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Adolescence in an age of opportunity in Thailand. The main health issues of this age group are related to pregnancy, injuries and poisoning, all which should be preventable. This article presents the experiences of Thai physicians, who received adolescent medicine fellowship training in North America and brought their experience, knowledge, skills, and adolescent health care principles and practice back to Thailand. The anticipations and the facts faced in everyday practice, training, research, and collaboration in a place with their own culture and societal norms are described. Currently, there are six adolescent medicine specialists who work with experienced specialist in the subcommittee of adolescent health under the Royal College of Pediatricians of Thailand. There has been collaboration with both the public sector and health care sector, government and non-government organizations with regards to health care service and promotion. Many hospitals especially residency training institutes have increased the cut-off age of patients to be seen by pediatricians to 15 or 18 years of age. Since 2011, adolescent medicine was made one of the mandatory rotations in all pediatric resident training programs. There is still more work to be done - issues around policies for confidentiality and a lower age of consent, collaboration between other specialties to enable a large-scale youth-friendly one-stop services, and multicenter research opportunities are still awaiting.

Background Patient-centred care is internationally recognized as a foundation of quality patient care. Attitudes of students towards patient-centred care have been assessed in various health professions. However, little is known how chiropractic students’ attitudes towards patient-centred care compare to those of other health professions or whether they vary internationally, and between academic programs. Objective To assess the association of select variables on student attitude towards patient-centred care among select chiropractic programs worldwide. Methods We conducted a cross-sectional study using the Patient-Practitioner Orientation Scale (PPOS) to assess students’ patient-centred attitudes towards the doctor-patient relationship. Eighteen items were scored on a 1 to 6 Likert scale; higher scores indicating more patient-centredness. All students from seven chiropractic educational programs worldwide were invited to complete an online survey. Results were analyzed descriptively and inferentially for overall, sharing and caring subscales. General linear regression models were used to assess the association of various factors with PPOS scores. Results There were 1858 respondents (48.9% response rate). Student average age was 24.7 (range = 17–58) years and 56.2% were female. The average overall PPOS score was 4.18 (SD = 0.48) and average sharing and caring subscale scores were 3.89 (SD = 0.64) and 4.48 (SD = 0.52), respectively. There were small but significant differences in all PPOS scores by gender, age, and program. Year/semester of study within a program typically was not associated with scores, neither was history of previous chiropractic care nor having family members who are health professionals. Conclusion This is the first international study assessing students’ attitudes of patient-centred care in chiropractic educational programs. We found small but significantly different PPOS scores between chiropractic programs worldwide that did not change across year/semester of study. Scores tended to be lower than those reported among medical students. Observed differences may be related to curricular content, extent of patient exposure and/or regional cultural realities.

Introduction International placements challenge students to find the right level of participation, as local practices, language and time pressure may affect their engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation. Methods Following a constructivist grounded theory approach, we conducted two individual interviews with 15 undergraduate healthcare students (before departure and whilst on placement). To identify emerging themes, we applied an iterative process of data collection and constant comparative analysis. Several team discussions informed further analysis, allowing us to reach a more conceptual level of theory. Results From our findings we constructed a four-phase model of healthcare students’ initiation of international clinical placements, which brings into focus how the phases of ‘orientation’, ‘adjustment’ and ‘contribution to patient care’ build up towards a ‘sense of belonging’. We identified several factors that induced active student participation in practice, such as a favourable workplace setting, opportunities for learning and a local support network. Discussion Active student participation is aimed at different goals, depending on the four phases of initiation that eventually lead to a sense of belonging and support workplace learning.

The increasing cost and inequitable access to quality healthcare, coupled with the merger of the information technology and health service sectors, has given rise to the modern field of telemedicine. Telemedicine, meaning medicine at a distance, allows us to transcend geographic and socioeconomic boundaries to deliver high quality care to remote and/or in-need patients. As technology becomes more affordable and a physician shortage looms, telemedicine is gaining attention as a possible solution to healthcare delivery. Simultaneously, telemedicine holds great promise with regard to medical education. Several studies integrating telemedicine in medical education have shown positive outcomes, demonstrating similar or greater efficacy compared with traditional educational methods with high student-reported enthusiasm. Other domestic and international telemedicine projects, largely spearheaded by universities, have also achieved great success. In a novel approach, by pairing medical schools with in-need partner communities, utilizing similar faculty resources as traditional learning methods with standardized patients, students can gain valuable experience and skills while serving actual patients. This progressive approach to medical education fosters collaboration, communication, longitudinal care and teaches students needed skills for their future practices as 21 st Century healthcare providers.

