title: Medical and pharmacy student concerns about participating on international service-learning trips.
abstract: BACKGROUND
  International Service Learning Trips (ISLT) provide health professional students the opportunity to provide healthcare, under the direction of trained faculty, to underserved populations in developing countries. Despite recent increases in international service learning trips, there is scant literature addressing concerns students have prior to attending such trips. This study focuses on identifying concerns before and after attending an ISLT and their impact on students.
  
  
  METHODS
  A survey comprised of closed and open-ended questions was developed to elucidate student concerns prior to attending an ISLT and experiences which might influence concerns. A five-point Likert-scale (extremely concerned = 1, minimally concerned = 5) was used to rate apprehension and satisfaction. Paired t-test was used to compare pre- and post-trip concerns; Chi-Square test was used to compare groups.
  
  
  RESULTS
  Thirty-five students (27 medical, 8 pharmacy) attended ISLTs in December 2013. All completed pre and post-trip surveys. Significant decreases were seen in concerns related to cultural barriers (4.14 vs 4.46, P = .047), disease/epidemics (3.34 vs 4.60, P < .001), natural disasters (3.94 vs 4.94, P < .001), terrorism (4.34 vs 4.94, P < .001), travel (3.86 vs 4.51, P < .001) monetary issues (3.80 vs 4.60, P < .001), hospitality (3.94 vs 4.74, P = .001) and food (3.83 vs 4.60, P < .001). Language and group dynamics remained concerns post-trip. On open-ended questions, students described benefits of attending an ISLT.
  
  
  CONCLUSIONS
  Students had multiple concerns prior to attending an ISLT. Most decreased upon return. Addressing concerns has the potential to decrease student apprehension. The results of this study highlight the benefits of providing ISLTs and supporting development of a curriculum incorporating trip-related concerns.
authors.affiliation: Department of Medical Education, Wayne State University, 320 East Canfield, Detroit, MI, 48201, USA. cchuang@med.wayne.edu.
authors.forename: Chih
authors.initials: C
authors.lastname: Chuang
authors.affiliation: Department of Internal Medicine, Wayne State University, 4201 St. Antoine, University Health Center 2E, Detroit, MI, 48201, USA. sidkhatri@gmail.com.
authors.forename: Siddique H
authors.initials: SH
authors.lastname: Khatri
authors.affiliation: Wayne State University, Detroit, MI, 48201, USA. manpalgill@gmail.com.
authors.forename: Manpal S
authors.initials: MS
authors.lastname: Gill
authors.affiliation: Department of Internal Medicine, Wayne State University, 4201 St. Antoine, University Health Center 2E, Detroit, MI, 48201, USA. ntrehan@med.wayne.edu.
authors.forename: Naveen
authors.initials: N
authors.lastname: Trehan
authors.affiliation: Department of Internal Medicine, Wayne State University, 4201 St. Antoine, University Health Center 2E, Detroit, MI, 48201, USA. masinenisilpa@yahoo.com.
authors.forename: Silpa
authors.initials: S
authors.lastname: Masineni
authors.affiliation: Department of Internal Medicine, Wayne State University, 4201 St. Antoine, University Health Center 2E, Detroit, MI, 48201, USA. Vchikkam@med.wayne.edu.
authors.forename: Vineela
authors.initials: V
authors.lastname: Chikkam
authors.affiliation: Wayne State University, Detroit, MI, 48201, USA. gfarah94@gmail.com.
authors.forename: Guillaume G
authors.initials: GG
authors.lastname: Farah
authors.affiliation: Department of Internal Medicine, Wayne State University, 4201 St. Antoine, University Health Center 2E, Detroit, MI, 48201, USA. amkha@med.wayne.edu.
authors.forename: Amber
authors.initials: A
authors.lastname: Khan
authors.affiliation: Department of Internal Medicine, Wayne State University, 4201 St. Antoine, University Health Center 2E, Detroit, MI, 48201, USA. dllevine@med.wayne.edu.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Levine
mesh_terms: D001291:Attitude of Health Personnel; D003906:Developing Countries; D005260:Female; D014943:Global Health; D006801:Humans; D007393:International Educational Exchange; D008297:Male; D008493:Medical Missions; D008507:Medically Underserved Area; D015397:Program Evaluation; D013337:Students, Medical / Q000523:psychology*; D013339:Students, Pharmacy / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States