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MedEdPORTAL. 2017 Jun 7;13:10590. doi: 10.15766/mep_2374-8265.10590.

Ethics Simulation in Global Health Training (ESIGHT).

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Undergraduate, Whitman College.
Medical Student, Oregon Health & Science University School of Medicine.
Associate Professor Researcher, Division of Hospital Medicine, University of California, San Francisco.
Associate Professor, Division of Hospital Medicine, University of California, San Francisco.
Associate Dean and Professor, School of Pharmacy, University of California, San Francisco.



Many health care trainees and providers have reported feeling unprepared for the ethical dilemmas they faced while practicing in global health. Simulation is an effective teaching modality in the training of health care professionals. This resource describes the development, implementation, and assessment of an innovative simulation training program for global health ethics.


We conducted simulation training with trainees and professionals from various health care disciplines. After a didactic component in which general ethical principles were introduced, participants acted as either lead or observer in four simulations representing different ethical challenges. Participants interacted with simulated patients within a set designed to resemble a resource-constrained environment. Data on the participants' experiences and evaluations of the program's effectiveness were collected through pre-/postsession surveys and focus groups.


All 53 participants (100%) agreed that the simulations "effectively highlighted ethical dilemmas I could face abroad," and 98% agreed that the content "was useful in my preparation for an international elective." Responses from surveys and focus groups stressed the importance of the realistic and emotional nature of the simulation in increasing confidence and preparedness, as well as a preference for simulation as the modality for teaching global health ethics.


Simulation for global health ethics training can help to raise awareness of the complex ethical challenges one may face abroad. Incorporating simulation training within broader global health curricula can improve trainee preparedness and confidence in appropriately and effectively identifying, strategizing, and navigating through ethical dilemmas in the field.


Ethics; Global Health; Medical Ethics; Simulation Training

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