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This book is open access under a CC BY 4.0 license. This book examines the current state of elective placements of medical undergraduate students in developing countries and their impact on health care education at home. Drawing from a recent case study of volunteer deployment in Uganda, the authors provide an in-depth evaluation of the impacts on the students themselves and the learning outcomes associated with placements in low resource settings, as well as the impacts that these forms of student mobility have on the host settings. In addition to reviewing the existing literature on elective placements, the authors outline a potential model for the future development of ethical elective placements. As the book concurs with an increasing international demand for elective placements, it will be of immediate interest to universities, intermediary organizations, students as consumers, and hosting organisations in low-resource settings.

Today's physicians are medical scientists, drilled in the basics of physiology, anatomy, genetics, and chemistry. They learn how to crunch data, interpret scans, and see the human form as a set of separate organs and systems in some stage of disease. Missing from their training is a holistic portrait of the patient as a person and as a member of a community. Yet a humanistic passion and desire to help people often are the attributes that compel a student toward a career in medicine. So what happens along the way to tarnish that idealism? Can a new approach to medical education make a difference?Doctors Serving Peopleis just such a prescriptive. While a professor at Rush Medical College in Chicago, Edward J. Eckenfels helped initiate and direct a student-driven program in which student doctors worked in the poor, urban communities during medical school, voluntarily and without academic credit. In addition to their core curriculum and clinical rotations, students served the social and health needs of diverse and disadvantaged populations. Now more than ten years old, the program serves as an example for other medical schools throughout the country. Its story provides a working model of how to reform medical education in America.

Psychological distress is prevalent in students and can predispose to psychiatric disorders. Recent findings indicate that distress might be linked to impaired cognitive performance in students. Experimental findings in healthy participants suggest that placebo interventions can improve cognition. However, whether non-deceptive (i.e., open-label, OLP) placebos can enhance cognitive function and emotional well-being is unclear. Using a randomized-controlled design we demonstrate a positive impact of OLP on subjective well-being (i.e., stress, fatigue, and confusion) after a 21-day OLP application in healthy students during midterm exams. OLP did not improve test performance, but, within the OLP group, test performance was positively correlated with measures of general belief in the benefit of medication. These results show that OLP can counteract negative effects of acute stress on psychological well-being and might improve cognitive performance if supported by positive treatment expectations. Additionally, our findings in healthy volunteers warrant further investigation in exploring the potential of OLP in reducing stress-related psychological effects in patients. The trial was preregistered at the German Clinical Trials Register on December 20, 2017 (DRKS00013557).

Background The question to involve or restrict medical students’ involvement in the coronavirus disease 2019 (COVID-19) pandemic response remains contentious. As their state of preparation and perceptions in volunteering during this pandemic have yet to be investigated, this study aims to evaluate Indonesian medical students’ willingness to volunteer and readiness to practice during the COVID-19 pandemic. Methods A web-based survey was conducted among undergraduate medical students throughout Indonesia. Socio-demographic and social interaction information, in addition to willingness to volunteer and readiness to practice, were obtained using a self-reported questionnaire. The significance level was set at 5%. Results Among 4870 participants, 2374 (48.7%) expressed their willingness to volunteer, while only 906 (18.6%) had adequate readiness to practice. Male students, students with prior volunteering experience in health or non-health sectors, and students from public universities or living in Central Indonesia (vs Java) had higher scores of willingness and readiness to volunteer. Students from Sumatra also had better preparedness (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.15–2.12, p  = 0.004), while the opposite occurred for students from Eastern Indonesia (OR 0.63, 95% CI: 0.44–0.89, p  = 0.002)–when compared to students from Java. In addition, compared to students with high family income, students from lower-middle income families were less willing to volunteer (OR 0.76, 95% CI: 0.59–0.98, p  = 0.034), though those with low family income had better readiness (OR 1.51, 95% CI: 1.10–2.08, p  = 0.011). Shortage of medical personnel, sense of duty, and solicitation by stakeholders were the main reasons increasing the students’ willingness to volunteer; whereas contrarily fear for own’s health, absence of a cure, and fear of harming patients were the primary factors diminishing their willingness to volunteer. Conclusion Our findings indicated that many Indonesian medical students are willing to volunteer, yet only few of them were ready to practice, indicating that further preparations are required to maximize their potentials and minimize their exposure to hazards. We suggest that their potentials as a firm support system during the pandemic should not be overlooked, and that the integration of relevant courses to the medical curricula are imperative to prepare for future public health emergencies.

