Monday Begins INMED’s 25th International Medicine And Public Health Course

August 19th, 2016 by Nicholas Comninellis
Posted in INMED Action Steps For You|

matt-cook

 

A dearth of accessible international health academic resources existed when we launched INMED in 2003. Sure, one who attend the Liverpool School of Tropical Medicine & Hygiene. But this required tens of thousands of dollars, plus six months living in the UK. Therefore, one of our first INMED priorities was to create quality, low-cost, readily accessible academic learning opportunities to complement the field experiences we already offered in developing nations.

 

First we introduced the INMED Self-Paced Courses in the major global health subjects. Under Micah Flint’s inspiration  we consolidated these into the comprehensive INMED International Medicine & Public Health Course, launched in 2009. Since then, some 450 individuals have earned the INMED Academic Qualification in International Public Health or the  INMED Academic Qualification in International Medicine & Public Health. And, the courses are now available at academic centers in Los Angeles, Long Island, Pittsburgh, Kansas City, Dallas/Fort Worth, and China.

 

Monday begins our 25th offering of the INMED International Medicine & Public Health Course, hosted by AT Still University at Kirksville College of Osteopathic Medicine. Matt Cook was a student in the 2015 course, and via Facebook penned this glowing recommendation for his classmates. Thanks Matt!

INMED Counts By The Numbers

August 12th, 2016 by Nicholas Comninellis
Posted in INMED Action Steps For You|

2007_emmc_attendees

 

We at INMED are all about personal accounts. We emphasize stories both of people in great need who are assisted with compassion and expertise, and people whose lives are transformed through personal sacrifice and service on behalf of our world’s most impoverished. Just consider for a moment the experience of Scott Biggerstaff, INMED student serving in Uganda this summer.

 

Numbers also help to communicate the extent of personal accounts. Since 2004…

• 4417 have participated in an INMED Humanitarian Health or Exploring Medical Missions Conference

• 1079 took part in an INMED Cross-Cultural Health or Disaster Management Symposium

• 442 graduated with an INMED Diploma or Certificate, including serious service among the poor

• 500 took part in an INMED Hybrid or Intensive Course

• 235 became Helping Babies Breathe Facilitators

• 114 participated in an INMED Ultrasound for Primary Care Course

• 449 took advantage of an INMED Self-Paced Online Course

 

Each number represents real people, both those served and those who are serving. Scott Biggerstaff helps us all to keep this truth at the forefront: “I cared for a patient on Friday with AIDS and pneumonia, and today I evaluated a stroke patient and an AIDS/tuberculosis patient with a spontaneous pneumothorax. Sick dudes. The ‘normal’ pathology out here is stuff fit for case reports in medical journals. I have just a few days left – hopefully tomorrow I’ll be able to join the community team and see some of the pubic health (disease prevention) outreach activities.”

 

Teaching Excels Your Profession

August 5th, 2016 by Nicholas Comninellis
Posted in Healthcare Education|

learning-pyramid

 

Does teaching help health-care professionals be better practitioners? Subjectively, most would agree this is true. But until now, few studies have provided a research basis for this assertion.

 

Research recently published in Medical Teacher set out to test this proposition using multi-source feedback (MSF) from large groups of diverse healthcare professionals. MSF data for 1831 family physicians, 1510 medical specialists, and 542 surgeons was obtained from physicians’ medical colleagues, co-workers (example: nurses, pharmacists), and patients, and evaluated in relation to information about these physician’s teaching activities – including proportion of time spent teaching during patient care and academic appointments.

 

Multiple statistical measures were used, leading to the observation that higher clinical performance scores were associated with holding any academic appointment, and generally with any time teaching versus no teaching during patient care. This was most evident for data from medical colleagues, where these differences existed across all specialty groups.

 

The study’s authors concluded that greater teaching was associated with higher clinical performance. “These results,” they wrote, “may support promoting teaching as a method to enhance and maintain high-quality clinical performance.’

 

These finding also resonate with the well-known ‘Learning Pyramid’ model, which shows that teaching any subject results in an 80% retention rate of the subjects itself – higher than any other common learning activity.

 

What’s the take away? See one, do one, teach one really does work!

 

INMED Graduates First Students In China

July 29th, 2016 by Nicholas Comninellis
Posted in Healthcare Education, INMED Training Sites In Action|

2016 Shenyang IMPH Course Participants CMU1

 

A long-term INMED vision has been to expand our Course offerings to outside of the United States. Over the years South Africa, Australia, and India were considered locales. Last October the prospects brightened when   LIGHT offered to host this complex learning event in the city of Shenyang, NE China. LIGHT has served INMED as a Training Site since 2004.

