Perceptions and Expectations of Host Country Preceptors of Short-Term Learners at Four Clinical Sites in Sub-Saharan Africa

Abstract

Objective: The demand for global health electives among medical students and residents has grown substantially, yet perspectives of international hosts are not well documented. This study aimed to assess how host country supervising clinical preceptors perceive learners on short-term global health electives of up to 6 weeks.

Methods: This study used a cross-sectional survey design and assessed international clinical preceptors' perceptions of short-term learners' (STLs) professional behaviors, medical knowledge, competency in systems-based care, as well as the benefits and burdens of hosting STLs. Surveys were sent to all clinical preceptors (n = 47) at 4 clinical sites in sub-Saharan Africa in 2015.

Results: Thirty-two preceptors (68%) responded to the survey. Most respondents (97%) were satisfied in their role hosting STLs and reported that STLs enhanced patient care and the professional image of the clinical site. Nearly half of respondents (45%) reported decreased self-perceived efficiency in clinical care tasks. Qualitative data identified concerns related to STLs' professionalism and teamwork. Respondents also identified knowledge gaps in understanding differences in health systems and epidemiology in host country settings. Respondents preferred that rotations last at least 4 weeks and that STLs complete predeparture training.

Conclusions: STLs were largely positively regarded by international host clinical preceptors. To improve mutuality of benefits, sending institutions should ensure learners understand host country expectations of professionalism and that learners are well prepared for medical, ethical, and cultural challenges through participation in predeparture curricula that prepare them clinically and emotionally for these international experiences. Rotations of at least 4 weeks may enhance benefits to learners and hosts.

Keywords: clinical electives; clinical preceptors; global health; medical education; residents; sub-Saharan Africa.