In the field of health care, knowledge and clinical reasoning are key with regard to quality and confidence in decision making. The development of knowledge and clinical reasoning is influenced not only by students' intrinsic factors but also by extrinsic factors such as satisfaction with taught content, pedagogic resources and pedagogic methods, and the nature of the objectives and challenges proposed. Nowadays, professors play the role of learning facilitators rather than simple \"lecturers\" and face students as active learners who are capable of attributing individual meanings to their personal goals, challenges, and experiences to build their own knowledge over time. Innovations in health simulation technologies have led to clinical virtual simulation. Clinical virtual simulation is the recreation of reality depicted on a computer screen and involves real people operating simulated systems. It is a type of simulation that places people in a central role through their exercising of motor control skills, decision skills, and communication skills using virtual patients in a variety of clinical settings. Clinical virtual simulation can provide a pedagogical strategy and can act as a facilitator of knowledge retention, clinical reasoning, improved satisfaction with learning, and finally, improved self-efficacy. However, little is known about its effectiveness with regard to satisfaction, self-efficacy, knowledge retention, and clinical reasoning. This study aimed to evaluate the effect of clinical virtual simulation with regard to knowledge retention, clinical reasoning, self-efficacy, and satisfaction with the learning experience among nursing students. A randomized controlled trial with a pretest and 2 posttests was carried out with Portuguese nursing students (N=42). The participants, split into 2 groups, had a lesson with the same objectives and timing. The experimental group (n=21) used a case-based learning approach, with clinical virtual simulator as a resource, whereas the control group (n=21) used the same case-based learning approach, with recourse to a low-fidelity simulator and a realistic environment. The classes were conducted by the usual course lecturers. We assessed knowledge and clinical reasoning before the intervention, after the intervention, and 2 months later, with a true or false and multiple-choice knowledge test. The students' levels of learning satisfaction and self-efficacy were assessed with a Likert scale after the intervention. The experimental group made more significant improvements in knowledge after the intervention (P=.001; d=1.13) and 2 months later (P=.02; d=0.75), and it also showed higher levels of learning satisfaction (P<.001; d=1.33). We did not find statistical differences in self-efficacy perceptions (P=.9; d=0.054). The introduction of clinical virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning in an initial stage and over time, and it increases the satisfaction with the learning experience among nursing students.

Background The shortage of primary care physicians in the United States is expected to grow to 17,800–48,000 physicians by 2034. Student Run Free Clinics are an increasingly popular component of medical schools and may provide an avenue for increasing medical student interest in primary care specialties. However, there is limited research on the impact of Student Run Free Clinics on medical student specialty choice. This investigation sought to determine whether volunteering with the Interprofessional Community Clinic (ICC), the Student Run Free Clinic associated with Chicago Medical School, was associated with an increased likelihood of matching into primary care specialties. Secondarily, the authors investigated associations between volunteering and matching into family practice. Finally, the authors explored associations between volunteering and the competitiveness of specialty choice. Methods This retrospective review utilized data on medical school graduates from 2015 – 2021 including their matched specialties, the number of ICC shifts they volunteered for, and whether they held an ICC leadership position (executive officers). Primary care specialties were defined as internal medicine, family practice, pediatrics, or combined internal medicine/pediatrics. Residency fill rate was used as a proxy for competitiveness. Results This analysis included 506 medical students (254 ICC volunteers and 252 non-volunteers). Among ICC volunteers, 47.2% matched into a primary care specialty compared to 36.5% of non-volunteers (RR 1.29, 95% CI 1.05–1.59). Each additional shift worked at the ICC was correlated with increased odds of matching into family practice by a factor of 1.042 (95% CI 1.005–1.079). Conclusions Medical students who volunteered with the ICC were more likely to match into primary care residencies. Students who volunteered more frequently were more likely to match into family practice. Further investigation is warranted to determine whether these associations are causative and could thus be leveraged to encourage medical students to pursue primary care careers.

