Book Review: Where No Doctor Has Gone Before: Cuba’s Place in the Global Health Landscape

Where No Doctor Has Gone Before: Cuba’s Place in the Global Health Landscape

Robert Huish 

Waterloo, ON, Canada: Wilfrid Laurier University Press, 2013

156 pages. $31.65 USD

ISBN: 978-1-55458-833-6

Robert Huish, Assistant Professor at Dalhousie University, Department of International Development Studies, presents an overview of the Cuban health system, the Cuban medical education system, and the government’s effort to provide care beyond its borders.  This is a practical book that gives the historical background of how Cuba has survived decades of economic sanctions to become one of the world leaders in universal health care.  The author examines the different aspects of Cuban health care using credible evidence and a variety of sources including the author’s own experiences in Cuba learning how health care and medical education is delivered. 

The author seeks to show how the Cuban government views health care as a basic human right and refuses to compromise on their investment in human capital to provide primary care to all of its citizens.  The author delivers on this purpose by describing the historical background that led Cuba to use the model of training physicians to bring medical care to many outside of its borders.    

The first few chapters focus on the foundational aspect that health care should start at the community level with a focus on disease prevention and health promotion.  These chapters go into a rich and carefully documented amount of detail describing how health care is actually delivered, how Cuba has been able to use this model of care as a form of foreign policy, and how the country has benefitted from this focus on public health. There are also chapters dedicated to the concepts of Medical Tourism and Health Care Worker Migration.  Cuba’s approach to these topics has left positive imprints on many countries in the Caribbean and Latin America.   

The remaining chapters describe the Cuban medical education system, including the largest medical school in the world, the Latin American School of Medicine, or ELAM.  Medical education is discussed on a student level with multiple examples from student interviews that relate their experience of coming to Cuba to learn medicine for free. The only debt the students have is a moral one: a commitment to return to their countries and serve in the areas of most need.  Nevertheless, the author does not shy away from the challenges ELAM graduates face when returning to their native countries to practice. 

The author has written a very commendable book about how medicine, public health and international health blend together to meet the needs of thousands in Cuba. What is missing for me is how they use interprofessional health care teams as a model of care, a recent model of education for medical personnel.  This book was a pleasure to read. It would be perfect for those in medical education, public health, global health and primary care.  

The author ends the book with the five things he has learned from the Cuban health system.  This “top five” list, if you will, is a skillful reminder of the needs of global health and how a small island country has been able to use health care and education policy to make an impact in some of the worlds most underserved regions.   

Review by: Curt Stilp, Assistant Professor, Oregon Health & Science University

Summary: The use of information and communications technologies in the delivery of interprofessional education: A review of evaluation outcome levels

Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing; despite this, reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited.

A recent study by Vernon Curran and colleagues reviewed the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology.

Fifty-five studies were identified and a majority reported evaluation findings at level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities.

The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicates the need for more rigorous evaluation of outcomes in ICT-mediated IPE.

Read More: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1021002

Summary: Implementation of interprofessional learning activities in a professional practicum: The emerging role of technology

To prepare future healthcare professionals to collaborate effectively, many universities have developed interprofessional education programs (IPE). Till date, these programs have been mostly courses or clinical simulation experiences. Few attempts have been made to pursue IPE in healthcare clinical settings.

A recent pilot study in four healthcare settings by Isabelle Brault and colleagues addresses interprofessional learning activities (ILAs) implemented during students' professional practicum, and discusses the actual and potential use of informatics in the ILA implementation. Analysis was conducted based on focus group interviews with trainees, clinical supervisors, ILA coordinators, and education managers. 

Overall, ILAs led to better clarification of roles and understanding of each professional's specific expertise. Informatics was helpful for developing a common language about IPE between trainees and healthcare professionals; opportunities for future application of informatics were noted. 

The study results support the relevance of ILAs and the value of promoting professional exchanges between students of different professions, both in academia and in the clinical setting. Informatics appears to offer opportunities for networking among students from different professions and for team members' professional development. The use of technology facilitated communication among the participants.

Read More: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1021308

Summary: Interprofessional mental health training in rural primary care: Findings from a mixed methods study

The benefits of interprofessional care in providing mental health services have been widely recognized, particularly in rural communities where access to health services is limited. There continues to be a need for more continuing interprofessional education in mental health intervention in rural areas. There have been few reports of rural programs in which mental health content has been combined with training in collaborative practice.

