Studiegids

nl en

Global Health (Cuba)

Vak
2023-2024

Admission requirements

See Brightspace for the admission requirements.

Description

The society we live in is becoming more and more globalised and multicultural, with huge national and international socioeconomic and health disparities frequently arising. To be able to deal with the health challenges created by these developments, doctors with a broad view and perspective are needed. Simultaneously, there is a growing consensus that the strengthening of primary care and preventative healthcare are essential elements of effective and affordable healthcare (See 2008 WHO report “Primary care now more than ever”). This module, HM G3-14, provides a unique opportunity to familiarise yourself with the daily life and medical care of a middle-income country of the Global Southwhose culture and political system differ from the Dutch system. Education is a priority for the Cuban government and prevention and community care are the cornerstones of the Cuban healthcare system, making it an ideal learning environment for well-prepared students.

The HM G3-14 start with an extracurricular curriculum at the end of May in the second year of BA. There will be seven workshop with varied themes and teaching. From making acquaintance with each other to introduction in qualitative research, to public health themes in Cuba to a course in Spanish. There is no preparation needed for these extracurricular workshops.

Currently there are two LUMC HMs on Global Health, dealing with the health issues challenging low- and middle-income countries and discussing the relationship between global health policy and clinical disease manifestations. The HM Global Health in the Netherlands (G3-M11) (HM GH NL) and the HM Global Health in Cuba (G3-M14) (HM GH Cuba). The HM GH Cuba will be discussed here. The HM GH NL has a separate ‘Studiegids’ and examination plan. During the first four weeks, G3-M14 joins in with G3-M11.
The HMs G3-M14 and G3-M11 start together in September with a general Basic Course in Global Health (BC-GH) of four weeks, where the students become acquainted with the broad range of topics within global health. See for a description of this course the ‘Studiegids HM GH NL’.
For those students participating in HM GH Cuba, meetings will be organized during the BC-GH: preparing a research proposal for a qualitative research, providing more in-depth information about the current health situation in Cuba and discussing practical aspects of the visit, including training sessions in Spanish. Because of these demanding preparations, students who follow G3-M14 will not take part at the online course that is organised for the G3-M11 students. As a consequence they will not follow the whole HM GH NL course. Instead of this, students will write a qualitative research proposal. This research proposal will be assessed summatively. Students have to improve the proposal until 5.5 is reached (see rubric).
After the basic introduction the students of G3-M14 will travel to Cuba to follow a special program focusing on preventive medicine. Because of the relatively small size of this specialized module (12 students) the teaching approach will be individual and interactive with a particular focus on academic skills and professional attitude. The module in particular will demand active participation and significant academic skills of the students, e.g. group discussions, in-depth literature searches, fieldwork, presentations, writing of papers and reflection reports. Similar to the BC-GH in the first four weeks, the students also get the opportunity to meet true Cuban experts within specific areas of clinical and scientific global health research.
This module combines theory (classroom learning and self‐study – to be partly conducted online) and practical experience (observations, interviews, other fieldwork).

Course objectives

The programs of the HM emphasize the acquisition of academic skills. At the end of this period, students are able:

Main objectives:

1: Qualitative research – question and proposal
At the end of the course the student will have a thorough understanding of the purpose and nature of qualitative research (including how it differs from quantitative research), as well as be able to develop a research question for qualitative research and use this to set up an adequate research proposal.

2: Qualitative research – fieldwork
At the end of the course the student will be able to execute a qualitative study by carrying out fieldwork in Cuba. This entails managing fieldwork activities (interviews, observations, field notes, etc.), analysing and interpreting the qualitative data and presenting preliminary results (in Cuba), amongst others.

3: Critical thinking and knowledge of the healthcare system
At the end of the course the student will be able to critically reflect on aspects of the Cuban healthcare system and demonstrate in-depth knowledge (of one aspect) of the Cuban healthcare system as an example of a foreign healthcare system.

4: Analyse data from qualitative research and reflect on it
At the end of the course the student will be able to analyse and interpret the qualitative data collected in Cuba and reflect on the results in relation to political, social and cultural aspects of and current debates within the chosen research theme.

5: Written communication
At the end of the course the student will be able to write a research report (including recommendations for further research (or if applicable to practice)). The students will combine data from a literature search performed in the Netherlands, field research undertaken in Cuba and data extracted from other scientific sources.

