Cross-cultural learning during an international exchange program in medical education: a qualitative study

Abstract

Background: International exchange programs offer unique opportunities to foster mutual cross-cultural learning. The neurology Peru-Rochester exchange program (NeuroPro) was established in 2020 through agreements between the University of Rochester School of Medicine and Dentistry (URSMD) in Rochester, New York, USA, the Universidad Nacional de San Agustin (UNSA), Arequipa, Peru, and the Universidad Nacional Mayor de San Marcos (UNMSM), Lima, Peru. Between 2020 and 2024, six trainees from the URSMD completed structured electives in public hospitals affiliated with the UNSA and the UNMSM, three trainees from the UNSA and three trainees from the UNMSM completed structured electives at the URSMD. Methods: We explored the cross-cultural learning experiences of the trainees who completed an international elective as part of the NeuroPro. Prior to starting their electives, trainees received guidance to provide written reflections on diagnostic and therapeutic processes, financial decision-making related to patient care, administrative and logistic challenges related to patient care, community engagement, and other experiences they wanted to share. Reflections were collected 1–2 months after elective completion. Reflections underwent an interpretative phenomenological analysis to identify recurrent themes and select representative quotes. Results: Eleven of the 12 trainees provided written reflections. Constructed descriptive themes highlighted by trainees from the URSMD visiting the UNSA and the UNMSM included: (1) educational exposure to infectious diseases, (2) limited access to resources commonly available in the U.S., (3) empiric treatment used for diagnostic purposes, (4) patients and providers sharing social, financial and administrative challenges, and (5) community engagement for fundraising. Constructed descriptive themes highlighted by trainees from the UNSA and the UNMSM visiting the URSMD included: (1) educational exposure to rare diseases, (2) access to costly diagnostic tools and therapies, (3) limited involvement of providers in social, financial and administrative challenges, and (4) limited community engagement in the hospital. Constructed reflective themes highlighted by all trainees included overcoming the language barrier, cross-cultural experiences, and influence in their future practice. Conclusions: International exchange programs can provide structured electives that offer cross-cultural immersion and mutually complementary learning experiences.