 

Given the fact that English is a second language for most students, we doubled the online section of learning from ten weeks up to twenty. Thirty-three students began, and twenty-five successfully completed the INMED International Medicine & Public Health Hybrid Course, which climaxed on July 18-19 with 2 days of in-classroom skills and exams at Shenyang’s China Medical University Number One. How fascinating to see the live cross-cultural interaction of out students from China (10), Africa (10), India (2), and US (3). Several said to me how they especially appreciate receiving feedback on their weekly assignments, which is new in their university experience. Watch for the next INMED Course coming to China later this year.

 

Chinese Serving The Entire World

July 22nd, 2016 by Nicholas Comninellis
Posted in INMED Grads In Action|

edgar-wu

 

“We Taiwanese are an island people; citizens of the sea. We are comfortable going everywhere.” Let me introduce you to Edgar Wu, here receiving his INMED Academic Qualification in International Medicine & Public Health. Edgar is one of the most fascinating of the thirty-three students to took advantage of this 2016 Course offering in China. Originally from Taiwan, Edgar moved to Beijing seven years ago to pursue medical education. In the process, he not only developed astute clinical skills, he also gain a vision for the entire world – especially those who are impoverished.

 

China, like the United States, contains regions of profound poverty. But Edgar’s particular passion is to serve those most penniless. In this quest, Edgar has made journeys to western China, the Middle East, and to southern Asia. He’s recently decided to focus his career on providing care in Cambodia – a locale to where he’s been serving with LIGHT, the Liaoning International General Health Trainers. Freshly graduated from INMED, I came across Edgar diligently pursuing his next challenge: mastery of Khmer – the dominate language in Cambodia.

United States Trailing In Global Humanitarian Responsiveness

July 15th, 2016 by Nicholas Comninellis
Posted in Disaster Management|

drink-of-water

 

International humanitarian response to recent large-scale disasters is widely regarded as unnecessarily inadequate, especially in light of advancements in disaster management understanding and available response resources. This unnecessary inadequacy is manifested in several forms: 1. Insufficient rapid assessment of disaster status and immediate relief needs prior to emergency response, resulting in frequent interventions that are inappropriate, 2. Poor communication and coordination between disaster responders, resulting in both duplication and omission of critical response elements, 3. Insufficient basic skills among disaster responders, resulting in under par acute injury and disease management, sanitation and preventive health measure, and provision of essential human needs (shelter, water, food, reunification), 4. Host government’s failure to recognize the skill, preparation, and capacity of EMTs (Emergency Medical Teams), resulting in denial of entry and participation of these EMTs that have potential to provide significant aid, 5. Insufficient attention to post-disaster on-going healthcare needs, infrastructure rebuilding, and disaster prevention, resulting in post-disaster epidemics, hunger, and recurrent disaster.

 

In response to these enumerated inadequacies, the WHO at the May 2016 World Health Assembly announced the process of developing and launching internationally-recognized EMTs as a critical component of rectification. At the time of this writing, over 64 nations have either launched or are developing accredited teams to provide surge support to nations by delivering emergency clinical care to sudden-onset disasters and outbreak-affected populations. Neither the United States government nor large-capacity US based NGOs have yet committed to adopting the EMT concept, leaving our nation of altruism on the sidelines of this critical international humanitarian development.

 

Reasons for this lack of progress stem from issues of funding and of leadership. The US Government continue to struggle to find funding for high-profile Zika concerns, let alone equipping EMTs. Similarly, funding of NGOs is crisis centered, rather than anticipatory such as is required for EMTs. Parallel to these funding concerns, organizational leadership, however well intended, is largely driven by funding and urgently felt needs – rather than by the future-oriented prospect of EMTs role.

 

What will be the United State’s response to trailing other nations in global humanitarian responsiveness?

 

Honesty And Truth Telling Within Chinese Healthcare

July 8th, 2016 by Nicholas Comninellis
Posted in Cross-Cultural Healthcare Pearls|

masked-faces

 

Astute observations from Eva Holsinger, my pediatrician colleague here in northeastern China: “Do you want your doctor to tell you everything, right away, as soon as she knows something bad is coming at you? Take it another step: who do you want the doctor to tell first: you, or your family? In the US and other places like northern Europe, the answer to the former is umm maybe now but for sure eventually, and the second one is not even a question with HIPAA laws and all the other ways we strive to protect our privacy.

 

“My experience here in China has been vastly different. From our early days in 2009 we quickly heard about how often serious diagnoses are not disclosed to the patient, but to the other relatives, and they decide when and if to tell the patient. Of course I was aghast and fumed about patient autonomy, rights, lying to the patient, and more. There are many questions surrounding this that I can’t begin to answer, beginning with how..and why…and what on earth…and strong adjectives that I might quickly jump to using like insufferable and paternalistic.