6: (Oral) communication – presenting the data
At the end of the course the student will be able to present the qualitative study by means of an oral presentation (in the Netherlands).

7: Self-reflection of role in a group
At the end of the course the student will be able to evaluate their participation during the Half Minor Cuba by reflecting on his or her own contributions to and role within the group (e.g. contributions to group assignments).

8: Self-reflection of working in a different culture
At the end of the course the student will be able to reflect on his or her reaction to and attitude towards the new (unknown) situation in Cuba (culture, language, healthcare system) and cultural lessons learnt during the stay.

In summary:
Objective 1: active introduction to Cuba’s public health oriented healthcare system (Learning objective 3)
Objective 2: scientific education (Learning objectives 1,2,4-6)
Objective 3: self-reflection regarding group collaboration and intercultural functioning (Learning objectives 7 and 8)

The student will demonstrate mastering the learning outcomes though:

  • A scientific oral presentation with a fellow student at the Global Health symposium in November(objective 1 and 2) (summative assessment); (Appendix I.1.4)

  • A scientific research proposal written in pairs before traveling to Cuba (objective 1 and 2) (summative assessment) (Appendix I.1.5)

  • Two individual reflection‐reports. Submitted before returning from Cuba (objective 3);

  • Skills during the fieldwork period (objective 2); (formative assessment) (Appendix I.1.3)

  • A scientific report, written in pairs, in which individual contribution is evident. (objective 2; for possible lay‐out see “rubric” in Appendix I.1.2).

*For objective 1: *you will familiarise yourself with the Cuban healthcare by:
focusing on one of the 10 health‐topics of the Cuba‐module: (1) Healthcare system (and privacy); (2) maternal‐and childcare; (3) elderly care; (4) alcohol‐ and smoking abuse; (5) mental health; (6)LGBTQ+; (7) Complementary and alternative medicine (medical plurality); (8) Gender and health; (9) Environment, climate and health; (10) Covid-19 .
In consultation with the teachers, the student may choose to focus on other topics that are relevant to the minor and in line with the learning objectives.

For objective 2 (scientific education): every pair conducts an in‐depth analysis of a subject within their health topic; individual contribution has to be visible. Maximum length of final report: 5000 words.
Elements of objective 2 Scientific education

  • Conducting a literature study prior to the fieldwork

  • Formulation of a research question

  • Setting up a research proposal

  • Conducting qualitative research through fieldwork activities in Cuba

  • Analysis and interpretation of results

  • Presentation of results orally and in a written report

Objective 3 (reflection, while the student is still in Cuba)

  • For the self-reflection on the role within the group the student may ask her/himself: What role did I take in the group? What did I learn about my role in the group? How did I positively and/or negatively contribute to the team? What stimulated me? What did I find less interesting (and why)? How dedicated was I and how dedicated were my colleagues? What was an eye opener for me and what consequences did that have? What items am I going to pay more attention to in the future? (maximum of 500 – 1000 words for each reflection report on role in group).

Applicable CanMeds competencies:
1. Medical expert (objectives 1,2 and 3): explain one aspect of the Cuban healthcare system ; focus is mainly on individual patients;
2. Communicator (objectives 1-2): cross-cultural attitude towards global health issues focussing on the Cuban healthcare system;
3. Scholar (objectives 1-2): literature search, research proposal, fieldwork skills; presentation skills; writing skills.
4. Manager (objectives 1-2): demonstrate how to set priorities and manage time effectively; discuss the individual, organisational and societal elements of Cuban health care issues;
5. Professional (objectives 1,2 and 3): recognize and respect different cultural values, recognize ethical issues within a global health context;
6. Collaborator (objectives 1,2 and 3): apply common methods to collaborate in small groups and as member of a larger team, contribute to group assignments.

Timetable

All course and group schedules are published on MyTimeTable.

The exam dates have been determined by the Education Board and are published in MyTimeTable.
It will be announced in MyTimeTable and/or Brightspace when and how the post-exam feedback will be organized.

