摘要：Background: Clinical training in low-income countries has become increasingly popular among pre-licensure trainees
from high-income countries. The Working Group on Ethics Guidelines for Global Health Training (“WEIGHT Guidelines”)
were designed to identify and inform the complex and contentious field of international clinical education. The purpose
of this study was to use the WEIGHT Guidelines to evaluate an international clinical internship programme for Master’s-level
rehabilitation students at a Canadian university.
Methods: In-depth, semi-structured interviews were conducted with eight Canadian rehabilitation researchers, educations
and/or clinicians responsible for administering international internships across three clinical training programmes.
Interview questions were informed by the WEIGHT Guidelines. Directed content analysis was used to identify priorities for
policy, practice and research.
Results: Five themes relating to strengthening international clinical education were identified: (1) from one-time
internships to long-term partnerships, (2) starting a discussion about “costs”, (3) a more informed approach to student
selection, (4) expanding and harmonizing pre-departure training across disciplines, and (5) investing in post-internship
debriefing.
Conclusions: International clinical education is fraught with ethical, pedagogical and logistical issues that require
recognition and ongoing management. This is the first study to use the WEIGHT Guidelines as a qualitative research tool
for assessing an existing global health education programme. Results highlight new priorities for action at the Canadian
“sending institution”, including more explicit attention to the costs (broadly defined) borne by all parties. A crucial next
step is deepened engagement with educational partners at the “receiving organizations” based in low-income countries
to nurture dialogue regarding reciprocity, trust and sustainability of the partnership. Education research is also needed that
evaluates models of pre-departure training and post-internship debriefing for trainees.
关键词：Ethics;Rehabilitation;Global health;International clinical internships;Curriculum development
