The Global Health Classroom: Collaborative Global Health Learning between New Zealand and Samoan Medical Students in a Virtual Classroom

Background Global Health is recognised as an essential component of undergraduate medical curricula to equip future doctors with the relevant knowledge, attitudes, and skills to practice in a globalised world. The Global Health Classroom (GHCR), the subject of this research project, has been developed at the Otago Medical School (OMS), New Zealand in collaboration with medical schools in Samoa and Nepal. The aim of the GHCR is to promote collaborative global health learning between medical students in different countries in a virtual classroom. In 2016, GHCR pilot studies were conducted between the partner schools and formed the basis of this Bachelor of Medical Science (Honours) Research Project in 2017. In 2017, the GHCR was conducted between the OMS, Patan Academy of Health Sciences, Nepal (PAHS), and the School of Medicine, National University of Samoa, Samoa (NUS). Data collected from the GHCR participants at OMS and NUS were included in this thesis. At NUS, GHCR was integrated into the Year 4 and 5 medical curricula. At OMS, GHCR was integrated into the Year 5 Paediatrics Module at the University of Otago, Christchurch (UOC) and Year 4 Public Health Module at the Dunedin School of Medicine, Dunedin (DSM). Aim The aim of this study was to explore the self-reported learning outcomes and experiences of New Zealand and Samoan medical students in the GHCR, and ascertain the key elements contributing to their learning and experiences. Methods A census sample of UOC, DSM and NUS students who undertook the GHCR were invited to be participants in this research. Written, informed consent was obtained from students prior to their participation in this study. A mixed-methods approach was developed using a questionnaire for all participants, and semi-structured interviews for participants selected by random sampling following participation in the GHCR. The questionnaire had a range of Likert-type scale and open-ended questions. Quantitative data were descriptively analysed using SPSS Version 23 and qualitative data were thematically analysed. A triangulation approach informed the synthesis of the data. Results Of the participants, 85% (74/87) responded to the post-GHCR questionnaire. Nineteen interviews were conducted: six each with UOC and NUS students, and seven with DSM students. Students reported gaining knowledge about patient care, healthcare systems, and the culture and determinants of health, in their partner country. There was evidence that attitudes such as cultural understanding and respect, curiosity and interest, humility and vision for progress were encouraged among students by their GHCR experiences. Reported outcomes in the GHCR align favorably with the recommended global health learning concepts in the literature. Key elements for success in the GHCR were found to be: clinical cases and global health-themed guiding questions; teachers as facilitators and students as self-directed learners; peer learning and social interaction; and video-conferencing. Students’ experiences in the GHCR were largely positive. Students found learning with their international peers in a virtual classroom made learning about global health “more real and tangible” and “much more accessible than learning [about global health] on a purely theoretical basis.” Internet connectivity during video-conferencing and competing demands such as assignments, clinical teaching and assessments could at times be barriers limiting student engagement in the GHCR. Conclusion The findings in this study suggest that the GHCR presents a promising global health learning model embodying core values of partnership, collaboration and reciprocity between medical students and institutions in different countries