258 - Impacts of migrant health pathway participation during a global pandemic

Poster Number: 258
Publication Number: 258.419

Nandini Mandlik, UT Health San Antonio, San Antonio, TX, United States; Mia K. Vento, The University of Texas Health Science Center at San Antonio Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, United States; Rachel Pearson, 12/01/2020, SAN ANTONIO, TX, United States; Wisdeen Wu, The University of Texas Health Science Center at San Antonio Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, United States

Background: Challenges in global health are mirrored in the care of diverse migrant populations within US borders. Ideally, global health curricula guide learners at both local and global levels. Short-term electives abroad have been shown to improve medical knowledge and skills.

Objective: We explored how participation in a longitudinal pathway, rather than short-term single exposures, impacts attitudes toward care of a migrant child and recognition of parallels between local and international populations.

Design/Methods: This qualitative pilot study was developed with a conceptual framework of reflective practice.
The 2-year pathway was offered to rising PGY-2 pediatric residents. Due to travel restrictions, content relevant to migrant child health was adapted to include online videos and virtual meetings with local community partners (Center for Refugee Services and a faith-based migrant respite home). Using conventional analysis, de-identified open-ended responses from initial applications and post-pathway semi-structured interviews were independently coded by 2 expert pediatricians who did not develop the curriculum. Pre- and Post-curriculum responses were examined for attainment of personal educational objectives and changes in attitude.

Results: To date, 2 residents have completed the modified pathway. Themes identified were: confidence and insight into resources and systems, potential for local impact, culturally aware communication, career development, empathy and awareness of their own impacts. Analysis showed improved knowledge of: access to resources, health disparities, and cultural differences. We identified a positive direction change in attitude toward application of this knowledge to future practice and provision of equitable care, regardless of clinical context. This pilot study parallels impacts similar to qualitative studies of international electives despite lack of an abroad experience.Conclusion(s): Our curriculum resulted in improved knowledge and attitudes among participating residents. While implementation of pathway components into a busy resident schedule has been a complex process, and residents' feedback identified a need for more cultural exposure and hands-on patient care opportunities, they have enjoyed the online videos and modules. This pathway could, therefore, be replicated in any location with a large migrant population, with or without an international component. Based on this pilot, we will continue curriculum improvements with an overarching goal of creating lifelong child advocates.