Mayan Medical Aid
Clinical Elective
Photo: Mayan Medical Aid
If this elective is not the best global health elective in the world, we don't know which one is. It provides everything a global health experience could hope to provide.

Participants become impressively mature and competent as they both learn the importance of ethical and moral behavior and rapidly switch from one needed task to the next: a) communicating in Spanish with patients and interpreters, b) carefully taking patient histories in Spanish, and c) collaborating with the attending physicians in both Spanish and English to establish correct diagnoses and to implement the most culturally appropriate therapy.

It is an exciting and focused training experience in the provision of medical care to patients of a different culture, with an emphasis on health-related service to poverty-stricken patients, Spanish-language acquisition, and cultural education. Participants also learn the necessity for flexibility and adaptability, as well as the need to learn by example from prior, daily experiences.

Educational Goals and Objectives:

1. Patient care

• Learn how to deliver compassionate and quality care for patients of a different culture, in which cost and limited resources are major issues

• Take part as a supervised, hands-on participant in the development of appropriate management plans for common medical problems encountered in a rural clinic

• Demonstrate appropriate knowledge, attitudes and skills in the delivery of culturally sensitive care

• Develop a genuine concern for Latin American patients and their terrible misfortune of having to suffer the social, health, and economic inequities associated with poverty and a dysfunctional, government-guided health care system

• Learn how to approach patients by using a logical progression from general knowledge to specific conclusions

• Gather information primarily (no shadowing), based on skill levels

• Interact directly with patients and become their cultural and clinical advocates

• Manage patient encounters, numbering approximately 40-60 per week, per participant

2. Medical knowledge

• Build upon existing medical knowledge through exposure to a different patient population

• Improve medical communication in Spanish

• Observe procedures commonly completed by primary care physicians under the direction of the attending physician

• Participate in a reiterative process in which what participants learn in the didactic sessions, they practice in the clinical setting

• Realize the success of this method by the end of the elective, in which all hard-working participants, even if they arrive to the program with little or no prior Spanish or clinical knowledge, are able, with appropriate supervision, to evaluate and participate in the treatment of patients - all on their own and all in Spanish

3. Practice-based learning and improvement

• Learn to rapidly access, analyze, and assimilate information relevant to clinical diagnosis and decision-making in a rural clinic (Note: participants are not the responsible medical providers.)

• Develop the skills to rapidly switch from one needed task to the next: a) communicating in Spanish with patients and interpreters, b) carefully taking patient histories in Spanish, and c) collaborating attending physicians in both Spanish and English in order to perform physical examinations, to utilize obstetrical ultrasound, to arrive at correct diagnoses, and to implement culturally appropriate therapy

• Use clinical examples – all of which are culled from participants' daily experiences – to demonstrate the different ways in which patients of a different culture perceive illness, life, and health care

• Discuss why Latin American patients answer "yes" to the same questions, which patients of our own culture would answer "no"

• Acquire the skills to ask questions of patients with more clarity and without the use of English slang words, which, too often, participants use without even considering that the words they use are slang and, therefore, are not able to be translated to Spanish

4. Interpersonal and Communication Skills

• Improve communication skills while better understanding cross-cultural issues, including social, economic, and environmental factors that influence health

• Function as a supervised, participating member of a multidisciplinary health care team

• Demonstrate appropriate knowledge, skills, and attitude in integrating the psychosocial aspects of diagnosis and therapeutics in the primary care setting

• Learn effective communication skills with patients of a different culture, families, professional colleagues, and ancillary staff

5) Language Training

• Integrated, actual and supervised patient encounters - no shadowing

• Electronic charting in Spanish

• Debriefing sessions

• Cultural and language lecturers

• Electronic and paper educational materials

• Interactive Internet learning tools

• 10-20 social, medical, and cultural interactions per day

6. Professionalism

• Maintain high professional standards in interacting with patients, families, colleagues, and other health care professionals

• Respect differences in belief systems, cultural and ethnic backgrounds, values, and personal preferences encountered among patients of a different culture

7. Systems-based Practice

• Compare and contrast system-based practices in the global health arena with U.S. health care

• Work as a supervised, participating member of the interdisciplinary team in ensuring optimal care of patients of a different culture

• Become an integrated, supervised participant – no matter the participant's prior educational background – fully into the process of the systematic delivery of health care to a very needy population
Craig A. Sinkinson 2016
Medical Spanish
Cultural Learning
Clinical Elective
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