PC2098: A Qualitative Analysis of Physician and Trainee Perspectives on Medical Education in Laos

Background: Physicians and medical students in resource-limited environments face a myriad of challenges in medical education. In the Lao People’s Democratic Republic (Laos), these challenges are unique due to a constellation of factors. Laos is a landlocked country in Southeast Asia and is classified by the World Bank as lower-middle income. The University of Health Sciences (UHS) is the sole university in the country training physicians. Historically, due to French colonization, UHS faculty taught in French; current education is conducted in several languages, including French, Thai (due to geographic and linguistic proximity), English, and Lao. Previous work has reported that Lao students and physicians experience difficulties due to English language capacity, few Lao resources, and limited internet access. To explore these concepts in-depth and derive Lao-centered recommendations for improving Lao medical education, we designed a qualitative study exploring four aims: 1) Explore perceived barriers to obtaining medical knowledge; 2) Elucidate the complexities of the language challenges in Lao medical education; 3) Understand how Lao students and physicians use the internet in learning medication; 4) Garner Lao student and physician ideas for improving Lao medical education.

Methods: In-depth, semi-structured interviews were conducted in Vientiane, Laos. Inclusion criteria were: a Lao physician or medical student, English-speaking. Participants were recruited via a snowball sampling method and representation from students and physicians, from different specialties was sought. Interview data were analyzed using established content analysis procedures.

Results: Twenty-two participants were interviewed: 11 students and 11 physicians spanning several specialties. Four themes were identified: 1) Barriers to effective medical education included significant language-related challenges, such as instruction in multiple languages, difficulties in language translation, and several resource-specific limitations (Table 2); 2) Participants recognized resource constraints and universally described resiliency and adaptation when learning medicine by seeking additional resources, working in groups, translating between languages using Google Translate, and spending additional time learning English; 3) Participants relied heavily on the internet to supplement medical education, using a combination of social media, free open access (FOAM) resources, websites, UpToDate, and primary literature; and 4) Participants envisioned the ideal online resource for medical education to be comprehensive, suitable for all educational levels, locally applicable, available in English and Lao languages, and readily accessible to all Lao health care professionals.

Conclusion: Our work provides additional depth of understanding of the Lao medical education experience and is consistent with limited data from prior studies in Laos. Recommendations include addressing cost-associated concerns, increasing free and inexpensive options for learners, optimizing existing FOAM resources to be accurate and accessible in both English and Lao languages, linking in-class and out-of-class resources, and empowering existing group study strategies.