Background Investments in faculty exchanges to build physician workforce capacity are increasing. Little attention has been paid to the expectations of host institution faculty and trainees. This prospective qualitative research study explored faculty and resident perspectives about guest faculty in paediatric departments in East Africa, asking (1) What are the benefits and challenges of hosting guest faculty, (2) What factors influence the effectiveness of faculty visits and (3) How do host institutions prepare for faculty visits?
Methods We recruited 36 faculty members and residents from among four paediatric departments in East Africa to participate in semistructured interviews which were audio recorded and transcribed. Data were qualitatively analysed using principles of open coding and thematic analysis. We achieved saturation of themes.
Results Benefits of faculty visits varied based on the size and needs of host institutions. Emergent themes included the importance of guest faculty time commitment, and mutual preparation to ensure that visit goals and scheduling met host needs. We documented conflicts that developed around guest emotional responses and ethical approaches to clinical resource limitations, which some hosts tried to prepare for and mitigate. Imbalance in resources led to power differentials; some hosts sought partnerships to re-establish control over the process of having guests.
Conclusions We identified that guest faculty can assist paediatric institutions in building capacity; however, effective visits require: (1) mutually agreed on goals with appropriate scheduling, visit length and commitment to ensure that the visits meet the host's needs, (2) careful selection and preparation of guest faculty to meet the host's goals, (3) emotional preparation by prospective guests along with host orientation to clinical work in the host's setting and (4) attention to funding sources for the visit and mitigation of resulting power differentials.
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Handling editor Seye Abimbola
Contributors CMR substantially contributed to study conception and design, to acquisition, analysis and interpretation of data, drafted the manuscript, critically revised the manuscript and gave final approval for the manuscript to be published. LG and DM substantially contributed to study conception and design, to acquisition, analysis and interpretation of data, critically revised the manuscript and gave final approval for the manuscript to be published. MS substantially contributed to data analysis and interpretation, critically revised the manuscript and gave final approval for the manuscript to be published. EK substantially contributed to study conception and design, critically revised the manuscript and gave final approval for the manuscript to be published. SB-K and AL substantially contributed to study conception and design, to acquisition and interpretation of data, critically revised the manuscript and gave final approval for the manuscript to be published. All the authors agree to be accountable for all aspects of work ensuring integrity and accuracy.
Funding This study was funded by grants from the Global Pediatric Education Consortium and the Boston Children's Hospital Global Pediatrics Program.
Competing interests None declared.
Ethics approval This study was reviewed and approved by Boston Children's Hospital IRB, Kenyatta National Hospital/University of Nairobi Ethics Review Committee, Research and Ethics Committee of Makerere University College of Health Sciences, Uganda National Council for Science and Technology, Muhimbili University of Health and Allied Sciences Directorate of Research and Publications, and Tanzania Commission for Science and Technology.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.