Pre-exchange training - Developing ethical and cultural competencies in medical students

Background: The International Federation of Medical Students' Associations (IFMSA) organizes over 15,000 international medical exchanges per year in over 100 countries. In the past, there was no standardized Pre-Departure Training (PDT) for participants. A PDT is important to protect patient safety and prepare students for their exchange. Objective: To determine whether a two-hour case-based Pre-Departure Training can increase self-reported level of comfort on competencies in basic medical ethics, cultural competence, research ethics, and recognizing the limits of one's level of skill in medical students. Methods: In 2017, the PDT was implemented in nine countries for medical students prior to their IFMSA exchange. Participants self-evaluated their competencies in an online questionnaire before and after the PDT. Results: 234 students from 32 countries completed the pre-PDT evaluation and 104 completed both evaluations. Participants demonstrated statistically significant improvements in self-reported competencies in 16 out of 18 items including voicing lack of skill to a supervisor (p < 0.001) and recognizing personal cultural biases (p < 0.001). Conclusions: A case-based PDT can improve participants' self-reported comfort in treating patients from different cultural backgrounds and help maintain high ethical standards abroad. The PDT was implemented at large within IFMSA in 2018.