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Perspectives of South American physicians hosting foreign rotators in emergency medicine

BACKGROUND: Emergency Medicine (EM) is increasingly becoming an international field. The number of fellowships in International EM in the USA is growing along with opportunities to complete international health electives (IHEs) during residency training. The impact on host institutions, however, has...

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Autores principales: O’Donnell, Steve, Adler, David H, Inboriboon, Pholaphat Charles, Alvarado, Hermenegildo, Acosta, Raul, Godoy-Monzon, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306044/
https://www.ncbi.nlm.nih.gov/pubmed/25635188
http://dx.doi.org/10.1186/s12245-014-0024-5
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author O’Donnell, Steve
Adler, David H
Inboriboon, Pholaphat Charles
Alvarado, Hermenegildo
Acosta, Raul
Godoy-Monzon, Daniel
author_facet O’Donnell, Steve
Adler, David H
Inboriboon, Pholaphat Charles
Alvarado, Hermenegildo
Acosta, Raul
Godoy-Monzon, Daniel
author_sort O’Donnell, Steve
collection PubMed
description BACKGROUND: Emergency Medicine (EM) is increasingly becoming an international field. The number of fellowships in International EM in the USA is growing along with opportunities to complete international health electives (IHEs) during residency training. The impact on host institutions, however, has not been adequately investigated. The objective of this study is to assess the experience of several South American hospitals hosting foreign EM residents completing IHEs. METHODS: Anonymous, semi-structured one-on-one interviews were conducted with physicians working in Emergency Departments in three hospitals in Lima, Peru and one hospital in Buenos Aires, Argentina. All participants reported previously working with EM foreign rotators. Interviews were analyzed qualitatively and coded for common themes. RESULTS: Three department chairs, six residents, and 15 attending physicians were interviewed (total = 24). After qualitative analysis of interviews, two broad theme categories emerged: Benefits and Challenges. Most commonly reported benefits were knowledge sharing about emergency medical systems (78%), medical knowledge transfer (58%), and long-term relationship formation (42%). Top challenges included rotator Spanish language proficiency (70%) lack of reciprocity (58%), and level of training and rotation length (25%). Spanish proficiency related directly to how involved rotators became in patient care (e.g., taking a history, participating in rounds) but was not completely prohibitive, as a majority of physicians interviewed felt comfortable speaking in English. Lack of reciprocity refers to the difficulty of sending host physicians abroad as well as failed attempts at building long-lasting relationships with foreign institutions. Lastly, 25% preferred rotators to stay for at least 1 month and rotate in the last year of EM residency. This latter preference increased knowledge transfer from rotator to host. CONCLUSIONS: Our research identified benefits and challenges of IHEs in Emergency Medicine from the perspective of physician hosts in several hospitals in South America. Our results suggest that IHEs function best when EM residents rotate later in residency training and when relationships are maintained and deepened among those involved including host physicians, rotators, and institutions. This leads to future rotators, project collaboration, research, and publications which not only benefit individuals involved but also the wider field of Emergency Medicine.
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spelling pubmed-43060442015-01-29 Perspectives of South American physicians hosting foreign rotators in emergency medicine O’Donnell, Steve Adler, David H Inboriboon, Pholaphat Charles Alvarado, Hermenegildo Acosta, Raul Godoy-Monzon, Daniel Int J Emerg Med Original Research BACKGROUND: Emergency Medicine (EM) is increasingly becoming an international field. The number of fellowships in International EM in the USA is growing along with opportunities to complete international health electives (IHEs) during residency training. The impact on host institutions, however, has not been adequately investigated. The objective of this study is to assess the experience of several South American hospitals hosting foreign EM residents completing IHEs. METHODS: Anonymous, semi-structured one-on-one interviews were conducted with physicians working in Emergency Departments in three hospitals in Lima, Peru and one hospital in Buenos Aires, Argentina. All participants reported previously working with EM foreign rotators. Interviews were analyzed qualitatively and coded for common themes. RESULTS: Three department chairs, six residents, and 15 attending physicians were interviewed (total = 24). After qualitative analysis of interviews, two broad theme categories emerged: Benefits and Challenges. Most commonly reported benefits were knowledge sharing about emergency medical systems (78%), medical knowledge transfer (58%), and long-term relationship formation (42%). Top challenges included rotator Spanish language proficiency (70%) lack of reciprocity (58%), and level of training and rotation length (25%). Spanish proficiency related directly to how involved rotators became in patient care (e.g., taking a history, participating in rounds) but was not completely prohibitive, as a majority of physicians interviewed felt comfortable speaking in English. Lack of reciprocity refers to the difficulty of sending host physicians abroad as well as failed attempts at building long-lasting relationships with foreign institutions. Lastly, 25% preferred rotators to stay for at least 1 month and rotate in the last year of EM residency. This latter preference increased knowledge transfer from rotator to host. CONCLUSIONS: Our research identified benefits and challenges of IHEs in Emergency Medicine from the perspective of physician hosts in several hospitals in South America. Our results suggest that IHEs function best when EM residents rotate later in residency training and when relationships are maintained and deepened among those involved including host physicians, rotators, and institutions. This leads to future rotators, project collaboration, research, and publications which not only benefit individuals involved but also the wider field of Emergency Medicine. Springer 2014-08-02 /pmc/articles/PMC4306044/ /pubmed/25635188 http://dx.doi.org/10.1186/s12245-014-0024-5 Text en Copyright © 2014 O'Donnell et al.; licensee BioMed Central Ltd http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Original Research
O’Donnell, Steve
Adler, David H
Inboriboon, Pholaphat Charles
Alvarado, Hermenegildo
Acosta, Raul
Godoy-Monzon, Daniel
Perspectives of South American physicians hosting foreign rotators in emergency medicine
title Perspectives of South American physicians hosting foreign rotators in emergency medicine
title_full Perspectives of South American physicians hosting foreign rotators in emergency medicine
title_fullStr Perspectives of South American physicians hosting foreign rotators in emergency medicine
title_full_unstemmed Perspectives of South American physicians hosting foreign rotators in emergency medicine
title_short Perspectives of South American physicians hosting foreign rotators in emergency medicine
title_sort perspectives of south american physicians hosting foreign rotators in emergency medicine
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306044/
https://www.ncbi.nlm.nih.gov/pubmed/25635188
http://dx.doi.org/10.1186/s12245-014-0024-5
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