Quick facts

• Year: 2025

• Country: United States of America 

• Institution: Creighton University School of Medicine

• Learners: Pre-qualifying Students on a dual degree in Medicine / Public Health

• Aims: The intervention aimed to create an educational and academic partnership between learners, international partners and communities affected by the partnerships. 

Why was the education intervention developed?

It was felt that despite attempts to decolonise curriculum, medical education programmes in the Global North often perpetuated Eurocentric systems in relation to decision-making and leadership.

They also didn’t prepare students for the reality of working with different cultures, often using offensive language such as “developed” and “underdeveloped” to describe nations and reinforcing the saviour complex in Global North trainees, which reinforces hierarchies.

An intervention was required to address the roots of colonialism and racism in medical education. 

What was involved in the education intervention?

A five-year curriculum was developed and taught by experts in the global North and global South and Indigenous peoples.

Critical themes such as structural racism, liberation medicine and global determinants of health were explored. This consisted of monthly 90-minute didactic lectures, large and small group discussions, service-learning activities, five international immersion experiences (totalling 116 days) in four countries in the global south (Rwanda, Nepal, Dominican Republic and Ecuador).

This was followed by engaging students actively in discussions, self-reflection and advocacy. 12 learners enrolled on the course each year. 

The personal reflections would change each year with the following themes: 

• Year 1: Structural Racism and Racism in Medicine 

• Year 2: Decolonising Global Health and Liberation Medicine 

• Year 3: Global Determinants of Health 

• Year 4: Careers in Global Health 

• Year 5: Leadership and Management

How was the education intervention evaluated? 

Annual anonymous surveys were conducted measuring student satisfaction, growth of global health knowledge and skills, cultural humility, advocacy skills, personal development and well-being were used.

Additional data was also collected during quarterly mentorship sessions between students and administrators.

What was the impact of the education intervention?

The survey findings demonstrated high student satisfaction with the programme as well as gains in scores and knowledge related to decolonising global health, racism in medicine, empathy, and ministry of presence. 

Students were able to collaborate with the marginalised communities through the immersion experiences and because they returned to the same destination each time, they reported that it built long-term trust rather than acting as volunteering tourism.

Learners reported this enabled a real-life connection to the didactic lectures.

Furthermore, the programme was able to establish four power-balanced partnerships globally through the creation of shared values, including:

1. Trust among all partners

2. Shared leadership that fosters teamwork and prioritises co-creation

3. Humility, honesty and mutual respect that elevate all voices and experiences

4. Transparency in decision-making

5. Ethical behaviour from each partner

Key learnings

•  Long-term curriculum implementation is required if we want to see long-term benefit
  and to avoid the “saviour complex” and volunteer tourism

• Institutions need to acknowledge bias and be open to equitable bidirectional knowledge sharing.

• Students benefit from the integration of theory with immersion experiences.

Challenges

• The amount of quantitative and qualitative data collected from the surveys was time-consuming, making it difficult for the administration to provide a timely response in effectively implementing changes to the programme.

• A strong financial foundation is required to fund the programme.

Recommendations

• Programme developers and leaders should build equitable partnerships with co-creators.

• Responsibilities, roles and values should be clear.

• A longitudinal model should be implemented. This means inclusion in the curriculum in all years of study.