experiences in an international health setting allowed students to enter a transformational learning process with a global mind. Students can see the world as an interdependent society and develop the capacity to advance both their enlightened self-interest and the interest of people elsewhere in the world as they mature as global citizens. Medical schools are encouraged to foster these experiences by finding ways to integrate them into curriculum.