Becoming a healthcare professional is a complex process, where learning occurs in various ways. This study explores an extracurricular learning approach, called the Social Health Bridge-Building Programme, designed to address health inequities. Student volunteers accompany persons in a socially vulnerable situation to healthcare appointments. Operating outside the realms of health education, the programme intends to provide an alternative road to training healthcare students to become capable of engaging with diverse populations, and reducing barriers to healthcare access. Based on an ethnographic fieldwork, using interviews and participant observation (“walking along”) as methods, the aim of the study was to explore the learning processes and learning outcomes associated with bridge-building, as experienced by students. Our findings show that this extracurricular learning complemented the formal curriculum, and bridged the gap from theoretical knowledge to practice and to real persons, preparing students for their future roles. The particular positioning of walking alongside or sitting beside persons made the invisible visible, enabling student volunteers to see the variety of persons in need of bridge-building, ways of living in a socially vulnerable situation, inequity in health, and see the persons, beyond initial impression, fostering a deeper understanding and empathy among the students. Learning outcomes included communicational, relational, and observations skills, and a more comprehensive grasp of the healthcare system's complexity. We conclude that a non-governmental organization, independent of the healthcare system, may have found a novel way of providing extracurricular learning about health inequity to students. Demonstrating how the Social Health Bridge-Building Programme complements formal curricula, the concept could be applicable in other settings.

Humanistic education aims to promote educated people's practical and conscious activities to enhance their humanity, cultivate ideal personalities, and realize personal and social values, to develop a humanistic spirit. The advancement of higher education in China has led to the proposal to strengthen scientific and humanistic education integration. Medicine is between science and humanities, shouldering the important task of training senior medical personnel, the quality of medical students will affect the quality of future medical and health work; thus, medical students must explore and practice humanistic education. Promoting and practicing volunteerism is a specific act of constructing spiritual civilization in the whole society, and it is also considered beneficial for improving citizens' sense of responsibility and dedication. Medical students' practice of volunteerism and help in society is a precise manifestation of humanistic care. This review summarizes medical students' exploration and practice of humanistic education in volunteering.

Short-term medical service trips (MSTs) aim to address unmet health care needs of low- and middle-income countries. The lack of critically reviewed empirical evidence of activities and outcomes is a concern. Developing evidence-based recommendations for health care delivery requires systematic research review. I focused on MST publications with empirical results. Searches in May 2013 identified 67 studies published since 1993, only 6% of the published articles on the topic in the past 20 years. Nearly 80% reported on surgical trips. Although the MST field is growing, its medical literature lags behind, with nearly all of the scholarly publications lacking significant data collection. By incorporating data collection into service trips, groups can validate practices and provide information about areas needing improvement.

Background The volunteer Pre-Medical Health Coach (PHC) program engages student volunteers, in team-based primary care providing self-management support to patients with chronic conditions. Both the PHCs and the patients they serve are diverse. The aims of this study are to assess the impact of the PHC program on student outcomes and patient biomarkers. Methods All PHCs were students recruited from local universities, interviewed, then trained in motivational interviewing and evidence-based chronic disease self-management support. The 22 PHCs were diverse – 8 (36.3%) were underrepresented in medicine and 2 (9%) were first generation in college. The study setting was a public safety-net adult medicine outpatient clinic in Oakland, California. PHCs spent 5 h weekly, for 1–3 years, volunteering alongside primary care residents and faculty. Duties included: (1) observing the doctor-patient interview, (2) on-site health coaching, and (3) telephone follow-up. An internal medicine physician and a licensed clinical social worker supervised the program. Surveys were implemented to understand program impacts and career trajectories of the 22 PHCs and health action plans were reviewed over 4 years. In addition, a focus group was conducted with the PHCs using a deductive approach. Results Two years after completing the program, 90.9% of the PHCs were still on the path to health professions programs, 50% had applied to medical school, and 18.2% started medical training. Qualitative impacts on coaches included significant clinical exposure, meaningful connection with patients, ‘bridging’ between the community and health care system and having a more holistic view on health. Patient biomarkers included a decrease in hemoglobin A1c level by 1% point in diabetic patients with diabetes-focused action plans, and smoking-focused action plans led to decreased smoking or cessation. Conclusions The Pre-Medical Health Coach (PHC) program may benefit both PHCs and patients. PHCs were diverse and providing chronic disease self-management support to patients in a safety-net health care system. This program could be readily adapted in health care systems nationwide to increase diverse entrants to the healthcare workforce.