This study by Heath and colleagues used a sequential mixed-method and quasi-experimental design to evaluate the impact of an interprofessional, intersectoral education program designed to enhance collaborative mental health capacity in six rural sites. Quantitative results revealed a significant increase in positive attitudes toward interprofessional mental health care teams and self-reported increases in knowledge and understanding about collaborative mental health care delivery. The analysis of qualitative data collected following completion of the program, reinforced the value of teaching mental health content within the context of collaborative practice and revealed practice changes, including more interprofessional and intersectoral collaboration.

This study suggested that imbedding explicit training in collaborative care in content focused continuing professional education for more complex and chronic health issues may increase the likelihood that professionals will work together to effectively meet client needs.

Read More: http://informahealthcare.com/doi/abs/10.3109/13561820.2014.966808

Summary: Assessing interprofessional competence using a prospective reflective portfolio

The assessment of interprofessional competence or capability following interprofessional education (IPE) remains essential if we are to ensure future practitioners who are able to work in teams and collaborate for improved health outcomes. Any IPE curriculum must design and describe its theoretical stance and this also applies to how learning will be assessed.

A recent study by Sezer Domac, Liz Anderson, Michelle O'Reilly and Roger Smith addressed the use of an IPE portfolio by students across 10 professions as a flexible framework for students to demonstrate their learning. Using a qualitative approach, the completed portfolios of a proportion of students from medicine, social work, and speech and language therapy were read, and a sub-set of students were interviewed to gain their perceptions of this assessment process. 

The study highlights how emotional and cognitive learning triggers lead to new understandings for collaborative practice reached only because students were able to reflect on their experiences. The portfolio is now summative and includes other assessment components.


Read More: http://informahealthcare.com/doi/abs/10.3109/13561820.2014.983593

Book Review: Methods in Psychological Research

Methods in Psychological Research (3^rd Edition)

Annabel Ness Evans & Bryan J. Rooney. Thousand Oaks, CA: Sage, 2014

415 pages, $101.95

ISBN 978-1-4522-6104-1

Annabel Evans and Bryan Rooney, both professors at Concordia University College of Alberta, Department of Psychology, present an introduction to the foundational concepts of research methods in psychology.  In this introductory textbook, the authors have written a user-friendly and engaging account of core research concepts.  Topics are elucidated via a relaxed conversational style, and the reader is encouraged to apply ideas by linking them to common every-day scenarios.  The authors promote applicability by incorporating examples of specific research projects from not only professionals in the field of psychology, but also student research projects.  Thus, they see students as not only learners of research, but as active and resourceful participants in the research process itself.  In this way, the often intimidating world of research methods is transformed into a more accessible framework.

As the primary goal of this textbook is promoting an engaged understanding of the research process, the authors have cogently organized the topics to build upon each other.  Encompassing fourteen chapters in total, the first four explicate the fundamental tenets of research, including a general introduction, the literature review, ethics, and hypothesis formulation.  Chapters five through eleven focus on the specifics of methodology, such as the use of psychometric tests to operationalize and measure variables (including a discussion on reliability and validity), sample selection, different types of experimental designs, nonexperimental approaches, and data collection methods.  Finally, the textbook concludes with three chapters delineating the practical application of research methodology in the discipline of psychology.  These topics include program evaluation, archival research, meta-analytic designs, devising and implementing research projects, and written communication.

In addition to the flow of topic organization, each chapter follows a similar format.  Chapters begin with an outline of objectives, and these are subsequently reviewed in ordered detail.  Each chapter is also peppered with a variety of conceptual exercises to promote proactive learning, and the authors provide answers to these at the end of the chapters, allowing students to check their ideas relative to the authors’ ideas.  In line with the collaborative spirit of the book, they advise that differing conclusions do not necessarily indicate misunderstanding of the material.  Additionally, each chapter has practical features that are not always found in textbooks.  Perhaps most distinctly, FAQ sections are included where the reader will find common questions that the authors have been asked, and these are answered as they would have been in a classroom setting.  Finally, chapters conclude with a list of additional exercises (this time without answers so that professors may use them as assignments), potential student projects, and ancillary online learning resources related to the chapter topic.

Overall, Evans and Rooney have compiled an accessible yet thorough addition to the area of research methodology education.  It is a practical option for those interested in attaining an introduction to research methods, and I readily recommend it to both students and educators alike.

Review by: Rosita Sabzevari, Concordia University College of Alberta