Mode of instruction

Lectures and Research:
This module combines theory (classroom learning and self‐study – to be partly conducted online) and practical experience (observations, interviews, other fieldwork). Health topics of specific interest are:

  1. Healthcare system (and privacy)
  2. Maternal‐ and childcare
  3. Elderly care
  4. Alcohol‐ and drug abuse
  5. Mental health
  6. LGBTQ+ - Sexual and reproductive health & rights/HIV
  7. Complementary and alternative medicine (Medical plurality)
  8. Gender and Health
  9. Environment, climate and health
  10. Covid-19

Research question and research proposal:

  • to distil a new research question from a set of at least 5 articles. The question is clear, pertains to a very confined subject and might be answered by means of a simple research proposal and is the result of group discussions;

Data collection and analysis:
Data collection

  • to search for the relevant articles on a topic in Pubmed or another data base, helped by a brainstorm on relevant search terms in the domain;

  • if applicable: to search for information in other databases, or databases often used in the domain of the half minor;

  • to perform an empirical study within the field in Cuba (collection of data). Ethical issues are taken into account and described (see also below ‘Analysis’); to comment on the methods of research described in the protocol

*Analysis *

  • to perform a qualitative analysis and interpret the results; to take care that informant related information is made anonymous;

Discussion and Conclusion:

  • to discuss findings and draw conclusions regarding research topic and the relevance for future research from the fieldwork study and to weigh the relevance of the data thatthe student has collected

  • to pinpoint main issues in relation to the topic and to describe why the student considers certain issues to be secondary;

  • to relate the findings of his/her research to cultural and societal issues and discuss the implications;

  • to estimate the relevance of relevance of findings in relation to the (public) debate;

  • Writing/presenting skills:

  • to write a qualitive research proposal (approx.. 4000 words), which contains a research question that can be answered by literature minimum 5 (maximum about 8) high quality articles, but mainly data collection during the fieldwork in Cuba a description of the main steps of the proposal (that is operationalized in a concept matrix, a description of the methods uses and a justification of the methods used).

  • to present a topic (10-15 minutes per person). The presentation is structured on the IMRaD structure’, is coherent, the conclusions provide answers to the research question(s), is understandable and supported by effective power point slides;

  • to ask and answer questions which are directly connected to the presentation;

  • to use an academic register in writing and presenting.

Assessment method

**Overall assessment **

Your final grade consists of:

  • 20 % GH HM exam marks

  • 20% Research proposal (summative)

  • 60% Cuba marks, consisting of:
    o Fieldwork research skills (pass or fail - formative)
    o Scientific Presentation (2/5 of Cuba marks)
    o Scientific research report (3/5 of Cuba marks)
    o Reflection reports (pass or fail; if insufficient the student cannot pass and has to rewrite the report.)

To successfully complete the Half Minor Global Health Cuba, the final mark has to be a 5.5 or higher.

Retake of exam:
The knowledge test of the BC-GH module has to be retaken later in the year if the grade is lower than 5.5. The written research proposal and the written report have to be resubmitted if the grade is lower than 5.5. Retakes are scheduled by the module coordinator. There are no retakes of the oral presentation, with some special exceptions. Substitute assignments are exceptional. Failure of assignments, including the formative tests, might lead to obligatory repeat of the course in the following year.

Formative tests (pass/fail) of the BC-GH Cuba:
Formative (pass/fail) and summative

  • Presentation on one of the focus areas during preparation week, later in Cuba and at the Cuban embassy (duo, formative)

  • Scientific research proposal (duo, summative (with clear contribution by each team member) The research proposal need to be uploaded via Brightspace within indicated time periods. They will be evaluated in duos and general feedback will be provided. In addition, most of the comments will be discussed during lectures and/or scheduled meetings.

  • Oral presentation during final symposium– duo, summative (with clear contribution by each team member)

  • Weekly refection reports (individual, formative (first two weeks) and pass/fail (final week)

  • Fieldwork research skills (duo, formative. (with clear contribution by each team member) When applicable it will be possible to receive a bonus in the scientific research report.

  • Scientific research report (duo, summative (with clear contribution by each team member)

General active participation
Assessment: pass/fail
Assessed by: Minor coordinators
Assessment criteria: pro-active approach during the course, active participation within the working groups, capable and willing to ask appropriate questions during lectures and meetings, active participation by preparing the research design of peer students.

An Study Assignment can also be used by the coordinators as an alternative assignment in specific situations.

Reading list

You can find the complete reading list for the bachelor of Medicine here.

Registration

Information about the registration process can be found on the Brightspace course Half Minors.

Contact

Dr. Kirsten Langeveld: k.langeveld@lumc.nl

Remarks

For more information about this minor, please watch this video.