 

“However… A friend was telling me about her father’s recent diagnosis with advanced lung cancer, and how she and her sister want to tell him but their mother does not. The mother has declined chemotherapy for him and they are telling him that his illness cannot be cured but he should eat healthy foods and take good care of his health. Every weekend the three adult kids come home with their families and have a good family time together. The dad says he didn’t have it so good until he got sick. She is pretty sure he suspects.

 

“My friend says they will go along with their mother because she will be around a lot longer and they don’t want to upset her too much since they have to deal with her. As we talked and she described their family’s situation I had a sudden a-ha moment. In the Chinese culture parents take care of children when they are young, and the expectation is that the children will take care of the parents when they are old and/or sick. In addition, major decisions about a young person’s life-college, career, spouse-are often all made by the senior decision makers in the family. When they age, the roles are flipped to some degree.

 

“In the US a big deal is made about living wills, health care power of attorneys, DNR statuses. We entrust our decision making to our designated loved ones only at the very end of the journey when we can’t make the decision ourselves. I wonder if the same choice is made but much earlier in the process here-at the beginning of the diagnosis, not at the end of life.

 

“There is an element of trust that seems very deep-trusting that your spouse and children will do their utmost to decide what is best but not only for you but for the family as a whole. I may not necessarily agree with that method in every regard, but that doesn’t mean it is less valid than my western perspective. Can family members be loving, honest and truthful without the element of naked and complete disclosure that we value so much in the west? Can doctors work within this system and still make sure that the needs of the actual patient are met appropriately?

 

“These are some of the bigger cross-cultural issues we are grappling with as we, a group of western-trained doctors, attempt to teach and mentor a group of young Chinese physicians.”

 

Join the INMED Course At Massachusetts General Hospital!

July 1st, 2016 by Nicholas Comninellis
Posted in INMED Action Steps For You|

cranmer-endorsement

 

We must do better at doing good was the overwhelming evaluation of organizations responding to Haiti’s earthquake. Massachusetts General Hospital (MGH) Global Health, Harvard Humanitarian Initiative, Heart to Heart International, among others, are working in partnership with INMED to substantially improve the quality of both disaster response and sustainable community health improvement.

 

An essential element of doing better at doing good is you – the person who steps forward into such laudable service. Right now INMED is offering several opportunities to enhance your effectiveness via the INMED International Medicine and International Public Health Hybrid Courses. The 2016 Boston MA Courses are hosted by MGH and begin online Monday July 4, with in-classroom on Sep 16-18. Also starting very soon are identical INMED Courses in Glendale CA, Pittsburgh PA and Long Island NY. Please join in!

Lana Borden Teaching Nursing in Zambia

June 23rd, 2016 by Nicholas Comninellis
Posted in Healthcare Education, INMED Grads In Action|

borden-lana-zambia

 

In 2013 Lana Borden, an RN from Kansas City’s Children’s Mercy Hospital, we recognized with the INMED Diploma in International Public Health, which included her formative service-learning experience at Mushili Health Center in Zambia, southern Africa.

 

“In January I was in the Copperbelt area of Zambia again,” says Lana “to visit nursing colleges and interview for professorship. A private college called Nkana wants me to return for an internship as a sort of working interview and orientation process with the dean of nurses. I would be working alongside 6 other nursing “tutors” to train about 350 students through their three year nursing program. This was just the sort of thing I was hoping to do, as I believe the impact of training the next generation of nurses from the beginning of their studies will have an exponential effect on healthcare in Zambia. Doctors are scarce, especially in rural areas, and nurses are often the primary healthcare providers in their communities. INMED’s public health program was instrumental in getting me started on this journey.

 

“As a Christian and missions-minded nurse, I am excited at the opportunity to earn a living in the country I’ll be serving, although some may think it unusual. It is similar to the way the apostle Paul was able to generate income with his tent making trade as he traveled abroad and shared the gospel. It will be a challenging endeavor, but I am excited for what may be to come.”

 

Transformation In Healthcare Education

June 10th, 2016 by Nicholas Comninellis
Posted in Healthcare Education|

blooms-taxonomy

 

Paul Larson, INMED Faculty and family medicine instructor at the University of Pittsburgh, notes how in 1956 Benjamin Bloom and collaborators developed a framework for classifying educational objectives. This image describes categories of behavioral learning of increasing cognitive complexity. In its most primitive form, learning is confined to recitation. With increasing maturity, learning expands toward application of what is learned, analysis of the validity of that information, and even to creation of new information.

 

This model of understanding has lead to tremendous shifts in healthcare education; moving the field from knowledge-orientation toward competency-accomplishment. Associated with this transformation has been the role of the teacher. She or he is no longer simply a source of information, but rather one who facilitates learning through creation of effective learning opportunities. Hence, the Bloom’s Taxonomy impacts both the Learner and the Teacher.