title: Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships.
abstract: BACKGROUND
  Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs' fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies.
  
  
  METHODS
  Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions.
  
  
  RESULTS
  The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background.
  
  
  CONCLUSIONS
  Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky's sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program.
authors.affiliation: Center for International Health CIH, Department of Surgery, Faculty of Medicine, LMU Munich, Nussbaumstr, 20, 80336 Munich, Germany. fabian.jacobs@med.uni-muenchen.de.
authors.forename: Fabian
authors.initials: F
authors.lastname: Jacobs
authors.forename: Karsten
authors.initials: K
authors.lastname: Stegmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Siebeck
mesh_terms: D002983:Clinical Competence; D003142:Communication; D054521:Cultural Competency; D004501:Education, Medical / Q000379:methods*; D005002:Ethiopia; D005858:Germany; D006801:Humans; D007393:International Educational Exchange; D007407:Interviews as Topic; D007858:Learning; D010817:Physician-Patient Relations; D013337:Students, Medical