International Clinical Education: Bridging Global Communities while Developing Professional Competency

Pechak C.¹, Hall M.², Okidi C.³, Hampanna B.⁴

¹The University of Texas at El Paso, Physical Therapy, El Paso, Texas, United States of America, ²Department of Physical Therapy, University of Alberta, Canada, ³Disability Service Programme, Nyanza, Kenya, ⁴Samuha Samarthya, Disability Programming, Koppal, India

Learning objectives:

1. To examine the benefits and challenges of international clinical education as a means of preparing physical therapists to practice. 2. To explore the potential impact that student clinical placements have on community services in low-resource settings and propose methods for evaluating impacts. 3. To describe existing partnerships that exist between community programmes and international student placements among 3 WCPT regions as potential models/frameworks for future educational collaborations. 

Description:

Global health educational initiatives have been gaining interest among students and faculty throughout health professions education programmes, including physical therapy. An increasing number of students in North America appear to be engaging in international clinical placements as part of their academic training. Despite this growth, limited research has been done to explore the impacts of international student placements on the students or on the hosts. These student placements place added demands upon students, faculty, and host communities. Additionally they often occur in resource poor settings. Therefore, it is incumbent upon the physical therapy profession to critically examine these partnerships for the benefit and protection of all stakeholders.

This symposium will address some of the complex issues involved in international clinical education. The convener will provide a brief overview of the emerging trends in clinical placement activities between global north and south communities. Key concepts related to service-learning principles including cultural competency and reciprocity will be highlighted, and ethical considerations will be introduced. Then presenters from Canada, India, and Kenya will discuss the impact of international clinical education in resource poor settings from both the university and host community perspectives.

Preparing, Debriefing and Reflecting
Canadian Programme Example
Academic institutions are required to carefully consider the processes involved in ensuring positive and equitable learning experiences. Academic clinical placement coordinators are therefore faced with the challenge of determining the suitability of student participation in proposed international settings. The process of preparing and debriefing students and their clinical supervisors following placements is presented as crucial to advancing education in international student placements.

Within this process, students identify learning objectives and reflect upon whether they have been met. Through examining student reflections from their international experiences, this presentation will focus on the impacts that international student placements have had on students' learning and preparation for physical therapy practice. In addition to personal learning, other student outcomes will be explored.

Balancing Benefits and Challenges
Kenyan Programme Experience
The Disability Service Programme (DSP) in Nyanza, Kenya is a grassroots community- based rehabilitation programme focused on the care of people living with disabilities and of vulnerable populations. Since 2003, the programme has annually received rehabilitation students from a number of universities as part of their academic training. A description of the programme highlights the need for rehabilitation services and the careful balancing act that is required by programmes to maintain services while hosting visiting foreign students.

This programme has begun to explore methods for evaluating the impacts of international student placements on the community in terms of direct access to service and promoting awareness of disability issues. During this session, other benefits of student placements such as introduction of new intervention strategies, evidence-based practices and the development of a resource library will be described. This presentation will also consider the challenges that are inherent in international student placements (including community expectations, utilization of limited resources, and programme sustainability), and will describe how these challenges have been addressed in order to advance physical therapy practice in this programme.

Community Partnerships as Key to Advancing Local and Global Practices
Indian Programme Example
Samuha Samarthya is a community-based rehabilitation (CBR) programme that works with people with disabilities in the region of Koppal, in rural India. Since 1992, this programme has worked with foreign trained rehabilitation professionals to provide skills and training to local volunteers to provide rehabilitation and care support for people with disabilities throughout the region. A description of the student placement programme will outline one model for integration of visiting foreign students into a CBR structure in partnership with foreign trained supervisors who accompany them during these placements.

This presentation will focus on the benefits, challenges and lessons learned from the international student placement programme and will provide recommendations that may be applied to other resource limited programmes to support student engagement initiatives.

Implications / Conclusions:

As more students participate in international placements, it is important to address the potential benefits and harms that may be introduced. Lessons learned from these existing partnerships provide a framework for future potential collaborations that may build student competency and local capacity.

Keywords:

Global Health; Education; International

Funding acknowledgements:

None

Relevance to WCPT and expected audience:

This session addresses a very important topic, international clinical education (ICE), that likely currently impacts or will impact many if not all WCPT member organizations. This discussion is particularly important as it highlights the importance of considering the complex issues involved in sending students to work in resource poor settings. We expect to attract faculty, students, and clinicians who are currently involved in ICE as well as those who wish to become involved.

Target audience:

Faculty, students, clinicians involved in global health initiatives.

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