Implementing a Practical Global Health Curriculum: The Benefits and Challenges of Patient-Based Learning in the Community

Seema Biswas, Nathan T. Douthit, Keren Mazuz, Zach Morrison, Devin Patchell, Michael Ochion, Leslie Eidelman, Agneta Golan, Michael Alkan, Tzvi Dwolatzky, John Norcini, Igor Waksman, Evgeny Solomonov, A. Mark Clarfield

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Background: A growing number of medical schools across the world have incorporated global health (GH) into their curricula. While several schools focus GH education on lecture-based courses, our premise is that global health education should embody a holistic approach to patient care and medical education in local communities. Medical students may learn global health by focusing on real patients, their families and communities as part of a practical curriculum. Aims and Objectives: A unique GH curriculum was devised to compare student learning outcomes on a practical vs. lecture-based course. The premise was that learning from patients would result in a greater breadth of coverage of the global health syllabus as compared to that from a lecture-based course. Methods: A teaching and learning program was developed over 3 years to provide medical students interaction with real patients in the community on a first-preclinical-year Introduction to Global Health and Medical Anthropology course. Learning outcomes on the practical vs. lecture-based course were compared using thematic analysis of the written assignments of both courses: global health case reports and literature reviews, respectively. All members of three cohorts of students undertaking the course in successive academic years were compared (Group A: literature review; Groups B and C: case reports; n = 87). Results: Case reports provided evidence of a greater breadth of learning outcomes when compared to the literature review (p < 0.001). The writing of the case report was enhanced by completion of a field journal and family health needs assessment tool (p < 0.001). Students demonstrated a closeness to their patients that added depth, understanding and motivation to assist patients in health activities and advocate for their needs. Discussion: Placements with patients in the community provided students with a rich learning environment and facilitated the formation of relationships with patients to better understand the social determinants of health and advocate for improvements in their living and working conditions and access to healthcare. Conclusions: Global health may be better learned experientially by following patients rather than from frontal lectures. Patient-based learning inspires a commitment to the individual and facilitates medical schools in meeting their obligations to the communities they serve.

Original languageEnglish
Article number283
JournalFrontiers in Public Health
StatePublished - 17 Jul 2020

Bibliographical note

Publisher Copyright:
© Copyright © 2020 Biswas, Douthit, Mazuz, Morrison, Patchell, Ochion, Eidelman, Golan, Alkan, Dwolatzky, Norcini, Waksman, Solomonov and Clarfield.


The authors would like to thank the patients, their families, the students (including the GHML volunteers), social workers, clinicians, tutors, and university staff who developed and facilitated the practical placements on the global health course. Funding. This work was supported in part by funding from Ben-Gurion University of the Negev for SB's Ph.D. thesis work.

FundersFunder number
Ben-Gurion University of the Negev


    • global health
    • global health competencies
    • medical education in the community
    • patient-centered curriculum
    • social determinants of health


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