Introducing global health into the undergraduate medical school curriculum using an e-learning program: a mixed method pilot study.
BACKGROUND
Physicians need global health competencies to provide effective care to culturally and linguistically diverse patients. Medical schools are seeking innovative approaches to support global health learning. This pilot study evaluated e-learning versus peer-reviewed articles to improve conceptual knowledge of global health.


METHODS
A mixed methods study using a randomized-controlled trial (RCT) and qualitative inquiry consisting of four post-intervention focus groups. Outcomes included pre/post knowledge quiz and self-assessment measures based on validated tools from a Global Health CanMEDS Competency Model. RCT results were analyzed using SPSS-21 and focus group transcripts coded using NVivo-9 and recoded using thematic analysis.


RESULTS
One hundred and sixty-one pre-clerkship medical students from three Canadian medical schools participated in 2012-2013: 59 completed all elements of the RCT, 24 participated in the focus groups. Overall, comparing pre to post results, both groups showed a significant increase in the mean knowledge (quiz) scores and for 5/7 self-assessed competencies (p < 0.05). These quantitative data were triangulated with the focus groups findings that revealed knowledge acquisition with both approaches. There was no statistically significant difference between the two approaches. Participants highlighted their preference for e-learning to introduce new global health knowledge and as a repository of resources. They also mentioned personal interest in global health, online convenience and integration into the curriculum as incentives to complete the e-learning. Beta version e-learning barriers included content overload and technical difficulties.


CONCLUSIONS
Both the e-learning and the peer reviewed PDF articles improved global health conceptual knowledge. Many students however, preferred e-learning given its interactive, multi-media approach, access to links and reference materials and its capacity to engage and re-engage over long periods of time.
Department of Family Medicine, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. gruner18@yahoo.ca.
Douglas
D
Gruner
Department of Family Medicine, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. kpottie@uottawa.ca.|Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5, Ottawa, ON, Canada. kpottie@uottawa.ca.|C.T. Lamont Centre for Research in Primary Care, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. kpottie@uottawa.ca.
Kevin
K
Pottie
Department of Family Medicine, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. darchibald@bruyere.org.|C.T. Lamont Centre for Research in Primary Care, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. darchibald@bruyere.org.
Douglas
D
Archibald
Division of Community Health and Humanities, Memorial University of Newfoundland, 300 Prince Phillip Drive, A1B 3V6, St. John's, NF, Canada. jill.allison@med.mun.ca.
Jill
J
Allison
C.T. Lamont Centre for Research in Primary Care, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. sabourin.vicki@gmail.com.
Vicki
V
Sabourin
Department of Family Medicine, University of Ottawa, 43 Bruyère Street, K1N 5C8, Ottawa, ON, Canada. ibelc081@uottawa.ca.
Imane
I
Belcaid
Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa Hospital General Campus, 501 Smyth Road, K1H 8L6, Ottawa, ON, Canada. amccarthy@toh.on.ca.|Office of Global Health, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5, Ottawa, ON, Canada. amccarthy@toh.on.ca.
Anne
A
McCarthy
Department of Paediatrics, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, S7N 0W8, Saskatoon, SK, Canada. mahli.brindamour@usask.ca.
Mahli
M
Brindamour
Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5, Ottawa, ON, Canada. laugusti@uottawa.ca.
Lana
L
Augustincic Polec
Department of Family Medicine, Memorial University of Newfoundland, 300 Prince Phillip Drive, A1B 3V6, St. John's, NF, Canada. pduke@mun.ca.
Pauline
P
Duke
D000328:Adult; D003194:Computer-Assisted Instruction / Q000379:methods; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D017144:Focus Groups; D014943:Global Health / Q000193:education*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D015397:Program Evaluation; D036301:Qualitative Research; D012647:Self-Assessment; D013663:Teaching / Q000379:methods; D055815:Young Adult