ABSTRACT Objective: To characterize the experiences of undergraduate students of the School of Nursing of the University of São Paulo (EEUSP) who participated in international mobility programs between January 2011 and July 2017. Method: Exploratory, descriptive study with quantitative approach. Of 68 reports, only 38 (56%) were considered valid and were submitted to descriptive statistical analysis. Data were categorized in general, institutional, academic and cultural aspects and cost of living. Results: The main destination was Portugal and the years with most participation were 2012 and 2013. The mean stay was six months and the students took a mean of three to four courses. The main funder was the university of origin. Conclusion: Academic activities were limited to theoretical and practical courses, with little insertion in research. There is a need to increase investment in learning other languages and to expand partnerships with larger centers of foreign education and research. RESUMO Objetivo: Caracterizar as experiências dos estudantes de graduação da Escola de Enfermagem da Universidade de São Paulo (EEUSP), participantes dos programas de mobilidade internacional, entre janeiro de 2011 e julho de 2017. Método: Estudo exploratório, descritivo de abordagem quantitativa, de 68 relatórios. Desses, apenas 38 (56%) foram considerados válidos e submetidos à análise estatística descritiva. Os dados foram apreendidos em aspectos gerais da experiência, institucionais, acadêmicos, culturais e custo de vida. Resultados: O principal destino foi Portugal, entre os anos de 2012 e 2013, com permanência média de seis meses, cursando em média três a quatro disciplinas. O principal financiador foi a universidade de origem. Conclusão: As atividades acadêmicas limitaram-se a disciplinas teórico-práticas, com pouca inserção na pesquisa. Há necessidade de aumentar o investimento na aprendizagem de outros idiomas e ampliar parcerias com grandes centros de ensino e de pesquisa estrangeiros. RESUMEN Objetivo: Caracterizar las experiencias de los estudiantes de graduación de la Escuela de Enfermería de la Universidad de São Paulo (EEUSP), participantes de los programas de movilidad internacional, entre enero de 2011 y julio de 2017. Método: Se trata de un estudio exploratorio, descriptivo de abordaje cuantitativo, de 68 reportes. De estos, solamente 38 (56%) se consideraron válidos y se sometieron al análisis estadístico descriptivo. Los datos se recogieron según los aspectos generales de la experiencia: institucionales, académicos, culturales y costo de vida. Resultados: El destino principal fue Portugal, entre los años 2012 y 2013, con permanencia media de seis meses y cursando, promedio, de tres a cuatro disciplinas. La principal financiadora fue la universidad de origen. Conclusión: Las actividades académicas se limitaron a disciplinas teórico-prácticas, sin involucrarse mucho en la investigación. Existe la necesidad de aumentar las inversiones para el aprendizaje de otros idiomas y aumentar los convenios con los grandes centros de enseñanza e investigación extranjeros.

