P2B168: Evaluating Student Experiences from a Cross-cultural Virtual Elective Among US and Peruvian Medical Students

Background: Travel restrictions due to the COVID-19 pandemic necessitated changes in global health education activities. Multiple institutions and organizations have reported that a virtual platform provides favorable advantages, such as increased access to global health (GH) education and communication with partner countries. The CCC is a virtual GH elective between a medical school in the United States and a medical school in Peru. This elective was held annually from academic years 2020 to 2023 and featured monthly virtual sessions held in both English and Spanish to facilitate bidirectional learning about healthcare systems, culture, and barriers to care in the United States and Peru through large group didactics and small group discussions. We report the successes, challenges, and outcomes of CCC over three years.

Methods: Medical students from the US and Peru were enrolled in a longitudinal virtual elective. We administered pre- and post-elective surveys to students in the CCC elective in the students’ native languages. We evaluated students’ self-reported comfort with English or Spanish language skills (non-native language for each student), knowledge of health systems and global health, and cultural sensitivity through multiple choice questions and extended responses to case vignettes (scored using the validated Cross-Cultural Competence Instrument for the Healthcare Profession (CCCHP)). Additionally, we surveyed students about course efficacy in attaining the aforementioned objectives. Data collected included demographic information, self-assessments of learning objectives mastery, challenges students faced in the course, and cultural sensitivity competencies. We performed non-parametric statistical analyses to evaluate trends in survey responses among students before and after completion of the CCC within each year and will do so between each of the years.

Results: Over three academic years, 92 students participated in the elective (Figure 1). Participants reported increases in their understanding of competencies, with students from the US cohort having statistically significant increases in their self-reported understanding of the Peruvian healthcare and medical education systems compared to Peruvian students (p = 0.013). US students also had an increase in their cultural sensitivity scores, with statistically significant increases in the knowledge (p = 0.035) and motivation components (p = 0,031). The most frequently reported challenges encountered throughout the course included: additional assignments from other coursework and obligations, conflicts with the time of the sessions, and language barriers.

Conclusion: A cross-cultural virtual elective can be effective in teaching trainees about healthcare systems different from their own. It also can have a modest effect on improving some cultural sensitivity domains. Based on feedback, strategies to improve the course in the future include: reducing the course workload, improving engagement of leadership and survey participation from both countries, and teaching in bilingual languages.