Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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448 Surgery and Healing in the Developing World
medical education program based in case presentations and consultations with the
team leader in each location.
In the paper submitted at the outset of this medical mission, the proposal had
been to research and evaluate attitudes and changes in the health care students through
this process of service learning, based in the sparse literature on this subject, but
with the urgency of increasing pressures to carry out such missions in settings of
need. While abroad, an American Medical Association (AMA) resolution had reached
me (Appendix E) strongly recommending service learning as a component of medical
education. The findings of such research as proposed in the prior paper might be
useful in supporting (Appendix C) or modifying such recommendations.
The Question: What Is the Effect of a Volunteer Medical
Mission on Entering Health Care Students’ Attitudes,
Knowledge Base, and Reported Humanitarian Motivations?
This research question was translated into the interview questions appended as
questionnaires A and B for self-assessment before and after the medical mission to
the beleaguered island of Hispaniola, filled out immediately before arrival, and upon
leaving by the appended instruments completed on the outbound and returning
flights. Each were supplemented by detailed individual interviews throughout the
mission, and recorded in narrative on tape recordings, text from notes immediately
transcribed, and in photojournalism of many of the clinical interactions of the subject
students and the patient population we were intent on treating. The personnel
(Appendix D) engaged in this study were aware of the plan and purpose of its being
carried out and were offered the option of not participating in the study even if they
wished to continue as part of the mission, a consent reflected in their voluntarily
filling out the questionnaires and volunteering their views in interviews. None of
the students chose not to participate. One hundred percent of the population, therefore,
responded in both questionnaires and no statistical derivations were necessary
on a unanimous sample.
Data Presentation Questionnaire “A” Responses
From the pretrip questionnaire, language capabilities were limited, with seven
participants alleging “some” knowledge of Spanish, but only two of those were fluent
enough to function as patient interpreters and that was limited to the DR. Two
attested to knowledge of French, which was of no use until we reached, only briefly
in transit, the capital of Port au Prince, and only one of the student participants was
fluent in Creole, and several local translators were impressed into service to maintain
four clinical teams.
Six of the students alleged to have done something like this before, but except for
two of them, the experience had been largely as an observer in a setting in which
they had no capacity for even beginning professional interaction with patients. Of
those thirteen who had been abroad before, only four had been in true developing
world settings, and two of those as tourists. In answer to how each had decided to
come along on this trip, six participants said it was quite an adventure they anticipate,
three said they had nothing better to do for the summer, two responded that it
was potentially a great experience and the price was right as a subsidized mission,
three responded that they had always wanted to accompany me on such a mission,
and after many prior incompatible calendar conflicts, this one finally fit, and two