Objective: To describe the experience of a Brazilian undergraduate nursing student through a Canadian scholarship program. Method: Descriptive experience report of a Brazilian nursing student’s journey in a Canadian program from September 2023 to February 2024 funded by the Emerging Leaders in the America Program (ELAP). Results: The Brazilian undergraduate nursing student experienced significant personal and professional growth during her exchange at Brock University, Canada. Key outcomes included increased cultural sensitivity, improved English language skills, enhanced research capabilities, and the development of therapeutic communication skills. In addition, the experience facilitated the establishment of valuable international academic collaborations and enriched the student’s knowledge and practices upon her return to Brazil to continue her studies in the field in partnership with Canada. Conclusion: The ELAP significantly benefited both the student and her local academic community. The skills and knowledge acquired, including enhanced research capabilities and cultural sensitivity, were shared with colleagues and faculty in Brazil, fostering the student’s development in continuing her research studies and practice. Collaboration with a Canadian professor also paved the way for future national and international research projects. This highlights the immense value of international exchange programs in advancing nursing education and practice. Objetivo: Descrever a experiência de uma estudante brasileira de graduação em enfermagem por meio de um programa de bolsas de estudo canadense. Método: Relato descritivo da experiência de uma estudante brasileira de enfermagem em um programa canadense, de setembro de 2023 a fevereiro de 2024, financiado pelo Programa de Líderes Emergentes nas Américas (Emerging Leaders in the Americas Program, ELAP). Resultados: A estudante brasileira de enfermagem, em nível de graduação, vivenciou um crescimento pessoal e profissional significativo durante seu intercâmbio na Universidade Brock, no Canadá. Os principais resultados incluíram maior sensibilidade cultural, aprimoramento das habilidades em inglês, desenvolvimento de capacidades de pesquisa e aprimoramento de habilidades de comunicação terapêutica. Além disso, a experiência facilitou o estabelecimento de valiosas colaborações acadêmicas internacionais e enriqueceu o conhecimento e as práticas da estudante ao retornar ao Brasil para continuar seus estudos na área em parceria com o Canadá. Conclusão: O programa ELAP beneficiou significativamente tanto a aluna quanto sua comunidade acadêmica local. As habilidades e o conhecimento adquiridos, incluindo o aprimoramento das capacidades de pesquisa e da sensibilidade cultural, foram compartilhados com colegas e professores no Brasil, fomentando o desenvolvimento da aluna na continuidade de seus estudos de pesquisa e prática. A colaboração com um professor canadense também abriu caminho para futuros projetos de pesquisa nacionais e internacionais. Isso destaca o imenso valor dos programas de intercâmbio internacional para o avanço da educação e da prática de enfermagem.

Sleep medicine remains an underrepresented medical specialty worldwide, with significant geographic disparities with regard to training, number of available sleep specialists, sleep laboratory or clinic infrastructures, and evidence-based clinical practices. The American Academy of Sleep Medicine (AASM) is committed to facilitating the education of sleep medicine professionals to ensure high-quality, evidence-based clinical care and improve access to sleep centers around the world, particularly in developing countries. In 2002, the AASM launched an annual 4-week training program called Mini-Fellowship for International Scholars, designed to support the establishment of sleep medicine in developing countries. The participating fellows were generally chosen from areas that lacked a clinical infrastructure in this specialty and provided with training in AASM Accredited sleep centers. This manuscript presents an overview of the program, summarizes the outcomes, successes, and lessons learned during the first 12 years, and describes a set of programmatic changes for the near-future, as assembled and proposed by the AASM Education Committee and recently approved by the AASM Board of Directors. Citation: Ioachimescu OC; Wickwire EM; Harrington J; Kristo D; Arnedt JT; Ramar K; Won C; Billings ME; DelRosso L; Williams S; Paruthi S; Morgenthaler TI. A dozen years of American Academy of Sleep Medicine (AASM) international mini-fellowship: program evaluation and future directions. J Clin Sleep Med 2014;10(3):331–334.

Asians and Asian Americans in the USA have long been a part of a contentious racial history, yet the COVID-19 pandemic highlighted discriminatory stereotypes and beliefs. As revealed through this discourse analysis, Asian international students were simultaneously positioned as scapegoats, bearers of disease, cash cows, and political pawns, all within the context of the pandemic. Asian international students navigated their shifting social positionings within a national context that was heavily influenced by racist nativism. Findings indicated that during a health pandemic, Asian international students were positioned as both the Yellow Peril and cash cows within U.S. higher education.

The authors discuss the Human Resources for Health Program, which is working to improve the quality and quantity of health professionals in Rwanda by means of sustained collaborations with U.S. schools of medicine, nursing, dentistry, and public health. A global shortage of 4.3 million health professionals poses a major bottleneck to poor people worldwide with regard to benefiting from the fruits of modern medicine. 1 Among existing health professionals, there are also staggering inequities in skill levels and geographic distribution. 2 – 4 Unsurprisingly, the deepest national gaps in human resources for health run parallel to poor population-level health outcomes. 1 Sub-Saharan Africa bears 24% of the global burden of disease 5 but is served by only 4% of the global health workforce. 1 The health graduate schools in the region face overwhelming financial, infrastructural, and personnel constraints, limiting their ability to address the . . .

International medical electives should be mutually beneficial to the host institution and the student, writes Inez Murray