Ethical Challenges in Short-Term Global Health Training

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CASE 3: Exceeding Level of Training

Vignette 3: Jasmine is ready to return home after her elective rotation. She realizes how much she has learned about the local community, herself, and the global practice of medicine. As she prepares for her flight, she begins to fill out her post-elective evaluation form, which asks what advice she would offer to future medical students preparing for their elective rotations.

Jasmine thoughtfully considers this question. Which of the following responses do you think best fits what Jasmine learned? 

Select
"Before going on the elective, ensure that you, your advisors, and the local supervisors have communicated accurately regarding your training and competencies."
This is only partially correct. Jasmine is right to realize that, in her case, she and her local supervisor were unprepared regarding her abilities. Dealing with this upfront is easier than “on the spot,” though not all circumstances can be anticipated. But this is not the only answer. Choose a different answer.
Select
"When in-country, do not misrepresent your training status."
This is only partially correct. It is never ethical to knowingly misrepresent your status or allow others to proceed under false pretenses. But this is not the only answer. Choose a different answer.
Select
"You may be nervous about completing certain tasks. Always ask for help or supervision when necessary. If you have the requisite training, it is appropriate to attempt it on your elective."
This is only partially correct. Jasmine now knows to be proactive to ask for supervision. But this is not the only answer. Choose a different answer.
Select
"Short-term electives abroad are NOT a chance to practice unsupervised tasks or procedures for which you lack training!"
This is only partially correct. Jasmine was certainly nervous about unsupervised procedures. More importantly she recognizes that this would take advantage of local patients – some of whom might have inflated perceptions of her “Western” training. But this is not the only answer. Choose a different answer.
Select
All of the above.
This is correct!  Jasmine has learned all four of the above lessons during her short-term elective.
© Stanford University Center for Global Health and the Johns Hopkins University Berman Institute of Bioethics.

Project funding provided by Doris Duke Charitable Foundation (DDCF)