Global health classroom: mixed methods evaluation of an interinstitutional model for reciprocal global health learning among Samoan and New Zealand medical students.

BACKGROUND: Global health education partnerships should be collaborative and reciprocal to ensure mutual benefit. Utilisation of digital technologies can overcome geographic boundaries and facilitate collaborative global health learning. Global Health Classroom (GHCR) is a collaborative global health learning model involving medical students from different countries learning about each other's health systems, cultures, and determinants of health via videoconference. Principles of reciprocity and interinstitutional partnership informed the development of the GHCR. This study explores learning outcomes and experiences in the GHCR between students from New Zealand and Samoa. METHODS: This study used a mixed methods approach employing post-GHCR questionnaires and semi-structured face-to-face interviews to explore self-reported learning and experiences among medical students in the GHCR. The GHCR collaboration studied was between the medical schools at the University of Otago, New Zealand and the National University of Samoa, Samoa. RESULTS: Questionnaire response rate was 85% (74/87). Nineteen interviews were conducted among New Zealand and Samoan students. Students reported acquiring the intended learning outcomes relating to patient care, health systems, culture, and determinants of health with regards to their partner country. Interview data was indicative of attitudinal changes in relation to cultural humility and curiosity. Some reported a vision for progress regarding their own health system. Students in the GHCR reported that learning with their international peers in the virtual classroom made learning about global health more real and tangible. The benefits to students from both countries indicated reciprocity. CONCLUSIONS: This study demonstrates GHCR to be a promising model for collaborative and reciprocal global health learning using a student-led format and employing digital technology to create a virtual classroom. The self-reported learning outcomes align favourably with those recommended in the literature. In view of our positive findings, we present GHCR as an adaptable model for equitable, collaborative global health learning between students in internationally partnered institutions.

Randomised controlled trial of students access to resources in an examination.

INTRODUCTION: Assessment of healthcare professionals should be authentic to clinical practice. As clinicians regularly use resources in practice, similar resources should be available to those sitting assessment. There is limited information on the impacts of open-book (resource) assessments on standard setting for use in high-stakes assessments. This research aims to explore the effects on standard setting and student perceptions when open vs closed resources are available in high-stakes assessment of medical students. METHODS: Students sat multiple-choice question (MCQ) examinations under both closed- and open-resource conditions in a randomised crossover design. A standard setting panel set pass-marks for both closed- and open-resource conditions of delivery, and we compared these pass-marks with each other and with actual performance. Students responded to a survey on perceptions of open-resource assessments. RESULTS: The pass-mark was set higher when panellists considered open-resource conditions compared to closed conditions (59% vs 47%), but actual student performance showed no difference in scores between the two conditions. The net effect was that the pass rate was higher for closed than open-resource conditions (71% vs 34%). Open-resource conditions increased the time to complete the questions. The students perceived that open resource was more authentic but was more time-consuming and would require different preparation. Regarding the acceptability of including open resources in high-stakes assessment, the responses of students were mixed. DISCUSSION: Pass standards based solely on judgements by panellists experienced in closed-resource conditions might not be applicable under open conditions. Questions vary in how much time accessing resources may take and the degree of assistance in selecting the correct answer. A programme of assessment could be constructed to include both closed- and open-resource condition assessments depending on the questions' content and format. Open-resource conditions may promote assessment preparation that focuses more on seeking and evaluating resources rather than learning facts.