Exploration of the effects of bidirectional learning in medical education among global health partnerships: A scoping review

BACKGROUND: The flow of learners and healthcare professionals in Global Health remains primarily unilateral with a focus on sending individuals from high-resourced settings to resource-limited settings. There has been increased attention to promote parity in these partnerships through developing bidirectional exchanges where individuals experience the practice of medicine in other environments and are recognized as experts in their fields. This review is aimed at documenting (1) bidirectional initiatives within medical education, (2) integral features of these initiatives, (3) factors that contribute to successful partnerships, and (4) opportunities to increase parity within existing and future collaborations. METHODS: A systematic search was performed in the databases PubMed and Academic Search Complete from January 2010 to December 2024. Articles were screened by multiple authors using pre-established criteria to determine common themes among these works. RESULTS: After de-duplication, 416 records remained, and 255 were excluded at the title/abstract screening stage with three additional duplications removed. A total of 123 were excluded at the full-text screening stage. Thirty-five unique records were included in the full-text analysis. Articles demonstrated heterogenicity in the features of their bidirectional initiatives and the factors that contributed to their successes. Specific themes emerged including mutual respect and trust among partners, leveraging the expertise of senior clinicians, maintaining open dialogue, and ensuring alignment within an initiative's expectations, priorities, and deliverables. While included initiatives discuss the principles of bidirectional collaborations, a minority included author representation from low- and middle-income countries: 17% of first authors, 28% of middle authors, and 9% of last authors. CONCLUSIONS: Educators in the field of Global Health must remain cognizant of the importance of bidirectional learning and ensuring equity within collaborations. Efforts have been made to encourage mutual benefit within established partnerships, though additional attention is needed to further promote parity, especially within authorship representation.