Original Publication
Open Access

Refugee Health Elective

Published: July 1, 2013 | 10.15766/mep_2374-8265.9457

Included in this publication:

  • CUSOM Course Outcomes.pdf
  • Confidence Competence Survey.pdf
  • Final Course Evaluation.pdf
  • Instructor Guide.pdf
  • Refugee Health Curriculum.pdf
  • Session 1 Refugee Health Resettlement Programs in the U.S..pptx
  • Session 4 Medical Care of Refugees.ppt
  • Session 6 Common Oral Health Problems of Refugees.ppt
  • Session 7 Refugee Mental Health.ppt
  • Session 8 Culturally Effective Medicine.pdf
  • Session Evaluation.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

World disasters, conflicts and persecutions have resulted in growing refugee populations worldwide. According to the Colorado Department of Human Services, the U.S. admitted 80,000 refugees in 2011, 2,534 of which were anticipated to resettle in Colorado. In 2008, Florida received the largest number of arrivals, followed by California, Texas, New York, Michigan, and Arizona. Future medical professionals will need to be trained to provide culturally effective care to this population.

This curriculum is designed to introduce medical and other health professions students to the common medical, dental, and psychosocial issues faced by refugees in the United States. Each of the eight topics is presented in a one-hour session, in either a lecture or a panel presentation format.

The sessions include (learning objectives for each session provided in document titled “Refugee Health Curriculum"):

Intro: Refugee Health and Resettlement Programs in the U.S. (lecture)
My Life As a Refugee (panel)
Refugee Resettlement in the U.S. (panel)
Medical Care of Refugees (lecture, case presentations)
Refugees and the Healthcare System (panel)
Common Oral Health Problems of Refugees (lecture, optional oral exam demonstration)
Refugee Mental Health (lecture)
Challenges and Ethical Dilemmas of Providing Culturally Effective Care (lecture and group discussion)

At the University of Colorado School of Medicine, this elective was originally offered to first- and second-year medical students. However, all health professions students would benefit in some way from the topics presented.

Speakers were recruited from local clinics, resettlement agencies, and refugee populations to give presentations and discuss the various topics. Each had a presentation or case from their personal experience with refugees; the panelists discussed their work and obstacles to providing optimal resettlement or medical care to refugees. The refugees themselves described their own backgrounds to the extent they felt comfortable with, and relayed their experiences with healthcare in the United States.

The attached resources provide goals, assessment questions, and a suggested time frame for each session. The submission as a whole is intended to be used as a resource and outline for other institutions who wish to implement a similar curriculum. Presentations are included as samples of what speakers at our university discussed. However, many topics covered in this course are very dependent on the local economic, geographic, and demographic factors. They would best be presented by local professionals who have experience with the needs of the refugee population in their area. For example, one of the problems that refugees face in Colorado is the difficulty in finding transportation. In a different area, like New York City for instance, housing might be a bigger problem. Therefore, we present this curriculum as a skeleton and sample resource for other institutions, with the intent of encouraging the education of health care students and professionals on the unique aspects of providing quality care to refugees.

Students were asked to evaluate three measures on a 4-point Likert scale (1= strongly disagree, 2= disagree, 3= agree, and 4= strongly agree). Twelve students completed the course during its first semester. The results are as follows:

“I know more about refugee health care than before I started this course.” Mean= 3.89
“I believe this elective provided me with tools to provide culturally competent care.” Mean= 3.50
“This course will benefit my future medical practice.” Mean= 3.63

From the qualitative data gleaned via individual sessions and overall course evaluations, students were eager to get involved in refugee clinics and resettlement agencies. The next step will involve creating a service-learning experience that will benefit the refugee population and further prepare health professions students to provide culturally effective care.

(Please see the document titled, “CUSOM Course Outcomes” for more detailed results. Please see the document titled, “Instructor Guide” for a discussion of the lessons learned and suggested improvements.)

Educational Objectives

Overall Goal: To provide medical students with a foundational knowledge of the medical, dental, and psychosocial issues facing refugees, in order to improve the care of this culturally diverse population.

Session Goals:

Intro: Refugee Health and Resettlement Programs in the U.S.

  1. To recognize the definition of "refugee" and the circumstances that lead refugees to the United States.
  2. To describe the difference between a refugee and an immigrant.
  3. To describe the various refugee populations represented in your city and/or state.

My Life As a Refugee

  1. To describe the refugee experience of moving to and living in the USA from the perspective of a refugee.

Refugee Resettlement in the U.S.

  1. To identify the local and/or state agencies that are involved in resettling refugees.
  2. To describe the barriers refugees face when integrating into the community.

Medical Care of Refugees

  1. To identify common physical ailments affecting refugees.
  2. To describe special issues common to refugees that may affect physical and emotional health.
  3. To identify the major medical illnesses that refugees should be screened for.

Refugees and the Healthcare System

  1. To describe the barriers refugees encounter in accessing healthcare.
  2. To examine the limits encountered by healthcare professionals who care for refugees.

Common Oral Health Problems of Refugees

  1. To describe common dental problems refugees face.
  2. To perform a basic oral screening (If screening is taught).

Refugee Mental Health

  1. To describe the common psychological issues affecting refugees, such as PTSD, abuse, and rape, and how these are affected by moving to a new country.
  2. To identify the mental health resources that refugees have access to.

Challenges and Ethical Dilemmas of Providing Culturally Effective Care

  1. To describe methods to address ethical dilemmas when conflicts arise between your own beliefs and those of the refugees.
  2. To discuss the challenges students will face in providing culturally effective care and the rewards of knowing how to approach these challenges with the goal of providing the best healthcare possible.

Author Information

  • Helenka Stone: University of Colorado School of Medicine
  • Ray Choi: University of Colorado School of Medicine
  • Eva Aagaard, MD: University of Colorado School of Medicine
  • Paritosh Kaul, MD: University of Colorado School of Medicine
  • Jennifer Gong: University of Colorado School of Medicine
  • Daniel Savin: University of Colorado School of Medicine
  • Barbara Hummel: Colorado Department of Public Health and Environment
  • Brandie Andrews: Happy Teeth
  • Jamaluddin Moloo: University of Colorado School of Medicine
  • Anastasia Petkova: Happy Teeth

Disclosures
None to report.

Funding/Support
None to report.



Citation

Stone H, Choi R, Aagaard E, et al. Refugee health elective. MedEdPORTAL. 2013;9:9457. https://doi.org/10.15766/mep_2374-8265.9457