A Multidisciplinary Global Health Course with an Integrated International Field Experience

A new global health course was recently developed and implemented at Western New England University. The course brought together students from a variety of disciplines and academic levels to study issues related to healthcare from a global perspective. The centerpiece of the course was a faculty-led field experience in Guatemala that occurred at the end of the semester. During the field experience, the students visited clinical care facilities where they conducted a needs assessment by interviewing and surveying administrators, healthcare workers, and patients. In order to assess the impact of the new course on student interest and attitudes toward global health, a set of preand post-course surveys were developed and administered. The results from the surveys showed increased student-reported knowledge regarding global health issues after completing the course. The students also reported an increased level of interest in pursuing further studies and careers in the area of global health, as well as a desire to become more proficient in a foreign language. Introduction The development of solutions to healthcare problems facing the global community is of significant interest to biomedical engineers working in both academia and industry. These solutions often require technologies to be developed within constraints that differ from those found in a typical medical device setting, including strenuous economic restrictions as well as unique cultural considerations. Thus, in order to develop appropriate solutions for global health issues, biomedical engineers must possess a variety of skills that are not typically cultivated in the traditional biomedical engineering (BME) curriculum. For example, BMEs must be introduced to diseases that are prevalent from a global perspective, which are often quite different from conditions that are clinically relevant in the United States. Additionally, BMEs must be prepared to develop healthcare solutions in a range of unfamiliar environments, including foreign countries, languages, and cultures. Recently, a number of engineering programs have developed opportunities for their students that emphasize global perspectives. In general, these efforts are focused on developing global perspectives in a broad sense, and are not necessarily centered on biomedical topics. Within the biomedical engineering community, there are examples of programs involving extracurricular activities as well as research experiences. The Milwaukee School of Engineering offers a program called Healthcare Without Borders (HWB), which is a service club organized by students. This program is unique in that its activities are designed to exist outside of the curriculum, thus students do not receive course credit for participation. Rather, it is operated as a student life club. Students from a variety of academic backgrounds are encouraged to participate, including from nursing programs as well as all engineering majors. Efforts of the program have P ge 2.75. 2 included travel to developing countries, such as El Salvador, to complete assessments of healthcare clinics. The Georgia Institute of Technology recently described their China Undergraduate Research Experience (CURE) program. This program is designed to immerse undergraduate students in an international research experience for a full year, with an aim of enhancing research skills while also offering perspectives on global challenges within biomedical engineering. Secondary goals include impacting student interest in pursuing graduate studies, particularly in programs with international components. In order to help meet the needs for globally trained biomedical engineers, a new global health course was recently developed at Western New England University (WNE). The new course, which is titled Global Health & Technology, was designed to provide a multidisciplinary experience at the interface between global health issues and the technologies being developed to solve them. Additionally, the course contained an integrated field experience in Guatemala that was included to provide a practical module to complement the in-class learning. The objectives of the course were to 1) increase student knowledge regarding global health issues, 2) increase student interest in global health as an area for future study or careers, and 3) increase student interest in traveling abroad and learning a foreign language. Course Background The new Global Health & Technology course was developed and implemented for the first time in Spring 2011. The course was co-instructed by two faculty members from the College of Engineering, including one biomedical engineer and one electrical engineer (EE). Both instructors had prior experience with global health, including research projects involving medical devices and prior course-based trips to developing countries. Since one of the goals of the course was to create a multidisciplinary learning environment, the course was made available to all undergraduate students on campus through the Integrated Liberal and Professional (ILP) program at WNE. All students at WNE must complete one ILP course as part of the general requirements for graduation, thus the course counts toward the curriculum for BME and other majors. The student population for the first course offering included 6 biomedical engineering majors and 7 students from the College of Arts & Sciences. This included 1 first-year student, 7 secondyear students, and 5 third-year students. Of the 13 students in the course, 3 were male and 10 were female. The course enrollment was limited to 13 students due to travel constraints related to the Guatemala field experience. As a result of the limited size of the course, students were required to go through an application process in order to be accepted into the class. Additionally, each student was required to pay approximately $2,500 in extra tuition to cover the costs of the Guatemala field experience. This cost included all airfare, transportation, lodging, and food during the trip, and also covered the cost of travel for the two course instructors. P ge 2.75. 3 The class was realized as a standard three-credit hour course, with two lecture hours held per week during the semester and the remaining hour completed through the field experience at the end of the semester. The table below shows the list of topics that were covered during the lecture component of the course. Table 1 – Course Topics Topic Introduction to Global Health Global Health Case Studies Health Data Health Economics Major Disease Conditions Healthcare Systems & Costs New Global Health Technologies The focus of the class involved the relationship between healthcare and technology in a global context, thus the course content included a study of major diseases (e.g., malaria, tuberculosis, and diarrheal disease), types of healthcare systems (e.g., entrepreneurial, socialist, and comprehensive), and socioeconomic considerations (e.g., gross domestic product, health expenditures per capita, and Human Development Index). Additionally, each student conducted an independent literature review of the healthcare status of a foreign country and produced a term paper to communicate the content to the faculty. The students also presented their findings to the class in the form of an oral presentation. For another graded assignment, the students worked in teams to develop technology-based solutions to specific global health issues within economic and material constraints. The resulting design concepts were subsequently described to the class in the form of an in-class presentation. An example of a global health scenario that was assigned to one of the groups can be found in the appendix. In addition to the lecture content on the topic of global health, students were also prepared for the field experience with lectures on the history, current events, and culture of Guatemala. Team-building exercises were also incorporated into the course in order to facilitate the formation of a cohesive group ahead of an intensive field experience. The course content was delivered exclusively by the course co-instructors. The majority of technical content was delivered by the BME faculty member, whose research expertise involves the development of medical devices for low-resource environments. Specific case studies were included from the BME faculty member’s active research projects, as well as from the course textbook, journal articles, and the popular media. The content specific to Guatemala was delivered by the EE faculty member, who had participated in two prior course-based trips to the country involving a business focus. Spanish language training was also provided by this course co-instructor, who had moderate Spanish-language skills. These language training sessions, which were conducted over three hour-long periods during regular class time, included basic P ge 2.75. 4 grammar, pronunciation, and conversation. Additionally, students with Spanish language proficiency were encouraged to contribute to these sessions, which led to a dynamic classroom environment. In order for the course to be approved for offering as an ILP at Western New England University, and satisfy a general graduation requirement for each student, the students were required to demonstrate several competencies common to all ILP courses. Table 2 shows the mapping of the competencies to the assignments and assessment methods. An example of the grading scheme for the health report is shown in the appendix. Table 2 – Competencies and Assessments Competency Assignment Assessment Ability to explain or utilize the approach or method of analysis in the perspective Students will conduct a health assessment of a particular region of the globe via literature review and present their results to the class in the form of an in-class presentation Rubric for paper Rubric for presentation Ability to identify key elements of the discipline or perspectiv